[Hyperplastic ovarian processes from the clinico-morphological aspect]. / Giperplasticheskie protsessy iaichnikov v kliniko-morfologicheskom aspekte.

Clinico-morphologic analysis was carried out in 93 patients with hyperplastic changes in the ovaries (stromal hyperplasia, thecomatosis, interstitial gland, etc.) and endometrial hyperplasia (glandular, atypical, etc.). A relationship was revealed between endometrial hyperplasia and ovarian hormone-producing structures, but the intensity of proliferation and structural rearrangement of glandular epithelium did not correlate with the activity of gonadal hormone-producing structures determined by morphofunctional studies, nor did it correlate with blood plasma estradiol level. Ineffective hormonal therapy of patients with hyperplasia of the endometrium may be caused by hyperplastic processes in the ovaries.

[Structural changes in the endometrium of puerperae with high risk of development of endometritis in the postpartum period]. / Strukturnye izmeneniia éndometriia u rodil'nits s vysokim riskom razvitiia éndometrita v poslerodovom periode.

The endometrium of 72 puerperae referred to a high-risk group in respect of developing infectious complications was examined on days 3-18 of the puerperium. The periods of epithelialization and regeneration onset in abnormal course of the puerperium were detected, and the morphologic criteria of these processes specified. In cases with cesarean sections these processes started 2-3 days later than after spontaneous delivery. Bacteriologic examination of the uterine cavity contents is an indirect test for the detection of an infection; the final diagnosis may be made only after a comprehensive assessment of the endometrial status.

[Clinical-morphological parallels in postpartum endometritis]. / Kliniko-morfologicheskie paralleli pri poslerodovom éndometrite.

Clinicomorphologic parallels were studied in 45 puerperants with postpartum endometritis. This condition was histologically confirmed in 42 of the 45 patients with its clinical symptoms (in 100% of patients with the grave, in 95% with the medium-severity, and in 83% of those with the benign form of the disease). The authors came to the conclusion that the severity of postpartum endometritis was directly dependent on the extent and depth of the uterine wall involvement in the inflammatory process. By the end of treatment the morphologic signs of inflammation persisted in 40% of patients even without clinical signs of endometritis. Such women should be referred to a group at high risk of developing chronic endometritis.

[Clinical-morphological aspects of suppurative inflammatory diseases of the adnexa uteri]. / Kliniko-morfologicheskie aspekty gnoinykh vospalitel'nykh zabolevanii pridatkov matki.

Draining of pyo-inflammatory foci of the uterine tubes, monitored by transvaginal echography, computer-aided tomography and laparoscopy, or surgery were carried out in 169 patients. Morphologic analysis helped define the characteristic features of the most prevalent clinical forms of pyo-inflammatory conditions of the uterine appendages and thus promoted a more accurate diagnosis of such conditions and their differentiated therapy. Immediate and late results of therapeutic draining of the pyo-inflammatory foci in the uterine tubes, monitored by the afore-said methods, are analyzed.

[Echographic and morphological parallels in the evaluation of the condition of the uterine scar]. / Ekhograficheskie i morfologicheskie paralleli v otsenke sostoianiia rubtsa na matke.

Examinations of 86 women included echography, examination of the lower segment of the uterus during surgery, control manual examination of the postpartum uterus, and histologic examination of the tissues collected from the so-called cicatrix site. The authors claim that the criteria of the myometrial adequacy are the V-shaped lower segment of the uterus, at least 3-4 mm thick, continuous anterior contour of the uterus, the presence of a homogenous echostructure or a structure with small sites of elevated echogenicity. A balloon-shaped lower segment of the uterus and its thinness (less than 3 mm), no continuity in the uterine contour, predominance of elevated echogenicity incorporations in the echostructure of the cicatrix site indicate the inadequacy of the myometrium at the site of the transverse cicatrix in the lower segment of the uterus. The findings evidence that echography is a highly informative method for the diagnosis of the uterine cicatrix status and that echographic examinations should be widely used to choose the delivery mode for pregnant women with a history of abdominal delivery.

[Morphofunctional characteristics of uterine muscle in pregnant patients with hypochromic anemia]. / Morfofunktsional'naia kharakteristika myshtsy matki u beremennykh s gipokhromnoi anemiei.

Examinations of the myometrium wall samples of the uterine lower segment and upper section, obtained in cesarean section, carried out in 66 women with hypochromic anemia before labor (n = 26) and during the first period of labor (n = 40) have shown that even in light anemia forms dyscirculatory and destructive dystrophic changes are detectable in all myometrium layers, the intensity of these changes correlating with anemia graveness. In cases with second- and third-degree anemia sclerosis of the stroma and vascular wall developed, besides the aforesaid changes. Immunocompetent cells contributed to the development of this condition, particularly so in women with a history of multiple labor and in mothers aged over 30. The detected disorders in metabolic and biosynthetic processes and in lipid metabolism in the myometrium evidenced cellular membrane injuries and slowered oxidation processes in the myometrium.

