Pathomorphological Features Research Articles

Algorithm of topical oxidant application in the treatment of seborrheic keratosіs based on ultrasound and pathomorphological features

Objective — to develop an algorithm for the use of a topical oxidizing agent (hydrogen peroxide) in the treatment of seborrheic keratosis (SK), taking into account the ultrasound (US) and pathomorphological data and using statistical models.
 Materials and methods. 35 patients aged 35 to 75 (32 (91.4 %) women and 3 (8.6 %) men) with seborrheic keratomas were examined on the basis of «University Clinic» Medical Educational and Scientific Center of Zaporizhzhia State Medi­cal University. Clinical, dermatoscopic and pathomorphological research methods were used for diagnostic purposes. To determine the thickness of keratosis, an ultrasound scan was performed.
 Results and discussion. Topical adapalene was applied locally to SK foci for 2 weeks, 2 times a day in 35 patients. After retinoid administration, the thickness of most foci decreased (n = 26; 74.3 %), but some of them did not change significantly (n = 9; 25.7 %). For the purpose of chemical destruction, it was recommended to use a topical oxidant — 30 % solution of hydrogen peroxide. Group 1 (application of topical oxidant in one cycle) included 20 patients who used the remedy for 5—6 days. The duration of treatment for ≥ 7—10 days was recommended for 15 patients of group 2. A comparison of keratoma thickness in patients of both groups with different duration of oxidant use revealed a statistically significant difference between subgroups (U = 88.500; p < 0.05). The greater the thickness of the keratoma was, the more it needed additional application of hydrogen peroxide. Taking into account the pathomorphological and ultrasound signs, a discriminant analysis was performed between groups of patients with 1 and 2 cycles of hydrogen peroxide application. In case of less than 0 index, longer therapy was recommended.
 Conclusions. The scheme using topical oxidant is a promising area of treatment for patients with SK and requires further study. The application of statistical methods made it possible to identify the main variable features (pathomorphological variant and keratoma thickness), which determine the choice of the duration of hydrogen peroxide application.

Neuroinvasion and Neurotropism by SARS-CoV-2 Variants in the K18-hACE2 Mouse.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) not only affects the respiratory tract but also causes neurological symptoms such as loss of smell and taste, headache, fatigue or severe cerebrovascular complications. Using transgenic mice expressing human angiotensin-converting enzyme 2 (hACE2), we investigated the spatiotemporal distribution and pathomorphological features in the CNS following intranasal infection with SARS-CoV-2 variants, as well as after prior influenza A virus infection. Apart from Omicron, we found all variants to frequently spread to and within the CNS. Infection was restricted to neurons and appeared to spread from the olfactory bulb mainly in basally oriented regions in the brain and into the spinal cord, independent of ACE2 expression and without evidence of neuronal cell death, axonal damage or demyelination. However, microglial activation, microgliosis and a mild macrophage and T cell dominated inflammatory response was consistently observed, accompanied by apoptotic death of endothelial, microglial and immune cells, without their apparent infection. Microgliosis and immune cell apoptosis indicate a potential role of microglia for pathogenesis and viral effect in COVID-19 and the possible impairment of neurological functions, especially in long COVID. These data may also be informative for the selection of therapeutic candidates and broadly support the investigation of agents with adequate penetration into relevant regions of the CNS.

Surgical treatment of Littre hernia in a 6-month old child

Introduction. A surgical care in complicated hernias of the anterior abdominal wall remains an acute issue in pediatric surgery. Strangulated hernia is the most common and dangerous complication. It is worth mentioning that the risk of developing this complication in children during the first six months of their life reaches 24%. The clinical course of strangulated hernia in children is characterized by a large variety of symptoms depending on patient’s age, anatomical and pathomorphological features of his/her organs and systems. A correct assessment of clinical, laboratory and instrumental findings can help in identifying uncommon types of hernia infringement.Material and methods. A case of clinical observation and surgical treatment of a 6-month old child with Littre hernia is presented.Results. By the literature data, emotional and motor restlessness prevails in the structure of complaints in infants with strangulated hernia. Patients with uncommon types of hernia infringement may be regarded as a separate group. Patients with Littre hernia, which is one of the types of parietal infringement, belong to this group. Littre hernia incidence does not exceed 0.5% of the total number of hernia strangulations. Clinical symptoms of the atypical hernia infringement may be mild or non-classical. It is known that mild clinical manifestations of strangulated hernia as well as limited diagnostic potentials of laboratory, X-ray and ultrasound examinations in young children increase the risk of developing destructive changes in the intestinal wall. Therefore, an active surgical tactics of hernia treatment prevents the development of atypical forms of hernia infringement and complications associated with it.Conclusion. Thus, early detection of hernias of the anterior abdominal wall, since the neonatal period, an adequate observation tactics and timely performed surgical intervention is the basis for preventing peritonitis and intestinal obstruction in young children.

