Pathomorphological Examination Research Articles

Ecological and epizootological characteristics of setariosis in cattle on farms in the Altai Territory

The purpose of the research is to study the epizootiology and pathomorphology of setariosis in cattle on farms in the Altai Territory.Materials and methods. To make a diagnosis, blood samples were examined for the presence of microsetaria in calves of the current year of birth.Results and discussion. Microsetariae were found in cattle in all zones of the Altai Territory based on the results of a study of blood samples. Infection fluctuated between 23.3–31.9% depending on the zone and, on average, amounted to 27.6%. The intensity of infection also ranged from 7.4±0.7 to 9.3±0.8 sp. The highest infection was observed in animals aged 4–7 years (33.3%) with infection intensity of 11.3±1.0 sp./animal. Cattle are infected with Setaria sp. in all seasons with changes in different months. The maximum infection rate was observed in June – up to 40.0%. Single specimens of Setaria sp. larvae in the blood of calves up to one year old were found in December, i.e., 7 months after the start of the grazing period and mosquito activity. Pathomorphological examination revealed that in most cases, dying Setaria sp. in abdominal cavity are attached to the capsules of the liver, spleen and mesentery. To prevent microfilariaemia in cattle and the spread of Setaria sp. infection, we recommend using macrocyclic drugs.

Hysteroscopy with Endometrial Vacuum Aspiration in Repeated Implantation Failure: Diagnostic Significance and the Effect on IVF Success

Introduction. This study raises the issue of diagnostic and therapeutic value of hysteroscopy with endometrial vacuum aspiration in patients with recurrent implantation failure (RIF) in IVF programs.The purpose of the study is to determine the structure of uterine pathology in women with RIF according to hysteroscopy with endometrial aspiration biopsy and to study the effect of hysteroscopy with subsequent endometrial vacuum aspiration in patients with a history of repeated implantation failures on clinical pregnancy rate.Materials and methods. In this retrospective cohort study we investigated a sample of 143 patients who passed the program of IVF at the Clinical Institute of Reproductive Medicine (Ekaterinburg, Russia). We studied the frequency of detection of uterine pathology using hysteroscopy and endometrial vacuum aspiration in patients with RIF (n = 36) and in the control group without RIF (n = 89). We analyzed the differences in the chance of clinical pregnancy aſter embryo transfer (s) in the IVF program in patients with RIF aſter hysteroscopy with endometrial vacuum aspiration (n = 30) and in the control group (n = 18).Results. The structure of intrauterine pathology was not statistically different in patients with RIF and without this condition (p > 0.05 for all pathologies). Hysteroscopy with endometrial vacuum aspiration significantly increased the incidence of clinical pregnancies in patients with RIF compared with the control group (23/30 (77.0 %) and 8/18 (44.0 %), p = 0.032).Discussion. The obtained data on the structure of the pathology of the uterus correlate with the results of similar studies. The therapeutic effect of hysteroscopy in infertility remains a matter of controversy.Conclusion. Hysteroscopy with pathomorphological examination of the aspirated endometrium is the same intervention in terms of diagnostic efficiency for patients without identified uterine pathology on ultrasound, regardless of RIF status. Hysteroscopic examination with curative endometrial injury may increase the success rate of embryo transfer implants in patients with RIF.

A case of acute intestinal obstruction caused by Burkitt’s lymphoma

Acute intestinal obstruction is a multifactorial disease. Its causes may be intra-abdominal adhesions, volvulus, bezoar, gallstones, foreign bodies, intestinal tumors, etc. In rare cases, acute intestinal obstruction may be associated with intussusception, which is relatively rare in adults. The purpose of this work is to demonstrate a clinical case of acute small bowel obstruction caused by Burkitt lymphoma. During treatment for a herpetic infection, the patient underwent surgical treatment — ileostomy because of acute intestinal obstruction. In the postoperative period, the patient was hospitalized due to intestinal bleeding; during diagnostic colonoscopy, intussusception of the ileum into the ascending colon was detected; diagnostic laparoscopy, laparotomy, right-sided hemicolectomy with resection of the greater omentum, restoration of intestinal continuity with elimination of the stoma,and formation of an anastomosis were performed. The material obtained intraoperatively was sent for pathomorphological examination, including the method of fluorescent hybridization, which revealed a rearrangement of the 8th chromosome in the region of localization of the MYC gene in tumor cells, and a diagnosis of Burkitt lymphoma was established. The oncological council determined the chemotherapy treatment protocol. According to the literature, Burkitt lymphoma can debut in the cutaneous form, and it is necessary to carry out a differential diagnosis, including chickenpox. There is currently no information about intestinal complications occurring in the cutaneous form of Burkitt lymphoma. It is possible that in the described case, the initially established diagnosis of herpetic infection was incorrect, and Burkitt lymphoma occurred in the cutaneous form.

