[Widespread of Scleroma. A rare clinical case]. / Skleroma, rasprostranennaya forma. Redkoe klinicheskoe nablyudenie.

Scleroma is a chronic infectious disease characterized by developing inflammation nye granulomas, mainly of the upper respiratory tract, with subsequent scarring. The reasons for the development of scleroma remain unclear, but it is generally accepted that the gram-negative coccal bacterium Klebsiella rhinoscleromatis (pas-Volkovich's loch - Frisch) is the causative agent of this disease. Endemic in the spread of scleroma is considered There are tropical and temperate zones such as Africa, Asia, Eastern Europe, South America and Central America. Features of development scleroma in the present case and the complexity of the diagnosis caused by atypical, the rapid development of the disease, the greater prevalence of the process (including the orbit), with the transition to the soft tissues of the cheek bone and upper jaw, which is not typical for scleroma. The process was primarily localized in the left maxillary sinus and mimicked sinusitis. The presence of radicular cysts and darkening of the left maxillary sinus on radiographs, taking into account the clinical picture of the disease, were interpreted incorrectly, which led to the establishment of an incorrect diagnosis and subsequent surgical interventions. More targeted and consistent examination of histo-the logical material obtained after three surgical interventions made it possible to identify the characteristic signs scleroma, establish the correct diagnosis and prescribe effective treatment. In our case, we applied Ciprofloxacin course for 3 months at a maximum daily dose of 2000 mg in combination with probiotics. During treatment, it was noted a significant improvement in the patient's well-being, facial pains became less intense, a decrease in the volume of ma tissues of the left cheek and improved nasal breathing.

[A case of Lambl's excrescences of the mitral valve concurrent with myocardial infarction]. / Nabliudenie ékskrestsentsii Lamblia mitral'nogo klapana v sochetanii s infarktom miokarda.

Lambl's excrescences are a rare disease that is characterized by a lesion of the heart valves as filamentous growths on their surface mainly along the coaptation lines and that is mostly asymptomatic. Due to traumatic injuries during heart contractions, fibrin masses can be deposited on the surface of the growths, contributing to thromboembolic events or infection. The paper provides the data available in the literature and demonstrates a postmortem observation of Lambl's excrescences on the ventricular surface of the mitral valve concurrent with myocardial infarction.

Protective role of exogenous recombinant peroxiredoxin 6 under ischemia-reperfusion injury of kidney.

Peroxiredoxin 6 (Prx6) is an important antioxidant enzyme with various functions in the cell. Prx6 reduces a wide range of peroxide substrates, playing a leading role in maintaining the redox homeostasis of mammalian cells. In addition to the peroxidase activity, a phospholipase A2-like activity was demonstrated for Prx6, which plays an important role in the metabolism of membrane phospholipids. Besides that, due to its peroxidase and phospholipase activities, Prx6 participates in intracellular and intercellular signal transduction, thus triggering regenerative processes in the cell, suppressing apoptosis caused by various factors, including ischemia-reperfusion injuries. A nephroprotective effect of exogenous recombinant Prx6 administered before ischemia-reperfusion injury was demonstrated on an animal model. Exogenous Prx6 effectively alleviates the severeness of renal ischemia-reperfusion injuries and facilitates normalization of their structural and functional conditions. Infusion of exogenous Prx6 increases the survival rate of experimental animals by almost 3 times. Application of exogenous Prx6 can be an effective approach in the prevention and treatment of renal ischemia-reperfusion kidney lesions and in preserving isolated kidneys during transplantation.

[On the histogenesis of cardiac myxoma]. / K voprosu o gistogeneze miksomy serdtsa.

OBJECTIVE: to investigate the morphological and phenotypic features of cardiac myxoma (CM), to discuss argumentative issues on the sources of its growth. SUBJECTS AND METHODS: The investigation included 176 sporadic and familial myxomas originating from different cardiac chambers (96% from the atria). The histological, ultrastructural, and immunohistochemical features of the cells and vessels of this tumor were studied. RESULTS: The morphological and phenotypic features of the embryonic endothelium resembling the cells of the primary cardiovascular network were found in the cells and vessels of CM. No signs of other mesenchymal derivatives were detected. DISCUSSION: The authors anticipate that there is focal cessation of maturation of the embryonic endocardial endothelium and its persistence - hamartia. Postnatal proliferation of embryonic hamartia forms the tumor hamartoma. Differentiated cells may retain the phenotypic (but not morphological) features of closely related cells that have a common precursor. CONCLUSION: The results of the study have allowed the authors to consider CM to be hamartoma, a monohistioid benign embryonic endocardial endothelioma. Our findings do not exclude the possibility of developing CM from pluripotent mesenchymal cells.

