[Lung pathology in children with a long-term novel coronavirus infection COVID-19]. / Patologiya legkikh u detei pri dlitel'no tekushchei novoi koronavirusnoi infektsii COVID-19.

New coronavirus infection is registered less frequently in children than in adults. Among all patients with COVID-19, the share of children is 8.6%. Clinical practice shows that in children, COVID-19 can be severe and even fatal. Articles have been published reflecting the clinical manifestations of Long Covid in children, while data on pathomorphological examination of the lungs during long-term COVID-19 in children are not available in the literature. On the basis of the Department of Pathological Anatomy with a course of Forensic Medicine and the Pathological-Anatomical Department of the Clinic of St. Petersburg State Pediatric Medical University, an analysis of medical documentation was carried out, autopsy materials were selected from 3 observations of the death of children from COVID-19. The selection criterion was the duration of the disease. A histological examination using standard methods and IHC analysis using antibodies to the nucleocapsid of SARS-Cov-2, CD95, CD31 were carried out on the lung tissue of 3 children aged 2 months to 2 years who died from a new coronavirus infection. Microscopically, all three patients showed microvessels damage, their thrombosis, angiogenesis, as well as signs of diffuse alveolar damage The combination of expression of the SARS-CoV-2 nucleocapsid and the apoptosis marker on the vascular endothelium of the MCR is of interest. CONCLUSION: The data obtained indicate infection with coronavirus and death of endothelial cells due to apoptosis. Endothelial damage in the microvessels of the lungs is the initiating factor in the development of capillary-alveolar block, tissue hypoxia, and disseminated intravascular coagulation syndrome, leading in some cases to respiratory/multiple organ failure and death.

[To the 90th anniversary of the department of pathological anatomy with a course of forensic medicine named after professor D.D.Lokhov of Saint Petersburg State Pediatric Medical University]. / K 90-letiyu kafedry patologicheskoi anatomii s kursom sudebnoi meditsiny im. professora D.D. Lokhova Sankt-Peterburgskogo gosudarstvennogo pediatricheskogo meditsinskogo universiteta.

The article is devoted to the history of Professor D.D. Lokhov Department of Pathological Anatomy with a course of forensic medicine of the St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia, founded by one of founders of the national pathological anatomy of childhood and adolescence, Professor D.D. Lokhov, whose name has been awarded to the Department since 2022. The updated advances of the Department in research, teaching and diagnostic activity are presented.

[Practical value of microorganisms for forensic purposes (on the example of microbial flora of bony remnants from the historic burial site)]. / Prakticheskoe znachenie mikroorganizmov dlya tselei sudebnoi meditsiny (na primere mikroflory kostnykh ostankov istoricheskogo zakhoroneniya).

Phenotypic signs of dominants isolated from the surface of bony remnants from the historic burial site were analyzed in order to expand data on the biodiversity of microorganisms in the microbial flora of bony remnants and to assess the possibility of using the results of microbiological analysis in the evidence base of forensic examination and forensic archaeology. It was detected that only Deuteromycota and Eubacteria colonized all types of surfaces in the samples of bone fragments from the historic burial site (with the age in the range of 90-95 years); with the abundance of micromycetes, the proportion of Eubacteria naturally decreased, while with the increased bacterial background counts the rate of micromycetes detection decreased. The insignificant amount of nutrients in the bony remnants led to the decrease in the number and biological diversity of microorganisms contaminating them; species adapted to a hard-to-reach organic substrate dominated there. During the process of bony remnants decomposition, when the conditions of their location changed, inter-species competition and specific recolonization occurred by species of microorganisms most adapted to a hard-to-reach organic substrate in the abiotic and biotic conditions of existence given. The results obtained are important for the descriptive ecology and biology of specific groups of microorganisms in the postmortem microbiome and form the basis for a more thorough study of complex communications between species of microorganisms in the necrobiome of bony remnants - in the future it will allow putting forward original hypotheses about the involvement of microbes in the circulation of matter and energy, as well as to apply the information obtained in the evidence base of forensic examination and forensic archaeology.

