[Comparative morphological characteristic of immune deficiency in subjects with opioid addiction and chronic alcoholic intoxication].

The objective of the present study was to analyse changes of morphological properties in the organs of immune and endocrine systems in subjects with opioid addiction and chronic alcoholic intoxication (CAI) based on the results of 322 autopsies. These included 190 cases of drug addiction from 0.5 to 10.5 years in duration, 90 cases of chronic alcoholic intoxication, 42 cases of combined drug addiction and CAI. The study demonstrated phasic character of changes in the organs of immune and endocrine systems in subjects with opioid addiction. Three phases were distinguished in the development of immune and endocrine disorders (secondary immunodeficiency syndrome) that correspond to the stages of formation, compensation, and decompensation, respectively, of general adaptation syndrome as a reaction to chronic stress. These processes may be deranged in case of combination of opioid addiction and CAI when changes in the immune and endocrine systems resemble those observed in severe immunodeficiency with serious atrophic and sclerotic lesions in lymphoid organs and endocrine glands. Characteristics of immune deficiency resulting from the consumption of narcotic substances and chronic alcoholic intoxication have much in common even though either of the two underlying conditions shows certain specific features.

[The morphology of the immune system in opiomania, cannabism, and polynarcotism].

The organs of the immune system were morphologically and immunohistochemically studied in chronic opiomania (n = 219), cannabism (n = 22), and polynarcotism (n = 69) after excluding HIV-infected patients. In opiomania, immune disorders were identified in 98.6% of cases. These immune disorders differ according to their stage and characterize by the inversion of the T-helper/T-suppressor index, the reductions in the proliferative activity of lymphocytes and the production of immunoglobulins, atrophy of the thymus and T zones, and, in 37.4% of cases, persistent follicular hyperplasia of B zones with the impaired architectonics of lymphoid follicles. It is a cause of generalized lymphadenopathy and splenomegaly, which are similar to those observed in HIV infection. Infection with hepatitis B and C viruses enhances thymus and T-zone atrophy, but B-tone hyperplasia particularly in the lymph nodes of the hepatic hilum and spleen. In cannabism, the morphological signs of immunodeficiency were revealed only in 13.6% of the dead and there was no inversion of the T-helper/T-suppressor index. In polynarcotism, the involvement of immune organs is most severe and similar to that seen in opiomania.

[Change blood supply of a pancreas after a resection of a stomach in conditions of a chronic pancreatitis].

The aim of this study was to determine the role of stomach resection in the pathogenesis of a chronic pancreatitis. Experiments were carried on 14 outbred dogs. The animals were categorized into two groups according to problem put by. The first group was composed of (n=4) animals in intact state, and pancreas blood vessels were studied. The second group was composed of (n=10) animals. An experimental animal model of chronic pancreatitis was produced and the resection of stomach was performed. The investigation showed that after the surgical treatment there was a significant reductions in arterial diameter and in microcirculation channels. It was concluded, that stomach resection may be the cause of pancreatic ischemia and necrosis. Adequate treatment to improve blood supply in the pancreatic blood vessels after surgery is recommended.

[Infectious endocarditis in drug addicts].

Clinicomorphological features of infectious endocarditis (IE) were studied on autopsy material from chronic drug addicts. Of special interest were morphological changes in the lymphoid organs. The experience of the author and literature data suggest that IE in drug addicts is a manifestation of secondary immunodeficiency syndrome on the background of chronic narcotic intoxication.

[Morphological changes in the lungs in chronic drug addiction].

Morphological studies of the lungs and immune system organs were made in drug addicts with narcotic intoxication. Depletion of the central and peripheral lymphoid organs was found in most cases. It is shown that morphological changes in the lungs in acute and (or) chronic narcotic drug intoxication, the rate of acute and chronic inflammatory lung diseases reflect development of lung inflammation in the presence of aquired immunological deficiency in terminal chronic drug abuse. The documented features of different pathological processes in the lungs can improve diagnosis of acute and chronic drug intoxication by results of section and histological examinations.

[Immune system in chronic narcotic intoxication].

