Search

The effect of ascending infection of birth-ways on transport of maternal immunoglobulins (Igs) through the placental barrier in humans during the first trimester of pregnancy was studied. The transport of Igs is seen already in 3.5-to 5-week-old embryos, and different cellular and biochemical compounds participate at each stage of this process. Transport of Igs through the trophoblast is carried out due to the secretory component (SC) and, perhaps, to some other receptors. Monocytes together with Igs penetrate into capillaries between the endothelial cells and are transported with the blood all over the body. It seems that SC and other receptors help Igs to penetrate into capillaries through the endothelium. Further, Igs are transported with erythroblasts. In the development without infection the transport of IgG was seen in all cases studied. Inflammation of the birth-ways is accompanied by an increase in transport of all Igs, already in early embryogenesis. Three groups were distinguished: 1) abortions without inflammation; 2) cases with signs of moderate inflammation (endometritis, deciduitis); 3) cases with intensive inflammation with necrosis and leucocytic infiltration. Transport of Igs was seen in 77.8% cases of the first group and in all cases of groups 2 and 3. Transport of IgM was not found in the first group, but was seen in 50% cases of group 2 and 66.7% of group 3.

Using a modified method for alkalic dissociation, isolated ventricular cardiomyocytes were obtained from eight patients who had died of different diseases. The absolute number of cardiomyocytes, counted in the Fuchs-Rosenthal chamber, ranged between 1.10 x 10(9) and 3.25 x 10(9) in the left ventricle, and between 0.58 x 10(9) and 1.42 x 10(9) in the right ventricle depending on myocardial mass. Mean volume of cells ranged between 75 x 10(3) and 344 x 10(3) microns3, and the content of polynuclear, predominantly binucleated, cardiomyocytes amounted to 14 to 49%. An increase in ventricular myocardium mass was associated with an increase in cardiomyocyte volume. A negative correlation was demonstrated between the absolute number of cardiomyocytes on the one hand, and their mean volume and proportion of polynuclear cells on the other.

Water tests on atrioventricular valves of 125 dead patients with cardiological diseases revealed in 2 of them (1.6%) sagging of mitral cusps in the direction of the left atrium. The valve insufficiency was caused by the rupture of chordal threads in rheumatic desorganization of the connective tissues, necrosis and sclerosis of the papillary muscles in ischemic heart disease. Histological examinations of 104 papillary muscles from 24 autopsy cases showed their frequent involvement, particularly in myocardial infarction of the left ventricle. Under these conditions, comparatively rare development of insufficiency of the atrioventricular valves is explained by their great reserve and compensatory capacities.

Histologic and scanning electron-microscopic investigation of myocardium specimens from patients who had died of various diseases demonstrated cardiomyocyte dissociation which was more common for coronary heart disease accompanied by myocardial infarction and cardiac fibrillation. Consistent morphologic pattern and clinical manifestability of the process permit the establishment of cardiomyocyte dissociation as a specific form of myocardial affection.

Histologic and polarization-microscopic studies of the cardiac infarct area in 64 persons who had died several hours to 3 weeks following an angina attack led to the identification of three types of dying for cardiac muscle cells on the basis of a morphologic criterion (state of myofibrils), described as relaxational, contractional, and lytic, respectively. The cells showing these different types of dying differed with regard to time of appearance, frequency of occurrence, and location in the lesional area, which suggested that each of the three types of dying occurs by a distinct mechanism.

Alkaline dissociation of cardiomyocytes was used for investigation of concentric and eccentric myocardial hypertrophy in 8 deceased patients with carions ventricular myocardial mass. For both ventricles and forms of hypertrophy the length, diameter and volume of the cells were found increased, the increase being proportional for the left ventricle (except the volume) and gross for linear enlargement of the right ventricle in eccentric hypertrophy. Absolute number of cardiomyocytes reached maximum in concentric left ventricular hypertrophy showing the same values with normal-mass ventricles in eccentric hypertrophy.

