Pathologia

Protocol for pathologic examination of bladder cancer according to the updates of the 5th edition of the WHO classification (2022): biopsy and transurethral resection specimens

2024-10-21T10:43:56+03:00

Bladder cancer (BC) is the ninth most common malignancy in the world, and BC morbidity and mortality prevail in industrialized countries and, in particular, in Central and Eastern Europe compared to global rates. The availability of a standardised structured protocol for pathological examination of primary biopsy and transurethral resection (TURBT) samples of the bladder, including the latest updates to the 5th edition of the WHO classification of urinary and male genital tumours (2022), will significantly improve the quality of diagnosis and influence the choice of the optimal trajectory for further treatment.

The aim of the study is to highlight the key updates of the latest WHO classification of BC (2022), to study the standards and protocols for pathological examination of BC specimens used in world practice, as well as to develop a Ukrainian version of the protocol for pathological examination of BC, which will include clinically relevant aspects.

Materials and methods. Analysis of literature in PubMed and Web of Science databases using the keywords: bladder cancer, pathology report, grade, stage, histological subtype, biopsy, TURBT, WHO 2022.

Results. The review highlights the latest updates of the WHO classification of BC cancer and proposes standardized pathology protocol for specimens after primary biopsy/TURBT, developed by adapting existing international recommendations of the College of American Pathologists and the International Collaboration on Cancer Reporting.

Conclusions. Adaptation and standardization of the pathological examination protocol for BC will significantly improve the quality of diagnosis, improve the choice of appropriate therapy and may pave the way for the future development of standardized pathological examination protocols for tumors of other localizations for their widespread use by pathologists in Ukraine.

A modern look at pilonidal disease and endoscopic approach to its treatment

2024-05-14T10:12:34+03:00

The aim of the work is to review the literature on the modern view of pilonidal disease and to evaluate the effectiveness of endoscopic methods of treatment based on the results of research in recent years.

Results. The data of the world literature convincingly testify to the high effectiveness of treatment of pilonidal disease by endoscopic techniques. The endoscopic approach is associated with a painless postoperative period, good cosmetic results, a short period of disability and high patient satisfaction. Despite the short-term benefits obtained, randomized controlled trials are needed to definitively confirm the effectiveness of this technique to more accurately determine its effectiveness in the long-term follow-up period.

According to the recommendations of the Italian Society of Colorectal Surgery, it can be considered the gold standard in the treatment of unbranched pilonidal disease.

Conclusions. The endoscopic approach has significant advantages over other standard surgical methods: minimal pain, absence of early postoperative complications (seroma, hematomas, bleeding), short hospital stay (up to 1 day), rapid wound healing and return to everyday life, good cosmetic effect and a small percentage of relapses with short-term observations.

Ectopic thyroid cancer in the ovary – unresolved issues of diagnosis and treatment of struma ovaria maligna

2024-10-21T12:43:30+03:00

Struma ovaria is an ectopic localization of mature thyroid gland tissue in the ovaries. This rare form of monodermal teratoma is mostly a benign pathology. Primary malignant tumors of the thyroid gland in the appendages of the uterus are represented by thyroid carcinomas. Due to the rare pathology (less than 1 % of all tumors), insufficient information in the literature, lack of generalized recommendations and personal experience, doctors make many mistakes during the treatment of patients with struma ovary.

The aim of the work is to demonstrate a rare clinical observation of primary papillary thyroid cancer in the ovary and to discuss the mistakes that were made during treatment.

Case report. 5 women with a histologically confirmed diagnosis of struma ovary were under our observation. In 4 lesions were benign. One patient was diagnosed with ectopic thyroid carcinoma. The medical history of a 70-year-old woman who underwent hysterectomy without further treatment in a specialized oncology center for primary papillary thyroid cancer in the ovary is presented.

Conclusions. When managing patients with malignant struma ovary, clinicians mistakenly do not use the guidelines developed for the diagnosis and combined treatment of highly differentiated thyroid carcinomas, regardless of their eutopic or ectopic localization.