Molecular and Cellular Mechanisms of M. tuberculosis and SARS-CoV-2 Infections-Unexpected Similarities of Pathogenesis and What to Expect from Co-Infection.

Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against M. tuberculosis, especially in the Russian Federation. However, the emergence of a new coronavirus infection (COVID-19) has led to the long-term isolation of the population on the one hand and to the relevance of using personal protective equipment on the other. Our knowledge regarding SARS-CoV-2-induced inflammation and tissue destruction is rapidly expanding, while our understanding of the pathology of human pulmonary tuberculosis gained through more the 100 years of research is still limited. This paper reviews the main molecular and cellular differences and similarities caused by M. tuberculosis and SARS-CoV-2 infections, as well as their critical immunological and pathomorphological features. Immune suppression caused by the SARS-CoV-2 virus may result in certain difficulties in the diagnosis and treatment of tuberculosis. Furthermore, long-term lymphopenia, hyperinflammation, lung tissue injury and imbalance in CD4+ T cell subsets associated with COVID-19 could propagate M. tuberculosis infection and disease progression.

Lumpy Skin Disease: Pathomorphological Features and Molecular Detection in Dairy Cattle of West Coastal India

Lumpy skin disease (LSD) is an emerging pox viral disease affecting cattle population worldwide. Present investigation designed to study the prevalence, pathomorphological changes and molecular detection of LSD virus in naturally infected cat-tle. The overall morbidity of LSD was 4.48% among 30 dairy farms. Skin nodular biopsy, whole blood and serum samples (n= 66) were collected for the diagnosis of LSD by histopathology, PCR and gene sequencing. The envelope protein (P32), Fusion protein (F) and DNA dependent RNA polymerase 30 kDa subunit (RPO30) genes were targeted for PCR testing. Out of 66, 46 cattle showed generalized skin nodules and papules of various sizes on the skin particularly at neck, face, nose, tail, perineum and udder. Microscopically, skin nodule biopsy revealed presence of diffuse granulomatous inflammation, hyperkeratosis, focal to diffuse vasculitis and lymphangitis, vacuolar degeneration, spongiosis and acanthosis. The inflammatory cells along with diffuse necrosis seen in the dermis. Gel-PCR assay detected P32 gene in 80%, F gene in 70% and RPO30 gene in 75% of skin biopsy samples. Three blood samples were also found positive for P32 gene by PCR. Whereas, TaqMan™probe Real Time PCR targeting EEV glycoprotein gene (LSDV126) detected LSDV in 94% of biopsy samples and three blood samples which indicated its higher sensitive for the diagnosis of LSDV. Phylogenetic analysis of RPO30 gene sequence showed that the isolates from this study were grouped in same cluster with LSDV isolates of Bangladesh, Kenya and other Indian isolates detected during 2019-20.

Pathomorphological and biochemical features of the endothelium of the umbilical cord vessels during pregnancy complicated by preeclampsia

