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to investigate the clinical, morphological, and molecular genetic characteristics of serrated adenomas of the colon.The study included 82 colon adenomas from 63 patients aged 29 to 81 years, who underwent colonoscopy with biopsy or polypectomy. The mean age of men was 63.3 years; that of women was 56.8 years. Comprehensive clinical, morphological, immunohistochemical, and molecular genetic examinations were made.The histological examination showed that sessile serrated adenomas (SSA) of the colon were most common (46.4%), while hyperplastic polyp (HP) and traditional serrated adenoma (TSA) were found less often and with the same frequency (26.8%). The most typical location of SSA was the right colon; that of TSA was the left one. HP was detected equally on both sides of the colon. The immunohistochemical examination of the subtypes revealed no significant differences in the expression of markers. An analytical panel of antibodies against Desmin, Podoplanin (D2-40), CK20, CD34, Ki-67, Muc2, CEA, and CDX2 was used when identifying dysplasia areas, suspecting malignancy with invasion into the muscular layer of the mucous membrane and when determining the possible presence of emboli in blood and lymph vessels. BRAF gene mutation was identified in half of SSA cases; genetic BRAF mutation was observed in 41.7% of HP cases; genetic KRAS mutation was seen in 16.6%. The patients with TSA showed KRAS and BRAF mutations in 58.4 and 8.3% of cases, respectively. Mutations of these genes were absent.The study revealed that the subtypes of serrated adenomas substantially differ by sex, age, localization, and molecular genetic characteristics.Цель исследования — изучение клинико-морфологической и молекулярно-генетической характеристики зубчатых аденом толстой кишки. Материал и методы. В исследование вошли 82 аденомы толстой кишки от 63 пациентов в возрасте от 29 лет до 81 года, которым произвели колоноскопию с биопсией или полипэктомию. У мужчин средний возраст составил 63,3 года, у женщин — 56,8 года. Проводили комплексное клинико-морфологическое, иммуногистохимическое и молекулярно-генетическое исследование. Результаты. Гистологическое исследование показало, что чаще всего обнаруживали сидячие зубчатые аденомы (SSA) толстой кишки (46,4% наблюдений), в то время как гиперпластический полип (НР) и традиционную зубчатую аденому (TSA) — реже и с одинаковой частотой (по 26,8%). Наиболее типичным расположением для SSA оказалась правая половина толстой кишки, для TSA — левая. HP определялись равномерно в обеих половинах толстой кишки. При иммуногистохимическом исследовании подтипов значимых отличий в экспрессии маркеров получено не было. При выявлении участков дисплазии и подозрении на малигнизацию с инвазией в мышечную пластинку слизистой оболочки, а также с целью определения возможного наличия эмболов в кровеносных и лимфатических сосудах используется аналитическая панель антител к Desmin, Podoplanin (D2-40), CK20, CD34, Ki-67, Muc-2, CEA, CDX2. В половине случаев SSA выявлена мутация в гене BRAF, 41,7% HP имели генетическую мутацию BRAF, 16,6% — генетическую мутацию KRAS. В 58,4% TSA была выявлена мутация KRAS, в 8,3% — BRAF, а в 33,3% мутация генов отсутствовала. Заключение. В результате исследования выявлено, что подтипы зубчатых аденом существенно различаются по полу и возрасту пациентов, локализации, а также молекулярно-генетической характеристике.

The paper contains the results of clinical and morphofunctional examinations of a patient with eosinophilic esophagitis complicated by esophageal stenosis and detected in the presence of controlled mild persistent asthma and food allergy. The endoscopic and morphological diagnostic criteria pathognomonic for this disease have been confirmed. The immunohistochemical study of esophageal mucosal biopsy specimens revealed the specific features of the composition of an infiltrate, which account for the early development of fibrosis and permit eosinophilic esophagitis to be referred to as special immunocompetent diseases.

