[Role of intrarenal product TNF-alpha in the development of glomerular and tubulointerstitial tissues changes in elderly patients with diabetic nephropathy].

The aim of this study was to investigate the expression of TNF-alpha produced in the kidney in patients with diabetic nephropathy (DN) type 2 diabetes and its impact on the development of glomerular and tubulointerstitial tissue changes in these patients. The survey was conducted in 49 elderly patients (mean age 66.53 +/- 3.50 years) with type 2 diabetes complicated by the development of DN. The study included patients with serum creatinine less than 0.13-0.14 mmol/l and in the initial stage of chronic renal failure in the level of serum creatinine less than 0.20 mmol/l. Diabetes duration was 17.89 +/- 0.44 years, and the duration of diabetic nephropathy was 1.60 +/- 0.44 years. Light and immunofluorescence microscopy of the renal biopsy specimens obtained by needle lifetime biopsy was performed for all patients. Morphological changes in the tissue were assessed in accordance with the latest international classification of diabetic nephropathy. In addition to light and immunofluorescence microscopy the expression of TNF-alpha in the glomerulus and interstitial tissue by monoclonal antibodies labeled Fitc ("Dako", Germany) were determined in all patients. The location of TNF-alpha expression in the glomeruli (capillary loops, mesangial matrix, glomerular capsule) and in the interstitial tissue (urinary epithelium convoluted tubule basement membrane of urinary tubules, interstitial cells) were estimated. Correlation analysis of the influence of the expression of TNF-alpha on the expression of morphological changes of tissues revealed that a maximum of cytokine production in the glomeruli at the stage IIa class cytokine affected only the development of segmental glomerular sclerosis. With the decrease in TNF-alpha production in the glomeruli you can observe the progression of histological changes--periglomerulyarny sclerosis development, builds thickening of the glomerular basement membrane; mesangial expansion goes from mild to severe and affects more than 25% of mesangial matrix (IIb stage), nodular lesions of Kimmelstil-Wilson are forming. Interstitial produce of TNF-alpha remains relatively high in the epithelium of the urinary tubules and in the interstitial cells of the kidney regardless of the class of diabetic nephropathy and influence the development of tubulointerstitial fibrosis.

[The role of IL-6 in the development of morphological changes in renal tissue in elderly patients with type 2 diabetes complicated by diabetic nephropathy].

Studies in recent years suggest a role for inflammation, proinflammatory cytokines in particular, the development of microvascular complications of diabetes, including nephropathy. We investigated the expression of IL-6 in the biopsy tissue kidneys (in glomeruli and interstitium) in 24 elderly patients with type 2 diabetes complicated by diabetic nephropathy. The significant influence of intrarenal expression of IL-6 on the development of morphological (glomerular and tubulointerstitial) changes in renal tissue in patients with diabetic nephropathy is shown.

[Morpho-functional peculiarities of autoimmune gastritis in different age groups].

In 98 patients with chronic gastritis clinical-morphologic analysis was performed. The analysis included: the examination of gastric biopsy specimens, determination of HP-status by means of a group of methods, determination of antibodies to H+/K+ -ATPase of parietal cells of the gastric wall, IgG-EA-EBV and IgM-NA-EBN antibodies in the blood serum by means of IFA method, pepsinogene I, pepsinogene II, gastrin and antibodies to Hp with the use of Biohit gastric panel, 24-hour monitoring of intragastric pH with the use of Gastroscan-24 machine. Comparison of all parameters was performed in 4 groups: 27 children aged 6-17 with non-autoimmune gastritis and 119 children with gastritis of other etiology, 34 patients aged 18-80 with autoimmune gastritis and 43 patients of the same age group with non-autoimmune gastritis were described. Age-specific peculiarities of autoimmune gastritis in children were determined; and a diagnostic algorithm for its early diagnosis in the latter was developed.

[Association of the morphological features of gastric parietal cells with the concentration of H+/K+/ATPase autoantibodies in chronic gastrititis].

Chronic gastritis was morphologically verified in 119 patients. The count of parietal cells per 100 epitheliocytes of fundic glands was estimated. The sizes of parietal cells were measured by the morphometric computer program Videotest. For the diagnosis of autoimmune chronic gastritis (ACG), the level of antibodies to H+K+ATPase of gastric parietal cells in the patients' serum was determined by enzyme immunoassay. Childhood ACG has been found to be characterized by hyperplasia and structural changes of parietal cells with their preserved total count. The specific features of adult ACG include a significant reduction in the number of parietal cells, their sizes depending on the level of antiparietal autoantibodies, and marked ultrastructural changes as impairments in the differentiation and destruction of cytoplasm, organelles, and cell membrane.

[Primary esophageal melanoma ]. / Pervichnaia melanoma pishchevoda.

Two cases of esophageal primary melanoma in females aged 63 and 68 years with nodular and lentiginous forms of growth are reported. The diagnosis was made intraoperatively and at autopsy, respectively. Morphogenetically, there were primary multiple non-simultaneous zones of tumor growth with the apposition growth as a form of tumor progression. Early stages of morphogenesis were characterized by atypical borderline melanocytic activity, melanoma in situ with a starting invasive growth being basic criteria for diagnosis of primary esophageal melanoma in examination of endoscopic and surgical material.