Polarization-microscopic and micrometric investigations of the myocardium during infarction at autopsy and in experimental ischemic conditions, has shown that one of the earliest and most typical morphological signs of ischemic myocardium is sarcomere relaxation. The latter is expressed by the loss of contractility of muscle cells in life time and in strongly frozen corpses, and due to the effects of fixatives. Increase of the percentage of relaxed sarcomeres parallels the duration of experimental ischemia and the time after myocardial infarction. This allows the indirect calculation of irreversible cell change.

Histological examination of the myocardium in section and operation material and in experimental animals allowed two different types of its fragmentation to be distinguished. Type I is characterized by cellular dissociation of the muscle fibers, develops during life and may be accompanied by stromal reaction ending in sclerosis. Type II is of artificial nature and depends both on the direction of microtoming of the muscle fibers and on their increased fragility the nature of which is obscure as yet. Combination of both types of fragmentation in the same muscle fibers makes difficult their distinct differentiation.

In adult rats with experimental myocardial infarction and after swimming training load in atrial and ventricular cardiomyocytes a number of nuclei changes are revealed, which are characterized by deep strangulation with rounded borders, by fissural invagination of nuclear surface in transversal or longitudinal directions, by the presence of long intersection and micronucleus between the nuclei, by close nuclei location. The transferred pictures may be interpreted as manifestation of direct division of interphase nuclei in the absence of figures of mitotic division.

Ultrastructural changes in atrial cardiomyocytes of rats chronically exposed to +5 Gz were investigated. Immediately after exposure most cardiomyocytes showed hypertrophic and hyperplastic changes in practically all cell organelles. During a month-long recovery destructive changes that seemed to reflect hypertrophy regression did not return to norm. The above observations concerning changes in the system of atrial hormones together with pertinent data in the literature suggest that a factor produced by the system may be involved in the complex mechanism of acceleration-induced effects on the animal body.

Study of the DNA content in nuclei and of the number of polynuclear cardiomyocytes in the left auricula atrii and the left ventricle wall in the operation and biopsy material of patients with mitral valvular disease showed hypertrophy to be accompanied by polyploidization and division of the nuclei as well as division of cardiomyocytes themselves.

Electron-microscopic and electron-histochemical studies of specific granules (SG) in the cardiomyocytes of the left atrial auricle in mongrel white rats have shown that SG of intact rats contained proteins and a small amount of catecholamines. Adrenaline injection resulted in SG hyperplasia, while rausedile injection caused SG emptying. Hemodynamic heart overloading increased SG catecholamine content, with rausedile having a pronounced "exhausting" effect. It is suggested that part of auricular cardiomyocytes can be referred to diffuse endocrine cells.

Measurements of sarcomeres in papillary muscles of the right and left ventricles of the heart revealed the lack or an insignificant per cent of relaxed sarcomeres in patients dying with some diseases including ischemic heart disease without acute myocardial infarction and in those dying with acute myocardial infarction outside the zone of ischemic damage. Relaxation of sarcomeres in large groups of muscle fibers detectable even without measurements allows the diagnosis of acute myocardial infarction at a very early stage. Conditions of fixation may affect the size of sarcomeres. This should be kept in mind in analysing their sizes.

The composite use in the study of heart hypertrophy of the method of separate weighing of the ventricles and measurement of the percentage content and average thickness of muscle fibers permits to determine their total mass and length, and on this basis to judge of the level of hypertrophy of the true muscle elements of the myocardium.

A case of alveolar melanoma metastases is described in a 73-year-old female. The implantation metastases on the tendinous choridae of the mitral valve were complicated by tumor embolism of the left coronary artery of the heart along with myocardial infarction and rupture of the left ventricular wall.

