[Goodpasture's syndrome as a cause of pulmonary hemorrhages]. / Sindrom Gudpaschera kak prichina legochnykh gemorragii.

Analyzing the case histories of 5 patients with Goodpasture's syndrome who have admitted to an emergency clinic for suspected tuberculosis leads to the conclusion that the onset of the disease appeared as intoxication and lung damage, and evolving general weakness, fever, cough. Hemopoiesis appeared just when overall clinical manifestations appeared, it varied from single sputum blood filaments to more frequent mows of pure red blood sputum for several weeks, but there was never an increasing hourly progressively and this failed to cause a rapid drop of hemoglobin. Anemia is attributable by pulmonary blood imbibition, intoxication, and suppressed hemopoiesis in renal failure rather than by external blood loss as hemoptysis.

[Clinico-anatomical significance of the presence of blood in the gastrointestinal tract of patients who died of pulmonary hemorrhage]. / Kliniko-anatomicheskoe znachenie nakhozhdeniia krovi v zheludochno-kishechnom trakte u bol'nykh, umershikh ot legochnogo krovotecheniia.

Examining the follow-up and autoptic data on 133 patients who died from pulmonary hemorrhage in the presents of respiratory diseases, including tuberculosis has revealed a previously undescribed a phenomenon of the presence of blood varying in its pattern and volume in the proximal and distal gastrointestinal tract. The clinical and anatomic assessment of the phenomenon detected and its value in the patho- and thanatogenesis of asphyxial pulmonary hemorrhages are given. It is concluded that asphyxial hemorrhages do not develop suddenly, but they result from pulmonary hemorrhages lasting 1-2 days or more, wherein the patients digest great volumes of blood. The digesting of blood rather than its coughing away is observed in patients with mental disorders, during a deep or abnormal sleep, and in the agonal period of asphyxia. The paper shows the significance of the revealed phenomenon as a constituent of total blood loss and a cause of undiagnosed pulmonary hemorrhage in 24% of dead individuals.

[Infection and bacterial colonization of urogenital system in pregnancy, its effect on the clinical course of pregnancy, fetus and newborn]. / Infektsiia i bakterialnaia kolonizatsiia urogenitalii u beremennykh, vliianie na techenie beremennosti, plod i novorozhdennogo rebenka.

Colonization/infection of the genitals with Mycoplasma, group B Streptococci, and Chlamydia was studied in pregnant women. The course of gestation in women colonized with microorganisms was frequently aggravated by threatened spontaneous abortions, high incidence of hydramnion, late gestoses, pyelonephritis. For the newborns a reduced body mass and increased perinatal morbidity and mortality were characteristic. Transfer of microorganisms to the fetus and newborn was observed in 40-50% of cases and was not always associated with development of a disease. In cases of lethal outcomes of a neonatal disease pneumonia and placentitis were the constant morphological manifestations of the infection. In streptococcal and mycoplasmic infection the inflammation in the placenta was diffuse, involving the decium both in the placenta and in the extraplacental membranes.

[Morphology of the placenta in genital mycoplasmosis]. / Morfologiia platsenty pri genital'nom mikoplazmoze.

96 placentas from mothers with genital mycoplasmosis diagnosed during the pregnancy (main group), and without mycoplasmosis (group for comparison) were studied. Histological study was performed in parallel with electron microscopy of the amnion and use of fluorescent antibodies. Progression of the involutive-degenerative changes in the placenta with the development of lipophanerosis and destruction of the extra-placental amnion epithelium were observed in the main group in parallel with the increase of the immunoglobulins studied (A, M, G), fibrinogen, C3-component of the complement with fixation of pathogenic immune complexes (IC). IC are observed in the placenta of 51 +/- 6.35% and in the extra-placental coats in 100% of mothers with mycoplasmosis versus 9 +/- 4.91% and 40%, respectively, in the comparison group. The presence of IC in the placenta and extra-placental coats correlates with the neurological symptoms in newborns and the increase of infectious-allergic diseases in children of the 1st year of life.

[Morphology of the compensatory-adaptive responses in the placenta of multiparous women in uncomplicated pregnancy]. / Morfologiia kompensatorno-prisposobitel'nykh reaktsii v platsente mnogo rozhavshikh zhenshchin pri neoslozhnennoi beremennosti.

125 placentas of women with many (5-17) deliveries and 100 control placentas (with 1-2 deliveries) were studied morphologically. It is shown that placentas of women with 1-2 deliveries retain their structure, compensatory reactions are most active in the central part of the placenta. After 5-9 deliveries hemodynamic disturbances are observed, disorganization processes are less pronounced, the level of compensatory-adaptive processes increases. Hemodynamic disturbances and structural disorganization are observed after 10-17 deliveries with pronounced compensatory processes in the peripheral parts of the placenta. Dissociated disturbance of the villi maturation are revealed after numerous deliveries.

[Echomorphologic parallels in the ultrasound examination of the placenta]. / Ekhomorfologicheskie paralleli pri ultrazvukovom issledovanie platsenty.

Results of the ultrasound and morphological examination of the villous chorion of women with physiological pregnancy (34 cases) and with late pregnancy toxicoses (280 cases) were compared. A gradual decrease of the chorion acoustic density in physiological pregnancy correlates with a development of the compensatory-adaptive reaction (CAR) on the tissue level and serves a favourable prognosis for the pregnancy outcome. In patients with late pregnancy toxicosis, alterations of the chorion echogenicity occur at different periods of the pregnancy and reflect the CAR disturbances facilitating the development of various forms (stages) of the placenta insufficiency. The results obtained indicate possibilities of placentography use for a differential approach to the choice of methods and terms of delivery in late pregnancy toxicoses.

