Pathomorphological Study Research Articles

Surgical treatment of solitary bone cysts in children using alloimplants

One of the traditional methods for treating solitary bone cysts (CCMs) is edge resection and defect replacement with bone or ceramic implants. Materials based on allogeneic bone after various types of processing that combine optimal properties for osteoregeneration may be promising.Objective: to evaluate the results of surgical treatment of children with CCMs using bone alloimplants for plastic surgery of post-resection defects.Methods: the results of examination and treatment of 11 patients (8 boys, 3 girls, age from 5 to 16 years) were analyzed. The diagnosis was established on the basis of the totality of the clinical manifestations of the disease, data from laboratory tests, X-ray and pathomorphological studies. The distribution according to the localization of the pathological focus: the proximal femur — 6 (54.5 %), the humerus — 2 (18.2 %), the heel — 2 (18.2 %), pubic — 1 (9.1 %). Indications for surgical treatment: the presence of a massive lesion of bone tissue in the loaded area, a high risk of pathological fracture, a pronounced longterm pain syndrome. All patients underwent regional resection and chemical processing of CCMs; defects were filled with osteoplastic material. Results: according to x-ray, bone remodeling in the surgical area occurred in 6–12 months. after operation. After 12–18 months the bone structure of the patients was corresponded to normal without or with plastic residues. Infectious complications, recurrences of the pathological process and repeated fractures were not observed, pain was absent, motor activity was restored.Conclusions: the studied osteoplastic material of allogeneic origin can be recommended for use in the surgical treatment scheme for CCMs in children for plastic surgery of post-resection defects to restore bone structure.

Comparative immunohistochemical study of ki-67, p53, caspase-3 in distal colonic polyps and colorectal adenocarcinoma.

Background. Colorectal carcinogenesis is a multistep process that begins from the normal epithelium and includes the step of adenoma formation. The question of diagnostic and prognostic value of proliferation and apoptosis markers for the distal colorectal neoplasms is still open. Objective. To compare Ki-67, p53, caspase-3 expression levels in distal colonic polyps and colorectal adenocarcinoma. Methods. Pathomorphological and immunohistochemical studies of biopsies of distal colonic polyps from 30 patients and surgical material of colorectal adenocarcinoma from 30 patients were carried out. Results. Ki-67 expression level by epitheliocytes of hyperplastic polyps is 1.5 times lower than that for adenocarcinoma [26.23 (22.16, 48.88) % vs. 41.20 (36.62, 59.42) %], but adenomas are distinguished by 1.5 times higher Ki-67 expression level in comparison with adenocarcinoma [62.40 (48.65, 76.23) % vs. 41.20 (36.62, 59.42) %]. Caspase-3 expression level by hyperplastic polyps epitheliocytes is 1.7 times lower than that for adenocarcinoma [16.99 (11.86, 39.85) CUOD vs. 28.72 (15.84, 76.71) CUOD], but caspase-3 expression level by epitheliocytes of adenomas is 1.1 times higher than that for cancer cells [31.84 (19.53, 42.34) CUOD vs. 28.72 (15, 84; 76.71) CUOD]. The maximum proliferation and apoptosis levels were revealed for high-grade [76.23 (62.36, 85.36) % and 42.34 (33.78, 65.38) CUOD] and villous [79.09 (69.12, 84.27) % and 67.88 (63.92, 71.29) CUOD] adenomas. p53 expression level by epithelial cells of hyperplastic polyps almost is 40 times lower than that for adenocarcinoma [0.00 (0.00; 1.47) % vs. 39.67 (15.69, 83.75) %], and p53 expression level by epitheliocytes of adenomas is 16.5 times lower than that for cancer cells [2.39 (1.58, 8.26) % vs. 39.67 (15.69, 83.75) %]. Conclusion. The high levels of proliferation and apoptosis of epitheliocytes characterize the polyps-precursors of colorectal carcinoma that have the biggest malignant potential. Colorectal adenocarcinoma differs by the medium p53 expression level by tumor cells.

