Pathohistological Examination Research Articles

ВРОЖДЕННАЯ АНОМАЛИЯ ЧЕРВЕОБРАЗНОГО ОТРОСТКА, ОСЛОЖНИВШАЯСЯ АППЕНДИЦИТОМ

Congenital malformations of the appendix are an extremely rare pathology, do not have a specific clinical picture and are usually detected at the time of surgery or pathohistological examination of the removed appendix. The purpose of the study. To present a description of a rare pathology – a case of incomplete doubling of the appendix and its atypical location, which contributed to the development of chronic recurrent appendicitis and periappendicitis. Results. The patient, aged 19, was operated on with a diagnosis of acute appendicitis. Laparoscopy has revealed that the appendix is partially retracted into the inguinal hernia and purulent fibrinous periappendicitis occurs. The vermiform appendix was removed. During its examination by both the surgeon and the pathologist, no developmental abnormality was detected. Pathohistological examination revealed incomplete doubling of the appendix. The additional process was located in the thickened mesentery of the main appendix. The complete absence of the outer layer in the muscle membrane and the serous membrane of the accessory process was revealed. This abnormality has provoked the development of chronic recurrent appendicitis and periappendicitis with the formation of an appendicular infiltrate. Conclusion. This article describes a rare clinical case of not only abnormal development of the appendix with the formation of chronic recurrent appendicitis, the formation of periappendicular infiltrate, but also its atypical location – it was partially involved in an inguinal hernia.

Pseudokidney Sign in Gastric Cancer.

Pseudokidney sign (PKS) is a characteristic sonographic finding of an abnormal mass with a reniform appearance, and a hyperechoic central region surrounded by a hypoechoic area. It has been seldom documented in gastric cancer. A 75-year-old male patient presented with a palpable abdominal resistance in the left upper abdominal quadrant and ultrasound evaluation revealed a well-vascularized mass presenting with PKS. Regional lymphadenopathy was also found, and the working diagnosis of gastric cancer was established. The suspected diagnosis was later verified endoscopically and on pathohistological examinations as gastric adenocarcinoma. Computed tomography staging also revealed distant metastases to the lungs, liver, and adrenal glands and abdominal lymphadenopathy. The PKS often indicates gastrointestinal pathology, and it may be seen in benign and malignant conditions due to gastrointestinal wall thickening. Therefore, additional diagnostic examinations are advised for a more definite diagnosis.

CLINICOMORPHOLOGICAL FEATURES, DIAGNOSTIC AND TREATMENT OF CYSTS OF THE MINOR SALIVARY GLANDS

Small salivary gland cysts occupy a large percentage in the structure of oral cavity diseases in children and adults.
 The aim of the study is to determine the main diagnostic criteria and treatment tactics for patients with small salivary gland cysts.
 Materials and methods. 5 adult patients aged from 21 to 50 years and 2 children aged from 3 and 16 years were examined and surgical removal of small salivary gland cysts was performed. Pathohistologic studies of biopsy material were performed.
 Results obtained. Women (85.7%) prevail among the patients with cysts of the minor salivary gland. The average age of the patients was 27,0±6,1 years. The most frequent localization of small salivary gland cysts was the mucous membrane of the lower lip (85,7%). In 5 patients it was confirmed that the cause of cyst formation was mechanical trauma, namely biting or bruising of the lower lip. Clinically, a cyst of the minor salivary gland was a single oval or rounded mass with a size ranging from 0.4 to 1.1 cm. The average size of the cyst was 0.69±0.08 cm in diameter.
 According to the results of the pathohistological examination, the extravasation type of cyst of the minor salivary gland was determined in 3 patients, the retention cyst was also determined in 3 patients on the lower lip. A superficial extravasation cyst has been diagnosed on a soft palate in a woman aged 50 years old.
 In 3 patients, cystectomy was carried out in a traditional surgical method, in 4 patients with the use of a high-intensity diode laser. Hyaluronic acid gel hyaDENT BG was used to accelerate wound healing after laser ablation.
 Conclusion. Based on literature analysis and own clinical observations, the main etiological factors and clinical-morphological signs of various clinical variants of cysts of the minor salivary glands were determined. It is shown that only the mucous retention cyst is a true cyst, because it histologically has an internal epithelial lining.