Ultrasound diagnostics: assessment of tumor thickness and depth of invasion in squamous cell carcinoma of the oral cavity

Aim. To evaluate the capabilities of ultrasound using various approaches in determining the depth of invasion of squamous cell carcinoma of the oral cavity and to compare the results obtained with data obtained by the use of other diagnostic methods. Materials and methods. In our reserch, ultrasonography was performed on 193 patients with primary malignant tumors of the mobile part of the tongue, floor of the oral cavity and tumors of rare locations (mucous membranes of the lip, cheek, alveolar processes). The age of the patients ranged from 15 to 85 years. In all patients, tumors were squamous cell carcinoma. ultrasound was performed using submandibular, intraoral and transbuccal approaches. ultrasonic data were compared with the results of pathomorphological examination, as well as of X-ray computed tomography and of magnetic resonance imaging with contrast. Results. A statistically significantly high correlation was obtained for all ultrasound approaches (submandibular, intraoral and transbuccal) with the depth of invasion of the oral tumor determined pathomorphologically (r = 0.78; r = 0.89; r = 0.93; p <0.001). Ultrasound using all approaches shows statistically significantly better results in determining the thickness of tumorsof the tongue and mouth floor in comparison with X-ray computed tomography and magnetic resonance imaging (p <0.001). All diagnostic methods are characterized by an overestimation of the tumor invasion depth (overdiagnosis) as compared with pathomorphological examination. for exophytic tumors and oral cavity tumors of mixed growth with an exophytic component, the depth of invasion was less than the tumor thickness. Conclusion. Ultrasound is an accessible, easily reproducible, radiation-free method, the resolution of which makes it possible to accurately determine not only the depth of invasion of oral tumors, but also the distance from the tumor to the midline of the tongue, that represents an important information when choosing the extent of surgical intervention.

Clinical and morphological features of Osler-Weber-Randu disease with signs of visceral injury

Randu-Osler-Weber disease or hereditary hemorrhagic telangiectasia is an autosomal dominant disorder characterized by dilated capillaries and veins, which are usually localized on the skin and mucous membranes of the oral cavity, as well as in the respiratory, urinary and digestive tracts. The anatomical basis of the disease is damage to blood vessels with degeneration and hypoplasia of the muscle and elastic layers, resulting in focal thinning of the vessel walls with further expansion of their lumen. Violation of angiogenesis persists throughout the patient's life, and is manifested by the formation of aneurysms, telangiectasias, and arteriovenous shunts. The average life expectancy of patients with burdened heredity is 63.2 years. The peak of mortality occurs at the age of 50, which is mainly associated with acute complications of the disease. However, among people suffering from Randu-Osler-Weber disease there are also long-lived people who die at the age of 70-79 years, and the cause of death is the complication of the main disease and the addition of chronic diseases. The purpose of this article is to consider in more detail possible manifestations and complications, methods of treatment of Randu-Osler-Weber disease for timely recognition of the disease and provision of timely medical assistance. This article describes a case of an abdominal form of hereditary hemorrhagic telangiectasia in an 82-year-old patient. The results of the postmortem pathomorphological examination of damaged tissues due to Randu-Osler-Weber disease are presented. During the study of micropreparations of the mucous lip, small intestine, mesentery of the small intestine and liver, groups of vessels were found, the wall of which is thinned in places and thickened in places, in the wall of these vessels there is a decrease or complete absence of muscle and elastic fibers, only endothelium is present, surrounded by loose connective tissue, postcapillary venules expand and anastomose with arterioles. In the lumen of these falsely developed vessels, mixed thrombi are determined. An elderly patient suffered from a combined pathology: hereditary hemorrhagic telangiectasia with arterio-venous malformations in the liver, heart, mesentery, small intestine, and coronary heart disease. These processes were complicated by the development of congestive heart failure, which disturbed the hemodynamic and rheological properties of blood and contributed to the occurrence of thrombosis of arterio-venous malformations in the mesentery and the wall of the small intestine. In the following, necrosis of the loops of the small intestine occurred with the development of diffuse purulent-fibrinous peritonitis and endogenous intoxication. Patients with hereditary hemorrhagic telangiectasia have a higher risk of bleeding and neurological complications, including anemia, cerebral abscess, stroke, venous thrombosis, and heart failure, because of late diagnosis of this hereditary disease. Early diagnosis is based on clinical data and careful collection of family history. In 90% of patients under the age of 40, the diagnosis of hereditary hemorrhagic telangiectasia can be established using the Curaçao criteria. This disease brings a significant amount of suffering in everyday life for both patients and their families, and requires significant attention of a multidisciplinary team of doctors at every stage of medical care.

