[Papillary renal neoplasm with reverse polarity]. / Papillyarnaya opukhol' pochki s reversivnoi polyarnost'yu yader.

Papillary renal neoplasm with reverse polarity is a rare subtype of papillary renal cell tumors with unique morphology, specific molecular features and good prognosis. The article presents literature data and describes our own observation of a papillary kidney tumor with reverse nuclear polarity in a 73-year-old patient. The difficulties of preoperative diagnosis of a tumor are shown, histological and immunohistochemical criteria for diagnosis and differential diagnosis of this tumor with other kidney tumors are presented. This rare case is of interest for both pathologists and clinicians.

[Primary amyloidoma of the brain]. / Pervichnaya amiloidoma golovnogo mozga.

Primary brain amyloidoma is rare tumor-like lesion characterized by focal accumulation of insoluble fibrillar aggregates of amyloid in brain tissue without systemic amyloidosis. Literature review and a case report of primary brain amyloidoma in 61 years old female are given with a special attention on the complexity of preoperative diagnosis.

[Protocol for histological examination of liver transplant dysfunction]. / Protokol gistologicheskogo issledovaniia disfunktsii transplantata pecheni.

The protocol for histological examination of liver transplant dysfunction, which is used at the A.I. Burnazyan, Federal Medical and Biophysical Center and has been developed on the basis of the liver transplant rejection protocol designed at the University of Pittsburgh, is proposed for routine use.

[Primary splenic angiosarcoma]. / Pervichnaia angiosarkoma selezenki.

Primary splenic angiosarcoma is a rare and high-grade vascular tumor having a significant metastatic potential. The authors give the data available in the literature and describe their own case of primary splenic angiosarcoma in a 42-year-old male patient with multiple distant metastases in the lymph nodes and skin. The paper shows some difficulties in the morphologic diagnosis of this tumor.

[Morphological features of IgG4-related lesions at various sites]. / Morfologicheskie osobennosti IgG4-sviazannykh porazhenii razlichnykh lokalizatsii.

OBJECTIVE: To determine the morphological features of IgG4-related lesions and to improve pathomorphological criteria for diagnosing various clinical variants of IgG4-related disease. MATERIAL AND METHODS: Biopsy and surgical materials from 100 patients with tumor-like lesions at various sites (63 cases of IgG4-related lesion and 37 cases of non-IgG4-related inflammatory processes) were studied. Histological and immunohistochemical studies were conducted to determine the absolute counts of CD138+ cells, IgG+ and IgG4+ in the inflammatory infiltrates, as well as IgG4/IgG and IgG4/CD138 cell ratios. RESULTS: When IgG4-related disease manifested, pancreatic, lacrimal, and salivary gland lesions prevailed. Brisk lymphoplasmacytic infiltration is characteristic for tissue damage in the eye, salivary glands, thyroid, pancreas, and skin. The formation of moiré fibrosis was specific to damages to the pancreas, liver and bile ducts, and eye tissues. Obliterative phlebitis is most often observed in pancreatic and salivary gland lesions. According to international criteria, the frequency of achieving the required level of IgG4+ plasma cells in each organ was high in lesions of the pancreas, bile ducts, and lymph nodes and that was low in lesions of the salivary and lacrimal glands and skin. The IgG4+/CD138+ and IgG4+/IgG+ cell ratios exceeded 40% in all cases. CONCLUSION: The morphologic diagnosis of IgG4-related disease is based on the detection of lymphoplasmacytic infiltration, moiré fibrosis, and obliterative phlebitis, as well as on the calculation of the absolute number of IgG4+ plasma cells in the inflammatory infiltrate and on the determination of IgG4+/IgG+ and IgG4+/CD138+ cell ratios. The number of IgG4+ plasma cells depends on the location of the lesion and on the phase of the process.

[FACTORS AFFECTING SPERMATOGENESIS PRESERVATION IN RATS WITH SEMINIFEROUS TRACT OBSTRUCTION].

The aim of the study was to examine the effect of the seminal tract obstruction of different degree and duration on the morphological and functional condition of testicular tissue. The study was conducted in 50 male Wistar rats. Three experimental models of seminiferous tract obstruction were set up: obstruction of the proximal part of the ductus deferens, obstruction of the distal part of the ductus deferens and obstruction of at the epididymis level. Morphological evaluation of testicular tissue was performed at 3 and 6 months after the obstruction. It was found that obstruction at the epididymis level caused the most severe impairment of spermatogenesis.

Caspase expression in placental terminal villi in spontaneous and induced pregnancy.

