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Introduction Endometriosis ranks second place in the structure of infertility. The development of endometrial dysfunction is one of the infertility factors, which affects the degree of decrease in the receptive abilities of endometrium and subsequent implantation.Purpose of the study was to reveal morpho-functional state of receptivity and nidation ability of endometrium in patients of reproductive age with diffuse and nodal forms of adenomyosis.Materials and methods The study included 104 patients, which were divided into 2 groups. The first group consisted of 30 patients with a diffuse form of adenomyosis, second group included 30 patients with a nodal form. The patients underwent aspiration biopsy of endometrium in the middle secretory phase. The level of ER and PR expression in the glandular and stromal compartments of endometrium was assessed, the percentage and degree of maturity of pinopodes were determined.Results The analysis of ER and PR number in the stromal and glandular components of endometrium in patients with diffuse adenomyosis revealed an increase in the secretion of ER in the glandular cells in contrast to patients of the comparison group. Significant differences in the expression of ER and PR in glandular cells were verified among observed with the nodal form of adenomyosis. The immunohistochemical reaction with antibodies to ER and PR in the nodal form of adenomyosis was significantly higher than in diffuse form. Both in the first and second groups, a decrease in the formation ability of pinopodes on the superficial epithelium was noted.Discussion Adenomyosis leads to damage of the morpho-functional state and receptive abilities of the endometrium. In the nodal form the degree of detected disorders was significantly higher.Conclusion The nodal form of adenomyosis is more common in patients of younger reproductive age and is associated with a higher prevalence of endometrial dysfunction. This is especially important for the selection of adequate modern therapy in order to maintain and improve reproductive function.

Intrauterine adhesions (IUDs) are one of the unresolved and unsolved problems of modern reproductive medicine worldwide. Adhesive lesions lead to partial or complete obliteration of the uterine cavity and/or cervical canal. The main clinical manifestations of IUDs are menstrual irregularities, cyclical pain, infertility and other various reproductive disorders. Reproductive outcomes in women with IUDs remain poorly understood and difficult to verify. At the same time, there is currently no understanding of the basic mechanisms of IUD development, including the processes explaining the failures of the above complications. The problem of overcoming IUD recurrences after adhesiolysis remains far from being finally resolved. The gold-standard treatment for IUD is hysteroscopic adhesiolysis, which, however, is associated with a high frequency of complications and relapses, highlighting the need for preventive approaches to the management of IUD. The drugs with enzymatic activity inhibiting abnormal connective tissue include bovhyaluronidase azoximer created by the Russian developers back in 2005. The drug consists of two components – hyaluronidase and azoximer bromide. The former is an enzyme, and the latter is a stabilizer that prolongs the action of hyaluronidase. Several studies have shown that bovhyaluronidase azoximer causes the destruction of intrauterine adhesions and restores the endometrium status in inflammatory pelvic diseases. Due to prolonged antifibrotic effect of bovhyaluronidase, azoximer can be used to treat women with IUDs to reduce the risk of the subsequent development of adhesive process in the uterine cavity.

Objective. Objective of this review is the systematic analysis and summarization the scientifc data available in the current literature on the predictive approach to the management of women with endometrial hyperplasia without atypia.Material and methods. Scientifc literature was searched in PubMed, CochraneLibrary, Science Direct, and ELibrary databases using the keywords,endometrial hyperplasia and cancer, pathogenesis, risk factors, and recurrence for 2012–2022.Framework. Endometrial hyperplasia (EH) is a common disease that affects women of reproductive age and is caused by a disturbance of the local hormonal homeostasis of the endometrium. Several factors, such as age over 35, lack of pregnancy history, obesity, genetic predisposition, diabetes mellitus, anovulatory cycles, hormone replacement therapy, including menopausal therapy (without the progestin component) and immunosuppression can lead to the development of this condition. Modern predictive medicine can be used to identify women at high risk for developing this condition and target screening and surveillance, as well as individualized treatment plans. Overall, the use of predictive in the management of endometrial hyperplasia without atypia may improve the treatment outcomes of the patients in the cohort studied.Conclusion. Combined oral contraceptives (COCs) have been proven to have not only high contraceptive effcacy, but also to be considered as a pathogenetically justifed prevention of EH without atypia and its recurrence. Gestoden-containing COCs are recognized as an effective means not only for the prevention of endometrial hyperplasia, but also for the prevention of endometrial carcinoma, while having absolutely similar effcacy to other progestins, such as levonorgestrel. Thus, OCs containing gestoden should be considered as an attractive option not only to prevent unwanted pregnancy with high contraceptive effcacy, but also to regulate the menstrual cycle, to minimize breakthrough bleeding and to prevent EH without atypia.