Effect of Conditioned Medium and Bone Marrow Stem Cell Lysate on the Course of Acetaminophen-Induced Liver Failure.

A composition containing culture medium conditioned by mesenchymal stem cells and mesenchymal stem cell lysate improves biochemical parameters, reduces inflammation, and stimulates regenerative processes in the liver.

[The surgical treatment of electrocardiostimulator implantation septic complications with the system preservation].

Results of surgical treatment of local septic complications after the electrocardiostimulator (ECS) implantation in 86 patients were analyzed. Comparison of two patient groups allowed to prove the importance of the preoperative echocardiography and bacteriological blood test as well as the thorough surgical treatment.

[General surgical procedures in patients with electrical pacemaker].

Work of the implanted electric pacemaker (EP) was assessed in 99 patients, aged 62.4±9.6 years, during non-cardiological surgery. Inhibition of the EP stimuli was registered in 9 (9.1%) patients, short episodes of uneffective stimulation with synchronization disturbation--in 2 (2%) patients and change of stimulation regimen was registered in the same number of patients by electocoagulation. Episodes of myopotential inhibition not assotiated with electrocoagulation was registered in 4 cases. The ascertained rhythm disturbances require a thorough preoperative check-up, intraoperative ECG control and short use of monopolar electrocoagulation.

[Pathological anatomy in A/H1N1 influenza].

Forty autopsy cases died from A/H1N1 influenza in Moscow, the Moscow Region, and Chita were analyzed. Major changes were found to develop in the trachea and lung. The lung showed the pattern of exudative and proliferative stages of diffuse alveolar lesion. In addition, the signs of viremia-associated infectious-toxic shock, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes were revealed. Bacterial bronchopneumonia was detected only in 20% of cases.

[Pathomorphology of the lung in severe influenza A/H1N1].

Thirty-five autopsy cases of influenza A/HIN1 in Moscow were analyzed. Primary pathological changes were found in the trachea and lung. The lung showed a pattern of the exudative and proliferative stages of diffuse alveolar damage. In addition, there were signs of infectious-toxic shock associated with viremia, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes. Bacterial bronchopneumonia was detected in only 20% of cases.

[Pulmonary cryptococcosis].

Cryptococcosis is a deep mycosis that develops in immunosuppressed individuals. Isolated pulmonary cryptococcosis is a rare disease. The authors describe an autopsy case of pulmonary cryptococcosis in a 69-year-old woman with diabetes mellitus suppressing the immune system. Pulmonary inflammatory changes were characterized by disseminated destructive changes, a weak exudative reaction and the formation of epithelioid cell granulomas with the presence of Pirogov-Langerhans giant multinucleate cells. Round fungal cells weakly stained with hematoxylin and eosin can be mistakenly taken as artifacts. The diagnosis of chronic pulmonary cryptococcosis was established only after histological study using the selective staining.

[State of microcirculation in patients with atherosclerotic-aetiology stage IV chronic arterial insufficiency of lower limbs].

The authors have studied the findings of the examination of and therapeutic outcomes in a total of one hundred and thirty-one patients diagnosed with atherosclerotic-aetiology stage IV chronic arterial insufficiency of the lower extremities. Of these, the dynamic analysis of the tissue blood flow on the background of haemodynamically efficient direct revascularization of the lower limbs was carried out in ninety-six patients. In a further 35 patients, a comprehensive instrumental examination of the blood flow on the background of chronic critical ischaemia was complemented by evaluating the morphological alterations in the skin of the foot of the affected extremity. The findings obtained during the examination made it possible to single out three types of morphofunclional alterations in the micro-circulaiory bed (i. e., irreversible, severe reversible, and moderate), as well as to trace the patterns of transformation of the tissue blood flow in each of them on the background of efficient direct revascularization.

