[Visceral leishmaniasis: a challenging diagnosis in internal medicine].

Leishmaniasis is a vector-born parasitic disease characterized by predominant cutaneous or visceral involvement with fever, hepatosplenomegaly and anemia. Leishmaniasis has relatively high prevalence in tropical and subtropical areas. Several sporadic and mostly imported cases are detected in Russian Federation.

[Glomerulopathy with fibrillary and tubular deposits].

The advent of up-to-date electron microscopes and molecular biological methods for the examination of renal puncture biopsies could define earlier undetectable and unworthy cellular structures and stromas. There is a diversity of diseases that can be diagnosed exclusively at the ultrastructural level, thus the literature has identified the concept of glomerular diseases with organized deposits. The current classifications based only on the ultrastructual deposits are imperfect as they fail to account for the etiological and pathogenetic features included in these diseases.

[Morphological verification of renal lesion as a compulsory stage in the diagnosis of Fabry disease].

The paper describes a case of Fabry disease in a patient in whom kidney biopsy enabled the renal lesion be characterized in detail. Fabry nephropathy-associated kidney tissue changes, including renal lesion, have been verified using electron microscopy of renal tissue.

[Giant abdominal urate tumor-like mass with multiple crystalline deposits in the bowel and lung walls in a patent with terminal heart failure].

The paper describes a unique case of a large abdominal urate mass with a peculiar inflammatory process with giant cells and smaller urate deposits in the lung and small bowel without articular changes and kidney injury in a patient with terminal heart failure.

[Role of tubulin in the pathogenesis of fibrillary glomerulonephritis].

Fibrillary glomerulonephritis is a disease from a group of glomerular diseases with organized deposits. Its etiology and pathogenesis have not been studied. The paper deals with the clinical, morphological, immunohistochemical, and electron microscopic studies of 45 patients with fibrillary glomerulonephritis.

[Crystalline histiocytosis].

The paper describes a case of diagnosis of the rare monoclonal secretion-associated disease crystalline histiocytosis with kidney and bone marrow involvement. The female patient with multiple myeloma (MM) was found to have intralysosomal crystals in the cells of the bone marrow (histiocytes, plasmocytes), kidneys proper (mesangiocytes, podocytes), and subsequently in those of a kidney graft. Lower secreted monoclonal IgG and ceased Bence-Jones protein secretion after MM chemotherapy were accompanied by improved and stabilized kidney graft function.

[Fibrillary glomerulonephritis and immunotactoid nephropathy: the current view of the pathomorphological substrate of disease].

Fibrillary glomerulonephritis (FGN) and immunotactoid nephropathy (ITN) are diseases diagnosed only by electron microscopy. Until recently, information on the diseases has reached as reports on some cases. Much information, including the authors' observations, has been presently gathered so as there is a chance of attempting to pool and analyze it.

[Modification of direct immunofluorescence assay to study paraffin-embedded renal and skin tissue sections].

Immunofluorescence assay has been widely used so far to diagnose glomerular and some skin diseases. The optimal antigen persistence is achieved using the frozen sections; however, their considerable shortcoming is the impossibility to long store preparations and to use a morphology archive. Our laboratory has modified a direct immunofluorescence study on paraffin-embedded renal and skin tissue sections, substantially increasing its accessibility.

[Multiple myeloma in renal transplant recipients].

Severe renal failure (RF) may be the first and only clinical manifestation of multiple myeloma (MM). Occasionally the disease remains long unrecognized and the patients receive renal function replacement therapy, including renal transplantation (RT). To treat MM in renal transplant recipients is a complex medical and ethical problem.

[Clinicomorphological characteristics of renal disorders in patients with genetic thrombophilia].

Aim: To characterize the course and clinicomorphological features of chronic glomerulonephritis (CGN) in patients with genetic thrombophilia.

Material And Methods: A clinical picture and evidence on renal biopsy from 25 patients (12 females, mean age 32 +/- 12 years and 13 males, mean age 36 +/- 8.8 years) admitted to hospital with diagnosis of chronic glomerulonephritis were analysed.

[Renal monoclonal immunoglobuline deposition disease as a rare variant of renal damage in multiple myeloma].

A case of the immunoglobuline deposit disease diagnosis in MM patient having the symptoms of intensive proteinuria, macrohematuria and terminal renal failure is reported. The disease was diagnosed by the evidence from electron microscopy of the kidney and liver biopsies.

[Immunotactoid glomerulonephritis].

Immunotactoid glomerulonephritis is a rare disease of unclear etiology and pathogenesis. Clinically immunotactoid glomerulonephritis manifests itself as the nephrotic syndrome in most cases. The diagnosis of the disease is based on electron microscopic findings and characterized by tubules, average 30 nm in diameter, aligned in parallel in the deposits of immune complexes.

[Chronic heart failure in patients with cardiac amyloidosis].

Amyloidosis is a pathology caused by tissue deposition of amyloid, a compound composed of insoluble fibrillar proteins. AL-amyloidosis (primary amyloidosis) most frequently leads to cardiac disorders 50% of which are cases of chronic heart failure (CCF). The study was dictated by the rarity of this pathology among other causes of CCF, its severity, and poor prognosis in the absence of specific therapy.

[Prostate-specific antigen and telomerase in prostatic cancers].

A correlation between the blood level of prostate-specific antigen (PSA) and the prostatic tissue activity of telomerase was analyzed in prostate cancer (PC), low- and high-grade prostatic intraepithelial neoplasia (LG PIN, HG PIN) and in benign prostatic hyperplasia (BPH). The study was based on the results of a comprehensive examination of 92 patients from the Clinic of Urology, I. M.