Prostate cancer is one of the most common malignant diseases in men. Viral infections can be risk factors for prostate carcinogenesis. Based on the literature review, an assumption can be made about the pathogenetic role of viral infections in prostate carcinogenesis. Further study of this problem is required, the solution of which can make a great contribution to the diagnosis and prevention of prostate cancer

Данные последних лет указывают на то, что качество эндометрия играет гораздо более важную роль в успешной имплантации и наступлении клинической беременности, чем многие другие признанные факторы. Хронический эндометрит (ХЭ) ассоциирован с отрицательными репродуктивными исходами, которые включают повторные неудачи имплантации. Streptococcusspp., Escherichiacoli, Enterococcusfaecalis, Klebsiellapneumoniae, Staphylococcusspp., Corynebacterium и Mycoplasma / Ureaplasmaspp в настоящее время считаются основными возбудителями ХЭ. Это заболевание нарушает архитектонику эндометрия на разных уровнях: прежде всего, ХЭ способствует изменениям в популяции иммунокомпетентных клеток и, следовательно, способствует нарушению локального иммунного ответа в эндометрии в момент имплантации. Лечение ХЭ антибиотиками улучшает частоту имплантации и снижает частоту абортов, хотя хорошо спланированные проспективные исследования, подтверждающие этот вывод, отсутствуют.Учитывая недостаточную эффективность антибиотикотерапии ХЭ, особенно в случаях резистентности возбудителей, либо в случае вирусного хронического эндометрита, необходимо разработать схемы с дополнительным применением препаратов, влияющих на другие этиопатогенетические пути развития и поддержания ХЭ. Примером такого лечения может быть цитокинотерапия, требующая дальнейшего изучения в отношении эффективности и безопасности в терапии ХЭ.

This review of bladder cancer describes modern clinical and pathologic features of the neoplasm, reports new data about treatment and prognosis of this disease.

The aim of the study was to analyze the effect of surgical intervention on the status of the ovarian follicular apparatus in patients with benign ovarian cystic tumors (BCOTs) based on the results of morphometric studies.Material and methods. The authors have studied surgical material of 60 patients aged 18-47 years with BCOTs: serous cystadenoma (20 cases), serous papillary cystadenoma (7 cases), mucinous cystadenoma (12 cases), mature teratoma (23 cases). Microscopic slides of ovarian tissue stained with hematoxylin and eosin were obtained and morphological structure of BCOTs, presence of the intact ovarian tissue surrounding neoplasm and the density of follicles there were studied based on their qualitative characteristics (maturity, signs of degeneration).Results. It was found out that development of fibrosis in the wall of BCOTs significantly depends on the tumor histogenesis: the greatest thickness of fibrosis was detected in serous papillary cystadenomas, the smallest in the group of mature teratomas, the average values were determined in mucinous and serous cystadenomas of the ovaries. The influence of BCOTs on the ovarian reserve does not depend on its morphological structure, localization and diameter. The intact ovarian tissue is removed along with BCOTs during adnexectomy, ovarian resection and in 48.8% of cases – during cystectomy. During cystectomy, probability of the perifocal intact ovarian tissue presence is reduced due to the growth of fibrous tissue in this area. However, the negative impact of BCOTs on the ovarian reserve occurs not only due to surgical removal of the ovarian tissue, but also as a result of inhibition of folliculogenesis at the preoperative stage.Conclusion. BCOTs of the presented morphological groups negatively affect the follicular apparatus due to both – inhibition of folliculogenesis at the preoperative stage and loss of ovarian tissue during surgery. More pronounced perifocal proliferation of fibrous tissue was noted with serous papillary cystadenomas.

