[Morphofunctional changes of the neurosecretory system and microcirculatory bed of the hypothalamus in patients with chronic alcoholic intoxication of varying degree]. / Morfofunktsional'nye izmeneniia neirosekretornoi sistemy i mikrotsirkuliatornogo rusla gipotalamusa u lits s khronicheskoi alkogol'noi intoksikatsiei raznoi stepeni.

Microcirculation was studied in the hypothalamus in acute alcohol intoxication. Blood flow was sharply decelerated with capillaries paretically dilated, overfilled with blood. Stasis, sludge formation and venue microthrombosis were directly related to the alcohol concentration in blood and urine. In neurosecretion areas the hemorrhagic sites were detected with neurosecretory cells activity sharply reduced. Chronical alcohol administration increased the number of functionally inactivated capillaries. These with luminal vesiculation were also found as were lymphoid cell infiltrates in venule walls. The number of capillaries inactivated in the neurosecretory system paralleled the number of dark cells that reflected the inhibition effects.

[Characteristics of ventricular capillary blood filling of the human heart in sudden coronary death]. / Osobennosti krovenapolneniia kapilliarnogo rusla zheludochkov serdtsa cheloveka pri vnezapnoi koronarnoi smerti.

A histometric and histochemical study of myocardial ventricular capillaries was carried out in cases of sudden coronary death (SCD) in the absence of myocardial infarction and postinfarction cardiosclerosis. Heterogenic pattern of capillary blood filling, increased quantity of plasmatic capillaries, their reduced density per unit of area and sparser distribution, as well as greater metabolite ultrafiltration diameter were demonstrated, as evidence of disturbed myocardial transcapillary metabolism. Decreased muscular fiber/capillary rations, "vesicles" emerging in the capillary lumen and sludging in some vessels determine impairment of capillary perfusion. Two groups of cases were identified: those with uniform blood overfilling of capillaries and with uniform compression of the capillary lumen that must be due to the fact that death occurred during the systolic or diastolic phase, respectively.

[The microcirculatory bed of the human myocardium in sudden cardiac death]. / Izuchenie mikrotsirkuliatornogo rusla miokarda cheloveka pri vnezapnoi serdechnoi smerti.

A ventricular capillary bed was studied in 30 hearts of humans upon sudden cardiac death according to modified technique of Karnovsky-Roots. A 10-80% narrowing of coronary artery lumen was found due to formation of atherosclerotic plaques. The assessment of butyrylcholinesterase activity in myocardial sections proved helpful in providing the appearance of microcirculation from small arterioles to venules. Determination of volumetric density of microvessels suggested an inverse correlation between the degree of stenosis of major coronary arterial branches and volumetric density of ventricular capillaries in the heart.

[Mechanisms of the development of the terminal state in experimental emotional stress]. / O mekhanizmakh razvitiia terminal'nogo sostoianiia pri eksperimental'nom emotsional'nom stresse.

The development of ventricular fibrillation associated with experimental emotional stress was studied in chronic rabbit experiments. Changes in myocardial-fibre action potentials, thresholds for ventricular fibrillation and its precursors, blood and myocardial catecholamine levels and heart-muscle ultrastructure were examined. Emotional stress was shown to increase, via sympathoadrenal activation, functional and structural heterogeneity of the myocardium, leading, alongside other causes, to arrhythmias and death from ventricular fibrillation. Moderately prevailing parasympathetic effects on the heart during stress exposure contribute to the elevation of fibrillation and fibrillation precursor thresholds and prevent catecholamine rise and myocardial structural damage.

[Effect of hydrocortisone on changes in brain tissue in experimental brain abscess and leptomeningitis]. / Vliianie gidrokortizona na izmeneniia v mozgovoi tkani pri éksperimental'nom abstsesse mozga i leptomeningite.

A total of 286 rats were involved in an experiment, with 123 of them being control and 153 receiving daily injections of hydrocortisone (H) in a dose of 3 mg per 100 g body weight. Ten rats were intact. With regard to CNS changes 2 periods were identified in H-treated rats with experimental brain abscess and leptomeningitis: the first was characterized by the effect of the hormone at the acute period of the disease (3-7 days), the second by its action following the long-term administration (15-30 days). In the first 7 days, by reducing the inflammatory reaction, water-electrolyte disturbances and the activity of acid and alkaline phosphatases in the cerebral tissue, as well as by increasing the RNA synthesis in neurons, H prevented the dissemination of the process into the surrounding tissue, swelling and edema, expedited wound clearance and helped to reduce the mortality rate. The use of H for 10-30 days led to the tigrolysis of neurons, elevation in the activity of acid and alkaline phosphatases and brain edema, as well as to a reduction in DNA levels in neurons and a dramatic rise in the mortality rate. The findings indicate the advisability of H utilization in the treatment of brain abscess and leptomeningitis only in the acute period of the disease and as a short course.

[Microcirculation in the human hypothalamus in sudden coronary death]. / Osobennosti mikrotsirkuliatsii v gipotalamuse cheloveka pri vnezapnoi koronarnoi smerti.

