[Clinical and morphological aspects of infectious endocarditis].

Comparative analysis of anamnestic, clinical, laboratory and instrumental data involved 106 patients with infectious endocarditis treated in S.P. Botkin City Clinical Hospital in 2000-2011 and 92 ones admitted in 1985-1977. The results give evidence of ongoing pathomorphosis of infectious endocarditis as is apparent from the growing number of male patients, increased frequency of primary cases and previous invasive or intravascular manipulations, thromboembolic complications including pulmonary thromboembolism, right heart chamber endocarditis. Over half of the patients are socially unadapted C-peptide level is of diagnostic value for the assessment of inflammation activity, precursors of natriuretic peptide can be used to detect preclinical and clinical stages of cardiac failure related to infectious endocarditis. There is correlation between severity of inflammation and myocardial dysfunction. Early surgical intervention in the absence of effect of combined antibacterial therapy improves prognosis. Morphological studies of inflammation-related changes in myocardium, destruction of cardiomyocytes, dystrophic processes, and fibrosis play an important role in the development of cardiac insufficiency and prognosis of infectious endocarditis.

[Myocardial infarction and acute coronary syndrome: definitions, classification, and diagnostic criteria].

The review gives the definitions and classification of and diagnostic criteria for myocardial infarction and acute coronary syndrome in accordance with the "The third universal definition of myocardial infarction" adopted in 2012 (Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, 2012). It also discusses the clinical and morphological comparisons of and the problems in the differential diagnosis of myocardial infarction as a nosological entity within coronary heart disease with other coronarogenic and non-coronarogenic necroses of the myocardium.

[Injuries to myocardium in infectious endocarditis].

Clinical and morphological characteristics of myocardium in infectious endocarditis (IE) are described as exemplified by pathological changes in the vascular bed, stroma, and myofibrils. Multiple sclerotic changes in myocardium in the form of "sheath sclerosis" were revealed. It is shown that progress of cardiac insufficiency in IE may be due to specific changes in the heart muscle. The necessity of early diagnostics of myocardial lesions is discussed with reference to revision of antibiotic therapy and modern surgical treatment of lE.

[Development of targeted indicators of quality in postmortem examination].

The indicators of quality for impartial quantitative assessment of postmortem examination have been suggested. These indicators were based on ratio of achievement and target indexes of pathologicoanatomic activity. The indicators are necessary for decision making for enhancement of pathologicoanatomic service quality in the health-care agencies.

[Primary (idiopathic) cardiomyopathies].

The lecture gives the clinical and morphological characteristics of different forms of primary (idiopathic) cardiomyopathies. It presents macroscopic, histological, and ultrastructural changes in primary cardiomyopathies.

[Morphological and biochemical criteria for cell death].

The state-of-the-art of classifications of and criteria for cell death in the light of the 2009 recommendations of the Nomenclature Committee on Cell Death is presented as a lecture. Motivation is given for the necessity of using the unified criteria in the description of cell death and more than one study in its verification. The major structural and biochemical signs of four typical types of cell death--apoptosis, autophagia, keratinization, and necrosis are compared. Data are given on the major atypical forms of cell death--mitotic catastrophe, anoikis, exitotoxicity, Wallerian degeneration, paraptosis, pyroptosis, pyronecrosis, and entosis.

[Formulation and coding of a postmortem diagnosis by using the ICD-10 in blood circulation disorders].

The paper presents the rules of formulation and coding of a postmortem diagnosis in blood circulatory diseases in accordance with the requirements of the ICD-10 and the standards of morbid anatomy service, which have been approved by the Federal Agency for Health Care and Social Development of the Russian Federation.

[Clinical morphology of acute coronary syndrome].

The paper describes acute coronary syndrome and gives its definition, classification and current possibilities of its clinical and morphological diagnosis. Emphasis is laid on the troponine test and clinicoinstrumental imaging of coronary arterial obstruction and myocardial ischemia. Data on the morphological criteria for vulnerable atherosclerotic plaque, different stages of ischemia and early myocardial necrosis are presented. Recommendations on establishing the postmortem diagnosis of acute coronary syndrome are given.

[Standards of postmortem studies and services: a new normative basis of postmortem service].

Standards for organization of a postmortem service have been approved by the Russian Health Care Surveillance Committee in 2006.

[Principles in the organization of voluntary certifying system for studies and services in pathologic anatomy].

The aim of voluntary certification is to improve the quality of pathology service and to implement it under the Russian Federation's laws and existing standards. The noncommercial organization "Voluntary Certifying System for Postmortem Studies" has been set up, which includes expert groups comprising highly skilled specialists.

[Sudden cardiac death: state of the art].

Sudden cardiac death (SCD) is an integral term for several heart diseases among which SCD caused by ischemic heart disease (IHD) designated as sudden coronary death (SCD) ranks first. SCD associated with alcoholic cardiomyopathy ranks second. Risk factors and pathologic manifestations of SCD correspond to those of IHD, atherosclerosis, myocardial infarction. Cardiac arrest takes place because of fibrillation of ventricular myocardium. Factor inducing fibrillation is an advanced irreversable myocardial ischemia complicated with reperfusion. The latter promotes elimination of arrythmogenic substances from the ishemic zone leading to electric unstability of the myocardium and fatal arrythmia. Possibility of idiopathic ventricular fibrillation and its mechanisms is discussed.

[Morphological alterations of the rat myocardium in chronic morphine intoxication]. / Morfologicheskie izmeneniia miokarda krys pri khronicheskoi intoksikatsii morfinom.

