[Prevalence of hepatitis B and C viral infection according to the data on fetal outcomes in Moscow in 2015-2017]. / Rasprostranennost' infektsii, vyzvannoi virusami gepatita V i S, po materialam letal'nykh iskhodov v Moskve v 2015-2017 gg.

OBJECTIVE: To elucidate the prevalence of hepatitis B and C viral infection among the people who died in Moscow in 2015-2017, by studying the primary medical records of a representative sample of fatal outcomes, followed by the mathematical extrapolation of the data obtained to the total number of all deaths. MATERIAL AND METHODS: The 2015-2017 primary medical documentations from 8 therapeutic-and-preventive establishments with morbid anatomy units in the administrative districts and from 2 infectious diseases hospitals of the Moscow Healthcare Department were studied. The sample of those who died was 11.8-12.1% of the total number of all-cause deaths in Moscow during these years and was representative at a 0.95 confidence probability and a ±5% confidence interval. The Bernoulli theorem and the Laplace function for the 95% confidence probability were used to extrapolate the obtained data to the number of all those who died in these years. RESULTS: The mortality rates associated with acute viral hepatitis B and C were 0.04-0.07 and 0-0.008, respectively, per 100,000 population, which corresponds to the official statistical data. The mortality rates for chronic viral hepatitis and liver cirrhosis in their outcomes, including hepatocellular carcinomas in their presence, exceeded the official statistical data by many times, accounting for 0.5-1.6 and 10.4-12.1 persons with viral hepatitis B and C, respectively, per 100,000 population and rose by 22.5% over 3 years. The rates obtained for hepatitis B virus were 1.7-5.6 lower, and those for hepatitis C virus were, on the contrary, 1.3-1.5 times higher than average in the European Union countries. There was a manifold (7.4-24-fold) prevalence of hepatitis C virus in the etiology of chronic liver damage. The mortality from liver cirrhosis of alcoholic and unknown etiology was 14.4-19.5 persons per 100,000 population and declined by 21% over 3 years. The percentage of deaths caused by acute viral hepatitis was 0.5% per 100,000 population in Moscow in 2017; that caused by chronic viral hepatitis, including liver cirrhosis in the outcome and hepatocellular carcinoma, which had developed in their presence, was 46.3%; and that of liver cirrhosis of alcoholic and unspecified etiology was 48.7% of the total number of all liver lesions. CONCLUSION: The study of primary medical records of a representative sample of fatal outcomes, followed by the mathematical extrapolation of the data obtained to the number of all deaths, makes it possible to objectively estimate the burden of mortality from hepatitis B and C viral infection.

[Clinikomorphological features of complicated colon diverticulosis]. / Kliniko-morfologicheskie osobennosti oslozhnennogo divertikuliza tolstoi kishki.

79 surgical and postmortem cases of colon diverticulosis with complications were studied clinicomorphologically. Sequence in the development of inflammatory complications was revealed: diverticulum perforation-peridiverticulitis-pericolitic infiltrate, sometimes with the abscess-fistula. Segmental colitis may join the process. The complications onset depends mainly on discoordination of the intestinal peristalsis and intramural vascular deficiency.

[Use of an x-ray method in the assessment of changes in the intestinal wall in colonic diverticulosis]. / Ispol'zovanie rentgenologicheskogo metoda dlia otsenki izmenenii kishechnoi stenki pri divertikuleze tolstoi kishki.

The authors analyze x-ray findings in 194 patients with colonic diverticulosis and its inflammatory complications. Findings of preoperative irrigoscopy were correlated with dates of morphological investigations. Roentgenomorphological and functional changes were assessed in different clinical types of colonic diverticulosis. Correlation was received between this changes and clinical sings of disease. Authors determined risk-groups of inflammatory complications of colonic diverticulosis.

[Pathomorphology of colonic diverticulosis]. / Patomorfologiia divertikuleza tolstoi kishki.

Two clinico-morphological forms of colon diverticulosis are distinguished on the basis of post-mortem and surgical material (89 observations) studied histologically, neurohistologically and electron-microscopically. The first form is characterized by the disturbance of colon peristalsis, inflammation, segmentation of the colon wall and the presence of staged changes in the colon wall muscles. Disturbances of the vegetative innervation and regional hemodynamic disturbances play a role in the patho- and morphogenesis. The second form develops in aged persons and is characterized by weakness of the colon wall with thinning of the muscle layer. In both forms atrophy of the circular muscle layer develops with dilation of perivascular spaces and formation of "weak sites" in the colonic wall.