[On using the corpses of large mammals as model objects for studying the postmortem period]. / Ob ispol'zovanii trupov krupnykh mlekopitayushchikh v kachestve model'nykh ob"ektov pri izuchenii postmortal'nogo perioda.

THE AIM OF THE STUDY: Is to justify using the corpses of large mammals as model objects for studying the postmortem period. Similarities in processes occurring postmortem in human and swine corpses (decomposition stages and the structure of dominant necrophilic organisms inhabiting the corpse), as well as similar changes of relative impedance parameters for the cartilaginous tissue and musculoskeletal flap of swine and human corpses have been established. The results obtained allow recommending the swine corpse as an adequate human corpse model both for scientific studies and for solving specific scientific and practical issues arising in the practice of forensic examination when determining the prescription of death coming and the postmortem period conditions.

[Ecological aspects of postmortem microbiome and possibility of their use in forensic practice]. / Ekologicheskie aspekty posmertnogo mikrobioma i vozmozhnost' ikh ispol'zovaniya v praktike sudebno-meditsinskoi ekspertizy.

Through experimental reproduction of the decomposition process using the cadaver of rabbit Oryctolagus sp., the dynamics of cadaver microflora was studied; the dominant bacterial taxa were isolated in pure culture and identified; their ecological and trophic profiles and biodiversity were described based on the values of Simpson and Menchinic ecological indices. The dependence of cadaver rotting and skeletonization rate on the taxonomic profile of microorganisms, decomposition period, and abiotic environmental factors (temperature, acidity, soil moisture) was demonstrated. The data obtained contribute to justifying the use of microbiological methods in forensic practice. To establish objective causality patterns of microbial transformation of organic matter in nature, further targeted study of ecological patterns of cadaveric microflora is necessary.

[Prospects for molecular-genetic support of research on proteolytics in the necrobiome composition]. / Perspektivy molekulyarno-geneticheskoi podderzhki issledovanii proteolitikov v sostave nekrobioma.

The aim of this work is to monitor the state of the proteolytic community in time and space for the subsequent development of approaches to an objective assessment of the late postmortem period. The study proposes a combination of standard bacterioscopic and bacteriological research methods with methods of molecular biology and genetics, which make it possible to identify species and strains of mammalian corpses' proteolytics at the level of specific DNA or RNA. On the basis of phenotypic traits and a comparative analysis of the nucleotide sequences of genes encoding 16S rRNA, the species belonging of the isolated strains was proved. The set of methods' combination, including traditional microbiological analysis and molecular genetic studies, seems promising both for the purpose of substantiating and widespread use of microbiological methods in forensic medical practice, and for development an objective scientific base for establishing the cause-and-effect patterns of microbial transformation of organic matter in nature.

[Features of physiological groups of microorganisms - participants in the diagenesis of bone remains]. / Osobennosti fiziologicheskikh grupp mikroorganizmov ­ uchastnikov diageneza kostnykh ostankov.

Objective - to study the diversity of physiological groups of microorganisms that control the transformation of bone remains in nature. Traditional microbiological methods were used to study the cytological, physiological, biochemical and environmental properties of microorganisms isolated from the bone remains of Oryctolagus sp. 8 of 14 physiological groups of microorganisms - participants of diagenesis are established: ammonifiers, nitrifying bacteria, bacteria decomposing cellulose, causative agents of lactic acid and acetic acid fermentation, nitrogen fixators and denitrifying bacteria. Most of the identified physiological groups are in constant dynamics that is probably due to the uneven distribution in the soil of organic substances formed at different times in the process of microbial transformation of bone fragments. The analysis of qualitative and quantitative characteristics of these microorganisms' groups makes it possible not only to assess the intensity of the processes taking place over time but also to define the dependence on environmental factors such as soil acidity and ambient temperature. The results obtained can be used to obtain reliable data in forensic medical examination to solve issue about the prescription of death or the term of burial of bone remains.