[Activity of enzymes in amniotic fluid in prenatal diagnosis of cystic fibrosis]. / Issledovanie aktivnosti fermentov amnioticheskoi zhidkosti v prenatal'noi diagnostike mukovistsidoza.

The activity of microvillar enzymes--gamma-glutamyltranspeptidase, aminopeptidase, general and intestinal forms of alkalyne phosphotases was studied in amniotic fluid (AF) of 33 women with 25% risk of cystic fibrosis (CF) (mucoviscidoses) in their progeny. The figures obtained in this group were compared with corresponding values of the same enzymes in 100 AF samples from normal pregnancies (negative control) and with 9 AF samples from women which were known to give birth to the children with CF (positive control). CF has been predicted in 5 cases, pregnancies were artificially terminated in 4 women. Biochemical CF prediction was proved by immunochemical assay of albumin contents in meconium of fetal ileum. One woman from the high risk group refused abortion and gave birth to a CF child. Among 26 cases of low CF prediction, 13 resulted in birth of a child without a sign of CF, one - in a child with clear-cut diagnosis of CF and 12 other pregnancies still proceed. The efficiency of complex biochemical, pathomorphological and molecular approaches for verification of intrauterine CF diagnosis in aborted fetuses as well as for detection of heterozygous carriers of CF gene and prenatal diagnosis of CF is discussed.

[Clinico-morphological aspects of placental insufficiency]. / Kliniko-morfologicheskie aspekty platsentarnoi nedostatochnosti.

The paper is concerned with the problems of placental insufficiency diagnosis, pathogenesis and potential effect on the fetus. The diagnosis involves the comparison of the compensatory and adjustment reaction to the number and pattern of pathological placental alterations in line with clinical and laboratory findings. The author employed the methods of macro-, microstereometry, electron microscopy, histochemistry, immunofluorescence. The essential role in placental insufficiency pathogenesis is attributed to the failure of regulatory metabolic mechanisms. This permits further investigation with employment of membrane pathology and biochemical methods of investigation.

[Human extracorporeal fertilization with subsequent successful embryo implantation and the birth of a child]. / Ekstrakorpoal'noe oplodotvorenie u cheloveka s poslediushchei uspeshnoi implantatsiei émbriona i rozhdeniem rebenka.

With the aim to use a previously elaborated method of extracorporeal fertilization of human ova for treating sterility, resulted from obstruction or absence of the uterine tubes, ova were obtained at laparoscopy after a previous hormonal stimulation of women. From 119 women 159 ova were obtained. Fertilization of the ova was performed in the medium Ham F-10 previously capacitated with the husband's spermatozoa. Fertilization rate was 66%. Embryos at the stage of 2-8 blastomeres were implanted transcervically into the uterine cavity with a special catheter. The embryo transfer was performed in 37 women with tubular infecundity. Menoschesis up to 3 weeks was noted in 5 women. In one woman on the 35th day after implantation, by means of hormonal-biological reaction and ultrasound investigation, pregnancy was diagnosed, it terminated in timely birth of a boy with body mass 3,500 gr. A conclusion was made that the main cause of failures at the embryo transfer was an inadequate preparation of the uterine mucosa (resulted from the main disease) to accept the fertilized ovum.

[Pathologico-anatomic diagnosis of placental insufficiency in various forms of maternal pathology]. / Patologoanatomicheskaia diagnostika nedostatochnosti platsenty pri razlichnykh formakh patologii materi.

Placental insufficiency is considered as a disorder of compensatory-adaptative reactions on subcellular, cellular and tissue levels. In cases of relative insufficiency diagnosed on subcellular and cellular levels, homeostasis of the mother-placenta-fetus system is maintained by the tissue reactions, mainly hemodynamic ones. Among morphological features of compensatory mechanisms the most informative is the index of chorionic villi vascularization. Rapid decrease of the index indicates the development of the absolute placental insufficiency. Among the factors which limit compensatory-adaptative reactions it is necessary to distinguish, besides involutional-dystrophic, circulatory, inflammatory processes, a disorder in the chorion maturation which proceeds in different versions depending on the character and duration of the maternal pathology influence.

[The human placenta and its normal role and in pathology]. / Platsenta cheloveka i ee rol' v norme i pri patologii.

The information on placenta formation, development and structure in health and disease, as well as the role of the placenta as a unique organ which ensures the fetal growth and development during pregnancy is given on the basis of the literature and author's data. Attention is drawn to the formation of the compensatory-adaptive reactions as a complex dynamic process whose manifestations are considered on the subcellular, cellular and tissue levels. Connection between the morphological equivalents of the compensatory mechanisms and the process of maturation of placental barrier structural elements is shown. Determining the character of maturation disorders in combination with the placenta damage allows one to suggest, by means of clinico-anatomical analysis, a particular maternal pathology as the most probable cause of the unfavourable intrauterine conditions of the fetal development. A working classification of placental insufficiency resulting mainly from the disturbance of the compensatory-adaptive reactions is proposed.

[Placenta in multiple pregnancy]. / Posled pri mnogoplodnoi beremennosti.

One hundred and thirty-one structurally different placentas during multifoetal pregnancy have been studied by the morphohistochemical and morphological methods. A high degree of conservation of placenta tissue structures of twins is observed in clinically normal pregnancy; the disorganisation is very mild, and the whole tissue, especially the margin, is actively included in the compensatory-adaptive processes. During clinically complicated pregnancy combined with congenital defects of the foetus and placenta, reorganization of the functional morphology of the placenta of twins occurs, which has a dynamic character reflecting the degree of disorganization o the structural elements, and also the level of the development of compensatory-adaptive processes. The knowledge of these changes allows an evaluation with a high degree of significance of the functional ability of the twins placenta as an organ in which metabolic processes between mother and child take place.