[Some aspects of examining the images of tracer hyperfixation foci in osteoscintigrams by computer-assisted automated analysis].

OBJECTIVE: to analyze the numerical characteristics of bone metastases according to scintigraphic data. MATERIAL AND METHODS: Computer-assisted automated analysis was used to examine planar skeletal osteoscintigrams in patients with breast cancer who had both complete remission and disease progression with skeletal metastases. Brightness in the image was used as an analyzed indicator. RESULTS: Examination of physiological tracer accumulation in patients without skeletal metastases suggests that there is a wide variability of brightness values in the scintigrams of individual skeletal areas. At the same time, the skeletal anatomic areas show significant differences in the average image brightness values (p < 0.01). In virtually all skeletal areas, the average brightness values in the pathological tracer hyperfixation foci (HFFs) in the scintigrams are dominant over the similar values of physiological HFFs. CONCLUSION: There is a direct relationship between the tracer accumulation levels in the skeletal areas without metastatic involvement and the bone metastases occurring in the same areas.

[Thyroid morphology in a children population living in the environmentally polluted area].

Comprehensive study of the "normal" thyroid gland in fetuses and children of different age groups in the Chelyabinsk region revealed a number of changes characteristic of the so-called dysregulation pathology. The role of ecological factors and outcome of resuscitation and intensive therapy in these changes is discussed. It is shown that the development and manifestation of tumoral and non-tumoral diseases of thyroid gland prone to a combination of various diseases are delayed till the school age.

[The characteristics of the epithelium and endometrial extracellular matrix in miscarriage during early pregnancy associated with chronic endometritis].

In miscarriage associated with chronic endometritis, the uterine mucosa was found to have a lower expression of TGFR-beta, gelatinases and a higher exposure of TIMP-1 and EGFR, which confirms a pathogenetic association between the imbalance of growth factors, endoproteases and their inhibitors and points to the active involvement of these cytokines and endopeptidases in the inflammatory, reparative processes and remodeling of tissues. The imbalance of growth factors, proteases, and antiproteases is likely to be a cause of uterine mucosal remodeling with progressive collagenogenesis and atrophy of the glandular apparatus along with pathogen persistence, which may be one of the factors predisposing to miscarriage. This makes it necessary to eliminate the causative agent of the endometrial infectious-inflammatory process in the earliest periods of the onset of disease and permits the drawing up of approaches to targeted drug therapy for some pathogenetic links of disease.

[Pathology service of the public health system of Russia: conceptual directions of creation].

The principles of effective pathology service in the public health system are presented and discussed, by taking into account its state-social administration on the basis of an industrial management model. To set up official pathology committees as pathology service-controlling centers monitoring the situation in the pathology institutions (respective subdivisions of health care facilities and other organizations) developing and implementing proposals to improve the system is the most important condition for the qualitative performance of work and services in the specialty of anatomical pathology.

[Evaluation of malignancy of squamous cell lung cancer by clinico-morphological, immunohistochemical and prognostic study of tumor markers].

An immunological study was carried out in 127 cases of surgical treatment of squamous cell lung cancer. Cryostat sections were used to identify markers of proliferation (Ki-67 and topoisomerase IIalpha), apoptosis (p53 and CAS) and intercellular adhesion (E-cadcherin). It was shown that Ki-67 and topoisomerase IIalpha proliferation rates and CAS expression may be interpreted as additional factors of squamous cell cancer aggressiveness while E-cadcherin expression--as a favorable prognosticator. In cases of Ki-67 in excess of 36%, 5-year survival dropped to 38% as compared with 70% when that index was below 36%.

[Significance of some growth factors in the pathogenesis of chronic gastritis in children].

Gastric biopsy specimens taken from 44 children aged 7 to 15 years who had a clinical diagnosis of chronic gastritis (CG) were studied. In Helicobacter pylori (Hp)-associated CG (n = 24), there were accelerated cell regeneration processes in the antral and fundal mucosae as compared with the rate of proliferation and apoptosis in Hp-unassociated CG (n = 20). The increased proliferation of gastric mucosal (GM) elements has been shown to be associated with the high density of EGFR, in Hp-associated CG in particular, which is generally observed in the insufficient level of TGFR-beta. The authors have ascertained the important role and heterodirectional functional load of EGFR and NGFR-beta in the pathogenesis of CG. This disease is characterized by the maximum EGRF expression that is directly correlated with the rate of cell regeneration processes and the activity of an inflammatory process. Moreover, the rate of proliferation and apoptosis are associated with the increased expression of EGRF on the other hand and with the inadequate reperesenation of TGFR-beta on the GM cell membranes, which is particularly prominent in children with Hp-associated CG.

[Endometrial pathomorphology in bacterial vaginosis associated with chronic endometritis].

