[Clinical pathomorphology of critical conditions].

The authors present a review of clinicopathologic manifestations of the most important syndromes of terminal period. Insufficiency and failure of the heart, lungs, brain, kidneys, and liver as well as multiple organ failure are characterized. Precise definition in the autopsy report of the prevailing syndrome and type of death makes it possible to assess adequacy of intensive care and resuscitation, reveal probable causes of their ineffectiveness and improve treatment protocols in premortal period of the disease.

[Experience in the treatment of severe forms of sepsis by extracorporeal therapy and hyperbaric oxygenation]. / Opyt lecheniia tiazhelykh form sepsisa metodami ékstrakorporal'noi terapii i giperbarooksigenatsii.

The results of multiple modality treatment of 81 patients with sepsis complicated by multiple organ failure are assessed. In 40 patients the traditional therapy of sepsis was supplemented with extracorporeal methods (hemoperfusion, autotransfusion of UV-exposed blood, and perfusion of xenospleen slices) and hyperbaric oxygenation (HBO) sessions. In the patients treated traditionally the mortality was 94%, whereas addition of extracorporeal treatment and HBO decreased this value to 40%. Hence, extracorporeal treatment and HBO are recommended for the treatment of sepsis.

[Structural-metabolic features of uremic gastroenteropathy]. / Structurno-metabolicheskoe osobennosti uremicheskoi gastroénteropatii.

Concentrations of uremic toxins in the blood and jejunal juice of 72 patients with chronic renal failure (CRF) were studied as well as morphologic changes in biopsies from jejunal mucosa and submucosa, activity and location of acid and alkaline phosphatase as markers of intracellular and transmembrane transport. It was found that maximal excretion of uremic toxins in the jejunum occurs in CRF stage IIA and IIB. In terminal CRF excretion of uremic toxins delays from their concentration in the blood. This process is related with changes in enzymic processes. Histologically, all the examinees exhibited signs of chronic enteritis.

[The principles and methods for the complex morphofunctional analysis of toxic injuries]. / Printsipy i metody kompleksnogo morfofunktsional'nogo analiza toksicheskikh povrezhdenii.

The authors analyze experimental intoxication manifestations under the effects of chemical compounds of different classes using various morphologic methods including cytospectrophotometric analysis of the activities of a number of redox and hydrolytic enzymes. Types of structural and metabolic restructuring of the elements and microcirculatory bed of some organs during their toxic injury are demonstrated. A complex functional and morphologic analysis of visceral injuries with mathematical processing of quantitative parameters is believed to be a perspective method for forensic medical expert evaluation of intoxications.

[The cytochemical characteristics of the epithelium of the proximal nephron and of the endothelium of the peritubular capillaries and kidney functional status in chronic glomerulonephritis patients]. / Tsitokhimicheskaia kharakteristika épiteliia proksimal'nogo otdela nefrona, éndoteliia peritubuliarnykh kapilliarov i funktsional'noe sostoianie pochek u bol'nykh khronicheskim glomerulonefritom.

To assess the role of metabolic shifts in pathogenesis of excretory renal dysfunction arising in chronic glomerulonephritis (CGN), two groups of patients were considered. Fourteen patients of group 1 had CGN in a preazotemia stage, thirteen patients of group 2 died of CGN-induced uremia. Cortical nephrobiopsies obtained intravitally (group 1) and renal tissue specimens obtained at autopsies during postmortal hours 0-2 (group 2) were investigated. Apical epithelium of proximal canaliculi in group 1 showed higher levels of acid phosphatase (AP), though much lower of succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) compared to group 2. In basal proximal nephrothelium of group 1 the activity of LDH and AP was inhibited against these values in group 2. The activity of NADPN2-dehydrogenase, SDH and AP in group 1 surpassed that in group 2 in endothelium of renal cortex peritubular capillaries. These structures LDH and AP proved more active in group 1. The authors observed a series of significant multidirectional correlations between the activity of the enzymes studied and renal excretion. The growing activity of NADN2-dehydrogenase and AP was associated with diminution of electrolyte and water excretion, while enhancing LDH activity exhibited the opposite effect. It is concluded that progression of cortical disorders in the kidneys of CGN patients entails serious metabolic derangement reflected by imbalance in aerobic and anaerobic metabolism. These biochemical shifts result in ambiguous functional sequelae and may contribute both to renal retention of fluid, electrolytes and their excretion. The latter is likely a compensatory mechanism involved in maintenance of water-salt homeostasis in relevant patients.

[Comparative structural analysis of the liver and kidneys in experimental chronic renal insufficiency]. / Sravnitel'nyi strukturnyi analiz pecheni i pochek pri éksperimental'noi khronicheskoi pochechnoi nedostatochnosti.

The enzymatic activity/succinate-, lactate-, NADP-H2- and NAD-H2-dehydrogenase, alkali and acidic phosphatase/in renal and hepatic tissues has been studied on subtotally nephrectomized rats. Activation of hepatic functions and metabolism has been shown to occur during the development of experimental chronic renal insufficiency.

[Interrelation of changes in the epithelium of kidney tubules and interstitium in nephrosclerosis based on morphometric and histochemical data]. / Vzaimosviaz' izmenenii épiteliia kanal'tsev i interstitsiia pochek pri nefroskleroze po dannym morfometrii i gistokhimii.