[Family myxoma of the heart with metachronic multiple growth]. / Semeinaia miksoma serdtsa s metakhronnym mnozhestvennym rostom.

A case of familial heart myxoma in 4 members of one family combined with myxomic (hamartomatous) syndrome is reported. The tumor in a proband was characterized with a multiple growth in various heart chambers. Five operations were made in the proband for 16 years and seven myxomas of different locations were removed. Myxomas originating from the endocardium of the interatrial septum oval hole were removed in 3 members of his family. The case confirms the conception of heart myxoma origin from endothelial hamartia of the endocardium.

[Heart myxoma histogenesis in the light of its histological and ultrastructural features]. / Predstavleniia o gistogeneze miksomy serdtsa v svete ee gistologicheskikh i ul'trastrukturnykh osobennostei.

In 168 cases of heart myxoma histological and electron-microscopic examination have revealed signs of embryonal endothelium capable of vasoformation and glycoprotein and glycosaminoglycanes synthesis in myxoma cells. Neither differentiation of myxomas cells up to mature endotheliocytes no signs of malignant transformation was found. According to the authors, heart myxoma is a true benign dysontogenetic tumor originating from embryonal endothelium. The term myxoma does not reflect morphological entity of the tumor and the authors suggest to call it embryonal endocardial endothelioma.

[The condition of the middle ear mucosa in chemodectoma of the tympanic glomus at the early stage of the disease]. / Sostoianie slizistoi obolochki srednego ukha pri khemodektome barabannogo glumusa na rannikh étapakh razvitiia opukholevogo protsessa.

28 samples of tissue from the middle ear obtained at removal of chemodectoma were studied histologically. Investigation of the tympanic cavity mucosa has shown correlation between the severity of fibroatrophic changes in the middle ear mucosa and duration of the disease. Pathomorphological alterations in the middle ear mucosa at early stages of chemodectoma (stage I and II) are similar to those in chronic lingering mucositis.

[Primary heart neoplasms]. / Pervichnye opukholi serdtsa.

The work analyses the anatomomorphological characteristics of primary tumors of the heart in 106 patients; in 101 patients the tumor was benign (myxoma, neurinoma, rhabdomyoma) and in 5 malignant (angiosarcoma, liposarcoma). Surgical treatment was conducted in 99 patients; hospital lethality was 7.1%. Six patients who refused an operation died at other therapeutic institutions, one patient died on admission to the clinic from occlusion of the left atrioventricular orifice by the tumor. It is pointed out that the diversity and the various degree of the clinical manifestations of the disease are predetermined by the localization and morphological characteristics of the new growths, their size, and mobility. The authors emphasize that knowledge of the anatomomorphological features of primary tumors of the heart and their early diagnosis are conducive to a differential approach in each concrete situation and to the choice of the optimal volume of an urgent surgical intervention.

Extracorporeal mechanical pulsatile pump and its significance for myocardial function recovery and circulatory support.

The authors performed 12 acute (on dogs) and 12 chronic (on calves) assisted circulation experiments with the use of the total extracorporeal mechanical pump (TEMP) artificial ventricles. The functional morphological research of the myocardium suggests that in addition to the possibility of the biological heart function full replacement, the artificial ventricle also helps recover damages in both the myocardial infarction and distal zones. The critical time period up to the onset of artificial circulation is not more than 2 h, and after that myocardial changes are irreversible.

[Nonspecific resistance and inflammation in patients with odontogenic phlegmons of the maxillofacial area]. / Nespetsificheskaia rezistentnost' i vospalenie u bol'nykh s odontogennymi flegmonami cheliustno-litsevoi oblasti.

Presented are data on morphological characteristics of maxillofacial odontogenic phlegmons observed in 98 patients with chronic periodontitis. The phlegmons have arisen in the presence of chronic inflammation of the soft tissue. Microbial flora in the inflammation focus proved opportunistic, abundant in nonclostridial anaerobic agents. Its composition contributed to morphological varieties of the phlegmons. There is a relationship between apparent destructive fasciitides and myositides and aerobic-anaerobic associations. Mechanisms of resistance to infection involve inhibited bactericidal activity of nonenzymatic cationic proteins of polymorphonuclear leukocytes reflecting nonspecific resistance in inflammation. Immunity status of the organism seems normal.