Placental levels of caspase 1, 8, and 10 were studied by the immunohistochemical method in full-term spontaneous and induced pregnancies. The levels of these caspases in the placental terminal villi were significantly higher in induced pregnancy. The changes were more marked after intracytoplasmatic injection of spermatozoa.

Expression of insulin-like growth factors in the placenta in preeclampsia.

Comparative morphological study of the placentas in women with preeclampsia and small-for-date fetuses was carried out. Expression of insulin-like growth factor-1 (IGF-1), insulin-like growth factor-2 (IGF-2), and insulin-like growth factor binding protein-3 (IGFBP-3) was detected by immunohistochemical methods. Low expression of IGF-1 and high expression of IGF-2 and IGFBP-3 in the placental tissue depending on preeclampsia severity were detected. The most pronounced changes were found in preeclampsia associated with small-for-date fetuses.

[Comparative immunohistochemical evaluation of vascular endothelial growth factor and its receptors in the placental villi in gestational diabetes mellitus and type 1 diabetes].

The authors performed a comparative immunohistochemical study of placental vascular endothelial growth factor (VEGF) and its receptors (VEGFR-1, VEGFR-2 and VEGFR-3) in gestational diabetes mellitus and type 1 diabetes. The expression of VEGF and its receptors was ascertained to be increased in the placental terminal and stem villi, mostly in type 1 diabetes. The changes found in the immunophenotype of terminal and stem villi suggest that the placenta is damaged and this may accordingly lead to intrauterine growth disturbances in the fetus and further to diseases in the neonatal infant.

The expression of matrix metalloproteinases in placental tissue depends on the severity of undifferentiated connective tissue dysplasia.

Immunohistochemical study of MMP-2 and MMP-9 expression in placental tissue of pregnant patients with undifferentiated connective tissue dysplasia of different severity showed that more severe condition was associated with higher expression of these MMP, this underlying the development of pregnancy and labor complications. The most pronounced elevation of the studied MMP levels was found in the basal plate decidual cells in women with undifferentiated connective tissue dysplasia of more than 18 score.

Morphometric evaluation of vascularization of hepatic focal nodular hyperplasia.

Comparative morphometric evaluation of the quantitative characteristics of vessels in hepatic focal nodular hyperplasia tissue was carried out on preparations stained with hematoxylin and eosin and by immunohistochemical detection of CD34 and CD105. Analysis of histological preparations stained with hematoxylin and eosin allowed the most ample characterization. Immunohistochemical detection of CD34 promoted better visualization of endotheliocytes, but just some sinusoids in the preparations were labeled. Expression of CD105 visualized the active endothelial cells and hence, helped to evaluate neoangiogenesis.

[Early neonatal mortality in the Russian Federation in 2010].

The paper analyzes the data of the Federal State Statistics Service on early neonatal mortality in the Russian Federation as a whole and its federal districts in 2010. There was a steady decline (ranging from 6.52 to 2.75%) in the mean early neonatal mortality rates in the Russian Federation in 2000-2010. In 2010, there were low, moderate, and high early neonatal mortality rates in 59 (71.1%), 20 (24.1%), 4 (4.8%) federal subjects, respectively. Most neonatal deaths were noted within the first 24 hours of life. According to the Federal State Statistics Service data, the commonest cause of early neonatal death in Russia is respiratory distress (103.2 deaths per 100,000 live births), hyaline membrane disease in particular. Among the causes of neonatal death, maternal diseases unrelated to pregnancy are indicated most commonly (in 22.7% of cases).

Morphological characteristics of the terminal villi in placental failure.

A comparative morphological study of the placentas in spontaneous and induced pregnancy aggravated by placental failure was carried out. Placental failure manifested by shrinkage of the terminal villi, lesser number and section areas of their capillaries, and higher expression of vascular endothelium growth factor and endothelial NO synthase in the syncytiotrophoblast and villous endotheliocytes. The changes were more pronounced in pregnancy developing after in vitro fertilization.

[Stillbirth rates in the subjects of the Russian Federation in 2010].

The paper analyzes the 2010 Russian State Statistics Service data on stillbirth rates in the Russian Federation and its subjects. There was a steady decline in the mean stillbirth rate (from 6.8 to 4.67 per thousand) in the Russian Federation in 2000-2010. In 2010, the rate was low in 10 (12%) subjects, moderate in 42 (50.6%), and high in 31 (37.4%). The reduction in the proportion of intranatal stillbirth is naturally accompanied by the increase in its antenatal component. According to the data of the Russian State Statistics Service, the most common cause of stillbirth is intrauterine hypoxia and birth asphyxia: 391.9 per 100,000 born alive and dead. The most frequent maternal cause was notified to be placental pathology: 209 per 100,000 born alive and dead.