<h3></h3> Преэклампсия (ПЭ) — тяжелое осложнение беременности, которое является одной из основных причин заболеваемости и смертности матери и плода. Пренатальный онтогенез плода зависит от целого ряда факторов, одним из которых является состояние пупочного канатика. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Определить морфологические, иммуногистохимические и биохимические особенности эндотелия пупочного канатика при беременности, осложненной ПЭ. <h3>МАТЕРИАЛ И МЕТОДЫ</h3> Исследовано 60 пуповин последов родильниц с ПЭ, составивших основную группу, в том числе 35 пуповин родильниц с умеренной ПЭ (1-я подгруппа) и 25 пуповин родильниц с тяжелой ПЭ (2-я подгруппа). Контрольную группу составили 30 пуповин родильниц без признаков ПЭ.<b></b> Морфометрию сосудов осуществляли с использованием системы анализа изображений «ВидеоТест-Мастер-Морфология-4». Иммуногистохимическое исследование проводили с применением моноклональных антител к фактору роста эндотелия сосудов (VEGF) и аннексину V типа (Santa Cruz) в рабочем разведении 1:200, визуализацию комплексов «антиген — антитело» — с помощью системы детекции Dako REAL EnVision Detection System (Dako, Германия). Определение содержания циклического гуанозинмонофосфата осуществляли с применением набора реактивов фирмы Enzo (Швеция), определение содержания eNOS и ангиогенина — с применением набора реактивов фирмы RayBiotech (США) иммуноферментным методом. Исследование показателей окислительного стресса методом железоиндуцированной хемилюминесценции выполняли на биохемилюминометре БХЛ-07 (Россия). <h3>РЕЗУЛЬТАТЫ</h3> При исследовании пупочного канатика у новорожденных, родившихся у женщин с ПЭ в период беременности, выявлены выраженный спазм артерий и дилатация вены с истончением стенки последней, атрофические изменения венозных эндотелиоцитов и их очаговая десквамация. При беременности, отягощенной умеренной ПЭ, отмечено увеличение экспрессии аннексина V типа в венозном компартменте пуповины. При беременности, отягощенной тяжелой ПЭ, выявлено снижение экспрессии VEGF в сочетании с истощением экспрессии аннексина V типа независимо от срока родоразрешения (<i>p</i>&lt;0,05). В ответ на развитие окислительного стресса в клетках эндотелия пуповины повышалась антиоксидантная активность. Отмечено повышение уровня циклического гуанозинмонофосфата и ангиогенина в лизате клеток у детей, родившихся у женщин с ПЭ в период беременности. Содержание эндотелиальной синтазы оксида азота в пуповинах основной и контрольной групп было сходным и статистически значимо не различалось. <h3>ЗАКЛЮЧЕНИЕ</h3> Установлено, что в сосудах пуповины новорожденных, родившихся у женщин с преэклампсией в период беременности, на фоне морфометрических изменений и развития окислительного стресса изменяется функциональное состояние эндотелиоцитов, что является компенсаторно-приспособительной реакцией в этих условиях.

PATHOMORPHOLOGICAL FEATURES OF GASTROESOPHAGEAL REFLUX DISEASE REALIZATION IN YOUNG PEOPLE WITH AUTOIMMUNE THYROIDITIS

The aim: To evaluate the pathomorphological features of the esophageal mucous membrane in young people with GERD and autoimmune thyroiditis. Materials and methods: 120 patients with GERD and AIT and 45 people with isolated GERD matched for age, gender and social status were examined. Esophagogastroduodenoscopy, histological study and comparative morphometry of the esophageal mucosa were performed. Results: The frequency of erosive GERD in the examined groups of patients did not statistically differ. At the same time, integral analysis of the structure of erosive forms of GERD revealed statistically significant redistribution of grades of esophagitis towards its enhancement in patients with comorbid pathology. The histological study showed that in patients with GERD and AIT all the morphometric parameters studied had a significantly more severe course and exceeded similar indicators of the group with isolated GERD: epithelium total thickness, epithelium basal layer thickness, connective tissue papillae height, intercellular space. The analysis of morphological changes frequency showed that epithelium basal layer hyperplasia, dystrophic changes and epithelial edema, elongation of papillae and dilation of intercellular space were significantly more frequent in the group with comorbid pathology. Conclusions: GERD and euthyroid AIT comorbidity in the student population is accompanied by a statistically significant redistribution of esophagitis grades towards its aggravation. The presence of concomitant euthyroid AIT in patients with non-erosive GERD leads to statistically more pronounced disorganization of esophageal mucosal epithelium.

Pathomorphological features of thymus in intrauterine-infected newborns with body hypotrophy

Pathomorphological features of thymus in intrauterine-infected newborns with body hypotrophy

Clinical, biochemical and pathomorphological features of direct acute lung injury in rats caused by intratracheal administration of Salmonella enterica lipopolysaccharide

Clinical, biochemical and pathomorphological features of direct acute lung injury in rats caused by intratracheal administration of Salmonella enterica lipopolysaccharide

Особенности формирования неспецифических патоморфологических изменений в ткани печени при опухолевых процессах (экспериментальное исследование)

