[Morphopathology of myocardial hypoxic-ischemic injuries in newborns at 22-27 weeks' gestation]. / Patomorfologiya gipoksicheski-ishemicheskikh povrezhdenii miokarda u novorozhdennykh 22­27 nedel' gestatsii.

OBJECTIVE: To determine the parameters of myocardial structural injuries developed in chronic intrauterine hypoxia conditions in newborns at 22-27 weeks' gestation. MATERIAL AND METHODS: A battery of morphological techniques, including organometry studies and separate weighing of the heart; 3D histology; morphometry with the determination of the area of cardiomyocyte nuclei, the specific area of the muscular and interstitial components of the right ventricular myocardium; immunohistochemistry with monoclonal antibodies to transforming growth factor ßi (TGF-ßi), cardiac troponin T (cTnT), and transmission electron microscopy, was used to examine heart samples from 30 deceased newborns at 22-27 weeks' gestation who developed in chronic intrauterine hypoxia conditions. A control group consisted of hearts from 20 extremely low body weight (ELBW) newborns, the main cause of whose death was asphyxia caused by the premature detachment of a normally positioned placenta. RESULTS: Analysis of the organometric parameters of heart samples from newborns at 22-27 weeks' gestation, who had experienced chronic intrauterine hypoxia, revealed right ventricular hypertrophy with increases in the area of cardiomyocyte nuclei and in the specific area of the muscle component compared to the control group. Impaired myocardial microcirculation and destructive changes in cardiomyocytes were diagnosed in conjunction with the decreased troponin T and increased TGF-ß1 expressions. Incomplete differentiation of cardiomyocytes and their myofibrillar component was revealed at the myocardial ultrastructural level in ELBW newborns who had experienced chronic intrauterine hypoxia. CONCLUSION: The parameters of myocardial structural rearrangement in ELBW newborns who had experienced chronic intrauterine hypoxia are compensatory right ventricular hypertrophy, microcirculatory disorders, destructive changes in cardiomyocytes, decreased cTnT and increased TGF-ß1 expressions in conjunction with impaired cardiomyocyte differentiation.

[Immunomorphological aspects of miscarriage at late gestational ages].

AIM: to reveal the morphological features of placentas and to define a role of the lectin pathway for activation of the complement system in the development of premature birth. MATERIAL AND METHODS: A complex morphological study was conducted to examine 37 placentas, 25 of which were obtained from women with clinical signs of threatened miscarriage and 12 placentas from apparently healthy pregnant women. RESULTS: Placental tissue CD59 expression was ascertained to be significantly less in the women with threatened miscarriage than in those having full-term babies. CONCLUSION: Decreased CD59 expression in threatened miscarriage at late gestational ages leads to additional activation of a maternal immune response and serves as a possible predictor for premature birth.

[Morphogenesis of Human Fetal Thymus during Weeks 22-27 of Development].

Distinctive features of human fetal thymus morphogenesis in early ontogeny in the case of uncomplicated pregnancy have been characterized. A steady increase of thymus dimensions and weight occurred concomitantly to differentiation of morphofunctional zones within the organ. Cell differentiation in the subcapsular and inner cortical zones of the thymus lobes was manifested as changes in parameters of expression of T-lymphocyte antigens CD1, CD2, and CD3 and ultrastructural features of reticuloepithelial cells (REC) type I and II forming a microenvironment for lymphocytes. RECs of the medullar zone formed a glomerular syncytium with desmosomal interepithelial contacts by week 22 of fetal development. Small lymphocytes predominated among thymocytes (66%). Hassall's corpuscles, the structural correlates of morphological and functional maturity, predominated in the fetal thymuses during developmental weeks 25-27.

[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.

[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.

[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.

[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.

[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.

[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.

[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.

Heterogeneity of smooth muscle cells in embryonic human aorta.