[Fibrillary glomerulonephritis].

Fibrillary glomerulonephritis is a rare disease of unknown etiology and pathogenesis. In two thirds of cases, it is clinically manifested by the nephrotic syndrome resistant to cytostatic and corticosteroid therapy. Fibrillary glomerulonephritis is diagnosed by electronic microscopy and characterized by the presence of chaotically located fibrils with an average diameter of 18-22 nm in the deposits of immune complexes.

[Types of lupus nephritis exacerbations: prognostic significance].

Aim: To characterize the course of lupus nephritis (LN) in terms of demographic indices (sex, age of renal disease onset), the presence of antiphospholipid syndrome (APS) and to ascertain a prognostic role of the disease exacerbations.

Material And Methods: A total of 121 LN patients were followed up from 1997 to 2004 (mean duration of the follow-up 5.6 +/- 6.

[Clinicomorphological features of nephropathy in primary and secondary antiphospholipid syndrome].

Aim: To investigate specific features of extrarenal manifestations of antiphospholipid syndrome (APS) in patients with APS-associated nephropathy (APSN) in primary APS and lupus nephritis (LN) with secondary APS; to compare clinicomorphological signs of APSN in primary and secondary APS.

Material And Methods: We examined 44 APSN patients with primary APS and 90 patients with LN: 57 with secondary APS, 33 with antiphospholipid antibodies (APA) without history of thrombosis. In addition to clinical and immunological examination, detection of serological APS markers, morphological examination of renal tissue and ultrasound dopplerography (USDG) of the renal vessels were made (in some patients) for assessment of the condition of intrarenal vascular bed.

[Clinical implication of urine test for markers of endothelial dysfunction and angiogenesis factors in assessment of tubulointerstitial fibrosis in chronic glomerulonephritis].

Aim: To evaluate contribution of endothelial dysfunction and impairment of endothelial proliferation/ regeneration to mechanisms of development of tubulointerstitial fibrosis (TIF) in chronic glomerulonephritis (CGN) basing on urinary levels of markers of endothelial activation/impairment and angiogenesis factors.

Material And Methods: A total of 67 CGN patients entered the study: 19 patients with moderate urinary syndrome (group 1), 37 patients with nephrotic syndrome (group 2), 11 patients with nephrotic syndrome and persistent renal failure (RF). A control group consisted of 12 healthy subjects.

[Independent postmortem examination: contents of its concept, organizational aspects of its performance].

The paper discloses the contents of the concept of independent postmortem examination and describes the organizational aspects of postmortem examination according to the materials of primary postmortem studies of autopsy and biopsy of surgically removed organs.

[An AA-amyloidosis course in patients with rheumatoid arthritis].

Aim: To characterize renal amyloidosis in patients with rheumatoid arthritis and stages of amyloid nephropathy.

Material And Methods: The trial covered 30 patients (6 males and 24 females) with documented rheumatoid arthritis (RA) complicated with secondary AA-amyloidosis. Amyloidosis diagnosis was confirmed in all the patients morphologically, the samples were studied with the peroxidase immunohistochemical method using specific monoclonal antibodies to SAA.

[Clinical and morphological characteristics of lupus nephritis in systemic lupus erythematosus with antiphospholipid syndrome].

Aim: To ascertain clinical and morphological features of lupus nephritis (LN) in systemic lupus erythematosus (SLE) associated with antiphospholipid syndrome (APS).

Material And Methods: Immunological markers of SLE and APS, clinical picture, urine indices were examined in 138 patients with SLE, APS and renal dysfunction.

Results: LN associated with APS is characterized with marked arterial hypertension, such patients had arterial thromboses more frequently than patients with isolated LN.

[The role of smooth muscle alpha-actin in development of renal fibrosis in patients with chronic glomerulonephritis].

Aim: To estimate expression of smooth muscle alpha-actin (a-SMA) in renal glomeruli and interstitium of patients with chronic glomerulonephritis (CGN) for assessment of the disease progression and prognosis.

Material And Methods: Expression of a-SMA in renal tissue was studied immunohistochemically, area of the interstitium and the degree of its interstitial inflammatory infiltration were investigated morphometrically in 45 biopsy specimens of renal tissue from patients with different morphological types of CGN and 7 specimens of normal renal tissue.

Results: a-SMA expression in the glomeruli was higher in patients with proliferative morphological forms of CGN [34.

[Urine excretion of a monocytic chemotaxic protein-1 and a transforming growth factor beta1 as an indicator of chronic glomerulonephritis progression].

Aim: To measure urine and renal tissue levels of profibrogenic mediators (monocytic chemotaxic protein-1-MCP-1 and transforming growth factor beta1 - TGF-b1) in patients with chronic glomerulonephritis (CGN); to specify significance of these mediators for assessment of inflammation and fibrosis in the kidney and as prognosis criteria. ELISA, immunohistochemical tests, morphometry were used to study urine excretion of MCP-1 and TGF-b1, expression of TGF-b1 in renal tissue, interstitial area, respectively, in 63 patients with active proteinuric CGN.

Results: Patients with active proteinuric forms of CGN have higher urine excretion of MCP-1 and TGF-b1 than healthy controls.

[Renal lesion in hemoblastoses].

Aim: To study morphofunctional condition of the kidneys in patients with hematological malignancies.

Material And Methods: Renal function, i.e.