The study is due to an increase in nonspecific complications in oncological diseases. The research purpose is to study in experiment the features of the formation of nonspecific pathomorphological changes in liver tissue during tumor processes. Research objectives: to simulate toxic hepatitis on the tumor line of mice, to study the effect of the tumor process on pathomorphological changes in the liver with its toxic lesion, to study the effect of a tumor on pathomorphological changes in the liver when using methotrexate, to conduct a comparative analysis of the results and identify the features of the formation of nonspecific changes in liver tissue. Materials and methods. We conduct the study on mice of the Balb/c line. The work was carried out according to the recommendations set out by the Ministry of Health of the USSR no. 755 of August 12, 1977 and the Helsinki Declaration. We form a control group, a comparison group and an experimental group. In the comparison groups, carbon tetrachloride 0.1 ml of 40 % solution and methotrexate at a dosage of 0.2 mg were administered intraperitoneally to animals. The experimental group included animals with formed malignant tumors. Main results. Pathomorphological changes indicate the progression of nonspecific necrobiotic, cholestatic, inflammatory and microcirculatory processes under the influence of a hepatotropic agent. When using cytostatics, necrobiotic, cholestatic and microcirculatory changes progressed without a cellular reaction. Conclusion. The revealed pathomorphological features in the liver tissue indicate the pathogenetic significance of toxic liver damage leading to the progression of liver failure in tumor processes.

Вроджений нефротичний синдром у практиці лікаря-неонатолога (клінічний випадок)

Congenital nephrotic syndrome (CNS) is an inherited disease that is caused by gene mutations and is inherited by an autosomal-recessive mechanism. In most cases, it is associated with genetically mediated defects in the components of the glomerular filtration barrier, especially nephrine and podocytes, with a typical histological picture of diffuse mesenteric sclerosis or focal-segmental glomerulosclerosis. According to genetic research, the primary CNS caused by gene mutations in one of the five genes (NPHS1, NPHS2, WT1, LAMB2, PLCE1) or chromosomal abnormalities. Secondary CNS is combined with other diseases of systemic or renal origin. The onset of the disease manifestation is possible in the antenatal period or during the first three months of life. CNS is manifested by significant hypoproteinemia, proteinuria and diffuse edema. Treatment of congenital nephrotic syndrome is mainly symptomatic therapy, such as: control of edema, azotemia, thyroid function, prevention and treatment of secondary complications (infections and thrombosis). Molecular genetic testing is the «gold» standard for genotyping of this disease. The course of СNS is unfavorable due to the rapid development of end3stage chronic renal failure. The purpose of article is to expand the knowledge of pediatricians and neonatologists about the clinical, laboratory, instrumental and pathomorphological features of Finnish type of СNS in the neonatal age. Clinical case. The article presents clinical, laboratory, instrumental, pathomorphological and molecular-genetic features of the Finnish type of CNS with the manifestation in the early neonatal period. Conclusions. The example of this case shows the necessity of a comprehensive approach at the examination of children suffered from CNS to verify the type of disease, determine the prognosis and treatment tactics. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: congenital nephrotic syndrome, newborn, molecular genetic testing.

Traumatic diaphragmatic hernias in patients with closed chest and abdominal trauma

The OBJECTIVE of the study was the pathomorphological features, diagnosis, and treatment outcomes of diaphragm ruptures in closed trunk trauma.MATERIALS AND METHODS. We prospectively studied diaphragmatic ruptures in 35 hospitalized patients with blunt trunk trauma and diaphragmatic defects in 9 patients with chronic traumatic diaphragmatic hernia, previously not recognized in other hospitals. Damage severity was assessed using the MFS-D (MI) scale; statistical data were processed using the WinPepi program: calculation of the boundaries of 95 % CI of medium and extensive values using the fisher method.RESULTS. Diaphragmatic ruptures were observed in 3.25 % of the victims. Damage to the left side occurred 2.4 times more often than the right side; on the left, they were mainly localized in the lumbar and adjacent costal parts. The average length of the rupture of the right half was 13.5, the left half was 9.8 (2-25) cm. More often, the greater omentum, colon, liver and stomach fell into the pleural cavity. During the first day, 2/3 of diaphragm ruptures were diagnosed, mainly during thoracotomy and laparotomy due to bleeding. Missing a rupture of the left half of the diaphragm was allowed at 6 laparotomies. Mortality rate was 31.4 %, the main causes were acute blood loss, severe brain damage; 2 out of 11 deaths were due to a complicated course of an unrecognized diaphragmatic rupture. All patients with chronic diaphragmatic hernia recovered after surgery.CONCLUSION. Diagnosis of diaphragmatic rupture in severe trunk injury on the first day is difficult, radiation methods: radiography, MSCT, ultrasound are not informative enough. When performing diagnostic studies and abdominal operations, it is necessary to study the diaphragm. Repeated survey radiography and MSCT of the chest during the first three weeks of inpatient treatment of the victim increases the detection of acute traumatic diaphragmatic hernia.