Possibilities of practical application of different culture mediums for laboratory diagnostic of diphtheria.

The purpose of the work is to evaluate the cultural and morphological properties of colonies of clinically significant corynebacteria on culture mediums for the isolation of corynebacteria. The study used 9 culture mediums for the isolation of corynebacteria: a culture medium for the isolation of corynebacteria (Corynebacagar); Tellurite-containing blood agars on base - Culture medium № 1 GRM, Culture agar for the cultivation of microorganisms (GRM agar), Culture medium for determining the sensitivity of microorganisms to antibacterial preparations - AGV, culture agar for the cultivation of dry microorganisms (SPA), Clauberg medium II, Hoyle Medium agar (Oxoid), Blood agar base (Conda), Columbia Agar Base (Conda). The work used 7 test strains of microorganisms from the State collections of pathogenic microorganisms - C. diphtheriae biovars gravis, mitis, intermedius, belfanti and subspecies lausannense, C. ulcerans and C.pseudotuberculosis. Studies were carried out in accordance with MUK 4.2.3065-13 «Laboratory diagnosis of diphtheria infection¼. We describe culture-morphological properties of strains on all tested culture mediums the isolation of corynebacteria after 24 and 48 hours of incubation. Analysis of the results on the growth properties of culture mediums showed that all culture mediums had high sensitivity - from dilution 10-7 for all test strains. Colonies of corynebacteria were visually detected on culture mediums after 19-20 hours of cultivation. When cultivating a suspension of corynebacteria from breeding 10-6 on culture mediums, the number of colonies ranged from 95±5 to 120±10. Conclusion. All culture mediums had differential diagnostic properties that ensure the growth of corynebacteria after the day of incubation.

[Integrative microbial-zoological assessment of the postmortem period in forensic medical examination]. / Integrativnaya mikrobno-zoologicheskaya otsenka posmertnogo perioda dlya tselei sudebno-meditsinskoi ekspertizy.

THE AIM OF THE STUDY: Is a complex microbial-zoological characterization of the post-mortal period and ways of its determination during forensic examination. The heterotrophic component of the microflora of the corpse and its bed were studied using standard methods of microbiological research and PCR analysis, necrophilic insects - entomological method, and damages from some vertebrate animals - traditional methods of their analysis. We studied 125 corpses of humans, pigs, chickens, mice and some other representatives of mammal class weighing from 100 g to 100 kg at different times of decomposition. We isolated and studied more than 1000 isolates of microorganisms, more than 32 000 insects and more than 100 damages caused by rodents, dogs, cats and birds. We determined the main trends in microbial decomposition of dead bodies. The general characteristics of the corpse decomposition by insects are given and anatomical-topographical and morphological features of the corpse damage by some vertebrates are established. Significant The heterotrophic component of the microflora of the corpse and its bed were studied using standard methods of microbiological research and PCR analysis, necrophilic insects - entomological method, and damages from some vertebrate animals - traditional methods of their analysis. We studied 125 corpses of humans, pigs, chickens, mice and some other representatives of mammal class weighing from 100 g to 100 kg at different times of decomposition. We isolated and studied more than 1000 isolates of microorganisms, more than 32 000 insects and more than 100 damages caused by rodents, dogs, cats and birds. We determined the main trends in microbial decomposition of dead bodies. The general characteristics of the corpse decomposition by insects are given and anatomical-topographical and morphological features of the corpse damage by some vertebrates are established. Significant microbial and zoological characteristics of the post-mortem period have been identified, and ways of its establishment have been determined and confirmed by practical testing during forensic examination. A set of practical recommendations has been developed for forensic experts on the collection of necrophilous insects during the examination of the corpse at the scene and the tactics of the examination with the involvement of entomologists. The results obtained prove that there is a close correlation between the impact of vertebrate scavengers, necrophilic insects and the enzymatic activity of a specific community of heterotrophic microorganisms on the corpse.