Retropharyngeal manifestation of T-cell-rich B-cell lymphoma in a 7-year-old Icelandic gelding

A 7-year-old Icelandic gelding was presented with acute severe dyspnea of one day duration and purulent nasal discharge that had been present for 6 weeks. Clinically, the initial examination focused on severe enlargement of the mandibular and retropharyngeal lymph nodes as well as a mixed dyspnea.The diagnosis of a malignant lymphoma was evident following laboratory diagnostics, endoscopy, and cytological examination of a fine needle aspiration of a mandibular lymph node. The gelding was euthanized due to the poor prognosis and a significantly disturbed general condition. Pathohistological examination revealed a multicentric T-cell-rich B-cell lymphoma.

До питання діагностики актиномікозу ротової порожнини

Aim: Discussion of the possibilities of diagnosing actinomycosis of the oral cavity. Materals and meshods. After the clinical examination, laboratory tests were carried out, which included histological and microbiological studies affected tissue of the tongue Results. Cytological and pathohistological examination revealed no signs of the oncological process. However, specific changes in the tissue characteristic of actinomycosis. According to the results of a microbiological study, S.pyogenes was detected in the amount of 104 CFU/ml and Candida albicans in the amount of 105/ml. The growth of colonies typical for actinomycetes was found on the mineral medium. Microscopic examination of the biomass from the colonies confirmed that the isolated culture belonged to Actinomyces. Conclusion. The diagnosis of actinomycosis remains a difficult issue and requires, first of all, the exclusion of an oncological process. The use of pathogistological research, which is the «gold standard» for the diagnosis of actinomycosis, makes it possible to solve the problem. However, in doubtful cases, the percentage of which can be significant, microbiological diagnosis is also important.The decision regarding treatment was made taking into account all factors. In our clinical case, the causative agent of the infectious process turned out to be a presumably low-virulence strain of Actinomyces israelii in association with streptococcus,Antimicrobial therapy was directed to the treatment of both actinomycosis and antistreptococcal treatment. The use of ceftriaxone and penicillin drugs was effective. Fluconazole was also prescribed to prevent candidiasis. Key words: tongue, oral cavity infections, actinomycosis, microbiological diagnosis.

COMMON CAUSES OF ABORTION IN COWS

The aim of this study is to determine the etiology of abortion in cows. The study was conducted in the period from 2019 to 2022. 162 cases of abortion from 65 farms from 14 regions of Ukraine were investigated. The study used pathological, histological, bacteriological and molecular genetic methods. The etiologic diagnosis was established in 24.07% of cases, the probable etiologic diagnosis in 29.01%, and the diagnosis of abortion of uncertain etiology in 46.91% of cases. Abortions with a definite etiology were caused by bacteria in 30.77% of cases, viruses in 10.26%, protozoa in 28.21%, and mixed infections in 30.77%. Abortions with established probable etiology were caused by bacteria in 10.64% of cases, viruses in 25.53%, protozoa in 34.04%, and mixed infections in 29.79%. The most common infectious agents are: BHV-4 was detected in 11, N. caninum - in 9, and Coxiella burnetii - in 6 regions of the country. Zoonotic pathogens such as Leptospira spp., Coxiella burnetii, Salmonella spp. Neospora caninum is the most common cause of cattle abortion. The most common pathological changes recorded were placental edema, liver irregularity, unevenly colored liver, cerebral hyperemia, multiple white streaks in skeletal muscles, gray-white foci in the liver, hemorrhages in/on internal organs, and placentitis. Also, a significant number of fetuses and/or placentas were in a state of autolysis. The main pathologic changes were encephalitis, gliosis, pericarditis, myocarditis, endocarditis, myositis, hepatitis, pneumonia, and placentitis. Pathologic and pathohistologic examination of the fetus and placenta is important for establishing the etiology of abortion.