Objective. To evaluate possibilities and advantages of SpyGlass DS system (Boston Scientific) in the diagnosis and treatment of pancreato-biliary diseases. Material and methods. SpyGlass DS has been applied in 24 interventions in 22 patients for the period from December 6, 2017 to July 6, 2018. There were 21 cholangioscopies, 2 pancreaticoscopies and one cholangiopancreaticoscopy. The indications for cholangioscopy were undifferentiated strictures (n = 14), suspected Mirizzi syndrome (n = 2), large choledocholithiasis and need for laser lithotripsy (n = 1). There was a need to pass a guidewire under visual control (n = 2) and to control bile duct stones extraction (n = 1). Scheduled removal of ligature after laparoscopic cholecystectomy was in 1 case. Indication for pancreaticoscopy was suspected malignancy within the strictures associated with chronic pancreatitis, for cholangiopancreaticoscopy – assessment of spread of major duodenal papilla tumor into common bile and pancreatic ducts. Results. Overall technical success rate was 95.8% (23/24). Intraductal biopsy was successfully performed in 13 out of 14 (92.9%) cases. Cholangiocarcinoma was histologically confirmed in 6 cases. Curative interventions were performed in all 4 cases. There were no complications and mortality. Conclusion. The main indications for endoscopic peroral intraductal interventions are various types of undifferentiated and complicated biliary and pancreatic strictures, as well as “difficult” bile and pancreatic duct stones. The technology of diagnostic and curative endoscopic interventions using the SpyGlass DS system is relatively simple while morbidity and mortality rates are similar to those after conventional transpapillary interventions.

The aim of the study was to investigate the effect of different methods of anterior abdominal wall separation on the increasion of the abdominal cavity volume (ACV) for the prevention of compartment sindrome. The effect of Novitsky posterior separation (Transversus Abdominis Release – TAR), Ramirez anterior separation and Ramirez anterior separation with the mobilization of posterior wall rectus sheath (R+MPRS) on increase ACV was studied. The study was conducted on autopsy materials of 30 non-fixed corpses. In the first part of investigation the results of Novitsky operation have been studied (n=10), in the second part – of Ramirez operation (n=10) and in the third part – R+MPRS (n=10). The ACV have been determined before and after surgery and the degree of it’s increasion after each operation have been counted. In Ramiraz's separation the average of ACV before the operation was 3.2±0.2 L, after the operation – 4.06±0.2 L with an average increasion in volume of 27.8±2.6%. In Novitsky operation the average of ACV before the operation was 3.1±0.1 L, after the operation – 3.9±0.1 L, with an average increasion of 24.2±1.7%. In Ramiraz + MPRS the average of ACV before the operation was 3.1±0.08 L, after the operation – 4.7±0.22 L with an average increasion of 49.8±4.6%. The study revealed different effects of the three types seperation of the abdominal wall on increasion the ACV. The operation of Ramiraz+ MPRS has the greatest effect on the increasion the ACV (49.8±4.6). The results were successfully used in the choice of the type of operation in 8 patients with large ventral hernias.

Despite the ever growing progress in antibiotic therapy and the advent of the new methods for this purpose, the number of patients suffering from chronic focal infection of the ENT organs has not decreased during the last decades which turns the problem of chronization of inflammation into a serious challenge for the physicians as exemplified by chronic inflammation in the mucous membrane of the middle ear. Pathological changes in the middle ear make up a large fraction of ENT diseases of importance not only for otorhinolaryngologists but also for the specialists in the related medical disciplines. The present article is an overview of etiological, pathogenetic, and pathomorphological aspects of chronization of the inflammation process that are known to occur in the mucous membrane of the middle ear. In the overwhelming majority of the cases, the main cause of the conversion of acute inflammation in the middle ear into the chronic condition is the inadequate (incorrect), inopportune or incomplete treatment of the acute inflammatory process in the middle ear.Несмотря на достижения в области антибиотикотерапии и появление новых методов лечения, число больных с хронической очаговой инфекцией ЛОР-органов за последние десятилетия не уменьшается, что делает проблему хронизации воспаления крайне актуальной. Патология среднего уха занимает ведущее место в структуре патологии ЛОР-органов и имеет важное значение не только для оториноларингологов, но и для смежных медицинских специальностей. Представлен обзор по этиологии, патогенезу и патоморфологии хронизации процесса воспаления в слизистой оболочке среднего уха. Основной причиной перехода острого воспаления среднего уха в хроническое в большинстве случаев является неадекватное (ошибочное), несвоевременное или незавершенное лечение острого процесса в среднем ухе.