Comparative assessment outcomes of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in patients with superficial epithelial lesions (SEL) of stomach and duodenum.Retrospective study includes 92 patients. The article contains detailed description of patients, superficial epithelial lesions, technique of EMR and ESD and indications for endoscopic procedure.99 endoscopic operations were performed: EMR--79, ESD--20. The mean operation time, en bloc resection rate, complete resection rate for early gastric cancer were assessed for EMR and ESD and compared in consideration of lesion's size. Comparative evaluation of immediate, short-term and long-term outcomes of endoscopic resections was performed.ESD provides better en bloc and complete resection rates and minimal local recurrence compared with EMR, but ESD is more time-consuming technique with the same rate of complications.

The article is devoted to a problem of diagnosis and treatment of postcholecystectomy syndrome caused by benign neoformations of the major duodenal papilla. The material of study was formed by 76 patients; among them 53 ones had isolated benign neoformations of the major duodenal papilla. The medical-diagnostic algorithm applied by authors for the examination of patients with postcholecystectomy syndrome is presented. It's been defined, that benign neoformations of the major duodenal papilla take an essential place in the structure of postcholecystectomy syndrome and make 13.5% of the reasons of its occurrence. Thus, the most widespread morphological substratum of these benign neoformations is the hyperplastic polyp.

The present morphological study was based on the analysis of materials obtained during the surgical treatment of 64 patients aged from 15 to 68 years presenting with long-term chronic purulent maxillary sinusitis. All the patients had been inadequately treated with antibacterial preparations during the pre-hospitalization period. It was shown that the patients developed well-apparent pathomorphological changes in maxillary sinus mucosa that promoted chronization of the inflammatory process.

Thirty-five autopsy cases of influenza A/HIN1 in Moscow were analyzed. Primary pathological changes were found in the trachea and lung. The lung showed a pattern of the exudative and proliferative stages of diffuse alveolar damage. In addition, there were signs of infectious-toxic shock associated with viremia, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes. Bacterial bronchopneumonia was detected in only 20% of cases.

Forty autopsy cases died from A/H1N1 influenza in Moscow, the Moscow Region, and Chita were analyzed. Major changes were found to develop in the trachea and lung. The lung showed the pattern of exudative and proliferative stages of diffuse alveolar lesion. In addition, the signs of viremia-associated infectious-toxic shock, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes were revealed. Bacterial bronchopneumonia was detected only in 20% of cases.

In the available literature, there are single papers on the association of the values of external respiratory function and the EchoCG sings of pulmonary hypertension with the morphological parameters of pulmonary arterial branches in idiopathic pulmonary hypertension (IPH) and secondary pulmonary hypertension (SPH). The present investigation comprised a comprehensive study of life-time functional changes in the cardiopulmonary system and postmortem morphometric changes in the heart and pulmonary vessels in idiopathic pulmonary fibrosis (IPF)-induced SPH and IPH. The investigation has indicated that PPH and SPH are characterized by the same-type rearrangement of pulmonary arterial branches as intimal hyperplasia and medial hypertrophy; however, IPH, as compared with SPH, induces a more significant cor pulmonale. The magnitude of right and left ventricular dysfunction corresponds to the degree of pulmonary hypertension (PH) and cor pulmonale. In IPF, the decreases in tidal volumes and pulmonary diffusion capacity favor PH progression.

Endoprostheses made from knitted fabric of 3 loop types were used for hernioplasty in rats. Biocompatibility of implanted textile constructions was evaluated after 6 months. The intensity of inflammatory reaction and types of complications in animals depended on the loop type and method of finishing of the mesh endoprosthesis tissue.

Morphological and morphometric studies have shown that secondary pulmonary hypertension is characterized by more pronounced pathological changes in the pulmonary arterial branches in severe chronic obstructive lung disease (COLD) than in idiopathic fibrosing alveolitis. Secondary pulmonary hypertension does develop in atopic bronchial asthma. Moreover, there are more significant pathological changes in the pulmonary arteries than in the bronchial ones. In severe COLD, the development of emphysema affects that of pulmonary arterial hypertension.