PATHOMORPHOLOGICAL FEATURES OF CRYPTOCOCCOSIS OF THE LUNGS AND CNS IN CASE OF HIV-INFECTION/AIDS

Background. Cryptococcosis is an important opportunistic infection that most commonly presents with meningitis or meningoencephalitis, especially in HIV-infected patients. Pulmonary disease is less common but is probably underdiagnosed because of the nonspecific nature of symptoms or the increased frequency of other pulmonary opportunistic infections.
 Aim: to investigate the pathomorphological features of cryptococcal lesions of the lungs and central nervous system in case of HIV infection/AIDS.
 Materials and methods. Pathomorphological examination was carried out on the autopsy material. HIV infection was diagnosed in the patients during life with serological verification and the patients were registered at the AIDS Center. Ziehl-Neelsen staining, and PAS reaction were used to detect cryptococci in lung and brain tissue. Standard histological preparations were examined under a microscope to clarify or establish the following data: the presence of cryptococci (both encapsulated and non-encapsulated), their localization and density, the presence of an inflammatory infiltrate and its severity.
 Results. The histopathology of lung lesions in cryptococcosis is characterized by the presence of granulomas with numerous cryptococci and a lympho-macrophagic reaction with multinucleated cells of the Langhans type. The total number of cryptococci in the field of vision (x400) is moderate to significant, their dissemination is uneven, localization is in the interstitium and among the inflammatory infiltrate, cryptococci are round in shape, including encapsulated, some deformed. Cryptococcosis of the brain in case of HIV infection/AIDS was characterized by the accumulation of numerous cryptococci in the expanded perivascular space and among the inflammatory infiltrate in meninges of the brain and cerebellum.
 Conclusion. Dissemination of cryptococcosis in the form of meningitis and meningoencephalitis is a prognostically unfavorable sign of the course of the disease. Cryptococcal lung disease was characterized by a polymorphic histological picture with the presence of an interstitial infiltrate and granuloma with multinucleated cells of the Langhans type and numerous cryptococci.

Immunohistochemical characteristics of epithelial-mesenchymal transition in pancreatic ductal adenocarcinoma

The epithelial-mesenchymal transition (EMT) plays a crucial role in the development of pancreatic ductal adenocarcinoma (PDAC). There are insufficient and contradictory data in the scientific literature on the peculiarities of epithelial and mesenchymal marker expression in PDAC ducts and EMT zone, which requires further research on the role of EMT in the development and progression of PDAC. Aim: to conduct a comprehensive assessment of epithelial and mesenchymal markers of EMT in the PDAC ducts and EMT zone at different degrees of differentiation. Materials and methods. A comprehensive pathomorphological and immunohistochemical examination including 49 cases of surgical material from patients with PDAC, divided into groups of moderate (G2) and low degree of tumor differentiation (G3). Results. PDAC was characterized by low levels of E-cadherin expression in both ducts and EMT – Me = 22.58 % [12.81; 36.23] and Me = 25.17 % [19.04; 35.37], respectively (p > 0.05). Only membrane expression of the marker was detected in the ducts and membrane-cytoplasmic one – in the EMT zone without significant differences in the groups. There was a significant decrease in the ductal β-catenin expression (p < 0.05) in G2 with membrane-cytoplasmic staining (Me = 15.58 % [10.42; 26.24]), in G3 – with membrane (Me = 4.42 % [2.35; 5.93]); in the EMT zone, only membrane-cytoplasmic expression was observed in both groups without significant difference (p > 0.05). Membrane expression of CK7 was positive in 100 % of PDAC, significantly lower at G2 (Me = 19.51 % [10.70; 27.24]; Me = 26.19 % [20.93; 30.05], p < 0.05), and CK18 (Me = 21.34 % [9.68; 29.96] – in G2, in G3 – Me = 22.50 % [8.24; 40.08], p > 0.05). Expression of α-SMA and Vim was seen in spindle-shaped stromal cells, around tubular and trabecular structures with membrane-cytoplasmic staining. There was no significant difference between α-SMA in G2 and G3, the level of vimentin was significantly lower in G3 (p < 0.05). Conclusions. The features of PDAC E-cadherin, β-catenin, CK7 and CK18 marker expression indicate a greater EMT process at the periphery of the tumor and its severity increases with tumor progression. The optimal markers to determine the mesenchymal phenotype of PDAC cells are α-SMA and vimentin.

Radiological and morphological features of vanishing lung syndrome development in patients with COVID-19 community-acquired viral pneumonia

BACKGROUND. Presently actively new direction develops in digital treatment of CТ images – radiomics, that presents the result of co-operation on verge of different sciences (radiology, computer sciences and mathematical statistics). Inaccessible for the unarmed eye additional information of CT images can be got by means of their mathematical treatment and creation of the segmented histograms. Last it is possible to compare and analyse both isolated and with regard to the dynamics of physiopathology descriptions of organs and fabrics at the different human diseases.
 OBJECTIVE. To define the roentgenologic and morphological features of development of vanishing lung syndrome for patients with non-hospital viral pneumonia.
 MATERIALS AND METHODS. Data of CТ are analysed in a dynamics for patients with non-hospital viral pneumonia of COVID-19, that were on treatment in SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky of the NAMS of Ukraine” or were directed from other medical establishments. The Dragonfly program from Object Research Systems (Montreal, Canada), which performs micro-X-ray structural analysis of the examined tissues, was used to analyze CT images of chest. Pathomorphological examination was performed in the laboratory of pathomorphology of the institute.
 RESULTS. Monitoring of CT is conducted in the group, that consisted of 90 patients with non-hospital viral pneumonia of COVID-19. 27 (30,0 %) patients (18 men and 9 women in age from 23 to 68) are educed with the roentgenologic signs of vanishing lung syndrome. 12 from them (9 men and 3 women in age from 23 to 56) were on treatment in the institute in an acute period of disease. Other 15 patients (9 men and 6 women in age from 26 to 68) directed from other curative establishments, where they treated oneself 3-4 months ago.
 CONCLUSIONS. Micro-X-ray structural analysis of data of CT allows to educe the features of changes of parenchima at development of vanishing lung syndrome. These changes are confirmed by the educed changes at pathomorphological research of postoperative preparations of lungs.