Denture-induced fibromatous hyperplasia - case report

<p><strong>Introduction.</strong> Denture-induced fibrous hyperplasia (DFH) is a reactive lesion that occurs as a result of chronic trauma caused by the denture on the oral mucosa.</p> <p><strong>Case report.</strong> A female patient, 56 years old, reported to the Specialist Center for Dentistry at the Faculty of Medicine in Foča for the fabrication of complete dentures. She wore previous complete dentures for about 25 years and complained about their age and discoloration. Clinically, both dentures were poorly retained and stabilized by short wings, with pronounced signs of wear. Denture hygiene was poor. Multiple folds of hyperplasic connective tissue were observed in oral cavity upper vestibule mucosa. The lesion folds were pink and firm, corresponding to denture edges. Based on the anamnesis and clinical examination, a temporary diagnosis of denture-induced hyperplasia was made. The patient was informed about clinical condition assessment as well as possible therapeutic procedures and gave written consent to accept the offered therapeutic procedures. She was advised not to wear dentures for four weeks and to maintain proper oral hygiene. After that, the hyperplasia was surgically removed under local anesthesia. A tissue sample was sent for pathohistological analysis. A new pair of total dentures was made. Removed tissue pathohistological examination confirmed the diagnosis: “Epulis fissuratum”.</p> <p><strong>Conclusion.</strong> Education and regular check-ups are essential for the prevention of DFH. Patients should be given detailed oral and written instructions on oral and denture hygiene maintenance, with special reference to possible changes in oral tissues and the importance of regular follow-ups.</p>

Hepatoprotective Activity of Pine cones Extract

Introduction. Fatty hepatosis is a widespread metabolic disease. There is an annual increase in cases of detection of fatty hepatosis both in Russia and around the world. An urgent task is to search for new medicines for the treatment and prevention of the development of fatty hepatosis.Aim. Investigation of the composition of procyanidins and the biological activity of pine cones extract on a model of fatty hepatosis in vivo.Materials and methods. To obtain the extract, cones of pine harvested on the territory of the Perm Region in December were used. The extract was obtained by processing raw materials with hot water. The component composition of procyanidins in the extract was determined using ultra-efficient liquid chromatography with a mass selective detector. Hepatoprotective activity was studied on a model of fatty hepatosis induced by the introduction of carbon tetrachloride in vivo on white mongrel rats. Silymarin was used as a reference for comparison.Results and discussion. As a result of chromatographic examination, the following procyanidins were identified in a dry aqueous extract of pine cones – B2, B3, C1, C2, D1. As a result of hepatoprotective activity, it was found that no changes were detected in the control (intact) group during the pathohistological examination of the liver. Index (degree) of steatosis: 0. In the experimental group, whose animals were injected with carbon tetrachloride without subsequent treatment, it was found that about 50 % of hepatocytes of the histological section were in a state of macro- and microvesicular fatty dystrophy. The steatosis index is 2. In the group of animals injected with carbon tetrachloride and treated with Karsil®, normalsized hepatocytes with single fatty microvesicles in the cytoplasm. The steatosis index is 0. In the group of animals injected with carbon tetrachloride and treated with pine cones extract, hepatocytes of normal size with an euchromic nucleus, in the central parts in a state of macro- and microvesicular fatty dystrophy (about 20-25 % of all hepatocytes of the histological section). The steatosis index is 1.Conclusion. The extract of pine cones contributes to a moderate decrease in the prevalence of protein, small-focal small-droplet fatty dystrophy of hepatocytes. To increase hepatoprotective activity, it is necessary to investigate the effect of the extract at a dose of 30 mg/kg and above.