[The assessment of uterine functional competence in pregnant women with a history of cesarean section: clinico-morphological comparisons]. / Otsenka funktsional'noi sostoiatel'nosti matki u beremennykh, perenesshikh v proshlom kesarevo sechenie: klniko-morfologicheskie sopostavleniia.

Clinical and morphologic determinants of uterine competence have been compared in 316 pregnant women with a previous cesarean section. The comparison identified populations with different functional states of the uterus. The findings suggested involvement of the lower uterine segment in the contractile function during a prelabor phase. Clinical, functional, structural and histochemical uterine abnormalities accounted for abnormal prelabor progress of these women.

[Interpretation of morphological changes in the tissues and organs of the reproductive system after radical surgical treatment of uterine leiomyoma]. / Traktovka morfologicheskikh izmenenii v tkaniakh i organakh reproduktivnoi sistemy posle radikal'nykh operatsii po povodu leiomiomy matki.

Ovarian and endometrial changes in most patients with uterine myoma had a histophysiologic nature. Clinical symptoms of "rapid growth" of myoma were largely determined by degenerative changes in the tumor and the surrounding myometrium. Uterine bleedings in patients with myoma may be related to hyperplastic lesions of the ovaries and endometrium, vascular myometrial and hemodynamic endometrial disorders.

[Clinico-morphological characteristics of internal endometriosis of the uterine body after menopause]. / Kliniko-morfologicheskie osobennosti vnutrennego éndometrioza tela matki v postmenopauze.

A study in 100 women with postmenopausal bleedings has identified internal endometriosis of the uterine corpus in 50 of them. The diagnosis was made on the basis of past history, hysteroscopy, ultrasound scanning, roentgenotelevision hysterosalpingography, histological examination of resected uterine and adnexal tissues. Thirty patients were operated on and found to have internal endometriosis of different locations and extent as well as nodular adenomyosis. Endometriosis was functionally progressive in 29 patients and regressive in 1 patient, as was confirmed with luminescence histological examination. Ovarian hyperplasia and/or luteinization of the theca interna, stromal hyperplasia, focal thecomatosis and granulosa cell tumour which were present in 56.7% of the patients accounted for active endometriosis. Duration of postmenopause did not influence the functional activity of internal endometriosis.

[Morphofunctional characteristics of the uterus in dystrophic changes and necrosis in leiomyoma]. / Morfofunktsional'naia kharakteristika matki pri distroficheskikh izmeneniiakh i nekroze leiomiomy.

Morphologic, histochemical and fluorescent microscopic studies of leiomyomas with necrosis and degenerative changes have been done in 100 patients. Morphologic and functional features of the endometrium and myometrium were examined at tumor-adjacent and remote sites. The study showed no relation between the ischemic changes of uterine leiomyomas and morphological/functional status of the myometrium and endometrium. In the presence of leiomyoma, the endometrium undergoes primarily histophysiological and aging-related changes. The study findings suggest that surgery for necrotic leiomyoma should be organ-sparing.

[Ultrastructure of the cervical epithelium in dysplasia]. / Ul'trastruktura épiteliia sheiki matki pri displazii.

A comparative and electron microscopic study was made of cervical tissue in 19 female patients with pseudoerosion, chronic endocervicitis and dysplasia with varying severity. The areas of dysplasia revealed cellular elements characteristic of squamous metaplasia, which suggested mild dysplasia arisen in mature and immature squamous metaplasia, severe dysplasia resulted in atypical immature metaplasia. The characteristics of a cellular population in dysplasia may be used to define the severity of the pathological process in question.

[Pathology of the cervix uteri as a consequence of hormonal therapy]. / Patologiia sheiki matki vsledstvie gormonal'noi terapii.

Morphological and functional characteristics are outlined for various types of endocervical hyperplasia attributed to prolonged administration of combined hormonotherapy with progestin-estrogenic and gestagen preparations for endometrial hyperplasia, external and internal endometriosis and myoma uteri. Endocervical hyperplasia belongs to iatrogenic pathology. Terminological issues of hyperplasia and differential diagnosis of atypical microglandular hyperplasia and adenocarcinoma are discussed.

[Plasma levels of sex hormones and their receptors in the endometrium of women with normal menstrual cycle]. / Soderzhanie polovykh gormonov v plazme i ikh retseptorov v éndometrii zhenshchin v normal'nom menstrual'nom tsikle.

Plasma estrogen, progesterone, cortisol and prolactin concentrations were determined by RIA in 20 healthy women on the 7th-10th and 24th-26th days of the menstrual cycle. The content of estrogen and progesterone receptors in the cytosol and nuclei of the endometrium was studied by a method of adsorption on dextran-covered carbon; pathomorphological investigation of the endometrium was performed. Sex hormone concentration was shown to be significantly lower in the middle (proliferative) phase as compared to the late one (secretory). Cortisol and prolactin concentrations in both periods did not change. The content of both sex hormone receptors was significantly higher in the middle (proliferative) phase. On the basis of the content and ratio of plasma sex hormones and receptor content in the endometrium a conclusion was made that the main factor in the regulation of receptor levels by sex hormones was the ratio of their concentrations in the plasma.