A histochemical, cytophotometric and morphometric study of hypothalamic microcirculatory vessels was conducted in 2 samples: 50 sudden cardiac deaths from coronary heart disease and 50 cardiac deaths from clinical myocardial infarction that were not sudden. Non-sudden cardiac death was associated with moderate venous hyperemia and high postcapillary alkaline phosphatase activity. In cases of sudden coronary death, three patterns of microcirculatory changes were identified that differed with respect to the quantity of functionally-inactive capillaries, the markedness of edema in hypothalamic tissues and hypothalamic content of vascular mast cells. Relationships between the said differences and different dates of death are discussed.

[Atherosclerotic stenosis of the coronary arteries and contraction lesions of the myocardium in sudden coronary death]. / Ateroskleroticheskii stenoz koronarnykh arterii i kontrakturnye povrezhdeniia miokarda pri vnezapnoi koronarnoi smerti.

Hearts of 50 patients (males of 30 to 54 years) after sudden cardiac death (SCD) without myocardial infarction, acute or recorded in the past, were studied. Heart slides were stained with an iron hematoxylin; polarizing microscopy was also used. The surface of cardiomyocytes diffusely stained with an iron hematoxylin was determined in histological slides by means of a 100-points ocular mesh. Essential differences in the spread of contractural myocardial lesions were found, this likely to be bound with different mechanisms of death (ventricular fibrillation, asystole). A low degree of spread of these lesions was noted more frequently in grave stenoses (greater than 75%) of coronary arteries. A direct correlation between the spread of contractural lesions and renin activity in plasma is found.

[Morphofunctional features of the hypothalamo-hypophyseal system in experimental cerebral abscess]. / Morfofunktsional'nye osobennosti gipotalamo-gipofizarnoi neirosekretornoi sistemy pri éksperimental'nom abstsesse golovnogo mozga.

The morphological characteristics of the hypothalamo-pituitary neurosecretory system (HPNS) were studied in 123 rats with an experimental abscess in the temporal area of the brain. It was found that changes in the HPNS in this pathology ran 2 stages corresponding to the periods of the development of the pyoinflammatory process in the cerebral tissue. In the first period (at the 3rd-10th day of the development of a cerebral abscess) the functional activity of the HPNS was inhibited: a decrease in both synthesis and excretion of neurohormones was evident. The mortality rate at this period was the highest (21 of 23 rats). At the second period (the 15th-30th day of experiment) there was an increase in the activity of neurosecretory nuclei and a decrease in the mortality rate (2 rats). It is suggested that the absence of NPNS activation was one of the causes of the high mortality rate at the first period of the experiment which was related to the direct damaging action of the abscess localized in the cerebral portions having the direct impact on the neurosecretory system.

[Features of microcirculation in the neurosecretory nuclei of the human hypothalamus in sudden cardiac death]. / Osobennosti mikrotsirkuliatsii v neirosekretornykh iadrakh gipotalamusa cheloveka pri vnezapnoi serdechnoi smerti.

The microcirculatory bed of the neurosecretory nuclei was studied post-mortally in three groups of patients with various levels of the functional activity of the hypothalamus-pituitary neurosecretory system (HPNS), namely basal, high and lowered. Sudden death from a heart attack was associated with signs of inhibition in the HPNS cells, edema manifestations in the HPNS zone, by a considerable increase in the number of functionally inactive capillaries, narrowing of their lumina and a decrease in their transport capacities determined by the level of alkaline phosphatase activity in their wall. These changes correlated with an elevation of the number of dark cells in the neurosecretory nuclei which suggests the existence of the functional connection between them.

[Cardiogenic shock and sudden cardiac death]. / Kardiogennyi shok i vnezapnaia serdechnaia smert'.

The study of 148 cases of sudden cardiac death revealed in 25 (17%) of them morphological signs of cardiogenic shock characterized by severe microcirculatory disorders: uneven blood-filling of the vessels of the microcirculatory bed and increasing number of nonfunctioning capillaries in the myocardium and hypothalamus; signs of juxtamedullar shunting in the kidneys and the development of sludge phenomenon in different parts of their microcirculatory bed combined with high activity of renin in the plasma. The signs of cardiogenic shock in the group of observations of sudden cardiac death were noted predominantly in the presence of myocardial infarction, large foci of ischemia in the heart or multiple scattered foci of cardiomyocyte damage. Cardiogenic shock was found to occur in sharp reduction of the density of adrenergic nerve structures in the myocardium.

[Effect of prolonged chronic stimulation of positive emotionogenic zones of the hypothalamus on blood lipid levels and arterial pressure]. / Vliianie dlitel'nogo khronicheskogo razdrazheniia polozhitel'nykh émotsiogennykh zon gipotalamusa na soderzhanie lipidov v krovi i uroven' arterial'nogo davleniia.

Chronic experiments on rabbits with electrodes implanted into positive affective zones of the hypothalamus, which provided the reaction of self-stimulation during experimentation have shown that prolonged, discrete (over 2 hours daily), chronic (over 2 months stimulation of these zones in unrestrained animals does not cause stable changes in the content of blood lipids but lead to a significant lowering of arterial blood pressure. Continued stimulation (for one month more) together with daily feeding of rabbits with small doses of cholesterol (60 mg/kg bw) produced the same effect as the stimulation of the negative emotiogenic zones, namely, a greater increase of alimentary hypercholesterolemia than in animals of two control groups (non-operated and with implanted electrodes), as well as arterial blood pressure elevation.