Analysis of lethal cases of pneumonia caused by SARS-CoV-2 virus according to the data of pathology department of Kharkiv Regional Clinical Hospital for the first half of 2021

Background. Given the great medical, social and economic significance of clinical research, pathogenesis and epidemiology of coronavirus infection, it is important to study the epidemiological and pathomorphological features of this infection in Ukraine, especially in fatal cases of this disease. Objective: to analyze the lethal cases of pneumonia caused by SARS-CoV-2 in comparison with lethal cases of pneumonia of other etiologies according to the pathology department of Kharkiv Regional Clinical Hospital for the first half of 2021. Methods. The material of this study was the observation of an autopsy from the archival material the pathology department of Kharkiv Regional Clinical Hospital. The study of autopsy protocols took into account the seasonality of the disease, sex and age of the deceased, the number of bed-days, data of clinical diagnosis and coincidences of pathological diagnosis, as well as the ICD code. 256 protocols of pathological examinations for the first half of 2021 were studied. Results. Of the 256 deaths from pneumonia of various etiologies, 201 (78.52%) were caused by SARS-CoV-2 infection. The highest number of deaths from pneumonia was registered in March, April and May 2021. The number of deaths of patients aged 18-44 years was 4.3% of the total, 45-59 years – 13.28%, 60-74 years – 47.27%, 75-90 years – 35.16%. The study sample among patients died of pneumonia caused by SARS-CoV-2 was dominated by women (57.42%, 147 cases), the number of men was 42.58% (109 cases). The direct causes of death were pulmonary-heart failure, multiple organ failure, acute pulmonary insufficiency, chronic pulmonary insufficiency, and pulmonary embolism. Conclusion. The obtained data can be useful for the analysis of regional features of epidemiology and pathogenesis of coronavirus disease in eastern Ukraine.

The characterization and frequency of diagnosis of EBV-positive variants with a lymphoid predominance in the structure of Hodgkin lymphoma

Introduction. Epstein — Barr virus (EBV) plays an important role in the pathogenesis of lymphoid tumors, in particular Hodgkin lymphoma. The frequency of expression of the EBV varies in different histological variants of classical Hodgkin lymphoma and is rarely observed in nodular lymphocyte predominant Hodgkin lymphoma.Aim — to study the pathomorphological features of the histological variants of Hodgkin lymphoma with lymphoid predominance associated with the EBV, as well as the frequency of their diagnosis in the structure of Hodgkin lymphoma.Materials and methods. The retrospective study included 794 patients with a verified diagnosis of Hodgkin lymphoma using histological and immunohistochemical methods on biopsy material for the period 2018–2019 (age range — 18–91 years old; median — 34 years old; men : women — 1.1 : 1). The presence of EBV in biopsies was assessed by immunohistochemical reaction with antibodies to EBV (clone LMP1), or by chromogenic in situ hybridization with probes for EBV-encoded small RNAs.Results. Classical Hodgkin lymphoma was diagnosed in 91 % (725/794) cases, nodular lymphocyte predominant Hodgkin lymphoma — in 9 % (69/794) cases. EBV-positive Hodgkin lymphoma accounted for 11 % (82/725) of all cases of classical Hodgkin lymphoma, (age range — 18–81 years old, median — 45 years old; men : women — 2.5 : 1). All cases of nodular lymphocyte predominant Hodgkin lymphoma were EBV-negative. Lymphocyte-rich classical Hodgkin lymphoma was found in 14 patients (14/725, 2 %), 4 patients showed intermediate morphoimmunohistochemical features with nodular lymphocyte predominant Hodgkin lymphoma, which were statistically significantly different from classical Hodgkin lymphoma by the presence of B-zones in the form of large nodules (p = 0.0157) and expression CD20 by tumor cells (p = 0.0404).Conclusion. Nodular lymphocyte predominant Hodgkin lymphoma is not characterized by a connection with EBV infection, unlike classical variant — lymphocyte-rich classical Hodgkin lymphoma. The obtained data support the concept of the existence of a transient form of Hodgkin lymphoma, which has the features of nodular lymphocyte predominant Hodgkin lymphoma and classical Hodgkin lymphoma, in the pathogenesis of which the Epstein — Barr virus likely plays a role.