The article presents the ultrastructural features of utero-placental area in early pregnancy with urogenital infection. The description of the ultrastructural changes in syncytiotrophoblast, decidual cells, multinucleated giant cells, blood vessels of the microvasculature.

to determine the clinical and morphological aspects of endometrial dysfunction caused by chronic endometritis (CE).The study included 239 reproductive-aged patients: 93 were examined for abnormal uterine bleeding; 37 patients of them had a history of miscarriage and secondary infertility, 17 patients had primary infertility (Group 1). The remaining 105 patients with infertility were examined for future in vitro fertilization (Group 2). A comparison group consisted of 41 patients with normal menstrual cycles and reproductive function across the cycle, who had separate diagnostic curettage before forthcoming surgery for uterine myoma. All the women in Groups 1 and 2 underwent standard clinical and morphological investigations, histopathological examination of the material obtained during hysteroscopy with separate diagnostic curettage (Group 1), and aspiration biopsy (Group 2) with the sections being stained with hematoxylin and eosin and by Mallory's method. Immunohistochemical diagnosis was used to assess endometrial receptivity to steroid hormones and glycodelin. Antibodies against CD4, СD8, and CD20 were employed to study local immunity.In Group 1, 52 (55.9%) of the 93 patients admitted to hospital for abnormal uterine bleeding were found to have CE on the basis of a morphopathological examination of the material after separate diagnostic study. In Group 2, CE was established in 59 (56.9%) of the 105 patients after postmortem examination. The patients with CE had a history of reproductive significant infections, such as Chlamydia, Trichomonas, Ureaplasma Mycoplasma, cytomegalovirus, papillomavirus infections, genital herpes, genital candidiasis, and bacterial vaginosis. The CE groups showed functional disorders of the endometrial glandular and surface epithelium. In the middle stage of proliferation, the expression of glycodelin in the glandular epithelial cells was detected to be moderate to strong in 83.3%. During the periovulatory period, no secretion of glycodelin is of fundamental importance for the regulation of reproductive function because this protein has contraceptive activity, by blocking the binding of sperm to the zona pellucida. Accordingly, endometrial glycodelin production during the proliferative phase, which has been identified by the authors in patients with CE, may be one of the pathogenic mechanisms for the development of infertility. In addition, the patients in Groups 1 and 2 compared with those in the comparison group were noted to have a decrease in CD4 cell counts with a simultaneous increase in CD8 expression and a reduction in CD20 levels, especially in Group 2.The patients with SE were identified to have endometrial dysfunction characterized by lower reception to steroid hormones, impairment in glycodelin secretion, retardation in the development of pinopods and in the phase of the menstrual cycle, and local immunity disorders. The above endometrial changes should be taken into account in the pregravid preparation of patients with CE.Цель исследования - определить клинико-морфологические аспекты эндометриальной дисфункции, обусловленной хроническим эндометритом. Материал и методы. В исследование включено 239 пациенток репродуктивного возраста: 93 поступили на обследование по поводу аномальных маточных кровотечений, из них у 37 пациенток в анамнезе имели место невынашивание беременности и вторичное бесплодие, у 17 пациенток - первичное бесплодие (1-я группа). Остальные 105 пациенток с бесплодием были обследованы по поводу предстоящего экстракорпорального оплодотворения (2-я группа). Группу сравнения составили пациентки (41) с нормальным менструальным циклом и репродуктивной функцией цикла, которые перенесли раздельное диагностическое выскабливание перед предстоящей операцией по поводу миомы матки. Всем женщинам 1-й и 2-й групп проведены стандартное клинико-морфологическое обследование, патогистологическое исследование материала, полученного при гистероскопии с раздельным диагностическим выскабливанием (1-я группа) и при аспирационной биопсии (2-я группа) с окраской срезов гематоксилином и эозином, по Маллори; иммуногистохимическая диагностика с оценкой рецептивности эндометрия к стероидным гормонам и гликоделину. С целью изучения местного иммунитета использовали антитела к CD4, СD8, CD20. Результаты. Среди 93 пациенток 1-й группы, поступивших в больницу с аномальным маточным кровотечением, у 52 (55,9%) диагностирован хронический эндометрит (ХЭ) на основании патоморфологического исследования материала после проведенного раздельного диагностического исследования. Из 105 пациенток 2-й группы ХЭ установлен у 59 (56,9%) после патоморфологического исследования. Среди репродуктивно значимых инфекций в анамнезе у пациенток с ХЭ выявлены: хламидиоз, трихомониаз, уреаплазмоз, микоплазмоз, генитальный герпес, цитомегаловирусная инфекция, папилломавирусная инфекция, генитальный кандидоз, бактериальный вагиноз. В группах с ХЭ в эндометрии отмечены нарушения функционального состояния железистого и поверхностного эпителия. В средней стадии фазы пролиферации экспрессия гликоделина в эпителиоцитах желез была обнаружена с интенсивностью от умеренной до сильной в 83,3%. Отсутствие секреции гликоделина в периовуляторном периоде является принципиально важным для регуляции репродуктивной функции, так как этот белок обладает контрацептивной активностью, блокируя связывание сперматозоидов с zona pellucida яйцеклетки. Соответственно выявленная продукция гликоделина в эндометрии в фазе пролиферации у пациенток с ХЭ может быть одним из патогенетических механизмов развития бесплодия. Кроме того, у пациенток 1-й и 2-й групп по сравнению с группой сравнения отмечено снижение уровня CD4 при одновременном повышении уровня экспрессии CD8 и снижении уровня CD20 особенно во 2-й группе. Заключение. У пациенток с ХЭ выявлена эндометриальная дисфункция, характеризующаяся снижением уровня рецепции к стероидным гормонам, нарушение секреции гликоделина, отставанием развития пиноподий и фазы менструального цикла, а также нарушением местного иммунитета. Вышеперечисленные изменения в эндометрии необходимо учитывать при прегравидарной подготовке у пациенток с ХЭ.