Inflammatory abdominal aortic aneurysms: place of Ig G4related diseases

Aim. Inflammatory abdominal aortic aneurysm may be one of the manifestations of Ig G4-related disease. This study analyzes the clinical manifestations of Ig G4related inflammatory abdominal aortic aneurysm. Material and methods. We examined twenty patients with abdominal aortic aneurysm (AAA). The clinical performance of the disease, the results of laboratory and pathomorphological studies were studied. In 8 cases, Ig G4-related inflammatory AAA criteria were identified. Results. Compared to atherosclerotic AAA, Ig G4-related cases were characterized by a less frequent presence of abdomen or back pain. The concentration of IgG4 in serum in Ig G4-related cases was significantly increased. Patients with Ig G4-related inflammatory AAA often had a history of allergic reactions to drugs, autoimmune diseases, a high concentration of Ig E and a high titer of antinuclear antibodies in blood serum. According to a histological study of intraoperative biopsy samples, Ig G4-related cases were characterized by thickening of adventitia and numerous infiltrates with Ig G4-positive plasma cells. Conclusion. The presence of Ig G4-related disease is diagnosed in the presence of irregular fibrous tissue proliferation with Ig G4 plasma cell infiltrates and with an increase in the concentration of Ig G4 in blood serum. Ig G4-related inflammatory AAA has clinical specifics in comparison with atherosclerotic aneurysm.

CLINICAL AND PATHOLOGICAL MANIFESTATIONS OF BRAIN DAMAGE IN HIV INFECTION

A feature of the HIV epidemic is currently a large number of comorbid and severe forms of the disease, with frequent involvement in the pathological process of the brain. Methods of in vivo verification of brain damage in clinical practice is sufficient, but in some cases they are limited by financial availability and time factor. Correct and timely deciphering of the nature of brain damage is necessary for the choice of treatment tactics, and as a consequence, reducing mortality. Objective: to study the epidemiology, clinic and pathomorphology of brain damage in HIV infection in conditions of urgent and planned admission of patients to a specialized hospital. Materials and methods. Clinical and pathomorphological studies of HIV-infected patients (n=85) receiving specialized medical care were carried out. The final diagnosis was made taking into account clinical, laboratory and morphological data on the classification of ICD-10 in accordance with the domestic requirements of the formulation of comorbid diagnosis. Conclusion. Brain lesions are clinically and morphologically detected in most HIV-infected patients. Opportunistic and secondary diseases with brain damage have their clinical picture, but it is not specific. From the timely decoding of the nature of brain damage depends on the choice of treatment tactics and, as a consequence, reducing the risk of death. Therefore for verification of the etiological agent, you need to conduct a comprehensive examination: clinical (neurological, psychological distress) and laboratory (cellular composition of CSF protein level and glucose) and bacteriological (seeding of CSF on the flora, on Wednesday Saburo to identify mushrooms on medium Bactec and Lowenstein-Jensen medium for detection of M.tuberculesis); immunological (number of CD4-lymphocytes, at.gondii IgM, at.gondii IgG antibodies), molecular genetic (HIV RNA; DNA HSV1, 2; VZV DNA; DNA EBV; CMV DNA; DNA ВГЧ6; T.gondii DNA; DNA of M.tuberculesis; DNA Cr.neoformans; JC virus DNA) and radiological (MRI brain) research methods. The structure of brain damage in deceased patients was dominated by toxoplasmosis in 28,8% of cases; neuroinfection of unspecified etiology in 28,8% and herpesvirus lesion in 11,9%. Rarely met: tuberculosis 8,47%; candidiasis 8,47%; PML 3,39%; cryptococcosis 3,39%; b-cell lymphoma with brain metastases 3,39%.

Summary of Clinical Laboratory Studies Performed During Preclinical Safety Evaluation of Medicinal Products (Part I: Haematological Studies)

Preclinical safety evaluation is an important stage in the development of medicinal products. Clinical laboratory studies, including haematological, biochemical and pathomorphological studies, are an essential part of chronic toxicity studies. A careful choice of methodological approaches to examination of toxicological characteristics of drug candidates makes it possible to assess the degree of risk associated with their subsequent clinical use, identify potential target organs, determine the extent of damage, as well as the possibility and dynamics of restoring damaged systems. Key prerequisites for obtaining adequate results of the studies are correct methodological implementation of all the stages of sample preparation and careful consideration of all factors during interpretation of the obtained data. Thus, the choice of methodological approaches to blood tests is often determined by the species, age and sex of laboratory animals, as well as by specific characteristics of the tested drug. The aim of the study was to summarise data on haematological studies performed in the Drug Toxicology Laboratory of the Federal State Budgetary Institute «Zakusov Institute of Pharmacology» when conducting chronic toxicity studies.