The causes of death were analyzed in patients with injuries treated at City Clinic No. 31 in 2004-2005. Over this period, 83 patients died, 64 of them underwent forensic medical examination, 17 were autopsied; 2 cases were not. The underlying and immediate causes of death are described in relation to the type of injury.

Glandular cystic ovarian endometriosis (OE) is characterized by a more intensive blood supply than cystic OE. This type of OE is characterized by a high proliferative glandular epithelial activity detected by an immunohistochemical study using antibodies to PCNA and CA-125. Moreover, a positive correlation is found between the serum concentration of CA-125 and the expression of this antigen in the epitheliocytes of an endometrioid cyst in both glandular-cystic and cystic OE. Thus, the findings permit the determination of the morphofunctional activity of a type of OE and its aptness to the progression of the disease and to the development of recurrences.

to investigate the histopathology of amyloid in liver biopsy specimens. MATERIAL AND METHODS. A total of 46 liver biopsy specimens were investigated in patients with histologically verified amyloidosis in 2006 to 2009 from the Amyloid Registry of the Charité University Hospital (Berlin). The liver biopsy specimens were fixed in formalin and embedded in paraffin. The paraffin sections were stained with hematoxylin and eosin and with Congo red. Amyloid was immunohistochemically classified using antibodies against amyloid P component, AA amyloid, apolipoprotein Al, lysozyme, fibrinogen, transthyretin, and κ and λ light chains.Amyloid deposits were diagnosed in the 46 liver biopsy specimens from 17 women and 29 men (mean age 60 years). Immunohistochemical subtyping was successful in 91% of the cases. AL amyloidosis was diagnosed in 87% of the biopsy specimens and further classified as AL lambda-light chain amyloidosis (57%) and AL kappa-light chain amyloidosis (30%). The 46 liver biopsy specimens showed one case of AA amyloidosis (2%) and one case of transthyretin amyloidosis (2%). The type of amyloid could not be classified in 9% of the biopsy specimens.The investigation revealed that the most common types of hepatic amyloidosis are AL lambda- and AL kappa-light chain amyloidosis associated with the signs of parenchymal atrophy and steatosis.Цель - исследование гистопатологии амилоида в печеночных биопсиях. Материал и методы. Исследовали 46 биоптатов печени у больных c гистологически подтвержденным амилоидозом за период с 2006 по 2009 г. из амилоидного регистра университетской клиники Шарите (Берлин). Печеночные пробы фиксировали в формалине и заливали в парафин. Срезы окрашивали гематоксилином и эозином и конго красным. Амилоид классифицирован иммуногистохимически с использованием антител к амилоидному Р-компоненту, АА-амилоиду, аполипопротеину AI, лизоциму, фибриногену, транстиретину, каппа- и лямбда-легким цепям. Результаты. Амилоидные отложения диагностированы в 46 печеночных биоптатах (17 женщин, 29 мужчин; средний возраст 60 лет). Иммуногистохимическая классификация была успешна в 91% случаев. AL-амилоидоз диагностировали в 87% биоптатов, далее заболевание классифицировано как AL-лямбда-амилоидоз (57%) и AL-каппа-амилоидоз (30%). Из 46 проб выявлено только по одному пациенту с АА- и транстиретиновым амилоидозом (каждый по 2%). В 9% биоптатов тип амилоида классифицировать не удалось. Заключение. Исследование выявило, что наиболее частыми видами амилоидоза печени являются AL-лямбда- и AL-каппа-амилоидоз, ассоциированный с признаками паренхимальной атрофии и стеатозом.

Morphometric study of blood vessels in serous tumors of the ovaries was carried out. Vascularization of benign, borderline, and malignant tumors is different, which agrees with the data of color Doppler mapping. Pronounced morphological changes in vascular wall (degenerative changes, sclerosis, and hyalinosis) were detected mainly in borderline and malignant tumors.

