[Clinico-morphological characteristics of pulmonary mycobacteriosis].

According to the criteria of the American Thoracal Societypulmonary mycobacteriosis has been diagnosed at 40patients without clinically important immunosupression (MAC--35%, Mkansasii--25%, M. xenopi--20%, M. fortuitum--12.5% and M. chelonae--7.5%). 95% patients have had clinically important symptomatology with polymorphic radiologic development such as a deformation of a lung pattern and focal dissemination (75%), locus and infiltration (52.5%), cavities (42.5%), marked pneumosclerosis (60%) and bronchiectasis (17.5%). 75% patients have had some changes of the bronhial tree. As opposed to tuberculosis the morphology of mycobacteriosis is more homogeneous and includes inflammation with epithelioid giant-cell granuloma and fibrosis, pneumogenic and bronchogenic cavernous cavities, mycobacterial endobronchitis. The polymorphism of clinic-radiologic developments, a similarity of lung diseases morphology caused by nontuberculous mycobacteria makes difficulties to diagnose theirs.

[Efficacy and tolerance of rezonizate in complex with fluoroquinolones or mycobutin on a model of experimental murine tuberculosis].

The efficacy of rezonizate, a novel antituberculosis drug, in combination with fluoroquinolones or mycobutin was studied in experiments on mice infected with Mycobacterium tuberculosis. By the pathomorphological and microbiological criteria, the highest therapeutic effect was observed when rezonizate was used in combination with levofloxacin, the lowest effect was produced by rezonizate combination with gatifloxacin.

[Immunophenotyping of epithelioid-cell granulomas in sarcoidosis].

The specimens of biopsy of the lung and lymph nodes from 24 patients with sarcoidosis were immunophenotyped. The monoclonal antibody panel for immunophenotyping the monocyte-macrophage cells included HLA-DR, CD64, CD163; CD7, CD3, CD4, CD8, HLA-DR, and CD20 were used to assess lymphocytic populations. In sarcoidosis, the majority of cell elements of a granuloma are in a state of activation, as evidenced by HLA-DR expression on the epithelioid, giant cells, T lymphocytes (which was observed in more than in 90% of cases), the extent of this expression decreasing as fibrosis develops. There is a statistically significant correlation between the presence of individual lymphocytic subpopulations and monocyte-macrophage cells in the granuloma. No clear relationship of the phenotype of a granuloma to the clinical form (stage) of sarcoidosis suggests that is based on the common self-sustaining process of formation, functioning, and involution of granulomas, which has no direct agreements in the X-ray and laboratory manifestations of the disease.

[Current aspects of the pathomorphosis of tuberculosis]. / Sovremennye aspekty patomorfoza tuberkuleza.

An analysis of the clinico-anatomical concept "pathomorphosis" allows distinguishing the factors that determine it: social-economical, therapeutic--preventive, ecological and evolutionary adaptive ones. The essence of "the induced pathomorphosis" of tuberculosis is revealed on the basis of epidemiological, clinical and pathological features. The category "pathomorphosis" is reported to be changeable and any weakening of preventive antituberculosis measures will result in the reccurence of classical forms of the disease.

[Necessity for unification of the clinico-anatomic classification of tuberculosis]. / O neobkhodimosti unifikatsii kliniko-anatomicheskoi klassifikatsii tuberkuleza.

Critical assessment of tuberculosis classification adopted at II(XII) Congress of Phthisiatrists Association on September 7-9 1994 in Saratov as well as the section "Tuberculosis" in the International statistical classification of diseases and problems associated with health 10th reevaluation is presented. Main critical remarks are the following: organo-pathological principles of the classification, uncertainty of the definitions, ignorance of the iatrogenic conditions.

[The tuberculosis epidemic in a morphologic light]. / Epidemiia tuberkuleza v morfologicheskom osveshchenii.

Epidemiologic situation with tuberculosis is worsening in Russian Federation. Induced pathomorphosis of this disease in the course of its epidemic is presented. Unsatisfactory level of therapeutic and diagnostic measures and the necessity to develop a unified classification and records of tuberculosis are emphasized. Its complications and iatrogenic pathology are shown.

[2 cases of pulmonary histoplasmosis in combination with tuberculosis]. / 2 sluchaia gistoplazmoza legkikh v sochetanii s tuberkulezom.

Two observations by the authors of a chronic cavernous histoplasmosis in a patient of 13 and a histoplasmoma of the lungs in a patient of 53 are described. The diagnosis was established by the examination of the operation material. Clinically, these patients were diagnosed as pulmonary tuberculosis cases. The attention of pulmonologists is drawn to the features and difficulties of differential diagnosis of histoplasmosis and tuberculosis.

[Pathomorphosis of tuberculosis]. / Patomorfoz tuberkuleza.