THE RESULTS OF 600 TRANSANAL ENDOSCOPIC SURGERIES OF RECTAL ADENOMAS AND ADENOCARCINOMAS

AIM: transanal endomicrosurgery (TEM) is the method of choice for local excision of rectal cancer. The presented series of patients is collected prospectively and is the largest of the published in the Russian medical periodicals. PATIENTS AND METHODS: six-hundred patients [average age ±σ 59.8±9 (31-90) years old; 375/600 (62.5%) – women]with rectal adenomas and adenocarcinomas, who underwent TEM in 2011-2019. RESULTS: the mean size of the removed tumors was 3.4±1.5 cm (0.5-10.0). R0 resection was performed in 571/600 (95.2%) of the cases. The complication rate was 3.6% (22/600). Pathomorphological study of the removed specimens revealed adenoma in 450/600 (75.0%) patients, adenocarcinoma in 150/600 (25.0%) cases. The mean time of observation of patients with adenomas was 38.4±25.1 months, with adenocarcinomas – 33.4±23.8 months. The rate of local recurrence in adenomas was 4.5%. Loco-regional recurrence of adenocarcinoma pT1 after TEM was revealed in 6.8% of patients and 30% of pT2 patients without adjuvant treatment. CONCLUSION: TEM is an effective and safe method of treatment of rectal adenomas. With rectal cancer, a thorough selection of patients is required.

Morphological changes of the testes in patients operated on cryptorchidism

Purpose: to study the morphological changes of testis in patients who had cryptorchidism in childhood.Methods. The examination results of 9 patients who underwent treatment for cryptorchidism and presented with infertility within marriage when they were 24–30 y. o. were studied. Clinical examination, ultrasound imaging of the scrotum, complete spermograms, hormonal studies, open biopsy of the testis with subsequent pathomorphological assessment of biopsy specimens were carried out.Results: observation of 9 patients with azoospermia who had undergone a course of conservative and surgical treatment for cryptorchidism when they were 4–14 years, resulted in testicular atrophy leading to the decrease in the tissue mass of the organ and high level of FSH.Conclusion: hormonal tests, ultrasound examinations and pathomorphological studies enable to estimate the extent of epitheliospermatogenic layer involvement.

Comparative Pathomorphologic Studies on the Incidence of Fractures Associated with Leg Skeletal Pathology in Commercial Broiler Chickens.

The aim of the present investigation is to report the prevalence of spontaneous fractures associated with leg skeletal pathology and compromised welfare in commercial broiler chickens. Our studies focused on fractures of different leg segments (femur, tibiotarsus, tarsometatarsus) detected as incidental findings during pathoanatomic examinations in cases of rickets, tibial dyschondroplasia (TD), and femoral head necrosis (FHN). The morphogenetic and etiopathogenetic aspects of the findings were further investigated through histopathologic, bacteriologic, and bone mineral analyses. The gross anatomy study showed that in about 10% of bones affected by rickets-specific lesions, fractures of the proximal tibiotarsus were present. A relatively low percentage (6.5%) of fractures of the same anatomic location could be attributed to TD lesions. The highest prevalence of fractures (68.5%), mainly of the proximal femur, was associated with FHN and osteomyelites. The results from the large-scale field surveys allowed us to confirm that the prevalence of spontaneous bone fractures of the legs in broiler chickens was largely associated with FHN, rickets, and TD. The poor vascularization of the grown prehypertrophic cartilage in cases of rickets and TD, as well as the osteolytic lesions in FHN, resulted in degenerative, necrobiotic processes which may entail bone fractures.