Aloarthroplasty of the Hip After Pathological Fracture of the Right Femoral Neck and Right Femoral Dyaphysis and Osteosynthesis after Fracture of the Left Femoral Dyaphysis in 41-Year-Old Female Patient with Polyostotic Fibrous Dysplasia? Case Report

A 41-year- old female patient with pathological basicervical right femoral neck fracture and fractures of both femoral bones 15-20 cm distally from the small trochanter is presented. Skeletal scintigraphy was performed and multiple pathological accumulations of radioactive substances were found in almost the entire locomotor system. First, we implanted a partial biarticular hip prosthesis with long stem in right femur, and one year later osteosynthesis of the left femoral diaphysis was done. Pathohistological examination did not find tumor cells and polyostotic fibrous dysplasia also was not clear. Our patient had not problems with bones earlier and she was never treated for this disease, except surgery of femoral fractures. Today, 11 years later the patient is in good general state, she has no pain in her legs and fractures of femur bones healed completely. We did not find a case in literature that a two fractures of proximal right femur bone (femoral neck and proximal diaphysis) and fracture of the left femoral diaphysis were solved with long stem prosthesis, and osteosynthesis of another femoral bone in patient who, we believe, has fibrous dysplasia and was never treated for this disease.

Alterations in the gene expression of SARS-COV-2 entry receptors and enzymes in lungs and hearts of controlled and uncontrolled diabetic mice.

The entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the host cell is carried out by specific receptors and enzymes, including human angiotensin-converting enzyme 2 receptor (ACE2), transmembrane serine protease 2 (TMPRSS2), and cathepsin-L (CTSL). COVID-19 patients with comorbidities, such as diabetes mellitus (DM), are more prone to severe symptoms and have a higher risk of mortality. The present study aimed to investigate the impact of controlled and uncontrolled type 1 DM (T1DM) on the gene expression of mouse Ace2, Tmprss2, and Ctsl and correlate it with the pathological alterations in the lungs and the heart of DM mice. Balb/c mice were administered a single dose of 240 mg/kg streptozocin to induce T1DM. The blood glucose level was measured to confirm the induction of DM. Normalization of blood glucose levels in T1DM mice was achieved using 0.1mL/kg Mixtard® insulin therapy. The mice's lungs and hearts were harvested, and the mRNA was extracted and converted to cDNA. The gene expression of Ace2, Tmprss2, Ctsl, Cyp4a11, and Adrb1 genes, which play a role in the homeostasis of lungs and hearts, were measured using quantitative real-time polymerase chain reaction (RT-PCR). The pathological alterations in the hearts and lungs induced by T1DM were evaluated using the relative heart and lung weights, in addition to the pathohistological examination. After inducing T1DM for 14 days, we observed a significant reduction in the total weight of uncontrolled DM (UDM) mice (P<0.05). Pathohistological examination of UDM lung tissues revealed thickening of the alveolar walls with narrowing of the surface of the alveolar sacs. Additionally, we found that UDM mice exhibited downregulation of Ace2 gene expression (P< 0.05) in their lungs, while both UDM and control DM (CDM) mice showed upregulation of Ctsl gene expression in their hearts (P<0.05). Notably, Cyp4a12 gene expression was significantly downregulated (P<0.05) in UDM mice but returned to normal levels in CDM mice. We conclude from this study that T1DM downregulates Ace2 receptor and Cyp4a12 gene expression, which is correlated with the thickening of alveolar walls and narrowing of the surface of alveolar sacs in the lungs. Insulin administration for controlling T1DM ameliorated these pathological alterations. These results can help increase our understanding of the impact of controlled and uncontrolled T1DM on the lungs and may explain, at least in part, why DM patients with COVID-19 experience exacerbation of symptoms.