Based on the analysis of changes considered from the point of view of 4 aspects (epidemiology, pathogenesis, clinico-anatomical manifestations, outcomes, of the disease), the current features of pathomorphosis of tuberculosis are described. It is noted that the present favourable epidemiological situation with regard to tuberculosis does not permit any weakening of measures for control of this disease. In economically developed countries, therapeutic pathomorphosis of tuberculosis is prevalent. In the qualitative spectrum of pathomorphosis of tuberculosis as a disease of the whole organism, particular attention should be paid to residual alterations after clinical cure of tuberculosis, late results of tuberculosis therapy, and complications of various medical interventions, particularly inadequate therapy with the development of immunodeficient condition.

[State of the microcirculatory bed of the visceral pleura in focal forms of pulmonary tuberculosis]. / Sostoianie mikrotsirkuliatornogo rusla vistseral'noi plevry pri ochagovykh formakh tuberkuleza legkikh.

The microcirculatory bed (MCB) of visceral pleura (19 resected lungs) in focal forms of tuberculosis was studied. MCB changes were of systemic character and were more pronounced in the postcapillary-venular link. The causes of the development of the observed structural-functional changes in MCB include tuberculosis as an inflamation of the immune nature, the possibility of tissue manifestations of therapy pathology, and the influence of stress operation situation. Venulites are first described as a manifestation of immunopathological reaction in focal pulmonary tuberculosis. Irreversible MCB changes in focal forms of tuberculosis, despite the limited pulmonary process and clinical lack of functional changes in the respiratory and cardiovascular system of the patients, are an additional proof in favor of the necessity of early etiotropic therapy and may be used as a prognostic sign in morphological examinations of the operation material.

[Tuberculosis mortality in the megapolis]. / Smertnost' ot tuberkuleza v megapolise.

1097 lethal cases of tuberculosis were analysed by 3 groups: Moscow citizens registered or not registered in the tuberculosis dispensaries (83%) and Moscow migrants (37%). Tuberculosis was diagnosed post mortem in 18%. Clinicoanatomical forms of tuberculosis were gravest in patients not observed in the dispensaries (disseminated tuberculosis, tuberculous pneumonia, generalized hematogenic tuberculosis--80.3%, fibrocavernous tuberculosis--18.9%). The main cause of this situation is poor economical situation and non-controlled migration.

[Plasmocytic granuloma of the lungs]. / Plazmotsitarnaia granulema legkikh.

Research Institute of Tuberculosis of the RSFSR Ministry of Public Health, Moscow Summary-Five observations of plasmocytic granuloma from the resected lungs are described. Polymorphism of the cell composition of these formations and the stages of their development reporter in literature are based on proliferation of the cells of mononuclear phagocytic system. Therefore the authors consider plasmocytic granuloma to be a local manifestation of incompetence of compensatory reactions of this system.

[Classification and coding of clinical-anatomical forms of tuberculosis]. / Klassifikatsiia i kodirovanie kliniko-anatomicheskikh form tuberkuleza.

Principal forms of tuberculosis are morphologically characterized as well as their complications. The comparison with ICD-10 is made.

[Clinico-anatomic correlations in active forms of tuberculosis]. / Kliniko-anatomicheskie sopostavleniia pri aktivnykh formakh tuberkuleza.

Basing on 1957 autopsies of the patients with active forms of TB that has been incorrectly diagnosed either intravitally, or postmortEM, the authors distinguish 5 forms of discrepancy between the pathoanatomical and clinical diagnoses. Thus, spread progressive TB was primarily diagnosed postmortem in 12.3%; the discrepancy of the diagnoses in form, stage, specific TB complications was found in 46.5%; "pseudo-diagnosis" of TB was made in 1.7%; the difference in the diagnoses concerning the associated diseases was noted in 26.6%; no information on TB in the pathoanatomical diagnosis when death occurred of other diseases and accidents was found in 12.9%. To improve the intravital and postmortal diagnosis of TB the authors recommend to organize a course of lectures on TB for different specialists, as well as to introduce special cards of emergency to be sent by the pathologic anatomists and medicolegal experts to the antituberculous dispensaries.

[Alveolar microlithiasis]. / Al'veoliarnyi mikrolitiaz

A total of three observations on alveolar microlithiasis are described: two in female patients aged 19 and 44, and one in a man aged 56 years. In two patients diagnosis was established following biopsy of the lung tissue, and in one--posthumously. Basing on the literature data, the authors discuss problems of pathogenesis, clinico-morphological manifestations and differential diagnosis of the disease.

[Viral inclusions of sarcoid granuloma into the epitheliocytes]. / Virusnye vkliucheniia v épitelioidnykh kletkakh sarkoidnoi granulemy.

Electron microscopy was used study the cellular composition of sarcoid granulomas in the lung of 10 patients. In 4 patients, epithelioid cells contained herpes virus virions. In these patients, the disease clinically began acutely, ran along with erythema nodosum; their treatment involved glucocorticosteroids. In the other patients, the cells of sarcoid granulomas did not contain viruses, the granulomas were at the fibrosing stage; diffuse pneumosclerosis was clinically diagnosed. It is suggested that in sarcoidosis, immunity is of not sterile character and the phagocytosis of virus aggregates with epithelioid cells demonstrates the degree of endocytobiosis. This process takes place in tuberculosis, which is a manifestation of the biological expediency of endocytobiosis as this allows infection immunity to be maintained.