Optimization of the pre-analytical stage of material processing for histochemical examination of skeletal muscle biopsies in the diagnosis of neuromuscular diseases

Diagnosis of neuromuscular diseases is complicated by the variety of clinical manifestations and requires the use of additional methods, an important place among which is the pathomorphological study of skeletal muscle biopsy. Despite the fact that the procedure for taking a muscle biopsy is not technically difficult, to obtain informative material a multitude of conditions must be observed at the stages of pre-analytical processing of the obtained tissue samples. Violation of the technology of taking, storing and fixing the material contributes to the formation of artifacts that limit the possibilities for further analysis of the morphological changes in tissue biopsy. A comparison was made of the effectiveness of various methods for cryoprocessing of muscle tissue samples and the manufacture of histological specimens with a subsequent assessment of morphological changes. As a result, the main causes of artifacts were identified. The optimal method for processing muscle biopsy specimens is indicated, which makes it possible to prevent the appearance of artifacts as much as possible and to ensure the preservation of tissue for research.

The primary diagnostic endoscopic methods for connective tissue diseases verification in patients with respiratory manifestations

The aim — to conduct a retrospective analysis of the connective tissue diseases diagnosis in 47 patients of different ages with respiratory manifestations.Materials and methods. A clinical analysis of the first diagnosed cases of connective tissue diseases in 47 patients treated on the basis of the department of thoracic surgery and invasive diagnostic methods, from 2010 to 2018 was done. Among patients, women predominated — 33 (70.2 %), men — 14 (29.8 %). Among them, at the age of 20 — 29 years old, there were 8 (16.8 %) patients; 30 — 39 years — 14 (29.8 %) patients; 40 — 49 years old — 12 (25.5 %); 50 — 59 years old — 9 (19.5 %); over the age of 60 years‑ 4 (8.4 %). The patients were hospitalized with the following diagnoses: disseminated pulmonary disease — 10 (21.3 %), disseminated pulmonary disease complicated by unilateral pleurisy — 12 (25.5 %) patients; disseminated pulmonary disease complicated by bilateral pleurisy — 1 (2.1 %) case; disseminated pulmonary disease complicated by unilateral pleurisy and intrathoracic lymphadenopathy — 2 (4.3 %) observations; rounded lung lesion — 1 (2.1 %) case; unilateral pleurisy— 4 (8.4 %); bilateral pleurisy — 6 (12.9 %); pleurisy with pericarditis — 11 (23.4 %) cases.Results and discussion. In all cases, the specificity of the autoimmune lesion was identified. The attention is paid to the need for early diagnosis of this pathology and the adequate pathogenic treatment appointment by profile specialists.Conclusions. Of newly diagnosed patients with total respiratory, cardiovascular and renal impairment without any history of chronic disease should be considered as a risk group for further diagnosis of connective tissue diseases. The use of video‑assisted thoracoscopic surgery diagnostic methods with biopsy of affected tissues should be the standard of study along with immunological confirmation when establishing the type of connective tissue diseases. The connective tissue diseases type identification should be done considering the clinical manifestations, based on the pathomorphological study results and the serological verification by specialists, since the nosology type establishment timely contributes to the immunopathological syndromes detection and allows the immune‑dependent complications prevention by adequately prescribed pathogenically valid treatment.

Репродуктивний потенціал жінок із матковим фактором безплідності

Intrauterine pathology, its diagnosis and treatment remain the most urgent problem of operative gynecology and reproduction, which is associated with a significant percentage of uterine submucosa, adhesions (senechias) in the uterus, endometrial hyperplasia and polyposis. The objective: on the basis of a detailed analysis of anamnestic data of women with an intrauterine factor of infertility, identify a high-risk group, which requires a deeper study of the hormonal features and the state of the endometrium. Materials and methods. 105 case histories of women of all ages with endometrial pathology – endometrial polyp, endometrial hyperplasia, intrauterine synechia, which were treated in the departments of infertile marriage, family planning and gynecological department, were selected for an observational cross-sectional retrospective study by continuous sampling. Special instrumental research methods were used in the work: ultrasound, hysterosalpingography, hysteroscopy, pathomorphological studies of remote preparations. Results. Clinical symptoms of intrauterine pathology in patients with long-term infertility treatment are represented by menstrual disorders, such as hypomenorrhea, amenorrhea, chronic pelvic pain, and obliteration of the cervical canal. In addition, the characteristic complications of pregnancy, manifested by miscarriage, threatened termination, abnormal placentation, which significantly reduces the reproductive potential and quality of life. Сonclusions. Among patients with intrauterine pathology, as the leading cause of infertility, it is advisable to select a separate group of high risk of miscarriage, and this affiliation depends on the multiplicity of intrauterine interventions, the age of the woman, the infectious profile and a combination of leading factors. The method of stratification analysis proved that instrumental interventions in the history of five times increase the chances of unsuccessful attempts of assisted reproductive technology programs (OR=5.92; 95% CI: 2.18–14.32; p<0.05), besides a significant factor is a high infectious index and inflammatory disease of the uterus, seven times increases the risk of reproductive failure (OR=7,36; 95% CI: 3.72–16.16; p<0.005), surgery on the pelvic organs and the uterus doubled, and the accompanying dyshormonal disorders and ovarian dysfunction five times (OR=5.84; 95% CI: 1.19–12.26; p<0.002). Key words: uterine infertility factor, endometrial hyperplasia, polyposis, uterine senechia, reproductive failure.