to investigate the morphological and immunohistochemical features of severe gastric dysplasia (SGD) and early gastric cancer (EGC).The fragments of gastric tumor tissue with adjacent mucosal portions from 50 patients aged from 34 to 79 years (mean age 63.8 years), which had been removed during organ-sparing endoscopic surgery, were histologically, histochemical, and immunohistochemically (IHC) examined.In EGC, there was a preponderance of intestinal-type cancer; the adjacent mucosal areas showed foci of SGD and colonic metaplasia in 100%. Cancer emboli were absent in the lumen of blood and lymphatic vessels in EGC at a рТ1а stage. Relapse of cancer occurred in 10% of the patients with EGC within 6-24 months after endoscopic dissection.Complex morphological and IHC examination allows timely diagnosis of SGD and EGC, namely: the ability to assess the histologic type and depth of invasion of EGC, the presence or absence of cancer emboli in the blood and lymphatic vessels, which is crucial in determining treatment policy and prognosis. The immunophenotype of SGD and EGC with a number of antibodies (Abs) (cytokeratins 7, 8/18, mucins 1, 2 and 5AC, and p53) was assessed, the most significant ones of which were, in our opinion, Abs to p53 and mucin 5AC.Цель исследования - изучить морфологические и иммуногистохимические особенности тяжелой дисплазии (ТД) и раннего рака желудка (РРЖ). Материал и методы. Фрагменты опухолевой ткани желудка с прилежащими участками слизистой оболочки, удаленные с помощью органосохраняющих эндоскопических операций у 50 пациентов в возрасте от 34 до 79 лет (средний возраст 63,8 года). Проведены гистологическое, гистохимическое и иммуногистохимическое (ИГХ) исследования. Результаты. В РРЖ преобладает рак кишечного типа, в прилежащих участках слизистой оболочки в 100% определяются очаги ТД и толстокишечной метаплазии. В РРЖ в стадии рТ1а раковых эмболов в просвете кровеносных и лимфатических сосудов не было. У 10% пациентов с РРЖ после эндоскопической диссекции возник рецидив рака в течение 6-24 мес. Выполнение комплексного морфологического и ИГХ-исследования позволяет своевременно диагностировать ТД и РРЖ, а именно возможность оценить гистологический тип и глубину инвазии РРЖ, наличие или отсутствие раковых эмболов в кровеносных и лимфатических сосудах, что имеет решающее значение для определения лечебной тактики и прогноза. Оценен иммунофенотип ТД и РРЖ с рядом антител (АТ) (цитокератины 7, 8/18, муцины 1, 2 и 5АС, р53), наиболее показательными из которых, на наш взгляд, явились АТ к р53 и муцину 5АС.