Clinical Observation of Acute Intestinal Obstruction Caused by Giant Granulosa Cell Tumour of the Ovary

Ovarian granulosa cell tumours (OGCT) are non-epithelial neoplasms of the ovaries and belong to the group of granulosa-stromal tumours. The most likely source of these tumours’ development is granulosis of the primordial follicles of the ovary as a result of hormonal imbalance.&#x0D; The aim of the study is to represent a clinical observation of acute intestinal obstruction caused by a giant ovarian granulosa cell macrofollicular tumour.&#x0D; A woman, aged 52 years, medical history № 2579, was admitted to the surgical department of Communal Non-Profit Enterprise (CNPE) City Clinical Hospital (CCH) № 1 in Ivano-Frankivsk as an urgent patient with complaints of nausea, vomiting, delayed passage of flatus and defecation, general malaise, abdominal distention. During the laboratory and instrumental examination, a giant tumour of the abdominal cavity was revealed; it has led to the compression of internal organs and the development of small- and large-intestinal obstruction. The operation was performed: middle-median laparoscopy, removal of a giant cyst of the right ovary. Complete hysterectomy with appendages, drainage of the abdominal cavity were also performed.&#x0D; During the operation, a giant tumour with dimensions of 65x70x50 cm, of dense but elastic consistency, pale-pink in color, with multiple chambers of different diameters filled with cloudy, yellow liquid was revealed. The removed uterus with appendages and a large omentum were also given for pathological examination. Pathohistological examination results included: 15824-8- granulosa-cell ovarian tumour; 15815-7- uterus - plethora; 15818-20-ovary - white bodies, fallopian tube - chronic salpingitis; 15812-4- omentum - focal hemorrhages. The postoperative period was uneventful, the patient was referred to a gynecologist-oncologist for consultation and treatment.

Clinical cases of tattoo-associated dermatoses

The aim of the work is to analyze clinical cases of tattoo-associated skin reactions as an example of the algorithm of differential diagnosis of dermatoses of this group.&#x0D; Materials and methods. The personal observation of two clinical cases related to tattooing for aesthetic reasons and the appearance of a pathological reaction on the skin after the introduction of dyes is described. In addition to the visual assessment of the clinical picture, the final confirmation of the diagnosis was based on pathohistological examination.&#x0D; Results. Variability of clinical manifestations associated with tattooing is presented. The first clinical case is represented by the symmetrical appearance of a rash in the form of small papules up to 0.3–0.4 cm in diameter with clear borders, pink in color, and rounded in shape in the area of the eyebrows after their tattooing. Morphologically, the effect of black pigment on the skin in this case is represented by non-specific granulomatous inflammation. The second clinical case is characterized by the appearance of a plaque with hyperkeratosis phenomena and subjective complaints of slight itching at the site of red tattoo dye injection. Pathohistological examination indicated dermatitis of the mixed group (lichenoid interface and granulomatous), which is most correspond to an allergic reaction to tattoo pigment.&#x0D; Conclusions. The increase in the number of patients with tattoos requires a wider consideration of the complications that can be provoked by the artificial injection of dyes into the skin. Despite the advantage of allergic complications after tattooing, the risk of systemic diseases should raise the level of vigilance of practicing physicians regarding the timely diagnosis of sarcoidosis or aggressive neoplasia. The pathohistological examination is the “gold standard” for the final verification of complications after the artificial injection of pigment into the skin.

Immunohistochemical investigation of FIPV3-70 antigen expression in the ileum of cats with effusive feline infective peritonitis

Abstract One of the most common infectious causes of cat mortality is feline infective peritonitis (FIP), along with panleukopenia and viral upper respiratory tract infections. FIP is more likely to affect cats whose immune system is weak or suppressed. It is thought that the infection of macrophages and monocytes plays a major role in the pathogenic process. In order to set a definitive diagnosis for this infectious disease, a histopathological examination of tissues, and feline coronavirus (FCoV) detection by immunohistochemistry (IHC) is necessary. In this investigation, 15 cats between the ages of 5 and 24 months with clinical suspicion of FIP, underwent post-mortem necropsy, pathohistological and immunohistochemical examination. The results showed that all the cats had abdominal effusion with pyogranulomas throughout the abdominal serosa. Ten out of fifteen cats were FIP positive using immunohistochemical methods. This method also showed the antigen deposition in the macrophages thus confirming their role in the pathogenesis of FIP.

Hepatoprotective effects of Niudali (Callerya speciosa) root aqueous extracts against tetrachloromethane-induced acute liver injury and inflammation.