Vascular endothelial growth factor and its receptors in the placental villi of pregnant patients with pre-eclampsia.

Comparative morphological study of the placentas from women with pre-eclampsia of different severity was carried out. The expression of vascular endothelial growth factor and its receptors (VEGFR-1, VEGFR-2, VEGFR-3) was studied by immunohistochemical methods. Branched angiogenesis processes predominated in the placentas of patients with pre-eclampsia. The syncytiocapillary membranes were thickened, the number of syncytial buds was greater than normally. Immunohistochemical studies showed high expression of VEGF and VEGFR-1 and low expression of VEGFR-2 in the placental villous structures.

[Optimization of an approach to solving the problem of a barren marriage in secretory azoospermic men].

AIM: To compare the efficiency of using different interventional procedures for a barren marriage in case of secretory azoospermia (SAS). SUBJECTS AND METHODS: The trial enrolled 110 patients aged 25 to 54 years with SAS. The levels of sexual hormones were determined; ovarian punch biopsy was performed. RESULTS: Decreased volume of the ovaries was noted in 85.3% of the patients; diffuse or focal changes in their parenchyma were seen in 65.7%. There was an increase of follicle-stimulating hormone levels and a reduction in testosterone ones. Hyperestrogenemia was identified in 26.5% of the patients. The level of inhibin B was lower in all the patients. The efficiency of standard testicular sperm extraction for cryopreservation was achieved in 28.7% of the patients and that of a microsurgical technique was in 56.7%. The wives of 37 out of the 57 patients included in an assisted reproductive technology program were more than 12 weeks pregnant after 95 intracytoplasmic sperm injection cycles. CONCLUSION: The microsurgical technique is most effective in achieving the successful treatment of patients with azoospermia in order to prevent male infertility.

[Comparative analysis of vascularization degree of hepatocellular carcinoma and focal nodular hyperplasia of the liver according to computed tomography and morphological studies].

OBJECTIVE: A comparative analysis of the degree of vascularization of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNG) of the liver at carrying out multislice computed tomography (MCT) and morphological studies. PATIENTS AND METHODS: 34 patients operated on for HCC (19 patients) and FNG of liver (15 patients) were survey. Preoperative we were analyzed four phases of CT-research: native, arterial, venous, delayed. Degree of vascularization of tissue were evaluated for immunohistochemical preparations on the relative share of the area of blood vessels. RESULTS: In native phase of the MCT-study HCC was detected as hypodense or izodensnoe education. Growth of the blood CT density depend on the type and extent of tumor histological differentiation of cancer. The highest values are set in the fabric of FNG and moderately differentiated HCC. The highest levels of venous growth observed in well differentiated HCC. Indicators of vascularization by CT have maximum values in the unaffected liver parenchyma, and the minimum--in the group of poorly differentiated HCC variant. CONCLUSIONS: Use of computed tomography with bolus contrast enhancement allows to study the characteristics of blood supply of the liver and focal formations. Frequently only the use of this method helps to evaluate specific morphological structure of tumors--hepatocellular carcinoma or focal nodular hyperplasia. As an additional differential diagnostic feature is recommended to increase the density determination of tissue formation in the arterial phase computed tomography study. The maximum of vascularization by computed tomography and immunohistochemistry (with antibodies CD34) are installed in a tissue of highly differentiated hepatocellular carcinoma.

Vascularization of hepatocellular carcinoma tissue depends on its differentiation degree.

Quantitative characteristics of vessels in hepatocellular carcinoma and adjacent liver tissue were studied by morphometric methods after immunohistochemical staining for CD34 and CD105. The number of immunopositive vessels decreased with reduction of tumor histological differentiation degree.

Expression of carbohydrate metabolism markers in full-term spontaneous and induced pregnancy.

Peculiarities of the expression of glucose transporter (GLUT1 and GLUT3) and insulin-like growth factor immunophenotypes in placental villi in full-term physiological pregnancy were studied by immunohistochemical method. In induced pregnancy, changes of different degree in the expression of carbohydrate metabolism markers were detected (most pronounced changes were detected in GLUT3 expression), which was probably associated with higher incidence of obstetrician complications in these patients.

Morphology of placental villi and development of hemorrhages in very small preterm newborns.

We performed a comparative morphometric and immunohistochemical studies of the placentas collected in preterm labor after 27-33-week gestation. Predominating branched angiogenesis processes and more pronounced vascularization of the placental villi were found in the group of newborns with hemorrhagic complications. These changes were paralleled by high expression of VEGF in all villous structures.