As seen at semithin and ultrathin sections, there are marked changes in the cells and extracellular components of the microcirculatory bed in chronic periodontitis. These changes affect endotheliocytes, subendothelial zone, basal membrane and pericytes. In the capillary lumen there are erythrocytes and other corpuscles, platelets, in particular. A close contact of plasmocytes with components of the vascular wall confirms the leading role of vascular theory of chronic periodontitis pathogenesis.

The morphology of aneurysmal bone cysts (ABC) in 10 children was studied by light and scanning electron microscopy. Angiodysplasia signs and disorder of bone remodeling occur in ABC areas leading to secondary hemodynamic disorders and abnormal bone remodeling with predominance of resorption in dynamics of remodeling.

We studied morphological changes in rat abdominal aorta and vena cava inferior induced by endovascular microwave destruction. This treatment induced thrombosis and necrosis of the vascular walls, but fibrous framework was not completely destroyed. Then we observed irreversible changes in vessels: obliteration, atrophy of the aorta walls, and sclerosis of venous walls. The preserved fibrous framework of the vessel walls probably plays a role of a framework for the formation of fibrous tissue.

Parodontal tissues were studied using semithin and ultrathin sections. Cell populations participating in parodontitis development consist of plasmocytes, fibroblasts, granulocytes, lymphocytes, endotheliocytes, mast cells and, to a lesser extent, epitheliocytes, thrombocytes, macrophages. The ultrastructural criterion of severe chronic parodontitis is the presence of pronounced changes in plasmocyte population with their transformation.

We studied morphological changes in the liver after local MW-destruction. Microwave radiation damaged vascular walls with the formation of extensive necrotic focus; demarcation zone appeared 24 h after exposure, encapsulation occurred after 7 days, and replacement with a fine cicatrix formed by mature connective tissue after 4 months.

In rats with hypertension modeled by the one kidney-one clamp method, constrictory responses of the isolated caudal artery to norepinephrine differed under various perfusion conditions. Vascular reactions in hypertensive rats were more potent at a constant flow rate, and less potent at a constant pressure compared to those in normotensive rats. Previous experiments demonstrated similar changes in constrictory responses of the caudal artery in spontaneously hypertensive rats. It is assumed that these peculiarities of the vascular reactivity during hypertension are determined by thickening of the smooth muscle layer of the vascular wall.

Chronic alimentary fluorine deficiency was provoked in goats by a semisynthetic diet with fruorine deficiency (less than 0.3 mg/kg dry feed). Teeth caries, emaciation in spite of higher consumption of food as compared to controls, focal inflammatory degenerative changes in the alimentary tract mucous membranes (catarrhal-purulent esophagitis, chronic duodenitis), chronic degenerative changes in the parenchymatous organs were observed. Endocrinopathies, accidental thymus involution, hypothyroid state, destructive changes in the pancreatic insullar cells were also common.

The vasoconstrictor effects of noradrenaline were studied in spontaneously hypertensive rats (SHR) compared with Wistar Kyoto rats (WKY), and in Wistar rats with regional hypotension (WH) compared to control Wistar rats (WC). The abdominal aorta was ligated in WH distal to the renal arteries, lowering blood pressure in the hindquarters by 41% and tail artery wall cross-sectional area by 35% compared with WC. A cylindrical segment was dissected from the proximal part of the tail artery, cannulated at both ends and perfused with Krebs-Henseleit solution either at constant flow starting from a pressure of 120 mmHg or at a constant pressure of 120 mmHg. The cumulative dose-response relationships for noradrenaline were determined in control conditions and subsequently in the presence of gadolinium (100 microM), a non-specific blocker of mechanosensitive channels. Under constant-flow perfusion noradrenaline evoked a more prominent resistance increase in SHR compared with WKY and in WC compared with WH. Similar relations were seen in the presence of gadolinium, although responses were reduced. At constant pressure perfusion the vasoconstrictor response to noradrenaline was lower in SHR compared with WKY and in WC compared with WH. Application of gadolinium under constant-pressure perfusion reduced responses in WKY and WH, so that vasoconstriction in SHR became more pronounced than that in WKY and in WC than that in WH. It is suggested that the results can be explained by the difference in wall thickness causing different degrees of activation of the myogenic response to distension.

