[A case of hypertrophic cardiomyopathy in an 8-month-old baby].

The paper analyzes a death due to undiagnosed asymmetric hypertrophic cardiomyopathy in an 8-month-old baby. The peculiarities of this case are the extent of myocardial damage, the irreversibility of structural injuries in the absence of clinical symptoms, and a concurrence of hypertrophic cardiomyopathy and severe pneumonia and meningoencephalitis.

[Primary cardiomyopathies].

The paper provides a review of literature on primary cardiomyopathy yet referring to as an inadequately studied abnormality that is diagnosed with difficulty by clinicians and frequently missed by pathologists at autopsy.

[Structural changes in the germinal matrix of the brain of fetuses and neonatal infants with ventriculomegaly and congenital hydrocephalus].

OBJECTIVE: To study structural changes in the germinal matrix (GM) in 22-to-40-week fetuses with ventriculomegaly (VM) and hydrocephalus (HC). MATERIAL AND METHODS: The width of the ventricular groove was borne in mind while forming study groups (the brain in VM (n = 30), HC (n = 20)) and a comparison group (n = 30). To trace changes in GM transformation, each group was divided into 4 subgroups according to the gestational sign. Materials were excised in the projection of the lateral ventricles onto the convexital surface of the brain. After the use of conventional methods, the specimens were stained with hematoxylin and eosin or Nissl. RESULTS: VM was found to be characterized by the early (at 22 weeks' gestation) regionalization of glio- and neuroblasts and by the completion of GM reduction at 35 weeks of intrauterine development. In HC, GM in all ventricular system regions was preserved and its structure was virtually unchanged at 22 to 40 weeks' gestation. CONCLUSION: The found structural changes may be used as diagnostic criteria for VM and HC and to elucidate gestational age in forensic medical practice.

[Variants of pathomorphological changes in the thymus of in utero infected extremely low birth weight neonatal infants].

OBJECTIVE: To analyze pathomorphological changes in the thymus of extremely low birth weight (ELBW) neonatal infants who have developed in the presence of in utero infection. SUBJECTS AND METHODS: A study group included 105 ELBW neonates who had developed in the presence of in utero infection. The main causes of their death were the following conditions: generalized viral and bacterial infection of mixed genesis (n = 56 (53.3%)), congenital pneumonia (n = 27 (25.7%)), bilateral hemorrhage into the ventricular system of the brain (n = 12 (11.4%)), congenital sepsis (n = 3 (2.8%)), and visceral malformations (n = 7 (6.7%)). A comparison group consisted of 30 ELBW babies; the main cause of their deaths was asphyxia resulting from acute uteroplacental circulatory disturbances. Transplancentally transmitted infections were not identified in this group. Thymic structural features in the examined groups were studied using a set of current morphological studies. RESULTS: Histological, immunohistochemical, electron microscopic, and morphological studies revealed three variants of thymic structural changes: normoplastic, retardant and dysplastic. Anomalies of the shape, ectopia, and hypoplasia of the thymus, impaired corticomedullary differentiation in the lobules, and decreased CD1a, CD3 T-cell expression were shown to be the morphological signs of dyschronic development of the thymus. CONCLUSION: The morphological criteria for the retardant and dysplastic types of dyschronic thymic development were determined, which constitute the structural basis of immunodeficiency states in in utero infected ELBW newborn infants.

[Effect of nitric oxide on the morphology of the placenta and the activity of placental macrophages during uncomplicated pregnancy in the experiment].

OBJECTIVE: To study the effects of nitric oxide (NO) on the morphology of the placenta and the activity of placental macrophages during uncomplicated pregnancy in albino rats. MATERIAL AND METHODS: The animals were divided into 3 groups. Group included animals with uncomplicated pregnancy; Group 2 was given drinking water containing 0.2% sodium nitrate on day 1 of pregnancy; Group 3 was intramuscularly injected with the NO synthesis inhibitor Nw-nitro-L-arginine methyl ester (L-NAME) in a dose of 10 mg/kg on day 1 of pregnancy. The central portion of hematoxylin- and eosin-stained placentas was morphologically examined. The activity of placental macrophages was assessed by incubating them with autologous erythrocytes. RESULTS: Pathological examinations of the placentas reveal that when sodium nitrite and L-NAME enter the animal body, structural changes in the placental show that there are maternal and placental circulatory disorders concurrent with dystrophic and destructive processes. CONCLUSION: The activity of placental macrophages in the examined groups is diametrically opposite.

