[Morphologic festures of cardiac lesions in rheumatoid arthritis]. / Morfologicheskie osobennosti porazheniia serdtsa pri revmatoidnom artrite

Morphological examinations of the heart in cases of articulo-visceral rheumatoid arthritis revealed in 20 of the 35 conducted observations certain changes attributable to the underlying disease. The following groups of changes were revealed: 1) endocarditis; 2) myocarditis; 3) pericarditis; 4) rheumatoid nodules; 5) valvular sclerosis and mural endocarditis; 6) cardiosclerosis; 7) amyloidosis; 8) coronaritis and coronary sclerosis; 9) adhesions in the pericardial cavity. The severity of cardiac leasion in rheumatoid arthritis is determined by the involvement of the serosa into the pathological process. Inflammatory and sclerotic changes in the myocardium are predimonantly of a subepicardial and subendocardial nature, usually non-accompanied by any clear clinical symptoms, or taking a latent course. Rheumatoid nodules typical of rheumatoid arthritis, and deposits of amyloid masses in the walls of the coronary arteries are noted rarely. Changes in the heart are observed mostly in "septic", subacute rheumatoid arthritis and in Still's disease. Cardiac lesions in rheumatoid arthritis are connected with microcirculatory disorders caused by immunopathological processes.

[Changes in the heart conduction system in sudden cardiac death]. / Izmeneniia provodiashchei sistemy serdtsa pri vnezapnoi serdechnoi smerti.

The conductive system of the heart was studied morphometrically in serial sections in 12 autopsy observations of sudden cardiac death. In 11 cases the sudden death was due to chronic ischemic disease of the heart, in 1 case to idiopathic myocarditis of Abramov-Fidler. The control consisted of 12 autopsy observations of subjects dying of mechanical trauma, alcoholic toxicity, cerebral hemorrhage in the presence of hypertension. In 4 out of 12 observations of sudden cardiac death, acute dyscirculatory disorders of the microcirculatory bed and focal destructive changes of specific muscle fibers were detected in the conductive system of the heart. The intensity of atrophic and sclerotic processes in ganglions of the conductive system was not significantly different from that in the controls.

[Determination of diagnostic significance of nonspecific morphological signs]. / Opredelenie diagnosticheskoi informativnosti nespetsificheskikh morfologicheskikh priznakov

For assessment of diagnostic significance of nonspecific morphological signs the authors suggest to apply calculation of their informativeness according to Kullback's formula. This qualitatively characterizes the degree of difference of crossed signs in differentiating diseases. An initial value is frequency of occurrence of a sign or a degree of its manifestation determined by a relative frequency index according to histometry findings. Calculation of informativeness may be applied only with respect to statistically significant differing aspects. The value of the informativeness index corresponds to diagnostic significance of a sign. The recommended objective method broadens the sphere of application of diagnostic biopsy and may facilitate putting into practice of pathological anatomy of methods of computer diagnosis.

[Morphology of the thymus gland in children with myasthenia gravis]. / Morfologiia vilochkovoi zhelezy pri miastenii u detei.

Thymus excised from 68 patients suffering from juvenile myasthenia was subjected to histological, histochemical and electron microscopy studies. The changes in the thymus involved hyperplastic immune response in the form of lymphoid follicles with the germinal centers and focal plasmocytic infiltration. In myasthenia, the permanent characteristic of the thymus was activation of epithelial cells and Hassal bodies. A direct relationship was discovered between the efficacy of thymectomy and intensity of hyperplasia of the glandular lobules of the thymus. The lobule number of lymphoid follicles with the germinal centers did not affect the results of the surgical treatment of patients suffering from myasthenia.