Niudali (Callerya speciosa) is commonly grown in southeastern regions of China and consumed as a food ingredient. Although Niudali root extracts showed various biological activities, the hepatoprotective effects of Niudali root phytochemicals are not fully studied. Herein, we prepared two Niudali root aqueous extracts, namely, c and Niudali polysaccharides-enriched extract (NPE), and identified an alkaloid, (hypaphorine) in NEW. The hepatoprotective effects of NWE, NPE, and hypaphorine were evaluated in an acute liver injury model induced by carbon tetrachloride (CCl4) in mice. Pathohistological examination and blood chemistry assays showed that treatment of NWE, NPE, and hypaphorine alleviated CCl4-induced liver damage by lowering the liver injury score (by 75.51%, 80.01%, and 41.22%) and serum aspartate and alanine transaminases level (by 63.24%, 85.22%, and 49.74% and by 78.73%, 80.08%, and 81.70%), respectively. NWE, NPE, and hypaphorine also reduced CCl4-induced hepatic oxidative stresses in the liver tissue by decreasing the levels of malondialdehyde (by 40.00%, 51.25%, and 28.75%) and reactive oxygen species (by 30.22%, 36.14%, and 33.54%) while increasing the levels of antioxidant enzymes including superoxide dismutase (by 21.36%, 21.64%, and 8.90%), catalase (by 22.13%, 33.33%, and 5.39%), and glutathione (by 84.87%, 90.65%, and 80.53%), respectively. Mechanistic assays showed that NWE, NPE, and hypaphorine alleviated liver damage by mediating inflammatory biomarkers (e.g., pro-inflammatory cytokines) via the signaling pathways of mitogen-activated protein kinases and nuclear factor-κB. Findings from our study extend the understanding of Niudali's hepatoprotective effects, which is useful for its development as a dietary intervention for liver inflammation.

Features of differential diagnosis of odontogenic cystsin children

Relevance: Odontogenic jaw cysts of inflammatory genesis in children are a cavity formation in the bone tissue with a predominantly asymptomatic course. This clinical and radiological picture may be characteristic of a number of different pathologies, which poses the clinician with the task of conducting a thorough differential diagnosis. The purpose of the study: To perform a retrospective analysis of histological examination protocols of surgical material of patients operated on for jaw cysts. Materials and methods: The analysis of protocols of pathohistological examination of surgical material of patients operated on for jaw cysts for the period 20182022 in the childrens dental polyclinic No. 2 of Volgograd was performed. The data obtained were processed by methods of variational statistics. Results: 89 histological examination protocols were studied, the majority were radicular cysts associated with temporary teeth-58 (70.7 %), followed by follicular cysts-16 (19.5 %), then radicular cysts associated with permanent teeth - 7 (8.5 %), and in 1 (1.2 %) case a residual cyst was diagnosed. In 6 (6.7 %) cases, there was a discrepancy between clinical and pathohistological diagnoses. Conclusion: A pathohistological examination of the cyst shell is mandatory to establish a final diagnosis, however, for the differential diagnosis of a radicular cyst from a temporary tooth and a follicular cyst, a correlation of clinical, radiological and pathohistological signs is necessary.

Diagnostic effectiveness of intraoperative express histological examination as a tool to take decisions on the extent of surgery for papillary thyroid cancer