[Features of bone destruction due to the collagenase activity of bacteria of the Bacillus and Clostridium genera]. / Osobennosti destruktsii kostnoi tkani za schet kollagenaznoi aktivnosti bakterii rodov Bacillus i Clostridium.

The purpose of work was to study the activity of collagenase biosynthesis by bacilli and clostridia isolated from the bone microflora in a pure culture at different periods of bone decomposition and at different values of acidity of the medium and the temperature of cultivation. The comparative collagenase activity of the strains of Bacillus mycoides, Bacillus subtilis, Clostridium putrificum, Clostridium sporogenes found in microflora of bone tissue was determined. The catalytic activity of collagenases was evaluated according to the modified method of agar blocks by the diameter of precipitation zone as a result of diffusion of enzyme into an agar medium with collagen. Within 6 months of experiment, the dynamics of changes in the number of collagenolytic strains was monitored. For all isolated Bacillus and Clostridium isolates, a steady increase in collagenase synthesis was observed throughout the study period, with the exception of Bac. subtilis, which is probably due to the acidity of medium, which did not correspond to the optimal pH range for this species. The optimum temperature for manifestation of the maximum collagenolytic activity of bacilli was 40 °C, and for clostridia - 30 °C. The study of proteolytically active species involved in the destruction of bone collagen is promising for the purposes of forensic examination. The use of bacterial enzymes in forensic practice remains a difficult task, however, the use of their substrate specificity can significantly expand the evidence base of the examinations.

[The use of the microbial and entomological data for the diagnostics of prescription of death coming]. / Ispol'zovanie mikrobno-éntomologicheskikh dannykh dlia ustanovleniia davnosti nastupleniia smerti.

The objective of the present study was to demonstrate the possibility of the diagnostics of prescription of death coming (PDC) based on the results of the studies with the application of the entomological and microbiological methods. The entomological materials included larvae of two dipteran species Stearibia nigriceps (Piophilidae) and Fannia vesparia (Fanniidae) collected from bone tissue fragments and the bony bed. The detailed investigation of the succession of necrophilic insects taking place in the course of decomposition of organic matter and the development of the preimaginal stages of the dipterans made it possible to determine the duration of the period during which the corpse remained in the ambient environment. The microbiological studies made it possible to determine the composition of necrobiome of the bone remains. It included, among other things, the association of soil bacterial forms belonging to the orders Actinomycetales, Pseudomonadales, and Aeromonadales in the combination with the fungi of the order Endomycetales. The enteral microorganisms that trigger putrefaction at the early stages of corpse decomposition were totally absent in the remains that hosted soil microorganisms destroying the hard tissues. The predominance of Actinobacteria in the samples of bone remains gave evidence of active disintegration of the skeletal tissues by the bacterial species inhabiting the local soil milieu. The study demonstrated that the results of the analysis of the microbial constituent of the washouts from the surfaces of the skull and the left upper arm bone of the human corpse were consistent with the conclusion about the prescription of death coming based on the entomological data. It is agued that the development of the methods for the diagnostics of prescription of death coming, including those to be used for the examination of the skeletonized corpses, based on the results of the entomological and microbiological investigations has good prospects as an area of research in the field of forensic medicine.

[The changes in the temperature of a corpse in the course of its decomposition (an experimental study)]. / Izmenenie temperatury trupa v protsesse ego razlozheniia (éksperimental'noe issledovanie).