Патоморфологічні особливості послідів у вагітних із затримкою росту плода

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

MUC1, MUC2, MUC4, MUC5AC, Cdx2: immunohistochemical characteristics in polyps and adenocarcinoma of distal colon

Aim – to study MUC1, MUC2, MUC4, MUC5AC, Cdx2 immunohistochemical expression in polyps and adenocarcinoma of distal colon. Materials and methods. Pathomorphological and immunohistochemical studies of biopsies from 30 patients, which underwent colonoscopy with polypectomy, and surgical material from 30 patients, which underwent surgery for colorectal adenocarcinoma, were carried out. Results. Distal colonic polyps are different from unchanged mucosa by increased MUC-1 expression. Maximum expression levels of the marker are observed in serrated adenomas, which are characterized by high MUC-1 expression level. Median of MUC-1 expression in adenocarcinoma is greater than that in unchanged mucosa, however, less than in polyps. Comparative analysis of data of the study of MUC2 expression indicates that the maximum expression of the marker is characteristic of unchanged mucous membrane. Polyps are distinguished by lower MUC2 expression levels; among them, highest expression levels are observed in hyperplastic polyps, lesser – in serrated adenomas and adenomas. Distal colonic carcinoma has extremely low median of MUC2 expression. The highest levels of MUC4 expression are observed in hyperplastic polyps, somewhat lower – in unchanged mucosa. Serrated adenomas, adenomas and adenocarcinomas differs by lower MUC4 expression levels. The minimum level of the marker expression is observed in serrated adenomas. In polyps MUC5AC expression levels are greater than in adenocarcinoma. Expression of this marker is not detected in unchanged mucosa. The maximum median of MUC5AC expression is observed in serrated adenomas, which are characterized by high level of the marker expression, somewhat lower – in adenomas, and more lower in hyperplastic polyps. High Cdx-2 expression level characterizes serrated adenomas and adenocarcinoma. The average Cdx-2 expression level is observed in adenomatous polyps, hyperplastic polyps, and unchanged mucosa, with the medians of the marked expression decreasing in that sequence. Conclusions . Distal colon polyps are characterized by increased MUC1 and Cdx-2 expression levels, with parallel decrease of MUC2 expression level and aberrant MUC5AC expression. At the same time, serrated adenomas are distinguished by the greatest deviations of the studied markers expression levels. Adenocarcinoma of the distal colon, compared with polyps, is characterized by decrease of MUC1, MUC2 and MUC5AC expression levels.

ANALYSIS OF ASSOCIATION BETWEEN THE DENSITY OF INFILTRATION IN PRIMARY CARCINOMA OF THE MAMMARY GLAND BY TUMOR-ASSOCIATED MACROPHAGES AND POSTOPERATIVE PROGNOSIS

