[Loss of heterozygosity at chromosome 6 as a marker of early genetic alterations in cervical intraepithelial neoplasias and microinvasive carcinomas].

Oncogenic human papilloma viruses (mostly HPV types 16 and 18) are the major cause of cervical intraepithelial neoplasia (CIN) that progress into cervical cancer (CC). To reveal early genetic alterations at chromosome 6 important for CC progression we have analyzed loss of heterozygosity (LOH) in DNA from 45 CIN cases, 47 microcarcinomas and 19 invasive squamous cell carcinomas stage IB. LOH analysis of DNA samples prepared with microdissection from all CIN foci as well as from CC lesions and synchronous CIN has permitted the investigation of CIN and CC heterogeneity. 79% of CC stage 1 showed LOH with 6 microsatellite markers at chromosome 6. LOH with microsatellite markers D6S276 (6p22) and TNFalpha (6p21.3) was found in 50% of CC cases. LOH frequency in CIN lesions, synchronous with CC, was higher then LOH in CIN cases without cancer, the statistical significance (p = 0.004) was shown for marker D6S291 (6p21.2). The finding suggests that high level of LOH frequency in CIN lesions may be a marker of unfavorable prognosis for CIN. Progression from microcarcinoma to invasive CC of IB stage was associated with higher LOH frequency at D6S344 (6p25) and TNFalpha (6p21.3). The early genetic alterations were found in CIN with microsatellites D6S273 and TNFalpha located at 6p21.3. Moreover the LOH frequency at D6S273 retained the same in CIN and CC cases. Based on HPV-typing, LOH analysis and X-chromosome inactivation the polyclonality of CC lesions as well as CIN was shown in a few patients.

[Twenty years' experience with the information system "biopsy" used in the work of a department of morbid anatomy].

The long-term use of the information system "Biopsy" has shown its efficiency in improving the organization of the department of morbid anatomy in a large hospital. Its advantages are the availability of materials and necessary information for the shortest period. The introduction of an electronic signature and the storage of signed documents are new real steps to the creation of paper-free technology, including the so-called electronic case history base. Automated exchange of orders for tests and their results not only reduces the time of their obtaining, but also lowers costs and enhances the efficiency of work pf a biopsy laboratory.

[Heterogeneity of causes of proteinuria in patients with non-insulin dependent diabetes mellitus]. / Geterogennost' prichin proteinurii u bol'nykh insulinnezavisimym sakharnym diabetom.

AIM: To make a retrospective clinicomorphological (autopsy) study of proteinuria causes. MATERIAL AND METHODS: The records have been analysed for 231 patients with non-insulin-dependent diabetes mellitus (NIDDM) over 60 years of age who died in a general hospital between 1990 and 1999. The choice of patients with diabetic nephropathy (DN) for a further morphological investigation was based on the presence of proteinuria (> 0.5 g/day), normal renal function. 72 patients met the above criteria. Of them 26 were women. RESULTS: Proteinuria occurred more frequently in men (63.4%). A morphological examination of the kidneys revealed diabetic glomerulosclerosis (diffuse and focal) in 48(67%) patients. In 24(33%) patients proteinuria resulted from non-diabetic affection of the kidneys: amyloidosis, atherosclerotic and/or hypertensive nephroangiosclerosis, membraneous and myelomic nephropathy, mesangioproliferative glomerulonephritis. Glomerular changes were not registered in 4 patients. 35(72%) DN patients had diabetic retinopathy which was not found in patients with non-diabetic renal affection. CONCLUSION: Diabetic retinopathy in patients with NIDDM and proteinuria allows to conclude that the latter is consequent to DN. The absence of diabetic retinopathy in such patients promotes a search for other causes of proteinuria.

[The epidemiological indices of multiple myeloma and concomitant nephropathies]. / Epidemiologicheskie pokazateli mielomnoi bolezni i sochetaiushchikhsia s nei nefropatii.

The authors have conducted an epidemiological study for multiple myeloma morbidity and mortality among 80,000 patients of the Medical Center examined in 1988-1995. Myeloma was diagnosed in 65 cases. Standard incidence rate was 4.09, 3.18 and 3.5 per 100,000 for myeloma in males, females and both sexes, respectively. Standard mortality was 2.76 and 1.73 per 100,000 for males and females, respectively. The above rates do not differ much from those of other countries. In terminal myeloma renal insufficiency occurred in 39 of 41 cases. In 8 cases chronic pyelonephritis was an independent course of renal failure thus indicating the importance of its persistent treatment.

[A rare case of manifestation of reticulosarcoma by development of multiple cerebral hemorrhages]. / Redkii sluchai manifestirovaniia retikulosarkomy razvitiem mnozhestvennykh krovoizliianii v golovnom mozge.

Metastatic injury to the brain occurs very rarely in reticulosarcoma patients, presenting considerable difficulties for clinical diagnosis. Such an injury has not been reported in the neurological literature. The authors describe a case of the generalized form of reticulosarcoma with multiple metastases and secondary hemorrhages to the brain attended by blood breakthrough to the ventricular system. Difficulties are noted, occurring in differential diagnosis, and specific features of the clinical picture and pathomorphological alterations are described. In contrast to the primarily hemorrhagic manifestations in the brain, blastomatous proliferation in the visceral system (the gastrointestinal tract, lymph nodes) provoked appreciable necrotic lesions.