Pathomorphological features of the uterus’ wall structure in case of fetuses with a gestational term of 37-40 weeks from mothers with a chronic infection of the lower genital tracts

In the following article we have provided a data towards a comprehensive research of the pathomorphological features of the uterus’ wall structure in case of fetuses from mothers with HILGT comparing to ones in case of fetuses from healthy mothers.&#x0D; The research methods: macroscopic, organometric, histological, immunohistochemical, morphometric, statistical.&#x0D; On the basis of the organometric research we have revealed a probable decrease of the weight, length and thickness indexes likewise one of the main components of the uterus wall in case of fetuses from mothers with a complicated pregnancy comparing to ones in case of fetuses from healthy mothers.&#x0D; By applying histological method we have revealed an increased growth of the connective tissue both in the endometrium and myometrium in case of fetuses from mothers with HILGT relatively to one in case of fetuses from mothers with a physiological pregnancy. Moreover, the massive growth of the collagen fibers leads to the disorder in the strucutral organization of the muscle component. The uterus’ endometrium in case of fetuses from the main group could be characterized by a few glands without features of the functional activity comparing to one in case of fetuses from the group of comparison. In the structure of the connective tissue in case of uterus of fetuses from mothers with a complicated pregnancy we have revealed mainly the collagen of the III type, while the collagen of the I type could be revealed in the form of small loci of reduced intensity of glow.&#x0D; By applying the immunohistochemical method we have revealed an increase of the apoptotic index in the endometrium of fetuses from mothers with a chronic infection of the lower genital tracts comparing to one in case of fetuses from healthy mothers. By applying MCAT to endotheline-1 we have revealed an increased glow of the endtheliocytes in the vessels both of arterial and venous types, in case of fetuses from the main group comparing to one in case of fetuses from the group of comparison. In the uterus of fetuses from mothers with HILGT we could observe a decreased hormon producing activity comparing to one in case of fetuses from mothers with a physiological pregnancy. All changes, that were revealed in the uterus of fetuses from mothers with an infectious pathlogy declare an existance of the severe disorder in the implementation and formation of main organ’s components, as well as are caused mainly by a chronic hypoxia as well as influence of the infectious agent. All pathomorphological features of the uterus wall structure in case of fetuses from mothers with HILGT, that were revealed, could contribute subsequently to the complications in the pregnancy’s onset as well as could lead to the disruption of one.

Retrospective cohort study of morphological features of recurrent schwannomas and neurofibromas

Recurrences of benign peripheral nerves sheaths tumours (BPNST) after total resection were described in 2.6–11.0% of patients. The significance of the histological features of recurrent BPNST is still insufficiently studied.Aim. To compare the pathomorphological features of recurrent and non-recurrent BPNST (schwannomas and neurofibromas).Materials and methods. A retrospective assessment was made of 101 patients with BPNST with a degree of anaplasia corresponding not more than Grade I. Recurrence of BPNST developed in 13 (12.9%) cases. The study included patients with histological archive: the study group (n = 7) included patients with one or more relapses of BPNST, the control group included patients (n = 5) without relapses after surgery for 5 or more years. The main clinical characteristics were studied and histological examination was performed.Results. There were no differences between the groups in baseline characteristics (the type of tumour (schwannoma, neurofibroma), distribution by sex, age, localization, clinical symptoms). The relapse rate among patients with neurofibromas was 8 in 3 patients vs. 6 in 5 patients with schwannomas. In all cases of recurrent schwannomas and in one of neurofibroma, the histological pattern was predominantly monophasic with rhythmic structures like Verocay bodies with underlined pattern and nuclear hyperchromasia, in contrast to the control group, represented by tumours with a mixed type of structure with uniform alternation of various histological patterns (p &lt; 0,05). Endothelial proliferation and lymphocytic infiltration in the stroma and perivascular area were more common in the relapse group (p &lt; 0.05). Pathomorphological signs of anaplasia: cell-nuclear polymorphism, nuclear hyperchromasia, endothelial proliferation, mitosis, as well as minor signs of anaplasia: solidization, muirization of the fascicular pattern of a tumour and apoptotic bodies were found with the same frequency in both groups. With relapse, the capsule was lost, thinned, intermittent, and sometimes invaded the surrounding tissues.Conclusion. Tumours with the initial signs of anaplasia, such as endothelial proliferation, tendency to hypercellularity, and histological pattern with prominent Verocay bodies dominate among recurrent BPNST.