Background. In case of the screening use of high-resolution ultrasound, the level of detecting thyroid neoplasms is about 25 % in the population. Ultrasound criteria are not enough to detect carcinoma. The following methods are used for the differential diagnosis of malignant thyroid neoplasms: ultrasound scans, computed tomography, fine-needle aspiration (FNA) biopsy, intraoperative express histological and histopathological examination. Some authors consider FNA to be the standard method for primary morphological diagnosis of thyroid nodes. It is not always possible to conduct FNA safely. Also, FNA cannot be a method of 100% morphological identification of a primary tumor. In such cases, the extent of the surgery will depend on the data obtained from the intraoperative express histological examination. Analysis of the diagnostic effectiveness of the express histological examination will help to take a decision on the need for it when choosing the extent of a surgery on the thyroid gland. Aim of the study: to evaluate the diagnostic efficiency of the intraoperative express histological method in the detection of papillary thyroid cancer on solitary nodes (Bethesda IV, V) and metastases of papillary thyroid cancer during surgery. Materials and methods. The results of intraoperative express histological and pathohistological examinations performed at the Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues from 2018 to 2021 were analyzed. The sample included materials of surgeries on the thyroid gland in case of papillary cancer T1ab-2N0–1 and solitary nodes (Bethesda IV and Bethesda V) according to data obtained using FNA. The sample size in the study of regional metastasis included 220 examinations, 845 examinations in the “gray zone” (Bethesda IV — 465, Bethesda V — 380). Cases of discrepancy between the results of intraoperative express histological and final histopathological examinations were considered. The data was processed using the EZR v. 3.4.1 statistical analysis program. Results. The sensitivity of the express histological examination in case of detecting metastases of thyroid cancer is 72.2 % with the method specificity of 99.9 %. The diagnostic efficiency in detecting metastases of thyroid cancer is 89.1 %. When the express histological examination is used for Bethesda IV nodes, the sensitivity of the method is 8 % with a specificity of almost 100 %. The diagnostic efficiency of the express histological examination is even higher in case of Bethesda V: sensitivity of 47 % with the method specificity of almost 100 %. The values obtained correlate with international data. This testifies to the need for further improvement of the of intraoperative diagnosis method. Conclusions. The diagnostic efficiency of the intraoperative express histological examination for detecting metastases of papillary thyroid cancer in the selected group is 89.1 % with sensitivity of 72.2 % and specificity of 99.9 %. The diagnostic efficiency of intraoperative express histological examination for verification of thyroid cancer in case of Bethesda IV nodes is 63.9 % with sensitivity of 8.2 % and specificity of 99.6 %. The diagnostic efficiency of intraoperative express histological examination for verification of thyroid cancer in Bethesda V nodes is 63.4 % with sensitivity of 47.3 % and specificity of 99.2 %. The intraoperative express histological examination method makes it possible to take decisions on surgical tactics during surgery within the determined limits, so we believe it reasonable to further use and improve it.

Resection interventions in the treatment of hepatocellular cancer in a specialized surgery center

Background. The relevance of the treatment of hepatocellular cancer (HCC) is determined by a significant increase in the incidence rate and its high prevalence among primary malignant hepatic tumors.The aim of the study. To summarize the experience of providing specialized medical care to patients with hepatocellular cancer.Methods. We studied the direct results of treatment of patients with primary hepatic cancer treated at the Kuzbass Regional Hepatological Center for the period from January 2015 to August 2022. The materials for the study were medical records of patients with an established diagnosis of primary hepatic cancer, surgical records, results of pathohistologic examination. The exclusion criterion was diagnosed cholangiocellular carcinoma.Results. During the period from 2015 to 2022, 59 patients with primary hepatic cancer were treated at the Kuzbass Regional Hepatological Center. Among them, hepatocellular cancer was diagnosed in 48 cases, cholangiocellular cancer – in 11 cases; radical surgery was performed in 12 patients with hepatocellular cancer; fatal outcome was noted in 1 (2.1 %) patient, complications in the postoperative period developed in 5 (41.7 %) cases and were ranked as I-3, IIIb-1 and IVb-1 according to Clavien – Dindo classification.Conclusion. The degree of risk of severe post-resection hepatic failure should be considered one of the main criteria in choosing a strategy for radical surgical treatment. New surgical approaches (laparoscopic vascular isolation of the portal blood flow, using temporary hemostasis in laparoscopic hepatic resections and the device for its implementation) in resection surgery of primary hepatic cancer can improve the immediate results of treatment.