[Treatment methods in colonic diverticulosis]. / Lechebnaia taktika pri divertikuleze tolstoi kishki.

The authors had 662 patients with diverticulosis of the colon under observation. Nonoperative treatment for clinically manifested diverticulosis was undertaken in 226 patients. A good effect was produced in 82.2% of them. An operative intervention was conducted on 146 patients. The indication for operation was clinically manifested diverticulosis in the absence of an effect of nonoperative management in 19 (13%) patients and complicated diverticulosis in 62 (41.3%) patients. Various types of reconstructive-restorative operations in many-stage treatment of diverticulosis of the colon were conducted in 64 (43.8%) patients. Postoperative complications were encountered in 29 (19.7%) patients. Ten (6.8%) patients died. The authors conclude that the choice of the volume and method of operation should be guided by the patient's general condition, the character of the developing complications, the spread of the diverticuli along the colon, and the existence or absence of signs of an inflammatory process in the diverticuli.

[Total diverticulosis of the large intestine, complicated by ischemic colitis with development of multiple inflammatory polyps]. / Total'nyi divertikulez tolstoi kishki, oslozhnennyi ishemichekim kolitom s razvitiem mnozhestvennykh vospalitel'nykh polipov.

One observation of total colon diverticulosis in a male of 62 is described. Clinical signs (abdominal pains, blood in faeces, vomiting) persisted for 7 years and was aggravated by ileus. Instrumental examination revealed multiple colon diverticula, stenosing villous tumour of sigmoid colon. Besides pseudodiverticula, chronic colitis with multiple inflammatory polyps stenosing the lumen of the sigmoid colon and simulating a villous tumour was found. The conclusion is made of the ischemic nature of the colitis complicating the course of diverticulosis.

[The phenomenon of the accumulation of biological and nonbiological corpuscular particles in mammalian lungs]. / Fenomen nakopleniia v legkikh mlekopitaiushchikh biologicheskikh i nebiologicheskikh korpuskuliarnykh chastits.

When injecting yeast, staphylococcus, polyacrolein microspheres, 3 microns in diameter, into the blood stream of white common rats, it was found that these tend to accumulate in the lumen of pulmonary capillaries, being disposed there in the cytoplasm of macrophages and neutrophils.

[Hemodynamic changes in the blood vessels of the lesser circulation in interstitial pulmonary diseases]. / Gemodinamicheskie izmeneniia sosudov malogo kruga krovoobrashcheniia pri interstitsial'nykh zabolevaniiakh legkikh.

Hemodynamic vascular changes of the lesser circulation in granulomatous and diffuse pulmonary diseases shown to be systemic and advanced are suggestive of the existing mechanisms underlying durable compensation of defected blood flow through alveolar septa. One of the mechanisms may be operable by means of arteriolar blood outflow into the venules along dilated major capillaries. In compliance with this conception is venous hypertrophy in tunica media and new growths of the intimal muscular layer.

[Some problems of the morphogenesis of bullous emphysema of the lungs]. / Nekotorye voprosy morfogeneza bulleznoi émfizemy legkikh.

The analysis of 93 cases of bullous pulmonary emphysema provided evidence for the significance of valvular mechanism of bulla formation operable at two levels: in small bronchi and bronchioles on the one hand and in the area of subpleural fibrosis on the other hand, the latter arising in the result of subpleural atelectasis or subpleural carnificating pneumonia. Relevant pathology is characterized by peripheral acinus situated tangentially to the pleural surface. Electron-microscopic examination revealed pneumocytes of the second type on the internal bulla surface.

[Transbronchial biopsy in the diagnosis of sarcoidosis and certain other interstitial lung diseases]. / Transbronkhial'naia biopsiia v diagnostike sarkoidoza i nekotorykh drugikh interstitsial'nykh zabolevanii legkikh.

Results of transbronchial pulmonary biopsy studies of patients of different sex and age suffering from interstitial pulmonary lesion are presented. Different diagnostic value of transbronchial pulmonary biopsy (TBBP) is shown in relation to different lesions. In case of sarcoidosis its informative value, for example, is high, while in the diffuse processes such as cryptogenic fibrosing alveolitis, the data allow only suggestive diagnosis and recommendation of an open lung biopsy. In chronic nonspecific pulmonary diseases TBBP helps to clarify the character and the activity of the process involved. In some cases it is possible to reveal a latent cancer. It is suggested to use the term "allergic alveolitis" (indicating the mechanism of development of changes mentioned) when such changes as alveolitis, small granulemas and intraalveolar outgrowths are found in the biopsy specimens.