The objective of the present work was to study dynamics of the temperature of a corpse of an experimental animal (a pig) between the moment of death till complete skeletization, The porcine corpse weighing approximately 100 kg was placed in the bilberry spruce forest in the southern part of the Karelian Republic. Variations in the temperature of the corpse were measured with the use of the EClrerk-USB-2Pt logger (an autonomous register of temperature) along with those of the environmental (the air and the soil) temperature during 86 days in the period from June till September. It was shown that the temperature of the corpse first decreased but began to increase thereafter due to the enhancement of the biological activity of microorganisms. It is concluded that putrefactive decomposition of the corpse does not always suggest the necessity to discontinue the measurement of its temperature. The forensic medical examination of a corrupted corpse should take into consideration the possibility of an increase of its temperature in the course of time because it may be a source of a mistake when estimating prescription of death coming. The problem of postmortem rise in the temperature of a corpse undergoing putrefactive decomposition needs a thorough theoretical interpretation with a view to promoting the practical application of the proposed method with due regard for the difference in the environmental conditions in various climatographical regions of the Russian Federation.

[The specific features of corpse putrification under the influence of necrobiome enzymatic systems]. / Spetsifika putrifikatsii trupa pod deistviem fermentnykh sistem nekrobioma.

The objective of the present study was to characterize the specific features of corpse putrification under the influence of necrobiome enzymatic systems depending on the duration of the post-mortem period. We present the results of investigations into the enzymatic activity of the dominant species of microorganisms making up the post-mortem microbiome. The domestic pork carcasses weighing 50-70 kg were used as an experimental putrification model. The study revealed the characteristic features of protein decomposition under the influence of proteolytic enzymes of pseudomonads, bacilli, and clostridia, such as alteration in the amount of necrobionts producing proteases in the entire carcass and its fragments during biodegradation in the air over 30 and 136 days of the post-mortem period. A series of experiments designed to evaluate the effectiveness of protein hydrolysis by necrobionts have demonstrated the dependence of the rate of biodegradation on the environmental temperature, duration of the putrification pocess, and the species composition of the necrobiome.

Case Report: Bilateral syringocele in an adolescent-area of focus.

Rationale: Cystic dilatation of the bulbourethral gland duct (Cowper's syringocele, CS) is a rare urethral pathology. No more than 150 cases of CS have been reported in the literature, of which the vast majority are children with a unilateral location. Bilateral CS has been reported in eight cases; however, detailed anatomy and clinical manifestations have not been reported. In this study, we report a case of bilateral CS with cavity junctions through the medial septum and its successful minimally invasive treatment in an adolescent. Case presentation: A 16-year-old adolescent patient complained of painful urination and post-micturition urinary dribbling. Magnetic resonance imaging (MRI), urethrography, and ureteroscopy data enabled the establishment of the diagnosis and determination of the type of CS. The surgical treatment that was performed was endoscopic marsupialization of both CS chambers. At follow-up examination after 7 months, the complaints had ceased, and there was complete normalization of urination. The maximum flow rate during uroflowmetry was 35 ml per second, on voiding cystourethrography, the residual cavities were not contrasted, and there was no residual urine or bacteriuria. Conclusion: MRI and retrograde urethrography made it possible to visualize changes in the bulbous part of the urethra, and ureteroscopy was the leading imaging modality. These studies was applied precisely because of the suspicion of the presence of a cavity communicating with the urethra. Minimally invasive surgical treatment for double-chamber CS was successful with no resulting complications.

[Quantitative electron microscopic and cytological analysis of breast cancer of various degrees of anaplasia]. / Kolichestvennyi élektronno-mikroskopicheskii i tsitologicheskii analiz raka molochnoi zhelezy razlichnoi stepeni anaplizii.

Electron microscopic and cytological study of mammary carcinoma cells of different degrees of anaplasia was carried out using morphometric methods in 15 patients with infiltrating carcinoma of this localization and correlation of cytological and histological data. The results showed the quantitative ultrastructural characteristics of the infiltrating mammary carcinoma reflecting the level of development of granular reticulum and polyribosomal apparatus to differ significantly depending on the degree of the tumor anaplasia established by cytological and histological studies with a light microscope. The cytological signs showing the maximum correlation with the ultrastructural changes in cells were found to include the numbers of "naked" nuclei, sizes of the cells and nuclei, number of nucleoli in the cell. Combinations of these signs typical for mammary carcinoma of different degrees of anaplasia are described.