Tumor-associated macrophages (TAM) of the M2-type dominate in tumors and produce molecules, favorable for their growth, stimulating tumor growth. However, changing the M2-type for M1 can slow down or arrest this growth. For realization of the M1 / M2 modulation direction in the treatment of carcinoma / breast cancer (BC), a substantiated diagnosis and confirmation of the TAM negative prognosis is necessary. Therefore, the aim of the study was to evaluate the relation of tumor associated macrophages to the postoperative prognosis / survival of patients with 5 molecular-biological types of breast carcinoma. Materials of the study were intraoperative tissues of tumors and ipsilateral lymph nodes in radically removed mammary glands. Pathomorphological study of lymph nodes was conducted to clarify the diagnosis in relation to N0/1. The density of TAM infiltration was determined by immunohistochemical staining of CD68 and CD163 in 30 samples of five molecular biological types of breast cancer (three clinical cases of each type). Immunohistochemical (IHC) studies for the determination of TAM and M2-like macrophages were conducted using streptavidin-peroxidase method. The quantitative representation of CD68 + and CD163 + Mph is very different from patient to patient and also within one sample, which depends, in particular, on the morphological characteristics of breast cancer, studied by the biopsy. The density of infiltration by CD163 + macrophages of the BC focus negatively correlated with postoperative survival, which did not reach statistical significance, but is included in the general concept of a negative prognosis of infiltration by M2-like macrophages. Further research is needed to confirm the negative significance of the ТАМ infiltration density in the BC primary focus for postoperative prognosis. Promising is the development of differential diagnosis and approach to the treatment of breast cancer, taking into account the levels of its infiltration by subpopulations of TAM.

Pathomorphological changes of the thymus of pigs at different stages of development of clinically expressed circovirus infection type ІІ

PCV2-infection of pigs plays an important role in the infectious pathology of pigs, having a significant impact on the economy of pig farms in different countries. Pathomorphological changes in the body of pigs with PCV2-infection occur moderately and in stages, as a result of the simultaneous launch of a set of mechanisms to counter the causative agent of the disease, resulting in the formation of a whole spectrum of reactive and pathological processes. The main “target” for PCV-2 is the immune system, and the multiplication of PCV-2 in the cells of the immune system leads to their death and development of immunodeficiency state. Thymus is the central organ of lymphocytopoiesis and imunopoiesis, in it occurs differentiation of all cellular forms of mature T-lymphocytes in the pre-T-lymphocyte stage, which migrate from the bone marrow to the bloodstream. The growth and development of the thymus, as well as the bone organs, is in direct interaction with the growth and development of the spleen, lymph nodes and is reflected in the structure of the interstitial connective tissue and lymphoid parenchyma. Purpose: determination of pathomorphological changes in the thymus of pigs at different stages of the development of clinically expressed PCV2-infection. Methods. The work was carried out in pig farms of Ukraine, with intensive technology of pig rearing, at the department of normal and pathological anatomy of agricultural animals and the Scientific and Research Center for Biosafety and Environmental Control of the Agroindustrial Complex Resources of Dnipro State Agrarian and Economic University. For pathomorphological studies, animals were selected with clinical signs of active PCV2‑infection (in 1 ml of whole blood of which contained more than 107 copies of the PCV-2 virus equivalent gene) and also piglets with positive optical density of specific antibodies (Ig G and Ig M) in serum blood. Pathomorphological changes were characterized by gradual exhaustion of the lymphoid parenchyma with a sharp decrease in the area of the cortical substance of the particles. Against the background of the degradation of the lymphoid parenchyma of the organ, there is a tendency to increase the relative area of the interstitial connective tissue, as well as the absolute size and number of thymic bodies, has been established.