Preventive central neck lymph node dissection as a stage in the treatment of papillary thyroid cancer

Relevance: The need of prophylactic cervical lymph node dissection for the detection of low grade thyroid cancer remains debatable since preoperative examination does not always allow determining the involvement of a group VI regional lymph collector.Objective: to evaluate the frequency of group VI nodes involvement with clinical N0–Nx based on the results of a morphological examination after performing a preventive central neck lymph node dissection.Materials and methods: the study included 295 patients who underwent surgery from 2016 to 2022 for papillary thyroid cancer with cT1–T2, N0–Nx. There were 11.5 % of men included (n = 34) and 88.5 % of women (n = 261). Of these, 40.7 % (n = 120) were less than 55 years old. All patients underwent surgical treatment which included thyroidectomy or hemithyroidectomy with cervical lymph node dissection.Results: The study included 295 patients with cT1 — 247 (83.7 %) and cT2 — 48 (16.3 %). Pathomorphological examination changed the T index in some patients: pT1 was found in 80.3 % of cases (n = 237); рТ2 — in 9.2 % (n = 27); рТ3 — in 10.5 % (n = 31). Central neck lymph nodes involvement was detected in 77 (26.1 %) out of 295 patients. There was a correlation between the frequency of metastases detection and the size of the primary tumor: 22.8 % (n = 54) of metastases with pT1, 33.3 % (n = 9) with pT2, and 45.2 % (n = 14) with pT3. Transient hypocalcemia was found in 32 % of patients with pT1, 69 % with pT2, and 84 % with pT3. Two patients had unilateral transient paresis of the larynx.Conclusions: Our analysis demonstrates that the preventive central neck lymph node dissection in patients with low grade thyroid cancer is an important component of surgical treatment, which allows to improve the treatment results with a possible subsequent reduction in the risk of distant progression. In this study 77 (26.1 %) of 295 patients had metastases in the lymph nodes of the central neck. The number of postoperative complications affecting the quality of life of patients was acceptable with 0.67 % of paresis of the larynx and 39 % of mild hypocalcemia.

Optimization of Diagnostics and Treatment of Nasopharyngeal Cysts

Nasopharyngeal cysts are typically benign, congenital lesions filled with fluid and encapsulated from surrounding tissues. Both children and adults may present with clinical signs.
 The aim of the study was to improve the efficiency of diagnostics and treatment of nasopharyngeal cysts in adults based on the differential diagnosis.
 Materials and Methods. The study was carried out at the Department of Otolaryngology with the Course of Head and Neck Surgery, Ivano-Frankivsk National Medical University, Ukraine, and encompassed both outpatient and inpatient-to-outpatient observations. Fifteen (9 females, 6 males) patients with nasopharyngeal cysts at the age of 28 to 51 years were examined. All patients underwent a comprehensive assessment, including a thorough evaluation of their medical history, a standard examination of the ears, nose, and throat (ENT) using conventional and optical techniques, alongside computed tomography (CT) of the nasopharynx and paranasal sinuses, complemented by a general physical examination.
 Results. Fifteen patients with nasopharyngeal cysts were examined and treated. In nine (60%) cases, the cyst appeared as a round mass with a dense wall, partially or completely obstructed by the excretory duct and containing dense content, localized in the central region of the nasopharynx. In four (26.6%) cases, the cyst ruptured. Cysts were localized laterally, originating from the fossa of Rosenmüller in three (20%) cases. All patients underwent minimally invasive surgery.
 Conclusions. Endoscopic examination, CT, and magnetic resonance imaging are the most informative diagnostic methods for nasopharyngeal cysts. A definitive diagnosis can be made based on pathomorphological examination. The treatment of choice for nasopharyngeal cysts is endoscopic endonasal surgery with a microdebrider and laser coagulation.