The death of a 39-year-old male patient occurred because of the tumor rupture into the abdominal cavity. Splenic hemangioendothelioma was not diagnosed clinically. The literature data on the incidence of this tumor, its clinical course and survival are presented.

According to the authors' concept, different forms of trace element deficiency show some general rules of development. All of them are followed by a decrease of immune resistance. Trace element deficiency is never isolated, it is always characterized by trace element unbalance and is followed by a considerable disturbance of metabolism (mineral, lipid, carbohydrate and protein) with relevant manifestations. Reduced immune resistance and pluriglandular endocrinopathy create the conditions for various malignancies.

Dieulafois syndrome is a rare congenital pathology with profuse gastric bleeding due to the damage to arterial wall in the submucosa layer. The case illustrates difficulties encountered in the treatment of such patients.

327 and 736 protocols of postmortem examinations from Moscow hospitals N 31 and 57, respectively, were evaluated statistically. The quality of clinical diagnosis of pneumonia was examined. Pneumonia caused death in 26.3 and 21.1% of cases in Moscow hospitals 31 and 57, respectively. Besides subjective reasons which were the main cause of diagnostic mistakes, there were such factors as poor condition of patients, atypical pneumonia course, alcoholism.

Pathology of congenital bromine deficiency is described in a she-goat whose mother was kept for two years on a bromine deficient diet. Anomalies of the bones and joints of the anterior limbs, disturbances of carbohydrate, lipid and mineral metabolism in the form of liver, kidney and lymph nodes glycogenosis, liver fat degeneration, haemosiderosis of the liver, spleen and lungs were found. Moderate thymomegaly with hyperplasia of the cortex and an increase in the number of Hassal bodies, microcystic ovary transformation, adrenal adenomatosis, cheilitis, flossitis, focal proliferative extracapillary glomerulonephritis were also observed.

Masshoff's disease (pseudotuberculous mesadenitis) was diagnosed in a 20-year-old male on the basis of histological investigation of surgically removed appendix and ileocaecal lymph nodes. The appendix was intact. Hyperplasia of lymphoid tissue with formation of small abscesses and karyorrhexis of neutrophils, but without giant polynuclear cells was histologically revealed in lymph nodes. Foci of fibrinoid necrosis were found in lymph node capsules. Serological test for pseudotuberculosis was strongly positive ( +).

Histological changes in chronic experimental hypocobaltosis manifest as atrophic-degenerative alterations and restructuring of endocrine organs as well as a decrease in systemic resistance (accidental transformation of the thymus, duodenitis and sigmoiditis in some animals). Pronounced fat hepatosis and signs of iron metabolism damage (cheilitis, spleen siderosis) are found as well.

Chronic (12 weeks) peroral administration of cadmium chloride to albino rats in a dose of 2.5 mg/100 g body weight results in arterial hypertension characterized by the increase in systolic blood pressure up to 148 +/- 1.8 mm Hg (vs. 115.4 +/- 1.5 mm Hg in the control animals); the increase in vascular resistance, left ventricular cardiomyocyte hypertrophy, as well as by hypertrophy of arterial walls, the decrease in the ventricular index, the activation of synthesizing function of atrial endocrine cardiomyocytes; enhanced secretion of ANP; a more than two-fold increase in plasma myoglobin concentration, as well as by the development of cadmium-induced nephropathy. In the rehabilitation period (9 weeks) a relatively quick fall in the blood pressure is observed, as well as morphological features of myocardial and renal function recovery, suggesting the nonpersistent nature of cadmium-induced hypertension.

A case of an internal cholecystogastric fistula that closed spontaneously and combined with low large-intestinal obstruction due to a gallstone is described. Other, similar cases reported in the literature are reviewed.