Clinical case of psoriasis in an HIV-positive patient

Modern ideas about psoriasis are becoming wider, while the incidence of this dermatosis is increasing every year. Psoriasis does not seem to be just a skin pathological process, since the basis of this disease is the development of chronic systemic immune inflammation resulting from the launch of a complex cascade of immune reactions with impaired activity of T-lymphocytes and the production of various pro-inflammatory cytokines and chemokines.&#x0D; The course of psoriatic disease has its own characteristics in a patient with human immunodeficiency virus. The peculiarities of the course of psoriasis in a patient with human immunodeficiency virus require a personalized approach in therapy.&#x0D; This article describes a clinical case of psoriasis in a patient with newly diagnosed human immunodeficiency virus. The stages of the diagnostic search for HIV infection are described. To confirm the diagnosis of psoriasis, a pathohistological examination of a skin biopsy was performed, as well as additional laboratory and instrumental studies. The main features of the course of psoriatic disease in an HIV-positive patient are demonstrated: a combination of several clinical forms of the disease, severe severity, lack of necessary positive dynamics against the background of external and basic anti-inflammatory forms of therapy.

Surgical treatment of primary hyperparathyroidism with ectopic parathyroid adenoma in the mediastinum

The paper presents a rare clinical case of a 36-year-old female patient with primary hyperparathyroidism (PHPT) and an ectopic parathyroid adenoma (EPA) in the mediastinum. Ectopic parathyroid adenoma in the mediastinum is found in 1–2% of cases. This is an extremely rare atypical localization as compared with many other possible uncommon locations. Thoracoscopic resection of the adenoma was performed. Pathohistological examination of the postoperative specimen confirmed the preliminary diagnosis. The specimen revealed typical parathyroid adenoma. On the seventh day after surgical treatment the patient was discharged in satisfactory condition.

Upregulation of Beta 1 and Arachidonic Acid Metabolizing Enzymes in the Mouse Hearts and Kidneys after Sub Chronic Administration of Rofecoxib.

An imbalance in the levels of arachidonic acid (ARA) metabolites in cardiovascular disorders and drug-induced cardiotoxicity have been previously described. This study aimed to investigate the influence of cyclooxygenase-2 (COX-2) selective inhibitors on the gene expression of ARA-metabolizing genes and beta1 gene in the hearts and kidneys of experimental mice. Thirty-five balb/c mice were divided into five groups with seven mice per group. The groups were then given two distinct types of COX-2 selective inhibitors, rofecoxib and celecoxib, in two different doses equivalent to those used in human treatment for 30 days. The mRNA expression of beta1, ace2, and ARA-metabolizing genes, coxs, lipoxygenases (aloxs), and cytochrome p450 (cyp450s) in mice heart and kidneys were assessed. Genes were analyzed using real-time polymerase chain reaction analysis. In addition, rofecoxib-induced histological alterations were examined. It was found that only the high dose of rofecoxib (5 mg/kg) caused toxicological alterations, a finding that was indicated by a significant increase (P < 0.05) in the relative weight of the mouse hearts and increase in the ventricle wall thickness as observed through pathohistological examination. This increase was associated with a significant increase in the mRNA expression level of the beta1 receptor in both the heart and kidneys of the mice (53- and 12-fold, respectively). The expression of both cox1 and 2 genes was increased 4-fold in the kidneys. In addition, the expression of the alox12 gene increased significantly (by 67-fold in the heart and by 21-fold in the kidney), while alox15 gene expression was upregulated in the heart by 8-fold and 5-fold in the kidney. The genes responsible for synthesizing 20- Hydroxyeicosatetraenoic acid (cyp4a12 and cyp1a1) were significantly upregulated (P < 0.05) in the hearts of high-dose rofecoxib-treated mice by 7- and 17 -fold, respectively. In addition, the expression of epoxyeicosatrienoic acid-synthesizing genes, cyp2c29 and cyp2j5, was increased significantly (P < 0.05) in the hearts of high-dose rofecoxib-treated mice by 4- and 16-fold, respectively. Rofecoxib caused upregulation of the mRNA expression of the beta 1 gene in association with increased expression of ARA-metabolizing genes in mouse hearts and kidneys. These findings may help us understand the molecular cardiotoxic mechanism of rofecoxib.