The analysis of the literature data demonstrates that secondary immunodeficiency in chronic narcotic intoxication results, primarily, from T-system dysfunction and attenuation of both cellular and humoral reactions. However, some evidence exist on the absence of such effects or even stimulation of the immune system by narcotic drugs. Morphological analysis of changes in the lymphoid organs of drug addicts who had died of different diseases in chronic narcotic intoxication was made by only few researchers, so functional morphology of immune system organs in chronic narcotic intoxication is an issue of the day which requires further investigation.

[Subdivision of certain morphological variants of chronic glomerulonephritis]. / O droblenii nekotorykh morfologicheskikh form khronicheskogo glomerulonefrita.

Modern methods allow to detail morphological classification of chronic glomerulonephritis, to adapt it to the clinical classification and to recommend it for practical use. This specification concerns minimal changes and a group of mesangial chronic glomerulonephritis. The term "minimal changes" is a light-microscopic definition and covers rather a heterogeneous group of diseases or their initial manifestations. Differential diagnosis of these diseases is feasible only at the electron microscopic level. A group of chronic glomerulonephritis (mesangioproliferative and mesangiocapillary) includes variants distinguished on the basis of immunohistochemical, light microscopic and electron microscopic methods. Of them, the immunohistochemical method is most valuable for differentiation of mesangioproliferative glomerulonephritis.

[Mesangioproliferative glomerulonephritis with IgM deposits as an independent form of nephritis]. / Mezangioproliferativnyi glomerulonefrit s IgM-depozitami kak samostoiatel'naia forma nefrita.

On the basis of 32 patients examination clinicomorphological characteristics of the mesangioproliferative glomerulonephritis (MPGN) with IgM deposits are given. The conclusion is drawn that MPGN is a distinct unity in the group of primary GN as well as in the group of IgM--nephropathy. The main pathogenetic component of the development of MPGN with IgM deposits is the fixation of IgM, especially in combination with C3. Moderate hypertrophy and hyperplasia of mesangiocytes, mesamgium enlargement and secondary changes in glomeruli characterize MPGN with IgM deposits electron-microscopically and light optically. MPGN with IgM deposits is followed by nephrotic syndrome in 3/4 cases although other clinical forms of nephritis can also take place. In most cases its clinical course is protracted and benign.

[The morphological heterogeneity of mesangioproliferative glomerulonephritis]. / Morfologicheskaia geterogennost' mezangioproliferativnogo glomerulonefrita.

Three variants of mesangioproliferative glomerulonephritis (MPGN) are distinguished on the basis of quantitative and qualitative morphological study of 172 kidney biopsies. The first variant is characterized by subendothelial and mesangial deposits of IgA and C3 in the glomeruli, the lack of fibroplastically transformed (FT) glomeruli and small tubulointerstitial component (TIC), the predominance of the phagocytizing mesangial cells; the second variant by the subendothelial deposits in the glomeruli of IgM or IgM and C3, the absence of FT glomeruli and TIC, the presence of an equal number of phagocytizing and synthetizing mesangial cells. Glomerular deposition of IgG or the absence in the glomeruli of all immunoglobulins and C3, the presence of FT glomeruli and TIC, pronounced accumulation of mesangial matrix and moderate proliferation of predominantly synthetizing and fibrosing mesangial cells are characteristic of the third variant. Recognition of the MPGN variants allows one to understand the variety of its clinical manifestations and differing prognosis.

[The immunohistochemical heterogeneity of mesangioproliferative glomerulonephritis]. / Immunogistokhimicheskaia geterogennost' mezangioproliferativnogo glomerulonefrita.

Immunohistochemical examination of puncture biopsies of the kidneys taken from 172 patients with mesangioproliferative glomerulonephritis (MPGN) showed its heterogeneity. MPGN with IgA deposits, MPGN with IgG deposits, MPGN with IgM deposits, MPGN with C3 deposits and immunonegative MPGN are separated. Clinically, nephrotic syndrome prevails in IgG and IgM, MPGN, various clinical forms occur in MPGN with C3 and immunonegative variants, hematuric and latent forms occur in MPGN with IgA. MPGN with IgM deposits has its own morphological and clinical features, this permitting to consider it as an independent form of glomerulonephritis.