Early Onset of Mycosis Fungoides

Introduction. Mycosis Fungoides (MF) is a primary epidermotropic T-cell lymphoma characterized by clonal proliferation of small and medium-sized T-lymphocytes with cerebriform nuclei. MF accounts for ≥ 50 % of all cutaneous lymphomas.The purpose of the study — description of a rare clinical observation of the debut of the development of Mycosis Fungoides in a patient in adolescence.Materials and methods. To verify the diagnosis, pathomorphological and immunohistochemical examination of a skin biopsy from the most infiltrated tumor-like lesion was used. The patient, born in 1978, turned to the clinic of Ural Research Institute of Dermatovenerology and Immunopathology with complaints of rashes on the skin of the trunk, accompanied by itching and soreness. Patient had been ill since the age of 16, when he first noticed the appearance of red spots on the skin of the chest without subjective sensations. In the last year he noted a significant deterioration of the disease: an increase in the number of spots, an increase in the intensity of itching, the appearance of tumor-like elements on the skin of the buttocks. In December 2022, he visited a dermatovenerologist and, in order to clarify the diagnosis, was sent to the Ural Research Institute of Dermatovenerology and Immunopathology.Discussion. The etiopathogenesis of the disease and the analysis of the few literature sources on the topic allows us to see the difficulty in early diagnosis and diagnosis in patients with early clinical manifestations of GM.Results. This clinical case demonstrates the possibility of the debut of GM in adolescence, the complexity of diagnosis in the early stages of development.Conclusion. The clinical case demonstrates the debut of GM in adolescence, emphasizes the need for clinical oncological alertness among dermatovenerologists.

Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

Background. In literature, data on the results of robot-assisted radical prostatectomy (RARP) in patients after transurethral resection of the prostate (TURP) are contradictory.Aim. To evaluate surgical, functional, and oncological outcomes of RARP after TURP.Materials and methods. At the Urology Center of the Mariinsky Hospital (Saint Petersburg), RARP was performed on 410 patients. Among them, 28 (6.8 %) patients (1st group) previously underwent TURP due to infravesical obstruction. Among them, 18 (64.3 %) patients were diagnosed with prostate cancer after pathomorphological examination of the tissue resected during TURP, and on them RARP was performed on average 3.2 months later. In 10 (35.7 %) patients, prostate cancer was diagnosed during transrectal biopsy due to increased prostate-specific antigen level; on them RARP was performed on average 42.0 months after TURP. The following parameters were evaluated: operative time, time of bladder neck reconstruction and urethrovesical anastomosis formation, blood loss volume, tumor pathological stage, Gleason score, surgical margin status, rates of urine continence and preservation of erectile function.Results. Mean operative time was higher in the 1st group compared to the 2nd: 210 ± 36 min versus 180 ± 25 min (р <0.0001). In the 1st group compared to the 2nd, reconstruction of bladder neck was necessary more frequently (82.1 % versus 10.7 %; р <0.0001), urethrovesical anastomosis took longer time (32 ± 2.3 min versus 24.5 ± 3.1 min; р <0.0001), mean blood loss volume was higher (240 ± 39 mL versus 170 ± 32 mL; р <0.0001). Frequencies of positive surgical margin were 14.3 and 10.7 % respectively in the 1st and 2nd groups (р = 0.840). Frequencies of all complications were 28.6 and 21.4 %, respectively. Severe complications (≥IIIb grade per the Clavien classification) were observed in 2 (7.1 %) patients in both groups. Frequency of anastomosis stricture after surgery was significantly higher in the 1st group: in 2 (7.1 %) and 1 (3.6 %) case, respectively (р <0.05). In the 1st group, total urinary continence was achieved in 14 (50.0 %), 20 (71.5 %), 22 (78.5 %) and 25 (89.3 %) patients at early and 3-, 6and 12-month follow-up after RARP; in the 2nd group, it was achieved in 18 (64.3 %), 22 (78.6 %), 24 (85.7 %) and 26 (92.9 %) patients in the same follow-up periods. After 6 and 12 months, in the 1st group among 15 (53.6 %) patients with normal initial erectile function, satisfactory erectile function was preserved in 46.7 and 93.3 % of patients; in the 2nd group among 19 (67.8 %) patients, in 57.8 and 94.7 % patients, respectively.Conclusion. RARP after TURP is a relatively complicated surgical intervention with long operative time and high blood loss volume. However, functional and short-term oncological outcomes of RARP in these patients do not differ at 12 months.

Evaluation morphofunctional state of broiler chickens body's under the applica-tion of various doses of Combiiod

One of the key and mandatory prerequisites for the creation and approbation of new veterinary preparations, both in the context of national legislation and the requirements of the International Community for Registration of Veterinary Medicines, is clinical studies in compliance with the provisions of “Good clinical practice” (GCP). This primarily concerns medicines with a new substance, pharmacology, and efficiency, which have not yet been studied. The technology of growing poultry requires the use of veterinary drugs not only for the prevention of infectious diseases but also for the improvement of metabolic functions and correction of the body’s resistance. One of the priority tasks is to ensure the complete work of the digestive system since it depends on the body's absorption of the nutrients required for the growth of poultry. Among poultry farms, there is considerable interest in drugs with antibacterial, general stimulating action, and coccidiostatics, especially those that do not have an elimination period. The company “Brovafarma” LLC has developed a new form of drug based on Povidone-iodine and sodium selenite for oral use of poultry for the treatment and prevention of diseases caused by bacteria, viruses, myxomycetes, protozoa organisms sensitive to iodine, and for metabolic disorders. That is why the purpose of our experimental studies was to study the safety of a new veterinary drug “Combiiod”, a “solution for oral use”, for healthy broiler chickens. According to the results of the study, it was found that the feeding of the drug “Combiiod” chickens-broiler at a therapeutic dose (0.2 ml per 1 liter of water) and in 5 multiple therapeutic doses (1.0 ml per 1 liter of water) within 5 days for two courses with weekly interval was well tolerated by the experimental poultry, did not cause death and violation of the morphofunctional state of broiler chickens bodies. In the blood of broiler chickens, which received the drug “Combiiod” at the therapeutic dose, most studied morphological and biochemical indicators were within the physiological values for this type of poultry. They did not differ significantly from the indicators of the control group. In the serum of poultry, which used 5 multiple therapeutic doses, a significant decrease in the content of erythrocytes, hemoglobin, and uric acid and an increase in the activity of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and the content of bile acids were revealed. Analyzing the coefficients of individual internal organs and mass of broiler chickens, no significant difference in indicators between experimental and control groups has been noted. Pathomorphological examination has not established a violation of the morphofunctional state of broiler chickens ’ bodies, which received a therapeutic dose. Histological changes in the structure of the kidneys, liver, and heart, which were reversed, were found in the poultry that received 5 multiple therapeutic doses of the drug.