Distal colonic polyps: immunohistochemical study of proliferation and apoptosis

Background. It’s well known that colonic polyps can be precursors of colorectal cancer. But exact immunohistochemical parameters, including proliferation and apoptosis levels of polyps’ cells, that may have prognostic value, still not known. Objective. To study the features of immunohistochemical expression of proliferation and apoptosis markers by distal colonic polyps’ cells. Methods. Pathomorphological and immunohistochemical studies of biopsies of distal colonic polyps from 30 patients (the age ranged from 41 to 83 years) were carried out. Results. Distal colonic polyps are characterized by the medium proliferation level of epithelial cells [Me=62.40% (48.65; 76.23) for adenomas, Me=26.23% (22.19; 48.88) for hyperplastic polyps], the low proliferation level of stromal cells [Me=2.94% (1.23; 4.35) for adenomas, Me=1.18% (1.10; 1.86) for hyperplastic polyps], the low p53 expression level of epithelial and stromal cells [Me=2.39% (1.58; 8.26) and Me=1.23% (0.72; 1.49) for adenomas’ cells, Me=0,00% (0,00; 1,47) and Me=0,00% (0,00; 0,05) for hyperplastic polyps’ cells], and also by the low apoptosis level of epithelial and stromal cells [Me=31.84CUOD (19.53; 42.34) and Me=43.87CUOD (25.47; 73.09) for adenomas, Me=16.99CUOD (11.86; 39.85) and Me=28.64CUOD (19.20; 30.71) for hyperplastic polyps]. There are direct correlations between the expression levels of proliferation and apoptosis markers and also the dysplasia grade of the distal colonic adenomas: between the Ki-67 expression levels of epithelial and stromal cells and also the dysplasia grade (γ=0.65 and γ=0.70, respectively), between the p53 expression level of epithelial cells and the dysplasia grade (γ=0.53), between the caspase-3 expression levels of epithelial and stromal cells and also the dysplasia grade (γ=0.80 and γ=0.63, respectively). Moreover, there are direct correlations between the expression levels of proliferation and apoptosis markers of distal colonic polyps’ epitheliocytes: between the Ki-67 and p53 expression levels (r=0.71 for adenomas, r=0.79 for hyperplastic polyps), between the Ki-67 and caspase-3 expression levels (r=0.61 for adenomas), between the p53 and caspase-3 expression levels (r=0.59 for adenomas, r=0.79 for hyperplastic polyps). Conclusion. These data indicate the close association between the processes of proliferation, accumulation of p53 protein, and apoptosis of the distal colonic polyps’ cells.

Clinical and morphological features of scar tissue of the uterus.

One of the key issues for increase uterine scars is the rapid and unwarranted Caesarean sections (CS) as in the world same in Ukraine. One of the way to reduce CS is delivery truth vaginal births in women with previous surgical intervention on the uterus or after CS. The ability of scar on the uterus is the main criterion for an attempt to vaginal birth. Objectivе — to analyze the structural changes of the scar tissue of the uterus. Pathomorphological examination was fragments of uterus scar. The material was fixed in a 10% solution of neutral colored formalin (pH 7.4) carried out according to the standard procedure, poured into paraffin. From the paraffin blocks on the rotary microtome of HM 325, serial histological sections were made in a thickness of 4–5 microns, which were stained with hematoxylin and eosin. Scar tissue was additionally stained for Van Gieson, according to Masson. Fragments of scar tissue were subjected to an immunohistochemical study (IGHS) using monoclonal antibodies (MATs) to CD31 to assess the degree of vascularization vascular component and α-SMA for assessing the condition smooth muscle tissue. Having conducted a comprehensive pathomorphological study in two groups, one can state that in group 1 the pathomorphological picture of the changes in the scar was minimal and confirmed by the retained proportions between the fibrous tissue and the smooth muscle fibers, as well as their characteristic location. Muscle fibers with minimal pathological changes, developed by compensatory changes from the side of the vascular complex. These data were confirmed by conducting IGHS from MAT to CD31, which gives a pronounced positive response in the endothelial layer of the vascular wall, forming continuous cell chains. IGHS from MAT to α-SMA exhibits pronounced homogeneous intensive expression, indicating minimal pathological changes in muscle fibers. These figures make it possible to talk about the ability of uterine scar in 61% in group 1, as opposed to in group 2, this result was only 41%. As a result of a comprehensive clinical and morphological study, it was found that the majority of women in group 1, according to the morphological and histological characteristics, had a capable scar on the uterus, that is, potentially could be considered as a reserve for vaginal birth in women with uterine scar after the previous CS. In the second group, a significant proportion of women confirmed the correlation of regenerative and degenerative changes in the tissues of postoperative scar, indicating prevalence of fibro-sclerotic changes and insufficient vascularization, that is, it states the validity of operational resolution.

Beneficial effects of vitamin E on radioiodine induced gastrointestinal damage: an experimental and pathomorphological study.

