[Pulmonary histological and ultrastructural changes in HIV infection concurrent with tuberculosis].

OBJECTIVE: To analyze cellular and subcellular disorders in the lung in the presence of HIV-associated tuberculosis. MATERIAL AND METHODS: The investigators made a comprehensive morphological examination of 25 autopsy specimens from patients who had died from HIV-associated tuberculosis. Lung pieces from the foci of caseous necrosis at its boundary and adjacent lung segments and from macroscopically intact perifocal pulmonary segments were microscopically explored. Plain stains and Ziehl-Neelsen histobacterioscopy were used for light microscopy. An immunohistochemical study was conducted using tuberculosis mouse monoclonal antibodies (clone 1.1/3/1, Vector). Seven early autopsy specimens (1-2 hours after statement of biological death) were investigated ultrastructurally. Ultrathin sections were contrasted with Reynolds' lead citrate and looked through a Libra-120 transmission electron microscope (Germany). Semithin sections were stained with toluidine blue. RESULTS: HIV-associated tuberculosis is a disease accompanied by dual aggressive infection. Impaired blood-air barrier integrity gives rise to structural and ultrastructural changes primarily in type I alveolocytes that are responsible for physiological gas exchange and detoxification. Type I alveolocytes have been noted to be in close contact with plasmocytes that are most ultrastructurally preserved and at the same time display the phagocytic and detoxifying functions being redistributed, which is necessary to keep cells viable and which is a characteristic sign of this comorbidity. This redistribution is due to severe damage to macrophages that are unable to ensure complete mycobacterial phagocytosis; thereby the plasma cells partly assume this function, as supported by ultrastructural examination. Severe destruction of granulocyte organelles and partial and complete cell necrosis with its preceding apoptotic changes were established. A study of vessels in the microcirculatory bed has indicated that the ultrastructural changes in the endothelial cells are polymorphic, which is characteristic of an exudative-inflammatory response of lung tissue. CONCLUSION: Cellular and subcellular changes, the pattern of intercellular relationships, and necrotic and apoptotic cell rearrangements, which are in one way or another involved in the pathophysiological processes maintaining definite hemostasis, are an important component in the pathogenesis of HIV-associated tuberculosis.

[Structural changes in the gastric and duodenal mucosal capillaries in asthma].

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.

[Comparative morphology of the gastric mucosa in asthmatic patients using inhaled glucocorticosteroid therapy].

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.

[Eosinophilic esophagitis in an asthmatic patient].

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.

[Eosinophilic oesophagitis in bronchial asthma].

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.

[Pathomorphology of the uterus in decreased labor activity].

A comprehensive study of the pathomorphology of the corpus, lower segment, and placental bed of the uterus during powerless labor revealed the systematic pattern of uteroplacental complex abnormalities. In powerless labor, tonic uterine tonic component inactivity that develops in the presence of morphofunctional incompetence of the placental bed is determined by inadequate lacunar transformation of venous collectors of the corpus uteri and a forming lower segment. This leads to insufficient blood accumulation in the uterine venous vascular bed and to the development of hypotonic nonproductive birth pangs.

[Morphofunctional characteristics of microvessels in serous tumors of the ovaries].

High vascularization is noted in serous papillary ovarian tumors of a low malignancy grade, particularly in malignant serous ovarian tumors with low vascularization in benign neoplasms. Pronounced morphological changes in the vascular wall are found mainly in malignant tumors and tumors of a low malignancy grade where primitive blood vessels of a sinusoid type with a thin muscle wall prevail. Types of vascularization in the tumors studied are variable and this correlates with results of color doppler mapping.

[Ultrastructure of the heart conduction system in diphtheria]. / Ul'trastruktura provodiashchei sistemy serdtsa pri difterii.

Cytoarchitectonics and ultrastructure of the node and conducting myocardiocytes of the conducting system of the heart and surrounding blood capillaries and nervous fibers are described. In diphtheria, metabolic and destructive changes were found in the node myocytes, conducting myocardiocytes and surrounding structures. The most noticeable changes were seen in the left pedicle of the atrioventricular fascicle and later others components of the conducting heart system. These changes are more pronounced in clear cells of conducting myocardiocytes as compared to the node myocytes.

[Ultrastructural characteristics of microcirculatory gingival vessels in chronic periodontitis]. / Ul'trastrukturnaia kharakteristika krovenosnykh sosudov mikrotsirkuliatornogo rusla desny pri khronicheskom parodontite.

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.

[Morphological characteristics of cell populations in bronchial biopsy from mining-chemical factory workers]. / Morfologicheskie osobennosti kletochnykh populiatsii bronkhobioptatov u rabotnikov gornokhimicheskogo predpriiatiia.

A clinicomorphological examination of bronchial and transbronchial biopsies from the workers of a mining and chemical enterprise in Zheleznogorsk has demonstrated that long-term exposure to low-dose radionuclide radiation induces essential inflammatory and scleroticatrophic changes in the bronchopulmonary tissue. All the cell populations of the bronchial epithelium and stroma as well as a respiratory part of the lungs are involved into the pathological process. Squamous metaplasia of the bronchial epithelium is observed in 50% cases, in half of them various dysplastic processes occur. The complex of the above morphological alterations evidences for an oncological trend in pathological processes in the lungs of workers exposed to radionuclides.