Postinfectious epilepsy: clinical and diagnostical features

Background. According to some authors, neuroinfection agents play a role in the development of several neurological disorders, including epilepsy. For many years, it was believed that acute infectious diseases, such as tick-borne encephalitis virus and meningococcus played a leading role in the emerging epileptic process of postinfectious etiology. Regarding a role for chronically persistent infections, it has not been fully explored.Objective: to identify clinical, diagnostic, and morphological features of locally induced postinfectious epilepsy, both at disease onset upon emergence of the first epileptic seizures during acute infectious process and during their recurrence in a chronically persistent infection.Material and methods. The study included observations of 1500 patients with locally induced epilepsy admitted and treated from 2007 to 2017 in various medical inpatient and outpatient institutions. Post-infection locally induced epilepsy with clear causality link between previous neuroinfection and onset of epileptic seizure was found in 127 patients (Group 1). During initial visits, infectious agents in a cohort of patients with recurrent epileptic seizures manifested as chronic persistent infection were suspected in more than 1/3 of the 1373 subjects who sought medical aid comprising 550 people (Group 2). In addition to the clinical evaluation of patients, instrumental studies were performed, including routine electroencephalography (EEG), sleep video-EEG monitoring, magnetic resonance imaging (MRI), and some patients underwent pathomorphological examination using electron microscopy and histological techniques.Results. Gross and marked diffuse disturbances in brain bioelectrical activity were most often detected (58% and 31%, respectively) during video-EEG monitoring in Group 1, whereas moderate alterations were recorded less frequently (11% of observations). In Group 2, the majority of diffuse disturbances in brain bioelectrical activity were of moderate level (79%) followed by mild and irritative changes recorded less frequently (in 21% of cases). MRI data showed that disorders of the amygdala-hippocampal system were observed in 41 (32%) and 211 (38%) patients in Groups 1 and 2, respectively. Histological and electron microscopic data revealed a number of morphological disorders in patients with locally induced postinfectious epilepsy common with earlier described mitochondrial encephalomyopathies (mitochondrial megaconia and pleioconia) as well as a set of specific manifestations typical to such pathology.Conclusion. The conducted clinical, neurophysiological, neuroimaging, and pathomorphological studies of postinfectious epilepsy revealed specific features underlying its development at different stages, from its onset in acute infectious process to chronization in persistent infection. It was found that a comprehensive analysis of the presence and impact of infectious agents in patients with epileptic seizures is important for course and prognosis of postinfectious epilepsy, which is relevant for timely diagnosis and development of specific pharmacotherapy.