[The morphogenesis of chronic synovitis in rheumatoid arthritis]. / Morfogenez khronicheskogo sinovita pri revmatoidnom artrite

The synovial sheath obtained in synovectomy in 35 patients with rheumatic- and rheumatic-visceral forms of rheumatoid arthritis was studied histochemically and immunomorphologically. At early stages of exacerbation of the pathological process in the synovial tissue there were revealed predominantly catabolic processes: an increased permeability of vessels; mucoid oedema; fibrinoid changes in the subintimal layer. Further development of the disease was characterized by predominance of anabolic processes with proliferation of synoviocytes, subintimal histiocytes, productive vasculites, massive lymphoid-plasmocytic infiltration, diffuse, or in the form of lymphoid follicles. Using the immunofluorescent technique the authors revealed luminescence of the rheumatoid factor and gamma=globulin in plasmatic cells, extracellularly, and more rarely in macrophages. Pronounced immunological changes in the synovial sheath in the active course of rheumatoid arthritis were accompanied by a high level of metabolic processes and an intensive phagocytic reaction in synoviocytes and subintimal histiocytes. In observations with a low activity of rheumatoid arthritis the synovial tissue was characterized by low levels of enzymes of oxidative metabolism and hydrolysis, emptying of the capillary bed, processes of sclerosis, hyalinosis, amyloidosis.

[Morphology and pathogenesis of psoriasis]. / Morfologiia i patogenez psoriaza.

Data from the literature on morphological features of foci of lesions on the skin which is the main target of the pathological process in psoriasis are presented as well as the materials confirming the systemic nature of the disease. The important role of immunopathological responses in the pathogenesis of psoriasis is emphasized. Viruses, congenital defects in the immune regulatory system, cellular membranes of the epidermis, blood and lymph vessels are discussed as possible etiological factors. The morphology of regression of psoriatic foci of lesions under the influence of photochemotherapy is described.

[Skeletal muscles in neuromuscular diseases]. / Skeletnye myshtsy pri nervno-myshechnykh zabolevaniiakh.

The paper offers recommendations concerning the specificity of biopsies withdrawn from skeletal muscles and histologic criteria for diagnosis of various forms of neurogenic atrophies, injuries, myositis, and myasthenia gravis.

[Skeletal muscles in myotonic disorders and periodic paralysis]. / Skeletnye myshtsy pri miotonicheskikh narusheniiakh i periodicheskom paraliche.

Recommendations for histological criteria of diagnosis of dystrophic and congenital myotony as well as familial hypopotassemic periodic paralysis based on the results of skeletal muscles biopsies are presented.

[The immune system of the lungs in healthy subjects and in chronic nonspecific diseases]. / Immunnaia sistema legkikh v norme i pri khronicheskikh nespetsificheskikh zabolevaniiakh.

Resistance of lung to the action of damaging factors is determined by the mechanisms of non-specific defence and immunologic responseveness that is expressed by systemic and local immune reactions. Local immune response in bronchi is brought about by a lymphoid tissue associated with bronchi. Alveolar macrophages carry out a main protective function in the respiratory parts. Participation of an immune system in the pathogenesis of chronic non-specific diseases is expressed by a lymphoid tissue hyperplasia, increased synthesis of immunoglobulins, increased number of macrophages and neutrophils. The role of an immunocomplex mechanism and cell hypersensitivity factors in the focus of damage remains unclear. A promising hypothesis in the study of immunopathology of chronic non-specific lung diseases is that of the role of an immune imbalance is their etiology and pathogenesis.

[Morphology of the minor salivary glands in Sjogren's disease]. / Morfologiia malykh sliunnykh zhelez pri bolezni Shegrena.

Histochemical, immunohistochemical and histomorphometrical changes in sialadenitis have been studied on 33 biopsies of labial salivary glands (LSG) from patients with primary Sjogren's syndrome. The control group consisted of 10 biopsies from persons without oral cavity inflammatory diseases. A direct relation was established between xerostomia stage and the degree of LSG parenchyma substitution for the inflammatory cell infiltrate. Dependence of LSG tissue damage on local immunopathologic reaction was detected. With a highly active inflammatory reaction the changes were characterized by cellular hypersensitivity including inflammatory cell infiltrate (T-lymphocytes, macrophages, neutrophils), increased vascular permeability, destructive and proliferative changes of the intralobular ductuli and acini. Reduction in inflammatory activity was accompanied by a decrease in the number of macrophages and neutrophils, an increase in the number of plasma cells and mast cells, higher compensatory hypertrophy of the serous cells of semicircular mixed acini, secretion products status, as well as intralobular sclerosis and lipomatosis.