A complex morphological and morphometric study was used to examine endometrial biopsy specimens from 133 patients with bacterial vaginosis (BV). Chronic endometritis (CE) was detected in 100% of them. The morphological components of CE in BV were significant dystrophic changes in integumentary endotheliocytes and glandular cells, differently pronounced polymorphocellular infiltration of the uterine mucosa with signs of tissue lymphopenia, as well as stromal and vascular fibroblastic changes with the decreased volume density of the endometrial integumentary endothelium, lower relative volumes of glands, and increased relative volume of connective tissue. The characteristic structural changes for CE and BV are intensive processes of apoptosis of the uterine mucosal epithelium in the presence of its slight proliferative activity, which determines progressive endometrial atrophy and may contribute to non-developing pregnancy. As this takes place, discrinism occurs in the uterine mucosa, mainly as inadequate progesterone reception of endometrial target cells, which leads to uterine gland dysfunction and may also cause fetal depletion syndrome.

[Independent postmortem examination: contents of its concept, organizational aspects of its performance].

The paper discloses the contents of the concept of independent postmortem examination and describes the organizational aspects of postmortem examination according to the materials of primary postmortem studies of autopsy and biopsy of surgically removed organs.

[Correlation of proliferation, apoptosis, angiogenesis and metastasizing in various histogenetic types of pulmonary cancer (an immunohistochemical investigation)]. / Sootnoshenie protsessov proliferatsii, apoptoza, angiogeneza i metastazirovaniia v razlichnykh gistologicheskikh tipakh raka legkogo (immunogistokhimicheskoe issledovanie).

Surgical material from 157 patients with lung carcinoma was studied. Immunohistochemical detection of the following oncomarkers was performed: Ki67, p53, CD34, CAS, Topoisomerase II alfa, nm23 protein, E-cadherin. The existence of association between proliferation, tumour cell apoptosis and formation of vessels in the tumour stroma is established. Angiogenesis correlated with proliferative activity of tumour cells this resulting from the effect of growth factors secreted by cells of both tumours and stroma. Angiogenesis in lung carcinoma may also be stimulated by mitogenetic factors accumulating in tumour tissue due to the "uncompleted" apoptosis. Low nm23 and E-cadherin expression is found in lung carcinoma with regional lymphogenic metastases indicating probably cancer metastases.

[Morpho-ecological characteristics of thyroid diseases in various regions of Russia and Belorussia from surgical data]. / Morfoékologicheskaia kharakteristika zabolevanii shchitovidnoi zhelezy v razlichnykh regionakh Rossii i Belorussii po dannym operatsionnogo materiala.

Thyroid lesions were histologically studied on surgical material obtained in 1992-1996 in 12 regions of Russian Federation and Republic of Belarus. Various forms of thyroid pathology were considered with reference to local ecological situation. An increase of thyroid carcinoma incidence and particularly that of papillary carcinoma was observed in regions with radiation pollution (Chelyabinsk and Bryansk regions). A high degree of correlation exists between the incidence of various forms of thyroid pathology and radiation situation. This is also true for pollution of sewage and the presence of ferrous metallurgy factories. No correlation was found with the pollution of atmosphere.

[A rare complication after surgical correction of the rupture of Valsalva's sinus aneurysm into the right heart ventricle]. / Redkoe oslozhnenie khirurgicheskoi korrektsii proryva anevrizmy sinusaVal'sal'vy v pravyi zheludochek serdtsa]

Postsurgical myocardial infarction in a 68-year-old female was observed after occasional compression of the coronary artery by a teflon gasket when P-like suture was applied on the anterior wall of the right ventricle in the course of surgical intervention for closure of the aortic-right-ventricular fistula. The latter had formed after the rupture of Valsalva's sinus aneurysm into the right ventricle this being the cause of the surgery. The authors propose how to document the diagnosis and medical death certificate in similar cases.

[Morphological aspects of verification of pleural neoplasms in one's life time]. / Morfologicheskie aspekty prizhiznennoi verifikatsii opukholevykh porazhenii plevry.

Difficulties of diagnosis of pleural neoplasms in biopsies are discussed. The short history of serous tumors as entity, their classification, methodological approaches to their morphological diagnosis are outlined. It is concluded that the problem of neoplastic pleural diseases verification can be solved by clinical and morphological correlations. Histochemistry, immunomorphology, and electron microscopy should be combined with conventional morphologic methods used in biopsy investigations.

[Morphological characteristics of hyperplastic and adenomatous stomach polyps]. / Morfologicheskaia kharakteristikaa giperplasticheskikh i adenomatoznykh polipov zheludka.

A morphological study of biopsy samples of gastric polyps from 224 patients was carried out. Four stages in gastric polyp morphogenesis were distinguished: foveolar hyperplasia, hyperplastic polyp, "two-floor" adenoma and adenoma. The correlation was established between the degree of Helicobacter pylori infection in the polyp mucous membrane on the one hand, and epithelial and stromal reactions (immuno-inflammatory reaction of stroma, chronic inflammation, formation of Russel bodies, cystes and chronic erosions) on the other. Greater content of stromal collagens, type IV collagen in case of gastric hyperplastic lesions was observed. Appearance and progression of gastric adenomatous growth in hyperplastic polyp correlates with an increase of type III collagen content, decrease of types I, IV, V collagens and fibronectin.