Clinic and diagnostics of the non-penetrating gun-shoot craniocerebral injuries in the local war

Objective ‒ to evaluate the features of the clinical manifestations and effectiveness of multi-slice computed tomography (MSCT) of the head for the diagnosis of non-penetrating gun-shoot head injuries in the local war.Materials and methods. The medical data of 155 patients who received a non-penetrating gun-shoot head injuries during the war in the Eastern Ukraine between 2014‒2020 were analyzed. All patients were males between 18 and 60 years (average age ‒ 35.1 years). The peculiarities of clinical manifestations and results of diagnostic evaluation of non-penetrating gun-shoot head injuries during specialized neurosurgical care in medical institutions on the third and fourth levels of medical aid have been studied.Results. Wide diagnostic capabilities of MSCT were revealed for determination of the wounds localization, type of the projectile, the nature of the wound channel, gunshot skull fractures, and associated intracranial injuries. It was found that with non-penetrating bullet and shrapnel tangential cranio-cerebral wounds, incomplete and depressed fractures usually occurred, and with single and multiple shrapnel blind wounds, incomplete ‒ perforated and depressed fractures with the presence of bone fragments. The pathomorphological features of the nature of the wound channels and intracranial injuries were determined. They are always associated by traumatic subarachnoid hemorrhages and brain contusions, in most cases – focal. Intracranial hematomas were observed in 3.1 % of the patients.Conclusions. Clinical manifestations of the non-penetrating craniocerebral gunshot wounds depend not only on the type of cranial soft tissue injury, but also on the nature of the skull fracture and are mainly occurred because of the severity of the traumatic brain injury. MSCT of the head makes it possible to determine the localization of the wound, the type of the wounding projectile, the nature of the cranial soft tissues damage, wound channel, gunshot skull fractures and associated intracranial injuries.

Експериментальне моделювання туберкульозного спондиліту

Актуальність. Туберкульозний спондиліт (ТС) в структурі кістково­суглобового туберкульозу у дорослих займає провідне місце і досягає 40–61,5 %. Метою даної публікації є висвітлення процесу моделювання туберкульозного спондиліту і його особливостей у морських свинок для подальшого використання результатів експерименту у лікувальній та науковій практиці. Матеріали та методи. Експеримент ставився на 40 статевозрілих морських свинках. Моделювання туберкульозного спондиліту проводилось на основі розробленого нами способу (патент № 112423 (UА) Україна). Усі тварини були розподілені на чотири рівні групи: 1­ша — 3­тя групи (основні) — виконувалась ін’єкція 0,5 мл суспензії М.tuberculosis (0,1 мг сухої маси в 1 мл) в тіло хребця згідно з методикою; 4­та група — контрольна. Тваринам робилась ін’єкція стерильного фізіологічного розчину (0,9% — 0,5 мл) в тіло хребця. Група 1 (10 свинок) — лікування специфічними антибактеріальними препаратами (АБП) першого ряду (ізоніазид, стрептоміцин, рифампіцин). Група 2 (10 свинок) — лікування специфічними антибактеріальними препаратами другого ряду (амікацин, рифабутин, офлоксацин). Група 3 (10 свинок) — не проводилося лікування. За всіма тваринами проводилося динамічне спостереження з клінічними, рентгенологічними, патоморфологічними і лабораторними дослідженнями. Виведення ­експериментальних тварин з досліду проходило за раніше розробленим графіком — при виявленні ознак досліджуваних стадій туберкульозного процесу. Всім виведеним з експерименту тваринам проводилося патоморфологічне дослідження. При цьому основна увага приділялася вивченню патоморфології уражених специфічним процесом хребців. Результати. У результаті морфологічного дослідження встановлено наявність активного туберкульозного процесу в тілах хребців і паравертебральних тканинах у тварин із модельованим туберкульозом і лікуванням специфічним АБП першого ряду, а також у тварин, які не приймали специфічного лікування. Важливо зазначити, що ступінь вираженості деструктивних змін у вражених хребцях у тварин нелікованих і тих, які приймали АБП першого ряду, практично однаковий. У тварин, яким моделювали туберкульоз і лікували специфічним АБП другого ряду, виявлено пригнічення патологічного процесу з утворенням молодої кісткової та сполучної тканини різного ступеня зрілості та наявністю зони, що відмежовує вогнище запалення від здорової тканини в ранні терміни захворювання (один місяць). В результаті виконаної роботи вдалося простежити стадійність розвитку туберкульозного спондиліту у морської свинки та сучасні особливості клінічного, рентгенологічного та патоморфологічного перебігу. Виявлена ідентичність моделі основних клінічних форм туберкульозного спондиліту у морської свинки та людини. Висновки. Дане дослідження показало, що проведення сучасної інтенсивної специфічної антибактеріальної терапії в умовах експерименту дозволяє досягти відмежування деструктивного процесу в порівняно ранні терміни розвитку захворювання (4–5 тижнів). Отримані нові знання про патоморфологічні особливості перебігу туберкульозного спондиліту дозволяють проводити радикальні оперативні втручання на хребті без ризику генералізації туберкульозного процесу в більш ранні терміни.