Cellular composition of aortas from 5- to 12-week and 18- to 28-week-old human embryos were investigated using immunocytochemistry, scanning and transmission electron microscopy. The aorta of the 5- to 12-week-old embryos consisted of three sublayers differing in cellular composition. The inner sublayer adjacent to the endothelium contained round and ovoid cells with synthetic phenotype. In the intermediate sublayer, spindle-like cells ultrastructurally similar to smooth muscle cells were found. Cells of the outer sublayer resembled fibroblasts or poorly differentiated mesenchymal cells. There were not definite morphological borders between sublayers. In the 18- to 28-week-old embryo aorta the intima was separated from media by internal elastic lamina. Intimal and innermost medial cells had predominately stellate shape and synthetic phenotype. The outer part of media contained spindle-like cells that had well developed contractile structures. Both the 5- to 12-week-old and the 18- to 28-week-old embryo aortic cells were positively stained for alpha-actin and myosin and negatively stained for macrophage antigens. Thus, the majority of embryo aortic cells appeared smooth muscle cells, however there was a regional difference in shape and synthetic state of these cells.

[Changes in the form and ultrastructure of the smooth-muscle cells in the human aorta in prenatal ontogeny]. / Izmenenie formy i ul'trastruktury gladkomyshechnykh kletok aorty cheloveka v prenatal'nom periode.

The shape of smooth muscle cells (SMC) was analysed using the phase contrast microscopy of cell suspensions obtained by alcohol-alkali dissociation, as well as the semithin sections prepared in perpendicular planes. The phenotype of SMC was analysed using transmission electron microscopy. The shape of SMC changes from preferentially round to preferentially spindle-like and stellate one during development. The differentiation of SMC is accompanied with the increase in the contractile apparatus content and in the decrease in the content of synthetic organelles.

[A comparative ultrastructural and morphometric analysis of the smooth myocytes in the tunicae intima and media of the human fetal aorta]. / Sravnitel'nyi ul'trastrukturnyi i morfometricheskii analiz gladkikh miotsitov vnutrennei i srednei obolochek aorty ploda cheloveka.

Transmission electron microscopy was used for studying the thoracic part of the aorta of 9 human fetuses of 20-28 weeks of development. In the medial tunic of the human fetus aorta there are smooth myocytes (SM) of the contractile and synthetic phenotypes. The latter are localized mainly in the inner part of the media. In the inner tunic there are also SM of the synthetic phenotype. With the help of processes they make contacts with endotheliocytes and processes of SM of the media. In the gaps between the subendothelial SM and endothelium there are particles of elastin which form the structure resembling an additional elastic membrane. It is reasonable to think that the migration of SM into the intima is a stage of normal development of the vessel associated with the adaptation to local hemodynamic conditions rather than an initial manifestation of atherosclerosis.

[The three-dimensional structure of the tunica intima and tunica media of the human fetal aorta studied by a new method]. / Issledovanie trekhmernoi organizatsii vnutrennei i srednei obolochek aorty ploda cheloveka s pomoshch'iu novogo metoda.

A new method is developed for revealing the latent surfaces in the structure of organs by scanning electronic microscopy. The method is based on the treatment of specimens with potassium ethoxide until cells start to appear in the dissociating solution. Using this method, thoracic aorta of nine human fetuses at the stage of 20-28 weeks was studied. Subendothelial intima and media of human fetal aorta contain smooth muscle cells differing by their arrangement, shape and surface microrelief. The intima cells are arranged in a mosaic pattern formed of single cells or cell clusters. By means of cell processes they are connected with each other, as well as with endothelial and smooth muscle cells of the media. Smooth muscle cells in the inner part of the media also have processes and form an open network. Part of the cells penetrate the intima through pores of the inner elastic membrane. In the deeper layers of the media, laterally adjoining spindle-shaped smooth muscle cells are found. It is suggested that the observed cell polymorphism is due mostly to penetration of the media smooth muscle cells into subendothelium and modification of their shape under the effect of the microenvironment.

[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.