[Intravital and postmortem morphological studies and magnetic resonance imaging of arrhythmogenic right ventricular dysplasia].

The authors conducted histological, immunohistochemical, and morphometric studies of 47 endomyocardial biopsies and 33 hearts with a high morphological criterion for the diagnosis of arrhythmogenic right ventricular dysplasia after F.I. Marcus et al. (2010), as well as intravital and postmortem cardiac magnetic resonance imaging (MRI). The average residual cardiomyocyte area was 39.7 +/- 12.8%, and the average cardiomyocyte diameter was 10.4 +/- 1.5 microm. Muscle fiber atrophy, lipomatosis, and fibrosis in the right ventricle were detected in all cases, myocarditis in 44%, mitral valve prolapse in 42%, and muscle fiber dyscomplexation in the right ventricular in 33%. The most informative signs for the diagnosis of arrhythmogenic right ventricular dysplasia using MRI are right ventricular contraction dyssynchrony and those using a morphological study are a residual cardiomyocyte area and muscle fiber atrophy in the right ventricle. A decrease in or focal absence of gamma-catenin expression in the muscle fibers was observed only in 60% of the patients.

[Myocardial morphological changes in atrial fibrillation].

Hearts of 21 died patients with ischemic heart disease (IHD) have been studied by histlological and morphometrical methods. The atrial auricles derived after operation of 66 patients with heart diseases and IHD have been researched by automatic semiquantitative and immunohistochemical techniques. In general atrial fibrillation (AF) has been evident in chronic myocarditis probably conditioned by viral infections. In quantity of observations enterovirus and parvovirus B19 antigens have been found out in myocardium. In 18% studied myocardium antigen of adenovirus has been established. The result of myocarditis has been fibrosis and adiposis. In myocardium of patients with AF diffuse amyloidosis has been abundant. Amyloid depots have been established in perimuscular stroma, under endocardium, in vascular walls and cardiac hystiocyte. The group of patients with paroxysmal AF has differed from the group of stable AF by fibrosis degree.

[Analysis of the quality of lifetime diagnosis of renal cancer].

The quality of the clinical and postmortem diagnosis of renal cancer was studied, by examining 510 cases of nephrectomies and resections of the kidney for its masses over 10 years. The clinical diagnosis of the stage of renal cell carcinoma (RCC) from the data available in the inpatients records cannot be considered qualitative in 76% of cases. Joint material cutting by a surgeon and a pathologist is the most important predictor that significantly affects the quality of lifetime clinical diagnosis of the TNM stage of renal cancer. The postmortem diagnosis of RCC can be recognized qualitative since the technique has been found to be highly sensitive and specific. However, the unavailability of data on tumor malignancy grade in two thirds of postmortem conclusions makes it impossible to tell about the impeccable quality of a study of renal carcinomas. The mean time needed to prepare a conclusion of the morphological study of surgical specimens was 5.8 days, which corresponded to the established standards, including for biopsy specimens.

[Analysis of survival rates in patients and prognostic models in non-metastatic clear-cell renal cell carcinoma].

The Cox multivariate regression analysis of survival rates in patients with non-metastatic clear-cell renal cell carcinoma, by taking into account both various clinical, anatomic, morphometric, and biomolecular factors and kariometric parameters, has revealed that Ki-67 and p53 expression rates along with histologic grade, a tumor portion made up of clear-cell components, and the presence/absence of tumor invasion into paranephral fat tissue are independent prognostic predictors of the disease. By applying the proposed three prognostic models (algorithms) using Ki-67 and p53 expression rates for predicting the corrected survival rates for patients with non-metastatic clear-cell renal cell carcinoma, the authors suggest that a combined biomolecular-morphometric model is of the greatest prognostic value.

[Histological malignancy grade of renal cancer: karyo- and stereometric analysis].

Karyo- and stereometric analyses using a computer imaging scanner, an ocular grid, and a micrometer have established a significant association between the histological malignancy grade of non-metastatic clear-cell carcinoma of the kidney and the stage of the disease, TNM stage, tumor size, tumor portion comprising a clear-cell component, and various karyometric parameters. In addition, a correlation was found between the latter, TMN stage, and tumor size. A histological grading system of clear-cell carcinoma of the kidney has been developed, which involves the most complete and objective morphological characteristics of tumor cellular nuclei and nucleoli.

[The Saint Petersburg Society of Pathologists is 100 years old].