[Sudden cardiac death in alcoholic cardiomyopathy]. / Vnezapnaia serdechnaia smert' pri alkogol'noi kardiomiopatii.

A composite morpho-histo-biochemical and ultrastructural investigation of the myocardium of 50 subjects dying suddenly in the presence of alcoholic cardiomyopathy (ACMP) was carried out. The dynamics of changes in the myocardium in the development of ACMP is shown indicating that the main feature of the heart in such cases is diffuse uneven atrophy of cardiomyocytes with their replacement by fatty tissue. There are large foci of lesions in the heart stained by Regot's method and the activity of succinate dehydrogenase is changed reflecting metabolic disorders. The ultrastructural changes included vacuolation of sarcoplasmic reticulum, increased amounts of lipids and lysosomes, and intracrystal inclusions in the mitochondria. Examinations of adrenergic heart innervation revealed focal deficiency of noradrenalin in atrial and ventricular plexuses. There was a hypothalamic edema with severe disorders in ACMP. The set of the above lesions appears to explain the sudden death as each of these lesions alone cannot cause sudden death.

[Hypothalamic characteristics in sudden human cardiac death]. / Osobennosti gipotalamusa pri vnezapnoi serdechnoi smerti cheloveka.

The hypothalamus was examined in cases of sudden heart death in 50 persons of both sexes whose ages ranged from 25 to 55. The microscopic and biochemical findings were compared with those in cases of heart death which had not occurred suddenly in patients with myocardial infarction of different duration (50 cases). It is shown that in sudden heart death diffuse edema of the white matter and dystonic changes in the microcirculation vessels develop in the hypothalamus. Biochemical examination discloses in the tissue of the hypothalamus in such cases a sharp decrease in the content of noradrenalin and the precursor of catecholamine synthesis DOPA and a marked increase in the level of adrenalin. It is assumed that there is a causative connection between vascular dystonia and the decrease in the noradrenalin level. An increase in the adrenalin content may be conducive to the intensification of cerebral hydrophilism.

[Neurosecretory system of the hypothalamus in acute and chronic heart failure]. / Neirosekretornaia sistema gipotalamusa pri ostroi i khronicheskoi serdechnoi nedostatochnosti.

The hypothalamohypophyseal neurosecretory system (HHNS) was examined in the deceased from myocardial infarctions and chronic cardiac insufficiency. All 80 cases of infarctions showed in increased functional activity of the HHNS, irrespective of the time from the beginning of the disease. If the infarction was complicated by decompensation, the HHNS was characterized by hypervasopressure accompanied by occurrence of small vacuolized cells in the supraoptical nuclei with a low secretion content and high activity of biosynthetical enzymes, and a drop of secretion in the neurohypophysis. In chronic cardiac insufficiency (50 cases) there were 2 variants of changes in the HHNS, which correlated with the level of sympathetic nervous system activity (which was vitally determined from the diurnal catecholamine excretion). With high sympathetic activity, the changes in the HHNS were identical to those in myocardial infarctions, complicated by decompensation. The low activity was associated with HHNS depletion, which correlated with patients' nonsusceptibility to pathogenetic therapy.

[Sudden cardiac death and hypothalamo-hypophyseo-adrenal activity]. / Vnezapnaia serdechnaia smert' i gipotalamo-gipofizarno-adrenalovaia aktivnost'.

The paper presents current concepts on possible mechanisms of sudden heart death and on systems of neurohormonal heart regulation changes in which may cause sudden heart death. The importance of the main humoral and hormonal changes in possible disorders of electrolyte cardiac balance determining the development of electric instability and ventricle fibrillation underlying most cases of sudden heart death is described. Some morphological changes both in the heart itself and neurohormonal systems regulating it are dealt with.

[Significance of the chronic hypoxia and neurohormonal activity in the pathogenesis of ischemic heart disease]. / Znachenie khronicheskoi gipoksii i neirogormonal'noi aktivnosti v patogeneze ishemicheskoi bolezni serdtsa.

Two kinds of changes in the myocardium were found in the heart beyond the focus of necrosis in people of two age groups (senescent and senile) dying of miocardium infarction. Changes of the first kind (hypoxic) reflect the influence of chronic hypoxia of coronoarogenic origin, are always regional and characterized by fields of optically "empty" muscle fibers with reduced enzymatic activity under sacrolemma and frequently by the presence of non-oriented glycogen granules. Those of the second kind correspond to cardiotoxic effect of high doses of catecholamines and are represented by numerous disseminated micronecroses, focal or diffuse lipid infiltration with myocytes against the background of stromal edema with cell reaction and hemorrhages in it. Cases are considered in which hypoxic and cardiotoxic changes were predominant. Their comparison with the activity of the hypothalamo-hypophysis-adrenal system determined by morphological and histochemical tests (very high and moderately high) revealed some correlation.