Pathomorphological peculiarities of microcirculatory bed in bronchial wall in workers employed in mining and chemical industry.

Morphological alterations of microvessels in bronchial mucosa and blood capillaries of alveolar septa during endobronchitis were examined in workers employed at a plutonium plant and not employed residents (Zheleznogorsk, Krasnoyarsk Region). Alterative, destructive, and dysadaptive changes in pulmonary vessels of workers were paralleled by developing reparative and adaptive processes in neighboring capillaries.

[Ultrastructure of cell populations of gingival soft tissue in chronic inflammatory processes]. / Ul'trastrukturnye aspekty kletochnykh populiatsii miagkikh tkanei desny pri khronicheskom vospalitel'nom protsesse.

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.

[Bacillary generalized angiomatosis in HIV infection]. / Batsilliarnyi generalizovannyi angiomatoz pri VICh-infektsii.

A unique case of generalized bacillary angiomatosis (BA) in a patient who died of HIV infection is described. Apart from widely spread skin lesions there were also manifestations in the brain, lungs, heart, esophagus and intestine. Gram-negative bacteria were found in the histological sections. Oval and roundish bacteria with a predominantly perivascular location were found electron microscopically in the archives material.

[Experimental and clinical pulmonary pneumocystosis]. / Pnevmotsistoz legkogo v éksperimente i klinike.

Rat lungs with hydrocortisone-induced pneumocystosis and a necropsy material from 5 patients with AIDS were studied light- and electron-microscopically. The identity of basic morphological features of lung pneumocystosis development in experiment and humans is demonstrated. Three main periods--latent, pronounced, terminal (pneumocystic pneumonia) are distinguished taking into account the relation of productive and vegetative forms of Pneumocystis carinii, state of the surfactants, type I alveolocytes and inflammation cells.

[Morphologic characteristics of epidermal cells in HIV infection]. / Morfologicheskaia kharakteristika kletok épidermisa pri VICh-infektsii.

Skin biopsies at the plaque regions and adjacent skin obtained from HIV-infected 22-40-year-old patients with Kaposi's sarcoma have been analyzed. Morphological changes revealed depended on the stage of the disease and cell specificity. The alterations were as follows: cell adenoma with degeneration and destruction of cell organelles, changes of the specific granules and microfilaments. Langerhans cells appeared to be most susceptible to HIV and showed all types of changes. In the course of the disease gradual decrease of the activity of the main metabolic enzyme - adenylate cyclase - was recorded.

[Morphologic characteristics of digestive tract mucosa in virus infections]. / Morfologicheskaia kharakteristika slizistykh obolochek pishchevaritel'nogo trakta pri virusnykh infektsiiakh.

Biopsies of mucous membranes of the alimentary canal in widespread viral infections (measles, chicken pox, HIV infection) in 17 to 40-year-old patients of both sexes were examined. Intracellular oedema and viral particles are found in the epithelial cells. The presence of membrane-granular structures in HIV-infection and their absence in other viral infections is of a different diagnostic importance.

[Ultrastructural and electron-cytochemical changes in large intestinal cells in virus diseases]. / Ul'trastrukturnye i élektronno-tsitokhimicheskie izmeneniia kletok tolstoi kishki pri virusnykh porazheniiakh.

Ultrastructural changes of large intestine cells were studied during AIDS and experimental grippe. The results obtained allow to determine the succession of ultrastructural changes by four groups, in which the changes of adenylate cyclase activity were included. The differences of diagnostic investigations were studied during viral alterations.

[The morphofunctional characteristics of the cecum in experimental influenza]. / Morfofunktsional'naia kharakteristika slepoi kishki pri éksperimental'nom grippe.

On the model of experimental influenza using morphological, immunomorphological, cytochemical, electron microscopy and morphometric methods, the authors provided morphofunctional characteristics of the caecum, showed the progression of infectious process and confirmed the dissemination of the virus, availability of virus particles in different cell populations, among them in lymphoid cells.

[The morphofunctional characteristics of the cecum in experimental escherichiosis]. / Morfofunktsional'naia kharakteristika slepoi kishki pri éksperimental'nom ésherikhioze.

Using the model of experimental escherichiosis in mice by means of morphological, immunomorphological, morphometrical and electron microscopy methods, the authors give morphofunctional characteristics of caecum 15 minutes to 2 weeks after inoculation. The authors show the dynamics of infectious process, characterized by changes of microcirculation, increasing lymphoplasmocellular infiltration, dystrophic changes in cells of neuroplexes and degranulation of mast and endocrine cells. The data obtained show that pathological process in caecum during experimental escherichiosis has an immune character, that the above portion of the intestine is a part of endocrine system.

[The ultrastructural characteristics of the endocrine cells of the normal murine cecum and in experimental escherichiosis]. / Ul'trastrukturnaia kharakteristika éndokrinnykh kletok slepoi kishki myshei v norme i pri éksperimental'nom ésherikhioze.

Ultrastructural investigations and a quantitative analysis of caecum endocrine cells were performed in the period from 15 minutes to 2 weeks after inoculation, using the model of experimental escherichiosis. The authors identified 5 types of endocrinocytes in the caecum of mice and showed the reaction of these cells: degranulation, extrusion of granules and their accumulation dependent on the time of the exposure.