Morphine was administered intraperitoneally to Wistar rats at increasing doses from 10 to 60 mg pay during 8 days. Cardiomyocyte damage in the form of myocytolysis and wave-like deformations of muscle fibers prevailed at the level of light microscopy. Microcirculatory alterations were characteristic: stasis, sludge-phenomenon, perivascular and interstitial oedema, diapedes hemorrhages, focal proliferation of vascular wall cells. Ultrastructural lesions were as follows: subsarcolemma edema, mitochondrial destruction, formation of giant forms of mitochondria, single contractures, increasing micropinocytosis, intestitial edema.

[The 40th anniversary of RAMS institute of human morphology]. / Institutu morfologii cheloveka RAMN--40 let.

Institute of Human Morphology of Russian Academy of Medical Sciences was established in 1961 and united efforts of morphologists of various profile--pathologists, cytologists, embryologists. The role of outstanding Russian morphologists and the first Institute heads is shown. Basic achievements in four research fields are characterized: in geographic pathology; structural basis of immune homeostasis in health and pathology; pathologic anatomy and pathogenesis of basic human diseases; human morpho- and embriogenesis in health and disease.

[Morphology of lymphoid tissue from airways in bronchiectasis]. / Morfologiia limfoidnykh obrazovanii vozdukhonosnykh putei pri bronkhoéktaticheskoi bolezni.

Morphological and morphometrical study is performed on serial and stepped sections of the lungs surgically removed from patients with bronchoectatic disease. As compared to healthy persons, hyperplasia of all structural components with formation of lymphoid and lymphoepithelial follicles was detected. The degree of lymphoid tissue hyperplasia in bronchoectatic disease is determined by inflammation activity and does not depend on the age. The number of interepithelial lymphocytes is significantly increased as well as that of peribronchial and peribronchiolar lymphoid accumulations, and the degree of diffuse infiltration. However, the number of periglandular and periductal lymphoid accumulations and lymphoid follicles is significantly reduced. Bronchoectatic disease with high active inflammation as compared to low activity is characterized by more pronounced hyperplasia with formation of lymphoid and lymphoepithelial follicles with clear centers.

[Morphology of the lymphoid tissue of the bronchus in healthy persons of various ages, and the effect of smoking]. / Morfologiia bronkhoassotsiirovannoi limfoidnoi tkani u zdorovykh lits raznykh vozrastnykh grupp i vliianie na nee faktora kureniia.

Bronchoassociated lymphoid tissue (BALT) is studied histologically and morphometrically in 49 autopsy cases of persons of various ages after violent death. Lymphoepithelial follicles typical for BALT of small laboratory animals were not observed in human lungs of healthy persons. BALT structural components are represented by interepithelial lymphocytes, diffusely scattered lymphocytes in the mucous membrane tunica propria, lymphoid agglomerations (focal loose agglomerations in the mucous membrane tunica propria, focal periglandular and dense periductal, dense peribronchial and peribronchiolar agglomerations). According to the morphometrical study, there is BALT hyperplasia at young and adolescent ages and involutive changes at advanced age. Reduction of periglandular lymphoid agglomerations and an increase of the alveolar macrophages number were observed in adult persons who smoked for many years.

[Pathological anatomy of alimentary fluorine deficiency in goats]. / Patologicheskaia anatomiia alimentarnogo ftordefitsita u koz.

Chronic alimentary fluorine deficiency was provoked in goats by a semisynthetic diet with fruorine deficiency (less than 0.3 mg/kg dry feed). Teeth caries, emaciation in spite of higher consumption of food as compared to controls, focal inflammatory degenerative changes in the alimentary tract mucous membranes (catarrhal-purulent esophagitis, chronic duodenitis), chronic degenerative changes in the parenchymatous organs were observed. Endocrinopathies, accidental thymus involution, hypothyroid state, destructive changes in the pancreatic insullar cells were also common.

[General pathology of trace element deficiency]. / Obshchaia patologiia gipomikroélementozov.

According to the authors' concept, different forms of trace element deficiency show some general rules of development. All of them are followed by a decrease of immune resistance. Trace element deficiency is never isolated, it is always characterized by trace element unbalance and is followed by a considerable disturbance of metabolism (mineral, lipid, carbohydrate and protein) with relevant manifestations. Reduced immune resistance and pluriglandular endocrinopathy create the conditions for various malignancies.

[Pathology of congenital bromine deficit (experimental observation)]. / Patologicheskaia anatomiia vrozhdennogo bromdefitsita (éksperimental'noe nabliudenie).

Pathology of congenital bromine deficiency is described in a she-goat whose mother was kept for two years on a bromine deficient diet. Anomalies of the bones and joints of the anterior limbs, disturbances of carbohydrate, lipid and mineral metabolism in the form of liver, kidney and lymph nodes glycogenosis, liver fat degeneration, haemosiderosis of the liver, spleen and lungs were found. Moderate thymomegaly with hyperplasia of the cortex and an increase in the number of Hassal bodies, microcystic ovary transformation, adrenal adenomatosis, cheilitis, flossitis, focal proliferative extracapillary glomerulonephritis were also observed.

[Comparative characteristics of deficiency and excess of the same trace element (as exemplified by nickel)]. / Sravnitel'naia kharakteristika odnoimennykh gipo- i gipermikroélementozov (na primere nikelezov).

General rules of biological effects of essential trace elements in human and animal body are discussed as illustrated by nickel model. Their action depends on the dose and duration of exposition. 5 levels of their action depending on the elements concentration in the body are distinguished. Pathology of low and high content of the same element in spite of the contrast of these conditions has certain similarity in the coincidence of the target organs and some pathological manifestations.