[Dynamics of necrotic changes in skeletal muscle in the prolonged crush syndrome]. / Dinamika nekroticheskikh izmenenii skeletnykh myshts pri sindrome dlitel'nogo razdavlivaniia

Forms, dynamics of and relationships between necrotic changes in the skeletal muscles in the early period of the crush syndrome, following 9-hour compression of the soft tissue of the dog's thigh and 2 -- 7 hours after removal of the press are considered. Two interdependent forms of necrosis of muscles have been established -- diskoid and coagulative. Electron-microscopy studies showed that discoid necrosis of muscular fibres began with the lysis of the myofilaments of isotropic disks and Z-strips with subsequent destruction of myofibrils and outcome into myolosis. The peculiar feature of this form of necrosis was nearly complete absence of lysosomes. In a light microscope discoid necrosis was revealed as clear-cut transversed streaky fibres. Morphologically, coagulation necrosis was manifested on the ultrastructural level by formation of myofilic conglomerates consisting of overcontracted myofibrils, these being subjected to gradual fragmentation and splitting by hydrolases of leukocytes and macrophages. Discoid necrosis predominated in the muscles prior to the removal of the press and apparently developed because of ischemia. Coagulation necrosis of myofibrils was observed mostly following re-vascularization and might be one of outcomes of discoid necrosis.

[Morphology of immune inflammation in rheumatic diseases]. / Morfologiia immunnogo vospaleniia pri revmaticheskikh zabolevaniiakh.

The results of combined histochemical, immunomorphological, and immunological studies on biopsy, operation, and autopsy materials from 184 patients with rheumatoid arthritis, 41 patients with systemic lupus erythematosus, 66 patients with systemic sclerodermia. 35 patients with periarteritis nodosa are summarized. The main morphological changes in rheumatic diseases were found to be due to immunopathological reactions manifested as immune inflammation. According to the pattern of immunopathological mechanism, early and late immune inflammation manifested by humoral and cellular immunopathological reactions are distinguished. The predominant localization of lesions typical of each rheumatic disease, and the chronic self-maintaining pattern of inflammation are discussed.

[Morphology of psoriatic arthritis]. / Morfologiia psoriaticheskogo artrita.

Twenty-four biopsies of the synovial membrane, 8 biopsies of the cartilage and 8 samples of the synovial liquid from the knee joint were studied histologically, histochemically and by the immunofluorescent method. Proliferation, degeneration and desquamation of the synovial layer, localization of the inflammatory process in the superficial subsynovial layer, polynuclears in the inflammatory exudate, annular vascular sclerosis in the deep parts of the synovial villi are distinct features of psoriatic synovitis. The evidence for the involvement of humoral and cell immunity factors in the pathogenesis of the disease are obtained by means of immunological and immunofluorescent methods. On the basis of clinicomorphological data psoriatic arthritis is regarded as an independent nosological variety of the joint disease.

[Morphology of articular cartilage in osteoarthrosis]. / Morfologii sustavnogo khriashcha pri osteoartroza.

A combined histological, histochemical, histoenzymochemical and morphometric study of 42 articular cartilage samples from patients with different degrees of osteoarthrosis (OA) was made. Ten cartilages without pathology taken at autopsy were used as controls. A characteristic feature in case of cartilage destruction by OA is a progressive loss of glycosaminoglycans (GAG) from the matrix with its defibrination and uzur formation. Decrease in GAG content is associated with partial destruction of chondrocytes and the emergence of cellular clones reflecting reparative regeneration of the cartilage. However, even at the early OA stage the reparation is not adequate, as the GAG content in the matrix at the sites of chondrocyte proliferation remains decreased compared to the control age group.

[Local defense mechanisms in chronic nonspecific pulmonary inflammation]. / Mestnye mekhanizmy zashchity pri khronicheskom nespetsificheskom vospalenii v legkikh.

The mechanisms of non-immune and immune injuries in chronic nonspecific lung inflammation are analysed on the basis of authors' research and literature. The data given concern the changes of the bronchial mucociliary transport system, incomplete functions of alveolar macrophages and polymorphonuclear neutrophils in chronic inflammatory foci, increase in the number of intra- and extracellular bacteria, metabolism of lung phagocytes in different chronic inflammatory lung diseases. The urgency of lung phagocyte and lymphocyte investigation both in specific cellular and humoral immune reactions, as well as in realization of immunopathologic mechanisms developing in chronic inflammation is emphasized.