[Cytologic findings in infiltrative carcinoma of the breast]. / Tsitologicheskie dannye pri infil'triruiushchei kartsinome molochnoi zhelezy.

In the work different cytologic patterns of infiltrative breast carcinoma are systematized. Based on cytomorphological, cytometric and cytochemical studies 3 types of cancer cytographs are distinguished: low-differentiated, with a moderate differentiation of the parenchyma and high-differentiated. This systematization may enable the precise cytological conclusion to be made, but in a number of cases the histological typing of a tumor too. The cytological data on the degree of cancer dedifferentiation may be used clinically to prognosticate the immediate effect of irradiation on the tumor. The degree of breast cancer dedifferentiation, evidenced by cytological preparations, not always corresponds to the grade of tumor malignancy revealed histologically.

[Prognostic value of cytological signs in breast cancer]. / Prognosticheskoe znachenie tsitologicheskikh priznakov pri rake molochnoi zhelezy.

From a variety of cytological patterns of breast cancer the signs are singled out, which may be of a prognostic value for determining the degree of tumor malignancy prior to instituting any kind of therapy. The data on 59 patients, radically treated for breast cancer, stage IIIb, are reported: 17 patients died during a year period, 42 - survived for 5 years and longer. There were singled out 11 cytological signs among which are those available in the WHO classification for typing breast cancer malignancy. The most informational signs were as follows: the character of cell location, the content of "naked" nuclei and nuclear hyperchromia. It was found that for low malignancy cancer a combination of the following signs is typical: a predominance of cell aggregations, the content of "naked" nuclei not exceeding 20%, and the absence of nuclear hyperchromia. To determine the rate of breast cancer malignancy in a cytological investigation, it is recommended to take into account, in addition to the recommended by the WHO classification signs (hyperchromia, the number of mitoses, heterogenity of nuclei in size, form and character of staining), also such a sign as the content of "naked" nuclei.

[Cytological method in the emergency surgical diagnosis of cancer at different sites]. / Tsitologicheskii metod v srochnoi operatsionnoi diagnostike raka razlichnykh lokalizatsii.

The results of 1,215 emergency surgical cytological assays conducted in 619 cases of cancer and some other malignant tumors are presented. Specimens were obtained by puncture of primary tumor, swollen lymph nodes, indurations and infiltrations, by attrition of primary tumor, serous surfaces and surgical incisions, from serous cavity fluids and imprints of bioptical material. The results of emergency cytological diagnosis of cancer and other malignant tumors were confirmed in 95% of cases.

[Cytological classifications of precancerous conditions and cancer of the lung, breast, esophagus and stomach]. / Tsitologicheskie klassifikatsii predrakovykh sostoianii i raka legkogo, molochnoi zhelezy, pishchevoda i zheludka.

Cytological classifications of cancer and precancerous lesions of the lung, breast, esophagus and stomach are suggested. They are based on the analysis of the results of research and practical experience gained at the Institute in the treatment of more than 2,000 cases. The cytological classifications are in conformity with those of WHO and provide for identification of malignancy, histological pattern, degree of tumor differentiation as well as the degree of dysplasia in precancerous lesions.

[Cytomorphological criteria of atypical hyperplasia and cancer of the endometrium based on data from a multivariate statistical analysis]. / Tsitomorfologicheskie kriterii atipicheskoi giperplazii i raka éndometriia po dannym mnogomernogo statisticheskogo analiza.

Multifactorial statistical analysis was used to identify differential diagnostic cytological features of glandular hyperplasia, atypical hyperplasia and well-differentiated adenocarcinoma of the endometrium. Twelve cytological features were identified for calculating linear discriminant function. The effectiveness of the diagnostic algorithm depends upon the diagnostic value of the sample and proficiency of the cytologist.