The paper describes the history of the Saint Petersburg Society of pathologists since it was founded in 1909. It shows what great role is played by outstanding Russian medical scientists who have established their own schools of pathomorphologists and are respected in our and foreign countries. The activities of the society's members in research developments in cardiovascular and infectious diseases, cancer morphology, etc., as well as their practical participation in the work of the health care facilities of the city and its region are characterized. This work is characterized by the permanent conformance to the world standards of human pathology as a basic science of the present day, by steadily maintaining the established traditions of the Saint Petersburg school. The authors follow the evolution of a pathologist and his/her becoming to a clinical pathologist as the problems facing pathomorphology are extended and its methodic and methodological capacities are improved.

[Quality of histological diagnosis and methods of its assessment].

Two aspects of histological diagnosis quality are considered: sufficiency and significance of clinical information. The sufficiency is determined as correspondence to relevant standards, significance or validity is judged by comis on of detectability and incidence rate, by comparison of the conclusions of different pathologists.

[Spinal osteochondrosis, mesenchymal dysplasia and herpes infection].

36 intervertebrate disks (IVD) were studied in spinal osteochondrosis concurrent with herniation. Expression of herpes simplex types 1 and 2 (HSV-1 and HSV-2) antigens, which was absent in IVD of the control group (autopsy cases without disk hernia). The similarity of herniation in osteochondrosis and cardiac mesenchymal dysplasia, a frequent concomitance of these processes and the presence of HSV-1 and HSV-2 antigens in the IVD cells and cardiac valves may indicate the same nature of these diseases.

[Proliferative activity by expression of antigen Ki-67 in solitary and multiple synchronous epithelial tumors of the colon].

Proliferative activity of sigmoid and rectal mucosa, and that of single and multiple (synchronous) adenomas and adenocarcinomas of the colon has been studied. A significant difference between antigen Ki-67 expression index in normal mucosa, adenomas and adenocarcinomas, and also in single and multiple colorectal cancers has been revealed.

[Isolated stenosis of the aortic orifice].

Five known to-day causes of the isolated aortal valve stenosis are reviewed: 1) atherosclerosis, 2) premature calcinosis of congenital bicuspidalis aortal valve; 3) rheumatism; 4) infectious endocarditis; 5) mesenchymal dysplasia. The authors consider that aortal valve calcinosis developing against the background of valve atherosclerosis complicates the above diseases and differential diagnosis of aortal stenosis causes.

[Mesenchymal dysplasia of heart valves, cystic medianecrosis of the aorta and herpetic infection].

Histologic and immunohistochemical studies (use of antibodies for viruses of herpes simplex type 1 and 2, desmin, vimentin, SMA as well as polymerase chain reaction to DNA of viruses of herpes simplex) were made on the material of the valves taken from 1326 patients with valvular heart disease, the ascending aorta of 30 patients with aneurysm, valves of 35 deceased patients without cardiovascular pathology. As a result, expression of viruses of herpes simplex type 1 and/or 2 was found in all cases with mesenchymal dysplasia and cystic medianecrosis in endotheliocytes, fibroblasts, smooth muscle cells of valves and aorta. This indicates the role of these viruses in the pathogenesis of these diseases and their common etiology.

[Androgen and estrogen receptors in intact, hyperplastic, peritumorous and malignant prostate tissues: a link to proliferation and apoptosis (immunochemical study)].

A total of 134 samples of intact prostate tissue, nodular hyperplasia and prostate cancer were examined. Number of androgen-positive cells was 28.51 +/- 3.50%, Ki-67 expression index - 2.76 +/- 0,45% and Bcl-2--6.25 +/- 1.38% in nodular hyperplastic tissue. In peritumorous epithelial tissue, that parameter dropped to 20.60 +/- 3, 10%, while stromal E+ cells index rose to 19.42 +/- 4, 81. Androgen expression varied 40-90% in tumor epithelium and that of Ki-67--8.26-13.93. Bcl-2 expression was lower in recurrent tumor (4.95 +/- 2.76) as compared with adenocarcinoma microfoci (5.41 +/- 0.71).

[Etiological diagnosis of isolated stenosis of the aortic valve]. / Etiologicheskaia diagnostika izolirovannogo stenoza aortal'nogo klapana.

