[On teaching philosophy at medical higher educational establishments].
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Biomedical subjects
Publications and source records attributed to M A Pal'tsev.
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Case 31 patients with Cushing syndrome are analysed. On the basis of the number of the atypical cells from dark-cell adrenal cortex adenomas, giant-cell adenomas were differentiated as a separate morphological type. Blood concentration of hydrocortisone depends on the cell composition of adenomas. Clear-cell adenomas can be hormone-active and hormont-inactive. The quantitative parameters oblained NMR-tomography, allow detecting morphological type of the tumor with greaf accuracy.
The interaction of IL-1 and TNF alpha in the autolous phase of anti-GBM nephritis was studied. The influx of mononuclear leukocytes into the glomerulus and high cytokine levels induced a decrease in mesangial cell proliferation and an increase in extracellular matrix production. The methylprednisolone suppression of mononuclear leukocyte infiltration caused the autocine cytokine secretion of mesangial cells. Cyclophosphamide decreased cytokine production, but did not affect mononuclear leukocyte infiltration. The absence of mononuclear leukocytes in the site of the injury induced by imbalance between the synthesis and degradation of extracellular matrix components. The uncontrolled metabolism of the extracellular matrix may be induced glomerulosclerosis.
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Autoimmune thyroiditis (AT) are a heterogenous group of organ specific autoimmune diseases (AID) of the thyroid. Their pathogenesis is associated with predisposing, initiating and promoting factors. Morphogenesis is based on the hypersensitivity reaction of the immediate and delayed types with the development of acute or chronic immune inflammation in combination with atrophic and hyperplastic alterations of the parenchyma (reaction of neutralization and inactivation). AT can be subdivided into primary ones (Hashimoto's thyroiditis, chronic lymphocytic thyroiditis, chronic atrophic thyroiditis) and the secondary ones which are the manifestation of the organ-specific AID.
Cyclophosphamide (CP) and methylprednisolone (MP) were tried on rats with experimental nephrotoxic serum nephritis and mice with experimental acute serum nephritis. Pathological processes were analyzed simultaneously in vivo and in vitro. CP reduced the antibody impairment and stimulated glomerular infiltration by mononuclear leukocytes whose mediator spectrum was oriented to repair. MP failed to stop the impairment and aggravated the infiltration. The resultant chaotic accumulation of the extracellular matrix raised the risk of sclerosis. CP showed the advantages in experiment demonstrable also in the clinical setting.
The use of a computer--based morphometric complex "DIAMORPH" for automated morphometric analysis of renal glomeruli is described. By combining the principles of morphological and functional approaches to diagnosis with the capabilities of present--day research equipment, a new informative morphometric parameter--the extent of capillary--mesangium contact--has been identified. With this parameter and its derivatives, it has been possible to differentiate, in a statistically significant way (p less than 0.01), healthy subjects (controls) from patients with manifest diabetes mellitus of up to I year in duration who could not be distinguished through light microscopic or conventional morphometric studies.
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The representatives from 90 departments of pathological anatomy at medical colleges participated in the 3d National Education and Methodology Conference held in December of 1991. The conference discussed the problems of teaching students and postgraduate specialists pathologic anatomy. The conference approved recommendations on further improvement of the system of clinical pathologists training. The International Association of Pathologic Anatomy Teachers has been established. The principal task of the association is coordination of the efforts in advancing the skill of the teachers and development of new guidelines, text books, etc.
Late heterologous and autologous stages of nephrotoxic serum nephritis were studied against the background of MP-induced immunological suppression and PP effect on arachidonic acid metabolism. MP prevented mononuclear infiltration of the renal glomerulus and the development of severe morphological lesions in the autologous stage, while cell culture and mononuclear leukocyte number drastically decreased. PP did not significantly influence the autologous stage of the nephritis though resulted in marked proliferation in both renal glomerulus and mesangial cell culture during the heterologous stage. In spite of more pronounced proliferative activity of mesangial cells interleukin-I level was lower than in animals with nephritis untreated with PP. The enhancement of the proliferative reaction is obviously related, apart from interleukin-I, to the effect of other growth factors.
Late heterologous and autologous stages of serum nephritis together with glomerular cells in culture are studied biochemically, morphologically and immunohistochemically for the assessment of the role of mononuclear leucocyte mediator system. The heterologous stage of the nephrotoxic nephritis is associated with the increase of Interleukin-I and TxA2 production. Role of Interleukin-I in the autologous stage is less pronounced in spite of proliferative activity of cultured mesangial cells. The effect of suppressive factors prevails in the glomerulus.
Immunohistochemical analysis was performed in 21 patients with acute and chronic dysentery, in 32 patients with different forms of salmonellosis in comparison with the cytoenzymatic status (CES) of immunocytes in the mucous membrane of the large intestine. It has been revealed that for acute dysentery the activation of the cellular and humoral links of local immunity is typical, but for salmonellosis--mainly of the humoral one. The chronic processes in dysentery and salmonellosis are connected with the increase in the subpopulation of T8-suppressors. Immunohistochemical data correlate completely with CES of immunocytes and that allows one use them with prognostic purposes.
To specify the role of mononuclear (MN) leukocytes in the development of mesangial cell proliferation, which is one of the main manifestations of glomerulonephritis, cell cultures of renal glomeruli of rats with nephrotoxic serum (NTS) nephritis were examined for the intensity of mesangial cell proliferation, the MN-leukocyte count, and for IL-1 production. The amount of mesangial cells and the intensity of their proliferation in the cultures of glomerular cells from rats with NTS nephritis were much higher than in intact rat cultures. At the same time the glomerular cultures from rats with NTS nephritis demonstrated an increase in the MN leukocyte count together with enhancement of IL-1 production. The treatment with prednisolone averted accumulation of MN leukocytes by the glomerular cultures and noticeably reduced mesangial cell proliferation. The supernatant liquid of cultures of peripheral blood MN leukocytes from patients with active nephritis suppressed human fibroblast proliferation, exerting no such action on mesangial cell culture. During the treatment with prednisolone, the supernatant liquid produced a reverse effect on fibroblast and mesangial cell cultures, which was associated with the clinical improvement of the health status. It is assumed that mesangial cell proliferation seen in nephritis may be related to infiltration of the glomeruli by MN leukocytes and to elevated production by them of IL-1 and that the therapeutic action of prednisolone may be determined by suppression of these processes.
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We investigated the intensiveness of the cell proliferation, number of mononuclear leucocytes (MNL) and production of interleukin-1 (IL-1) in glomerular cell cultures of rats with nephrotoxic serum (NTS) nephritis and control (C) rats. Five days after intravenous injection of nephrotoxic serum from rabbits the glomeruli were isolated, treated with collagenase and cultured over a period of 20 days. In cultures the number and intensity of mesangial cell proliferation in the NTS group were significantly higher than in the C group. Thus, the intensive mesangial cell proliferation in experimental nephrotoxic serum nephritis is related to infiltration of glomerulus by MNL of bone marrow origin with increased production of IL-1.