[Pulmonary granulomatosis in chronic active hepatitis of viral origin (report of a case)]. / Granulematoz legkikh pri khronicheskom aktivnom gepatite virusnoi étiologii (opisanie sluchai).

The authors describe pulmonary granulomatosis in a male patient with chronic active hepatitis of viral etiology with persistence of hepatitis B virus in blood serum and liver tissue. The presence of active virus infection with proven hepatitis B virus replication, evidenced by demonstration of HBeAg and HBcAb in blood serum, suggests an importance of universal etiological factor in the development of liver and lung lesions in the given patient, which is confirmed indirectly by demonstration of HBsAg in the cells of lavage fluid.

[Pathomorphology of the lungs and microcirculatory bed of the lesser circulation in chronic experimental allergic alveolitis]. / Patomorfologiia legkikh i mikrotsirkuliatornogo rusla malogo kruga krovoobrashcheniia pri khronicheskom éksperimental'nom allergicheskom al'veolite.

Granulomatous lung lesions were produced in rats by 5 intravenous or intratracheal injections of the killed BCG suspension as an antigen. On the basis of immunocomplex and cell-mediated immunopathological reactions this condition may be considered as a chronic allergic form of alveolitis. Granulomas were formed along the arteries when the antigen was administered intravenously and along the bronchi after its intratracheal administration. In both cases there were single granulomas in the alveolar septa interstitium. The microcirculatory bed was studied in semithin sections and morphometrically in thick sections after impregnation with an Indian ink and 5% gelatin. The alveolar septa capillaries in control rats were shown to form a network the parameters ow which rather correspond to the "sheet-blow" model (Fung and Sobin, 1969). In chronic allergic alveolitis, a reduction of the capillary network develops at the zone of granulomatous inflammation while in the relatively normal zone a network type of the microcirculatory bed is preformed into the main one with the formation of predominant routes of circulation that provide the blood filling of the heart cavities.

[Microvascular changes in the lungs of rats with bronchiolo-alveolar fibrosis caused by the intrabronchial administration of trypsin]. / Izmeneniia mikrososudov legkikh krys pri bronkhiolo-al'veoliarnom fibroze, vyzvannom vnutribronkhial'nym vvedeniem tripsina.

Rats were injected intrabronchially with trypsin solution. During the first 3 days, the animals developed acute desquamative alveolitis and at the second week bronchioloalveolar fibrosis. As for the capillaries of the alveolar walls, some of the capillary loops manifested obliteration, whereas other ones ectasia to the alveolar lumen. Deposition of immunoglobulins in the walls of pulmonary vessels was not revealed.

[Morphology, pathogenesis and classification of interstitial lung diseases]. / Morfologiia, patogenez, klassifikatsiia interstitsial'nykh zabolevanii legkikh.

The current literature data and the authors' material on the interstitial lung diseases (ILD) are presented. The authors' material includes the results of morphological (light and electron microscopy) examination of 36 intrabronchial biopsies in ILD patients, 2 open biopsies, 6 autopsy cases and lungs of laboratory animals with various forms of the bronchoalveolar sclerosis and interstitial pneumonia. ILD is shown to be a chronic inflammatory lung condition with a cooperation between the immunocompetent and inflammatory cells in the alveolar septa and fibrosis of the alveolar walls. The disturbance of the immune homeostasis, particularly that of cell immunity, plays a role in the ILD pathogenesis. Complex intercellular relationships, in which the mediators of cell-to-cell interaction are of importance, are being established in the alveolar interstitium. This makes ILD morphology resembling that of the immune inflammation in other organs. So-called "neutrophilic alveolitis" induced by the immune complexes is of great importance in the pathogenesis of certain diffuse ILD forms, for example, the cryptogenic fibrosing alveolitis. The "neutrophilic alveolitis" is characterized by the presence of few neutrophils among the mononuclear cells infiltrating the alveolar septa. The alterations of the arteries, veins and capillaries in ILD may be subdivided into haemodynamic and inflammatory. ILD can be reproduced experimentally by either intravenous or intratracheal administration of antigen.