[Morphological changes in ventricular germinal zone and neocortex of the cerebral hemispheres in human fetuses and newborns on weeks 22-40 of prenatal development].

In this study, we investigated the morphology of the ventricular germinal zone and neocortex of the cerebral hemispheres in the projection field no. 4 of the motor area in human fetuses in dynamics from week 22 to 40 of fetal development. Morphological study allowed us to clarify the following patterns of prenatal ontogeny of the human CNS. On weeks 22-27, an intensive formation of the main sulci of the first order, differentiating the brain into lobes, is observed. By weeks 28-32, the formation of all sulci of the first order is completed; and on weeks 33-37, additional sulci characteristic of an individual are formed. The spurt of gyrification of the cortex (weeks 22-27) practically coincides with the completion of neuronal differentiation and formation of the motor neocortex. The structure of the latter is characterized by a clear stratification of cytoarchitectonic layers and modular organization of neurons with their vertical orientation in cell columns (weeks 25-27). In subsequent weeks of prenatal development until birth, no significant changes in the topography and structure of the neocortex are observed. Structural rearrangement of the ventricular germinal zone on weeks 22-40 of prenatal development consists in its gradual reduction and is completed on weeks 37-40. The criteria of physiological reduction of this area are the zonal location of glioblasts and a progressive decrease in its thickness on weeks 33-37 of prenatal development.

[S-100 protein expression in the different brain structures of fetus and newborns suffering from ventriculomegalia and hydrocephaly].

Parenchyma of brains from fetus and newborns (22-40 weeks of gestation), suffering from dilatation of the ventricular system has been studied by immunohistochemical method. The increasing of S-100 expression in germinal matrix and subcortex under hydrocephaly was significantly higher than in cases of ventriculomegalia (p < 0.01) and control group (p < 0.05). The index of S-100 expression could be use as prognostic criteria of neuron and neuroglia mortality for differential diagnosis of hydrocephaly.

[Introduction into fetal nosology].

The urgent social and medical problems of intrauterine death of alive fetuses require that pathomorphological studies of the fetoplacental complex be improved to diagnose major fetal abnormalities. It is proposed to refuse the universal diagnosis of symptomatic intrauterine hypoxia and to shift to its nosological diagnosis. Particular emphasis should be placed on the detection of placental-umbilical and cardiovascular pathology and hematogenic, hemorrhagic, and other fetal diseases.

[Morphological criteria for thymic dyschronias in extremely low birth weight fetuses].

The paper emphasizes the importance of tissue malformations (dyschronias) in the development of immunodeficiency states in extremely low birth weight neonates. Thymuses from 115 fetuses at 22-27 weeks post-conception age were examined by immunohistochemical and electron microscopic studies. Two types of thymic structural changes were identified in fetuses developing during transplacental infection. The differential diagnostic signs of thymic tissue malformations were justified in extremely low birth weight fetuses.

[Pathomorphology of congenital ventriculomegaly].

The paper gives the results of a morphological investigation using ventricular system embedding, organometry, light and electron microscopies, histostereometry and immunohistohemistry of brains from 50 fetuses and neonatal infants of 22-27 weeks gestation. The comprehensive investigations revealed the morphological features of intrauterinally acquired ventriculomegaly, which reflect tissue immaturity of the parenchyma and the vascular component of the brain.

[Growth factors are markers of placental insufficiency in third-trimester miscarriage].

The paper characterizes placental growth factors in the third trimester of pregnancy. The placental expression of vascular endothelial growth factor (VEGF) and transforming growth factor-beta2 (TGFbeta2) was studied in miscarriage after 34-37 weeks pregnancy and during term labor. Chronic placental insufficiency was diagnosed in miscarriage. The expression of VEGF and TGFbeta2 with trophoblast and decidual cells was decreased in miscarriage as compared with that during uncomplicated pregnancy. The growth factors under study are markers of chronic placental insufficiency in third-trimester miscarriage.

[Some biochemical parameters in the placenta in discoordinated and powerless labors].