Вибухо-індукована нейротравма (патофізіологічні та патоморфологічні особливості)

The article presents the results of pathophysiological and pathomorphological features which were studied in experimental blust-induced neurotrauma in rats. The relevance of this study is associated with the frequent blust neurotrauma resulting from the use of explosives in military conflicts. At the same time, neurotrauma is more common, which is clinically manifested by cognitive impairment, even with mild and moderate severity. This, in turn, leads to complications and disability for young people. The purpose of the work was to study the consequences of the air-shock wave influence on the functional and morphological states of the central nervous system. Materials and methods. The studies were carried out on 36 white male Wistar rats 5-7 months old, weighing 180-220 g. The rats were divided into two groups: I – experimental group (n=18), the animals of which were anesthetized with halothane, fixed and explosion-induced neurotraum was simulated by generating a baroacoustic wave with an excess pressure of 26.4 ± 3.6 kPa. II group was a control group (n=18). Functional changes were investigated in the Barnes maze. For pathomorphological examination, brain sections were stained with hematoxylin and eosin. The animals were kept in standard conditions and in the standard diet of the vivarium, all studies were conducted in accordance with modern international requirements and norms of humane treatment of animals (Council of Europe Convention dated 18.03.1986 (Strasbourg); Helsinki Declaration 1975, revised and supplemented in 2000, Law of Ukraine dated 21.02.2006 No. 3447-IV), which is evidenced by an extract from the protocols of the meeting of the commission on biomedical ethics. Results and discussion. Analysis of the results of memory studies in the Barnes maze showed a significant (Р &lt;0.05) increase in the latent time of entering the shelter in rats of the experimental group in the acute and early post-traumatic period, which indicates memory impairment. General characteristics of the rats behavior in the experimental group showed an increase in anxiety and disorientation. The increase in research on "fake shelters" and the chaotic movement around the facility was evidenced. Analysis of frontal histological sections of the rat brain in the dynamics of the explosion-induced neurotrauma development showed the presence of characteristic signs in the form of diffuse microhemorrhages in the hippocampus zone in the acute period of injury, diffuse areas of perivascular and pericellular edema in the early post-traumatic period and paretic dilated capillaries in the structure of the cerebral region on 2nd-3rd week of the post-traumatic period. Conclusion. Thus, quantitative (increased latent time) and qualitative (increased anxiety) signs of impaired orientational-spatial memory and the development of specific pathomorphological signs of explosive brain damage in rats of the experimental group were established

Development of fibrosis and impairment of lung function in patients with a new coronavirus disease

The aim: review scientific research to find out whether the new coronavirus infection (NCI) causes fibrotic changes in the lungs and, if any, how long they persist and whether functional disorders of the respiratory system accompany them. Disruption of the functional state of the lungs in patients with severe novel coronavirus disease (COVID-19) is still seen 6 months after completion of inpatient treatment. High-resolution computed tomography (HRCT) demonstrates persistent pathological changes in the lungs, some of which are fibrosis-like. Pathomorphological features of the COVID-19 course, as well as the ability of the virus to activate connective tissue growth factor (CTGF) and enhance the signaling of transforming growth factor-beta (TGF-β), can contribute to lung tissue fibrosis. Increased titers of antinuclear autoantibodies and specific autoantibodies indirectly reveal dysregulation of the immune response leading to the progression of organizing pneumonia and fibrotic changes in the lung tissue. These increased titers can also indicate the need to prescribe immunosuppressive and antifibrotic drugs. Researchers are considering the possibility of including antifibrotic drugs in combination therapy for severe COVID-19 in the early stages of treatment in patients with risk factors for developing pulmonary fibrosis. However, further monitoring and determination of the role of antifibrotic drugs are required. Sometimes patients with COVID-19 develop severe, irreversible fibrotic lung disease, and lung transplantation is the only treatment option.Conclusion. There is no unequivocal opinion among researchers concerning the clinical significance and further prognosis of COVID-19 so far, which is a reason for further studies.