Micrometric studies of the sarcomeres of myocytes in the zone of experimentally induced myocardial ischaemia in rats, histological, polarization-microscopic and micrometric studies of the myocardial cells in the zone of infarction in dead humans and model experiments with fixation of distended papillary muscles demonstrated that relaxation of the sarcomeres is characteristic of the myocardial cells damaged by ischaemia. This sign indicating the loss of the contractile function in the injured cells develops in early ischaemia when other histological changes typical for the ischaemic lesions are absent. The percentage of relaxed and distended sarcomeres changes with the increasing duration of ischaemia, and therefore it can be used as an indirect index of the term of ischaemia and, consequently, as a criterion of the irreversibility of the ischaemic lesion of the myocardium.

The study of isolated cardiomyocytes after alkaline dissociation allowed to reveal an individual variability of the absolute number and average volume of cells, as well as characteristics of these indices in the left and right ventricle myocardia of the dead adult patients' hearts. On the basis of the analysis of these indices and of other parameters of isolated cardiomyocytes, a possibility of hyperplasia of nuclei and of muscle cells themselves during their hypertrophy is discussed.

Sarcomere measurements in the infarcted zone at sudden death, outside the infarcted zone and without acute infarction in the myocardium of patients with ischaemic heart disease (IHD) and in patients decreased due to other causes showed that sarcomere relaxation occurs in extensive areas of muscle fibres already in the earliest stage of infarction, and is not found outside the area of acute ischaemia. This phenomenon can be revealed even without sarcomere measurement, by analysing histological material stained by routine methods in normal and polarized light. This facilitates the diagnosis of acute myocardial infarction in subjects who have died suddenly.

The heart of 42 patients dying within 24 hours from acute myocardial infarction was studied by ordinary light and polarizing microscope. The interrelationship between the zone of irreversible ischemic damage and surrounding tissue was investigated. It is shown that during the time of the infarction formation the border zone which could be morphologically identified is absent. Altered cells with relaxated sarcomers are found to be in close neighbourhood with surviving cardiomyocytes or a relatively narrow zone of reperfusion changes also consisting of non-viable myocytes is present between them.

The weight and volume values of heart ventricles from patients dying of cardio-vascular and some other diseases were studied. Measuring of sarcomeres in freely fixed and controlled pressure-fixed hearts showed that with the former method of fixation heart ventricles were contracted and the volume of their cavity approached the tidal volume. In freely fixed and "fresh" hearts removed at autopsies within 2-27 hours after death, concentric and excentric hypertrophy of ventricles may be characterized by numeric values of the relative mass: the ratio of ventricle mass to volume of its cavity, and in the left ventricle--by the relative diameter of the cavity: the ratio of the cavity diameter in cross-section to the thickness of the ventricle wall.

As demonstrates the investigation of cardiomyocytes of the left cardiac parts performed in 16 practically healthy mature persons died in accidents, the average area of the cells projections in the auricular atria makes 644 +/- 15 mcm2, and the portion of the multinuclear cells--2.27%. In the ventricular wall and in the papillar muscle these parameters are 831 +/- 16, 700 +/- 30 mcm2 and 11.25, 12.62%, respectively. Distribution of nuclei in the cardiomyocytes of all the cardiac zones studied is characterized by a predominance of tetra-, hypertetra- and octaploid classes, therefore the average amount of DNA in the nuclei reaches certain high values. Differences in size of the cardiomyocytes revealed in various parts of the heart are explained at their unequal loading under pressure.

A possibility of a peculiar method for division of myocardial cells and nuclei--longitudinal splitting--has been studied in hypertrophic hearts of 19 corpses. Morphological examination of the myocardium (separate weighing of the cardiac ventricles, measuring of myocardial components and muscular fibres in microphotos of transversal sections) has not revealed any signs of longitudinal fibres splitting: their average thickness either increase or remain the same with growth of muscular mass, and per cent of thin and thick fibres remains within limits of unreliable fluctuations. Analysis of serial transversal sections of muscular fibres and their micrometry confirm the reality of longitudinal splitting of the nuclei which is realized through several steps and depends on the degree of hypertrophy of muscular fibres.