A number of biochemical parameters (total nitrites and nitrates (NO(x)), cyclic guanosine monophosphate (cGMP), nitrotyrosine, medium-weight molecules (MCM) in the placenta were determined in women with gestosis during discoordinated and powerless labor. Thirty placentas (10 placentas from parturients after discoordinated labor, 10 from those after powerless labor, 10 placentas as a control group) were examined. Changes in the parameters under study were found to result in the development of nitroxide and oxidant stresses and endotoxicosis. The biochemical parameters should be considered as placental criteria for the differential diagnosis of labor anomalies in gestosis, such as powerless and discoordinated labors.

[Additional markers of placental insufficiency in gestosis accompanied by impaired labor activity].

To detect additional markers of placental insufficiency in gestosis accompanied by labor impairments, the authors have performed a comprehensive placental morphological study using organometric, histological, morphometric, and immunohistochemical techniques. Along with the earlier established markers, VEGF and vWF have been found to be additional markers of placental insufficiency. The latter make it possible not only to diagnose, but also to specify the stages of placental insufficiency. Perspectives for using the above agents are outlined.

[Guidelines for pathomorphological study of the brain of fetuses and neonatal infants with hydrocephalus].

Guidelines are proposed to study the brain of fetuses and neonatal infants with hydrocephalus. Some of them (evaluation of the rate of gyrification and its correspondence to the gestational period of the fetus, by visualizing the cerebral hemisphic surface; perfusion of cerebral vessels by the Karaganov fixator) are original, informative, and developed by the authors and are successfully used in the scientific and practical work of pathologists.

[The role placental factors in formation of perinatal pathology in gestosis of different severity].

Morphological study of gestosis in 153 cases. In light degree of gestosis focal ishemic and hemorrhagic infarcti and vascular changes of villi are found; decrease of the size of intervillous space at moderate degree and the 2nd stage of chronical placental hypertension. Hypoplasia of placentas, umbilical cord pathology and chronical placental hypertension in gestosis of a grave degree.

[Morphologic and dopplerometric characteristics of spiral arteries in chronic placental insufficiency].

Placental basal membrane of 156 females of the reproductive age with various forms of placental insufficiency was quantitatively studied. Dopplerometry of spiral arteries with calculation of the resistance index (RI) was performed longitudinally at 20-40 weeks of the pregnancy. Non-complete gestational restructurisation resulted in the decrease of circulation in these vessels with high values of RI and this is one of causes in delay of fetus development. High values of RI is an additional criterion of differential diagnosis of chronic placental insufficiency.

[Morphological diagnosis of placental pathology in uterine contraction disorders].

100 placentas were studied and various forms of gestosis were diagnosed. Inflammation was frequent in weak activity of uterus. Discoordination of contractile uterus activity results in redistribution of fetal circulation resulting in vascular pathology of the umbilical cord and villi, in part gestation of vessels of terminal and intermedial villi and anemisation of trunk villi.

[Some problems of anatomopathological diagnosis in perinatology]. / Nekotorye problemy patologo-anatomicheskogo diagnoza v perinatologii.

The authors discuss the problems of adequate documentation of autopsy diagnosis in death of fetuses and newborns and relations to ICD-10. It is suggested to legitimize and perfect the structure of diagnosis in perinatology.

[Morphology of the cerebral cortex in fetuses and extremely low weight newborns in normal pregnancy and miscarriage of hormonal etiology]. / Morfologiia kory golovnogo mozga plodov i novorozhdennykh s ékstremal'no nizkoi massoi tela pri neoslozhnennoi beremennosti i nevynashivanii gormonal'nogo geneza.

Complex histologic, histostereometric and electron microscopic study of fields 4 and 6 of the brain cortex in fetuses and newborns with an extremely low body weight allowed to specify formation of histoarchitectonics of the motor analyser during the second trimester of perinatal ontogenesis. Stages of differentiation (20-23 weeks) and maturation (24-27 weeks) of neurons and cytoarchitectonic layers of the motor zone in uncomplicated pregnancy as well as slow maturation of this cortex region in incomplete pregnancy of hormonal genesis were discovered. In this condition, there are lengthening of the neuron differentiation stage up to 26 weeks of gestation and important reduction of histostereometrical values (thickness of individual cytoarchitectonic layers and that of all the cortex) and cytokaryometrical values (volume of neuron nuclei) as compared to those in uncomplicated pregnancy.