Search for germinal mutations in insulin-producing pancreatic tumors

BACKGROUND: It is known that insulinoma in approximately 5% of cases is associated with multiple endocrine neoplasia type 1 syndrome (MEN1), in which the prognosis and management tactics of patients have been developed in detail. The diagnosis of MEN1 often does not require genetic confirmation, since the syndrome has a typical clinical picture. At the same time, a combination of this tumor with other hereditary syndromes is found in the literature, which are characterized by the presence of malignant neoplasms of various localizations, primary multiple lesions, hormonal and other disorders. Thus, it is relevant to search for the genetic causes that cause the development of insulinoma, in addition to MEN1.AIM: to evaluate the frequency of detection of genetic causes of the development of insulin-producing tumors of the pancreas, in addition to MEN1; to analyze the phenotypic characteristics of patients with such tumors.MATERIALS AND METHODS: Based on the analysis of literature for the period up to 2020, a panel has been developed that includes coding regions of 10 genes (MEN1, VHL, TSC1, TSC2, KRAS, YY1, CDKN2A, MLH1, ADCY1, CACNA2D2) involved in the development of insulinoma. In 32 patients diagnosed with insulinoma, verified by pathomorphological examination, with the absence of clinical and/or genetic data indicating MEN1 syndrome, a panel of genes was sequenced with subsequent analysis of the identified genetic variants and phenotypic data obtained from the medical records of patients. In one patient, an additional molecular genetic study of the «Endom» panel was performed, revealing genetic variants of coding regions of 377 genes associated with endocrine diseases.RESULTS: In 8 patients (25%, 95% CI (11%; 43%)), 9 variants of mutations were identified that were not classified as benign, at that two mutations in the TSC2 gene were detected in one patient. Frequencies of genetic variants: TSC2 — 13%, 95% CI (4%; 29%), MEN1 — 6% (1%; 21%), MLH1 — 3% (0%;16%), CDKN2A/P16INK4A — 3% (0%;16%). When comparing patients with the identified mutation, with the exception of benign (n=8), and patients without mutation or with a benign mutation (n=24), there were no differences in the Grade (degree of differentiation), Ki67 proliferation index, frequency of concomitant tumors, burdened history, multiple pancreatic lesions or recurrence of insulinoma, however, patients with germinal mutation were found at the level of statistical trend to be younger at the manifestation of insulinoma and to have bigger tumors. In a patient who underwent an additional molecular genetic study using the new «Endome» panel, previously undescribed gene variants (APC and KIF1B) associated with various sporadic tumors, including endocrine ones, were identified.CONCLUSION: A panel of 10 genes has been developed, mutations of which are associated with insulinoma. A relatively high incidence of genetically determined insulinoma was determined (25% of cases), in half of cases — against the background of tuberous sclerosis. We consider it relevant to evaluate the effectiveness of genetic testing for patients with insulinoma. We believe that, first of all, patients with a high risk of hereditary pathology should be examined: with the manifestation of the disease at a young age and with a large tumor. The identification of a genetic mutation will make it possible to determine the prognosis of the disease, optimize the monitoring algorithm in order to timely identify concomitant diseases-components of the hereditary syndrome, and conduct genetic counseling of the family.

Endometrial hyperplasia and endometrial polyps: clinical and anamnestic characteristics of women

Aim. To study the clinical and anamnestic characteristics of patients with endometrial hyperplasia (EH) and endometrial polyps (PE).Material and Methods. a retrospective study was conducted, which included 267 sick women of reproductive and perimenopausal age who sought gynecological care at «Euromed» in 2022-23, who, before receiving the examination results, were diagnosed with N92 - heavy, frequent and irregular menstruation. Depending on the results of the pathomorphological examination, the patients were divided into 3 groups: group A included 89 patients with GE; group B – 99 women with PE; Group B (control) included 79 patients in whom endometrial pathology was excluded.Results. Among all women who came to the clinic with heavy menstrual bleeding, 33.3% had GE, 37.1% had PE, 29.6% had BUN-O ovulatory dysfunction. GE without atypia was detected in 72 (80.9%) cases of group A, GE with atypia – in 7 (19.1%), in group B PE was diagnosed in 91 (91.9%) cases, PE with atypia – in 28 (8.1%).In group B, in 22 (27.8%) cases, the endometrium was identified in the proliferation phase, in 57 (72.2%) cases, the endometrium was identified in the phase of incomplete secretion.Conclusion. Women with GE are characterized by early menarche, absence of pregnancies and childbirth during life associated with the woman’s choice, contraception, endocrine diseases, obesity, polycystic ovary syndrome, ovarian tumors, heavy bleeding with clots during menstruation, menstruation for more than 8 days, chronic iron deficiency anemia. Women with endometrial polyps are characterized by arterial hypertension, uterine fibroids, adenomyosis, infertility, dysmenorrhea, chronic endometritis, a history of cervicitis and vaginitis; clinical manifestations include intermenstrual bleeding.

Alveolar echinococcosis in fattening pigs in a conventional housing system

In a conventional fattening farm in southern Germany, up to 100 % of the livers of individual slaughter groups were condemned due to parasitic lesions during 2022. Intensification of antiparasitic metaphylaxis with fenbendazole to control Ascaris suum in the herd was unsuccessful. A pathomorphologic examination of 6 livers from two slaughter groups revealed oligofocal fibrotic inflammation. Histologically, chronic granulomatous hepatitis with massive involvement of eosinophilic granulocytes and central parasitic structures of a helminth were detected. Examination of the liver lesions by PCR revealed evidence of Echinococcus (E.) multilocularis. To determine the source of introduction into the herd, fecal samples were collected from semi-feral domestic cats near the feed mixer and in the corridor of the barn. Parasitologically, cestode eggs were detected in the fecal samples. Genome fragments of E. multilocularis could not be amplified by PCR. In the present case, domestic cats were suspected as the most likely source of entry into the herd. Control measures were aimed at preventing parasite entry by therapy of the domestic cats with antiparasitics. Differentially, no other possible pathogens could be detected by PCR and bacteriological examination.

Study of acute toxicity of a new drug “AOS” for the treatment of osteoporosis.