The article presents the results of histological examination of early gastric cancer, endoscopic submucosal remote resection. An algorithm for the morphological study: methods of histological, histochemical and immunohistochemical processing tissue samples, understands the sequence of morphological analysis with findings and conclusions on the effectiveness of endoscopic surgery.

to evaluate objectively the effectiveness of currently used diagnostic and curative approaches to gastrointestinal stromal tumors (GIST).Early and remote results of treatment of 49 patients with gastric GISTs were presented. Herewith in 20 (40.8%) patients the disease was complicated by gastrointestinal bleeding. 43 (87.7%) of 49 patients with gastric GIST were operated. Conventional surgery was performed in 24 (55.8%) cases, laparoscopic interventions - in 12 (28%) cases, endoscopic endoluminal - in 7 (16.2%). 6 (14.2%) patients were not operated.Intraoperative complications were observed in 2 (4.65%) patients. In postoperative period complications occurred also in 2 (4.65%) patients. In long-term postoperative period tumoral process progression was observed in 3 (8.3%) patients. Recurrence was diagnosed in 2 (5.6%) patients.Цель. Оценить эффективность используемых лечебно-диагностических подходов у больных с гастроинтестинальными стромальными опухолями желудка. Материал и методы. Представлен анализ непосредственных и отдаленных результатов лечения 49 пациентов с гастроинтестинальной стромальной опухолью желудка, при этом у 20 (40,8%) пациентов течение опухоли усугубилось желудочно-кишечным осложнением. Из указанной группы больных оперированы 43 (87,7%). В 24 (55,8%) наблюдениях выполнены традиционные хирургические вмешательства, в 12 (28%) - лапароскопические операции, в 7 (16,2%) - эндоскопические внутрипросветные операции. В 6 случаях оперативное вмешательство не проводилось. Результаты. Интраоперационные осложнения отмечены у 2 (4,65%) больных, послеоперационные осложнения также у 2 (4,65%) больных. В отдаленном периоде у 3 (8,3%) больных выявлено прогрессирование гастроинтестинальной стромальной опухоли, рецидив заболевания отмечен у 2 (5,6%) пациентов.

An endoscopic diagnosis of superficial epithelial neoplastic gastric lesions and early gastric cancer is the challenge of medicine today. It remains at a low level without the use of modern endoscopic technologies such as HDTV and magnifying endoscopy, narrow band imaging (NBI) and similar image-enhanced endoscopic methods, which provide the visualization of microsurface and microvascular pattern. There are a few endoscopic classifications of microsurface and microvascular patterns to distinguish benign and neoplastic superficial gastric epithelial lesions. However, the most effective classifications are based on the intuitive analysis of regularity of surface or/and vascular pattern or heterogeneity of vessels shape and thickness. They are complex for understanding and learning to inexperienced specialists. In this study, we performed expert and computer analysis of 104 HDTV and magnifying NBI endoscopic images of benign and neoplastic gastric lesions in parallel. The images were described for 7 clinical and 23 endoscopic parameters, including 12 qualitative parameters of microsurface and microvascular patterns by the expert evaluation. After statistical analysis, the significant parameters were defined, and the decision rule for the differential diagnosis of benign and malignant lesions were composed. An accuracy of the decision rule was 95.8% for selection of benign lesions and 81.8% for epithelial neoplasia. We performed the computer-aided image analysis using a method "bag of visual words" to distinguish endoscopic images based on irregular vascular pattern as the most significant parameter in expert image analysis and we have shown the accuracy 73-78% for this method. We plan to use this method for independent computer-aided analysis of endoscopic images for differentiation of benign and neoplastic epithelial gastric lesions and creating the clinical decision support system for endoscopy.