[Clinico-morphologic characteristics of X-linked pseudohypertrophic myopathy]. / Kliniko-morphologicheskaia kharakteristika psevdogipertroficheskoi miopatii, stseplennoi s X-khromosomoi

A clinical, genealogical, EMG and morphological study of the development of pseudohypertrophic myopathy linked with X-chromosome allowed one to distinguish 2 variants: 1) the malignant (Duchenne form) and 2) benign (Baker form). Although both forms have similar clinical symptoms, the Baker form has a later onset, a more favourable development and more preserved motor functions. The activity of fructosodiphosphataldolase and creatinphosphokinase in the blood serum of these patients was significantly lower than in Duchenne' myopathy. In the muscular bioptates of patients with Duchenne's myopathy as the disease progresses there is a gradual smoothening of the diameter of preserved elements at the expense of almost complete disappearance of hypertrophysed filaments. In Baker's myopathy besides expressed processes of muscular sclerosis and lipomatosis there are also hypertrophysed filaments.

[Structural-functional characteristics of phagocytes in the broncho-alveolar lavage fluid in acute focal pneumonia]. / Strukturno-funktsional'naia kharakteristika fagotsitov bronkhoal'veoliarnykh smyvov pri ostroi ochagovoi pnevmonii.

The alveolar macrophages and neutrophils of the bronchoalveolar fluid from 37 patients with acute focal pneumonia were studied cytochemically. A comparison group consisted of 20 patients with primary chronic bronchitis, 11 subjects without pulmonary affections served control. Phagocytes with a high motile, oxygen-dependent bactericidal and hydrolytic activity as well as with increased level of absorptive capacity prevailed during the peak of the disease and its regression. At the phase of convalescence the number of phagocytes with a high oxygen-dependent bactericidal and hydrolytic activity decreased but their high absorptive activity was retained.

[Morphologic lung changes in a female patient with Zivert-Kartagener's syndrome]. / Morfologicheskie izmeneniia v legkikh u bol'noi s sindromom Ziverta-Kartagenera.

Histologic and ultrastructural pulmonary changes in a female with a classical Zivert-Kartagener's syndrome are described. Congenital anomalies of the columnar epithelium brushes as well as defects acquired in the process of inflammation (decreased number and various length of bruches with their orientation disturbances, additional doublets and the lack of basal bodies) were revealed at transmission and scanning microscopy level. Follicular bronchiectasis, chronic pneumonia, dystelectasies, emphysema result from the mucociliary clearance disturbance and are of an acquired nature.

[Morphology and pathogenesis of chronic bronchitis]. / Morfologiia i patogenez khronicheskogo bronkhita.

Histologic and ultrastructural features of the chronic catarrhal bronchitis are presented and its pathogenetic mechanisms are discussed. An important role in the development of bronchitis of the mucociliary transport system damage, retention of the mucus and bacterial contamination of the respiratory tract is analysed. Current hypothesis of the chronic bronchitis development based on the disturbance of the protease-antiprotease and oxidative-antioxidative balance is presented. The data on the role of the specific and non-specific local immune mechanisms of the lung defence in the development of the exacerbations are given.

[Changes in the lesser circulation vessels in chronic nonspecific lung diseases]. / Izmeneniia sosudov malogo kruga krovoobrashcheniia pri khronicheskikh nespetsificheskikh zabolevaniiakh legkikh.

Clinicomorphological study of the pulmonary circulation vessels was performed in 20 patients with bronchiectatic disease without right ventricle hypertrophy and in 14 patients with chronic bronchitis complicated with pulmonary heart. Pathology data of persons dying from diseases other than vitium cordis and lung diseases were used as control. Morphological signs of pulmonary hypertension are found in all cases of chronic nonspecific lung diseases. The most pronounced changes develop in the vascular segment starting from arterioles and up to the arteries of muscle type with the diameter of 400 microns. The dependence of the pulmonary arteries changes on the type of lung disease is established. Pathological changes in the walls of the pulmonary circulation vessels, in parallel with pronounced compensatory alterations, are found in cases complicated with pulmonary heart.