We tried to objectivize etiologic diagnosis of isolated aortic stenosis. We studied 950 valves removed during operation on the heart and 15 valves of the dead patients without cardiac pathology using automatic semi-quantitative microscopic description of the valve pathology with further calculation of informative value of the signs. As a result of our investigation the list of the most important signs for the differential diagnosis was compiled. We found out that most often causes of aortic stenosis are calcinosis of bicuspid aortic valve and senile calcinosis. Silvering of the nucleolus organiser in endotheliocytes and fibroblasts in various pathology of the aortic valve showed an increase in the metabolism level and plastic possibilities of the cells in aortic calcinosis.

[Proliferation and apoptosis of epithelium in prostate cancer, in a peritumor region, and in benign hyperplasia]. / Proliferatsiia i apoptoz épiteliia pri rake predstatel'noi zhelezy, v peritumoroznoi zone i pri dobrokachestvennoi giperplazii.

Indices of Ki67, Bc12 expression, mutant gene p53, nucleolar organizers activity and the percentage of cells having nucleic acids levels higher or lower of the diploid levels were determined in prostatic epithelium in cancer, in the peritumorous area and in the area of benign prostatic hyperplasia. A considerable variability of the tumor epithelium by the level of proliferative activity, apoptosis inhibition and expression of mutant p53 gene was established. Increased proliferative activity and predominance of epitheliocytes with a nucleic acids level higher as compared to the diploid one were revealed in the tumor epithelium. Low apoptosis inhibition and increased degradation of the epithelium in case of a high level of Ki-67 expression index were noted in the peritumorous area. Changes in the peritumorous region were noticed both very close to the tumor lesion as well as at considerable distance from it.

[Structure and organization of the activities of the pathology services for adults in St. Petersburg]. / Struktura i organizatsiia raboty patologo-anatomicheskoi sluzhby Sankt-Peterburga (vzroslaia set').

Principles of organization of St. Petersburg pathology service are outlined. The service covers the Consultative and Methodological Council, the Department of Management and 53 departments including 12 departments attached to the city pathology bureau. The main problems of the service concern inadequate financing and material-technical support, lack of specialists in conditions of increasing amount of work (25,870 autopsies, about a million of intraoperative biopsy examinations, 72,000 cytological examinations performed in 2001).

[Comparison of the indices of occurrence of the diagnoses as a method of assessing the quality of histological diagnostics (using intraepithelial and invasive uterine tumors as an example)]. / Sopostavlenie pokazatelei vstrechaemosti diagnozov kak metod otsenki kachestva gistologicheskoi diagnostiki (na primere vnutriépitelial'nykh i invazivnykh novoobrazovanii matki).

The method of comparison of frequency of intraepithelial and invasive tumours established on biopsy and surgical material of uterine cervix and body is proposed. The frequency of invasive and intraepithelial tumours of uterine cervix in different anatomo-pathological cervices of general profile was 0.8-5.3% and 1.5-42.7% respectively, those of uterine body 0.2-2.2% and 0-2.3%. Frequency of uterine body tumour diagnoses was significantly higher at the age over 40 years. As a control of frequency it is suggested to consider maximum diagnoses at minimum level of errors: 8.4 +/- 2.2% diagnoses of intraepithelial and invasive tumours of the uterine cervix and 1.5 +/- 0.7% (2.1 +/- 1.1% in patients over 40 years)--of uterine body.

[The acid-forming function of the stomach and the signs of chronic "restructuring" gastritis in patients with pulmonary tuberculosis combined with clonorchiasis or metagonimiasis]. / Kislotoobrazuiushchaia funktsiia zheludka i priznaki khronicheskogo gastrita "perestroiki" u bol'nykh tuberkulezom legkikh v sochetanii s klonorkhozom ili metagonimozom.

The study has shown that 100% of patients with pulmonary tuberculosis concurrent with clonorchiasis and metagonimiasis develop a symptomatology of type A chronic gastritis with sharply inhibited gastric acid-producing function. The morphological features of this chronic atrophic gastritis are formation of surface microerosions and abrupt mucoidization of tegmental, foveolate, and cervical epitheliocytes.

[On the etiology of aortal insufficiency]. / K voprosu ob étiologii aortal'noi nedostatochnosti.

The authors describe the results of valvulometry, traditional histological and cytological investigations of dissected valves of 1084 patients and an analysis of causes of aortal insufficiency as compared to the literature data for the last 80 years. The main causes of heart valve diseases are considered to be mesenchymal dysplasia and infective endocarditis.