to improve the immunohistochemical diagnosis of AL amyloidosis, by generating novel peptide antibodies against the variable and constant regions of the κ-light chains.All amyloidogenic κ-light chains were sought in the scientific literature and the database of the National Center for Biotechnology Information. On the basis of the findings, a chain was formed from the most common amino acid residues that were used to choose peptide regions for immunization. Four antibodies were generalized via immunization of rabbits with two peptides that corresponded to the variant or constant regions of κ-light chains.The specificity of the obtained antibodies was confirmed using a series of 222 biopsy specimens from 193 patients with AL, AA, transthyretin, or insulin amyloidosis. All the novel polyclonal peptide antibodies produced positive staining in cases of ALκ amyloidosis.The generated polyclonal peptide antibodies against the variable and constant regions of κ-light chains are able to improve the immunohistochemical diagnosis of amyloidosis.Цель - улучшение иммуногистохимической диагностики AL-амилоидоза путем создания новых пептидных антител, направленных к вариабельному и константному регионам каппа-легких цепей. Материал и методы. В научной литературе, а также в базе данных национального центра биотехнологической информации (NCBI) провели поиск всех амилоидогенных каппа-легких цепей. На основании полученных данных составлена цепь из наиболее часто встречающихся аминокислотных остатков, из которых и были выбраны пептидные регионы для иммунизации. Четыре антитела были генерированы в результате иммунизации кроликов двумя пептидами, которые соответствовали вариабельному и константному регионам каппа-легких цепей. Результаты. Специфичность полученных антител подтверждена на серии из 222 биоптатов, полученных у 193 пациентов с AA-, AL-амилоидозом, транстиретиновым и инсулиновым амилоидозом. Все новые поликлональные пептидные антитела дали позитивную окраску в случаях с AL-каппа-амилоидозом. Заключение. Созданные нами поликлональные антитела, направленные к вариабельному и константному регионам каппа-легких цепей, способны улучшить иммуногистохимическую диагностику амилоидоза.

Preeclampsia is the most menacing complication of pregnancy and childbirth worldwide and remains one of the leading causes of maternal and perinatal morbidity and mortality. It is characterized by a complex etiopathogenesis with specific clinical and laboratory changes (hypertension, proteinuria and edema), as well as by the morphological pattern of target organ damage and uteroplacental blood vascular lesions. However, the triad of clinical signs of preeclampsia is not encountered in all cases now.to study the clinical and anatomical aspects of preeclampsia at the present stage.17 maternal deaths due to preeclampsia were studied at the medical institutions of the Moscow Healthcare Department from 2012 to the first half of 2017 through postmortem examination at City Clinical Hospital Thirty-One, Moscow Healthcare Department.This analysis showed the atypical course of preeclampsia (without substantial blood pressure elevations, with mild/moderate proteinuria, but almost always with edema). The characteristic feature is a laboratory sign, such as thrombocytopenia and liver enzyme dysfunction. Morphological examination of deceased patients showed that almost half of the cases had brain hemorrhages of different localization and size; in most cases, renal changes corresponded to the pattern of a shock kidney with endotheliosis and frequently with cortical necroses. The liver was characterized by a considerable increase in size with the development of fatty dystrophy, centrolobular necroses and hemorrhages; there were metabolic damage foci in the heart in almost half of the cases, as well as signs of disseminated intravascular coagulation with numerous hemorrhages in the organs and tissues.Characteristic uteroplacental artery morphological changes in both the surgical and autopsy material render a leading assistance in the diagnosis of preeclampsia/eclampsia.Преэклампсия (ПЭ) является самым грозным осложнением беременности и родов во всем мире и остается одной из ведущих причин материнской и перинатальной заболеваемости и смертности. Характеризуется сложным этиопатогенезом со специфическими клинико-лабораторными изменениями (артериальная гипертензия, протеинурия и отеки), а также морфологической картиной поражения органов-мишеней и кровеносных сосудов маточно-плацентарной площадки. Однако в настоящее время триада клинических признаков ПЭ встречается не во всех случаях заболевания. Цель - изучение клинико-анатомических аспектов ПЭ на современном этапе. Материал и методы. Изучено 17 случаев материнской смерти от ПЭ в медицинских учреждениях Департамента здравоохранения Москвы за период с 2012 г. по первое полугодие 2017 г. с применением патолого-анатомического исследования на базе ГБУЗ ГКБ #31 Депертамента здравоохранение Москвы. Результаты. Проведенный анализ показал атипичное течение ПЭ (без существенного повышения артериального давления, со слабой/умеренной протеинурией, но почти всегда с отеками). Характерным является и лабораторный признак - наличие тромбоцитопении и ферментативная дисфункция печени. Морфологические исследования умерших пациенток показали, что почти в половине случаев имелись кровоизлияния в головной мозг различной локализации и размера; изменения в почках в большинстве случаев соответствовали картине 'шоковой' почки с эндотелиозом и часто с кортикальными некрозами. Для печени характерно значительное увеличение размеров с развитием жировой дистрофии, центролобулярных некрозов и кровоизлияний; в сердце почти в половине случаев выявлены очаги метаболического повреждения; признаки ДВС-синдрома с многочисленными кровоизлияниями в органах и тканях. Заключение. Ведущую помощь в диагностике ПЭ/эклампсии оказывают характерные морфологические изменения маточно-плацентарных артерий как в операционном, так и в аутопсийном материале.