The aim of the present study was to investigate the radioprotective effect of vitamin E in the prevention of radioiodine (RAI) induced gastrointestinal damage. Twenty-four rats were randomly divided into three groups as follows: Group-1 was untreated control group, Group-2 was orally administered single dose of 111 MBq RAI, and Group-3 was orally administered 111 MBq RAI and 1 mL of oral vitamin E. Vitamin E was started two days before RAI administration and was continued for five days once daily after RAI. Pathomorphological parameters of gastrointestinal tissues (stomach, small intestines and bowels) were measured using Hematoxylin-Eosin and Masson's trichrome staining. Varying degrees of inflammation, edema, ulcer, mucosal degeneration, necrosis and fibrosis were seen in the stomach, small intestine and bowel tissues of the rats in both study groups and not in the control group. The differences were statistically significant between these groups for all parameters (p < 0.05). The histopathological damage in the vitamin E treated group was significantly less than the damage in the RAI only group (p < 0.05 for all pathomorphological parameters). The results of this study showed that vitamin E has a radioprotective property with antiinflammatory and antifibrotic effects protecting against gastrointestinal damage caused by radioiodine (Tab. 3, Fig. 3, Ref. 26).

Choroidal melanoma and retinal changes

To study the capabilities of optical coherence tomography (OCT) in terms of finding the ways CM spreads into the retina based on pathomorphological examination of the eyes enucleated due to CM. OCT tomograms of 64 eyes with CM (mean tumor elevation - 2.89±0.19 mm, diameter - 9.58±0.43 mm) were studied. Pathomorphological study was conducted on 18 eyes with CM elevated by up to 7 mm and without previous treatment. OCT revealed signs of melanoma invading into the retina in 49 eyes. Among those signs were: presence of retina/CM aggregation (21 eyes), tearing of Bruch's membrane and retinal pigment epithelium, disturbed differentiation of outer retinal layers (15 eyes). Combination of two types of invasion was found in 11 eyes. Pathomorphological study showed low mitotic activity of CM and the presence of a small number of fine-local necroses and hemorrhages. Invasion of CM into the retina was determined in 13 eyes. Retinal invasion began with local destruction of Bruch's membrane (BM) and was often limited by the photoreceptor level, disturbing architectonics of the retina and nuclear layers. Large CMs were accompanied by rough destruction of the Bruch's membrane, tumor cells - in the edematous retina with cystoid dystrophy, in its inner layers, invading into the vitreous body. Infiltration of the retina to inner nuclear layer was accompanied by its transudative detachment and cystoid dystrophy. Invasion of CM into the retina affecting all of its layers imposes use of OCT to examine the integrity of the retina, even with a tumor of small thickness. Tumoral infiltration of the retina and localization of tumor near the optic disc are two contraindications for local endovitreal resection. Brachytherapy requires consideration of tumor characteristics and thickness of the retina for calculation of apical radiation dose.

ПАТОМОРФОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ В ХРЯЩАХ ТРАХЕИ В ЗАВИСИМОСТИ ОТ СРОКОВ ИНТУБАЦИИ

Objective - to study the nature and prevalence of pathological changes in the cartilage of the trachea depending on the duration of intubation according to the results of pathomorphological studies. Materials and methods. Pathomorphological study of cartilage of the anterior tracheal wall was carried out on 37 patients at different times of mechanical ventilation. Depending on the timing of the ventilator before the tracheostomy, all patients were divided into three groups. In 10 people, the duration of ventilation until tracheostomy was no more than 3 days, in 15 people - 4 -7 days and in 12 people - more than 7 days. Results. On the 1st day of mechanical ventilation, dystrophic changes are determined, with the loss of cartilage cells. On the 2nd day of mechanical ventilation in the cartilage of the trachea significant dystrophic changes with pycnosis of the nuclei in chondrocytes were revealed. By the third day of mechanical ventilation, detachment of perichondria occurred, the surface of cartilage lacking perichondria was usurized, covered with fibrinous overlays, the cartilage no longer contained cartilage cells; by the 7th day of mechanical ventilation, deeper dystrophic and destructive changes were revealed in the tracheal cartilages - there was no perichondria, the cartilage surface was usurized, foci of chondronecrosis were observed in the areas adjacent to the damaged perichondria; by the tenth days of mechanical ventilation, the pathomorphological picture indicates the death of the cartilage and its replacement with granulation tissue, the presence of regeneration processes, expressed in focal proliferation of chondrocytes, thickening and fibrosis of the perichondria, the appearance and sequestration of dead cartilage. Conclusion. The severity of pathomorphological changes in the cartilage of the trachea due to the duration of intubation