Kidneys from 90 individuals who had died from atherosclerosis, hypertensive disease, or chronic glomerulonephritis were examined following early autopsies. The nephron epithelium and the endothelium of peritubular capillaries were studied for activities and distribution patterns of NADPH2 dehydrogenase, lactate dehydrogenase, succinate dehydrogenase, and acid and alkaline phosphatases, for relative capillary and connective tissue volumes, and for lymphocyte, monocyte, and plasma cell numbers. A mathematical analysis of the histochemical and morphometric data provided information on the nature of changes in the renal microcirculatory bed and on the roles of free stromal cells in various forms of nephrosclerosis as well as on the zonal distribution of the parameters studied. Intercellular and vascular-cellular links were found to be weakest in the most advanced stage of chronic glomerulonephritis involving reduction of peritubular capillaries. In cardiovascular disorders, the morphofunctional characteristics of the microcirculatory bed and of its volume showed reciprocal changes, probably of a compensatory character.

[Stereological characteristics and enzymatic activity of myocardial capillaries in different variants of pathology and death (data from immediate autopsies)]. / Stereologicheskaia kharakteristika i fermentativnaia aktivnost' kapilliarov miokarda pri nekotorykh variantakh patologii i smerti (po materialam srochnykh vskrytii).

Parallel stereo- and cytospectrophotometric examinations of human myocardial capillaries, 20-60 min after biological death were carried out. The activity of alkaline phosphatase, adenosine triphosphatase, lactate dehydrogenase and NAD-diaphorase in the capillary wall in relation to the sex and age in cardiovascular pathology, renal diseases and leukemias were studied. The permeability and level of energy supply of transendothelial transport were found to depend on the kind of the main pathological process and type of death. According to the parameters under study, the functional state of the capillary network of the myocardium in atherosclerosis with or without its combination with hypertension and also in secondary renal hypertension is described.

[Possibilities and various results of the use of contact microscopy in pathological practice]. / Vozmozhnosti i nekotorye rezul'taty primeneniia kontaktnoi mikroskopii v patologoanatomicheskoi praktike.

A method for tissue staining for contact microscopy is described. Preliminary results of using a contact microscope in histological examinations of operation, biopsy and autopsy materials are presented. The proposed method permits a rapid microscopic diagnostic examination of diverse pathological material in any dissecting room of wide profile.

[Cytospectrophotometric analysis in enzyme histochemistry (limits of reproducibility and reliability)]. / Tsitospektrofotometricheskii analiz v gistokhimii fermentov (granitsy vosproizvodimosti i nadezhnosti)

The article discusses results of the investigation into variability of the thickness of sections of a non-fixed frozen tissue obtained in cryostat, the dependence of optic density of histoenzymological preparations upon the thickness of a section and duration of incubation, degree of the accuracy of measurements of the optic density by probes of a different diameter, compatibility of results obtained by various techniques of cytospectrophotometry. It is shown that when the scale of microtome-cryostat was set at 5 mcm the thickness of sections varied in the range of 10%, at 10 mcm--in the range of 2%. In preparations as thick as 10 mcm2 and more lineal interrelationships between their optic density and duration of incubation were observed. In the photometric analysis of results of tetrasole reactions the accuracy of measurement is inversely proportional to the size of the probe: M+/-m--0.27+/-0.006--0.009 with area 3.0 mcm2 and 0.27+/-0.002 fith aea 0.8 mcm2. Results of measurement of optic density of ethanol by photoelectric and photographic techniques of cytospectrophometry (on the apparatus MUF-5, MUF-6, MF-2, MF-4, IFO-451) differ in the range of 0.5%, of histoenzymalogical preparations--in the range of 5--7%. On the basis of the data obtained a conclusion may be drawn that, if certain conditions are observed, the cytospectrophotometric analysis of histoenzymological preparations will give compatible results the accuracy of which meets the requirements put in a 95% level of probability.

[Functional morphology of gastric mucosa in the syndrome of celiac artery stenosis before and after decompression]. / Funktsional'naia morfologiia slizistoi obolochki zheludka pri sindrome stenoza chrevnoi arterii do i posle dekompressii

Under study were morphological changes in the gastric mucosa in 40 patients with the syndrome of abdominal ischemia due to a varying degree of stenosis of the celiac artery, and in 8 patients without any changes in the celiac artery. In 10 cases the mucous membrane was studied histoenzymologically. In a marked stenosis of the celiac artery there was observed an atrophy of the mucosa and decreased general activity of succinate-, lactate, and NAD-N-dehydrogenases on account of a decreased number of cells, in which these enzymes are revealed. In early stages of the disease restoration of blood flow would result in normalization of the mucous membrane structure.

[Methodological peculiarities of the preliminary preparation of the thyroid gland for histochemical and electron microscopic study]. / Metodicheskie osobennosti predvaritel'noi obrabotki shchitovidnoi zhelezy dlia gistokhimicheskogo i élektronnomikroskopicheskogo

Cryostate sections of tissues preliminarily frozen in benzine cooled with liquid nitrogen are recommended for use in a histological for use in a histological and histoenzymological study of the thyroid gland. In electron microscopic study the thyroid gland should be fixed by injection of a 4% solution of glutaraldehyde on a 0,075M cacodilate buffer immediately into the thyroid parenchyma.