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.

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.

Morphological examination of microcirculatory bed vessels in the gastric and duodenal mucous membranes was performed in asthmatic patients. The gastroduodenal area showed signs of capillary dysfunction and a vascular component of mucosal remodeling, like bronchial wall remodeling in asthma.

We studied morphological changes in the liver after local MW-destruction. Mircowave 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.

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 immunomorphological characteristics of the gastric mucosa were evaluated and analyzed in patients with asthma of varying severity who received or did not receive inhaled or oral glucocorticosteroid therapy and in the control group. Immunohistological examination and morphometric analysis were used to study inflammatory infiltration in fundic mucosal biopsy specimens from patients with and without asthma. There were crucial immunomorphological differences between the examined patient groups and signs of the gastroprotective effect of inhaled glucocorticosteroids used in the basic therapy of asthma on the gastric mucosa. There was evidence that it is urgent to prevent erosive and atrophic gastritis and other inflammatory stomach diseases in asthma.

The paper describes a case of Wegener's granulomatosis with upper airway and lung involvements in a 14-year-old patient. Cavernous pulmonary tuberculosis was presumptively diagnosed during planned examination. The diagnosis of Wegener's granulomatosis was established by examining the materials obtained during marginal resection of the lung. The clinical and laboratory indices and histological findings of the biopsy specimens taken during open lung biopsy were considered.

Combination of bronchial asthma and gastrointestinal pathology is frequently encountered in clinical practice. Clinical symptoms of this condition are highly diversified and gastrointestinal diseases play an important role in exacerbation of bronchial asthma. The prevalence of allergic diseases has recently become rampant. Eosinophilic oesophagitis is worth of special attention because its histological criteria, unlike clinical ones, are well defined. They include chronic immune antigen-mediated inflammatory oesophageal disease with pronounced intraepithelial eosinophilic infiltration and clinical symptoms resulting from oesophageal dysfunction that resemble manifestations of gastroesophageal reflux disease but fail to respond to antireflux and antacid therapy. Many specific and practical aspects of the problem remain to be elucidated. The poor awareness of clinicians of this disease hampers its adequate diagnostics and treatment. In order to revise and optimize the former diagnostic and therapeutic algorithm., an interdisciplinary expert group was set up in 2010 constituted by specialists of the American College of Gastroenterology, American Academy of Asthma, Allergy and Immunology, and Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Results of the work of this group together with the literature data on eosinophilic esopahgitis are discussed in the present review.