Background. Osteoporosis is one of the most common diseases, which, along with myocardial infarction, stroke, cancer, and sudden death, occupies a leading place in the structure of morbidity and mortality of the population. Postmenopausal women are most vulnerable and are approximately 4 times more likely to be affected than men (80 % of all patients), and osteoporosis-related fractures are responsible for a significant increase in morbidity, disability, and mortality, especially in the elderly.Objective. To study the acute toxicity of the new drug “Antiosteoporosis drug” (patent No. 02-04-16643/15-0 dated February 26, 2015) with a single intragastric administration to mature outbred rats of both sexes.Design and methods. The study was conducted on outbred rats of both sexes according to protocol OECD 420, GOST 32296-2013. The development of a toxic effect was concluded based on behavioral tests, clinical examinations, changes in body weight, the results of pathomorphological examination of organ tissue and biochemical parameters of blood and urine.Results. According to the results of the study, the tested drug was classified according to the active substance into category 5 according to the GHS classification (2000<LD50 (i/g)<5000 mg/kg). An assessment of the dynamics of body weight in experimental animals showed that a single intragastric administration of the test drug had no effect on this indicator. The study of individual behavior as part of the main study on the 14th day after a single intragastric administration of the test drug showed that a single intragastric administration of the test drug at a dose of 2000 mg/kg did not have a delayed effect on the general condition and indicative research activity of experimental animals. Autopsy and pathological examination of animals on the 15th day after a single intragastric administration of the test drug did not reveal the presence of any residual effects associated with the administration of the test drug. The tested drug did not have a local irritant effect on the injection site — the gastrointestinal tract. In all tests, the degree of change in indicators caused by the test drug was the same: there were no statistically significant differences in the recorded parameters between the test drug and the control group.

PLACENTAL DYSFUNCTION, FETAL AND NEWBORN CONDITION WITH COVID-19 IN PREGNANCY

Purpose. To determine signs of placental dysfunction, to assess the condition of the fetus and newborn in case of Covid-19, transferred to a woman during any.
 Materials and methods. 50 pregnant women with a severe course of Covid-19 (group 1) and 150 pregnant women with moderate severity of the disease (group 2) were examined. The control group consisted of 50 pregnant women who did not suffer from Covid-19. The state of uterine-placental-fetal blood flow was determined by the Doppler method. To assess the condition of the fetus, a cardiotocogram was recorded, cardiotocogram analysis was performed according to the Dawes/Redman criteria, and the biophysical profile of the fetus was established. Pathomorphological examination of the placenta was conducted.
 Results. Established placental insufficiency in most cases (72.0%) of patients with a severe course of Covid-19, supports the growth of the fetus and its distress in 32.0% and 48.0% of women. The results of dopplerometry at 32-34 weeks revealed significant violations of maternal-placental-fetal blood flow. A decrease in the pulsatility index in the middle cerebral artery of the fetus and cerebro-placental ratio indicates the centralization of fetal blood flow in response to hypoxia. When the status of the fetus is reduced, a reduced assessment of the biophysical profile of the fetus is indicated (6.69±0.30). According to the Dawes/Redman criteria, fetal protein acidemia occurred in 48.0% of patients, critical condition - in 8.0% of pregnant women. Pathomorphological examination of the placenta reveals violations of various structures in the form of degenerative and alterative-degenerative changes, dysmucoidosis, circulatory disorders, damage to the endothelium and thrombus formation, ischemia, infarction, and vasculitis. Signs of chorioamnionitis are found in 18.0% of placentas. 44.0% of children are born asphyxiated, 36.0% have respiratory failure, and 16.0% have bilateral pneumonia. High frequency of neurological disorders (56.0%), gastrointestinal (50.0%), hypoglycemic (34.0%) and hemorrhagic (32.0%) syndromes. 22.0% of children needed care in the intensive care unit. Perinatal mortality was 0.4 ‰.
 Conclusion. Сhildren born to women whose pregnancy complicated their SARS-CoV-2 infection belong to the high-risk group and require final follow-up to monitor the status of developed clear care algorithms depending on the condition.

Pathomorphological state of fish in the southern water area of Lake Ladoga

The entry of pollutants and nutrients in various ways (wastewater, aerogenic means and polluting surface runoff) had a negative impact on all parts of the cycle of substances in the reservoir. This was clearly shown by the results of a comprehensive study in the water system: lake. Ilmen - Volkhov river - lake. Ladozhskoye - r. Neva and Neva Bay, which especially affected the ichthyofauna of the studied reservoirs, both visually and during pathomorphological examination. The southern waters of Lake Ladoga are of great fishery importance. More than half of the water area is occupied by the littoral zone - the shallow part of the lake, limited to a depth of 8.4 m. The hydrological features of this water area, combined with sources of pollution, form a high level of anthropogenic influence, which affects the condition of fish and their reproduction. Fishing was carried out in three water areas of the southern part of Lake Ladoga, in the littoral zone. For the study, they took the brain, gills, liver, kidneys, spleen, and gonads. All studies of fish have shown massive toxicosis at the organismal level. A pathological and morphological study carried out at the cellular level confirmed the previously obtained results, revealing pathological changes in various organs. These changes are expressed in hemodynamic disturbances and various degenerative processes, including necrosis, which is the result of prolonged exposure to toxicological substances. On histological preparations, changes in the structural elements of gill tissue from petals to capillaries were observed. The conducted studies showed, along with previously conducted pathological studies, their effectiveness in assessing the condition of fish. They also make it possible to assess both the quality of the fish habitat and the level of its pollution.