Analysis of the prevalence of tobacco smoking in different age groups of patients with ischemic heart disease taking gender into account

2024-09-11T12:44:39+03:00

The aim to analyze the prevalence of classic and electronic cigarette smoking among patients with coronary artery disease of different ages, taking into account gender.

Materials and methods. The study included patients with CAD (n = 3674), both male (n = 3061) and female (n = 613). The material for analysis was anamnestic data on smoking classic or electronic cigarettes. The research design is based on the patient’s age group according to the WHO classification and gender.

Results. It was found that men with coronary artery disease smoke classic cigarettes significantly more often than women (p = 0.0001, χ²= 37.37). It was established that female patients smoke electronic cigarettes significantly more often than male patients (p = 0.008, χ²= 7.12). It was determined that the frequency of women who have never smoked is significantly higher than the frequency of male patients (p = 0.005, χ²= 8.03). It was found that in young male patients, the frequency of smoking classic cigarettes is significantly lower than the frequency in age groups: middle age (р = 0.0001, χ² = 48.27), old age (р = 0.0001, χ² = 64.80); oldest age (p = 0.0001, χ² = 24.04). It was found that middle-aged female patients smoke classic cigarettes significantly less than men of the same age (p = 0.0001, χ²= 56.02); respectively, in the old age group (p = 0.0001, χ² = 40.47) and in the oldest age group (p = 0.0001, χ²= 35.70). When analyzing smoking cessation, it was found that the frequency of individuals significantly increased with age in male patients. As for female patients who quit smoking, the reverse trend was established: with age, the proportion of people who quit smoking reliably decreased.

Conclusions. It was found that men with coronary heart disease smoke classic cigarettes significantly more often (р = 0.0001, χ²= 37.37). It was established that among young men, the frequency of smoking classic cigarettes is significantly lower than the corresponding frequency among middle-aged men (р = 0.0001, χ²= 48.27) and old men (р = 0.0001, χ² = 64.80) and oldest age men (p = 0.0001, χ²= 24.04). It was found that female patients smoke electronic cigarettes significantly more often than men (p = 0.008, χ²= 7.12). It was found that female patients smoke classic cigarettes significantly less in: middle age (p = 0.0001, χ²= 56.02), old age (p = 0.0001, χ²= 40.47) and oldest age (p = 0.0001, χ² = 35.70).

Hormonal-metabolic markers and their relationships in patients with coronary heart disease after suffering from the COVID-19 coronavirus disease

2024-07-18T12:18:58+03:00

The aim of the study. To investigate the peculiarities of changes in hormonal and metabolic markers and their relationships with neurovegetative disorders in patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period).

Materials and methods. 71 patients with coronary artery disease were examined: stable angina pectoris II–III FC (age 69.0 (64.0; 76.0) years): 1 group (main) – 31 patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period); Group 2 (comparison) – 40 patients with coronary artery disease who did not have a history of COVID-19. 15 practically healthy people were included in the control group. The concentration of vasopressin, ghrelin, and insulin in blood serum was estimated using immunoenzymatic analysis. The HOMA index is calculated according to the generally accepted formula. Statistical data processing was carried out in accordance with modern requirements.

Results. Significant changes in hormonal and metabolic markers were found in patients with coronary artery disease in the long-COVID period in comparison with the control group and with patients without a history of COVID-19: an increase in the concentration of vasopressin by 70.23 % and 33.38 %, insulin by 52.16 % and 32.76 %, glucose level by 31.20 % and 20.00 %, HOMA index by 60.00 % and 35.77 %, reduction of active ghrelin level by 45.71 % and 49.20 % (p < 0.05) respectively. The number of patients with insulin resistance in the 1st group was significantly higher compared to the 2nd group (χ²= 0.516, p < 0.001). Inverse correlations were established between the level of ghrelin and vasopressin (r = -0.33, p < 0.05), insulin (r = -0.25, p < 0.05) and the HOMA index (r = -0.24, p < 0.05); direct correlation between the level of vasopressin and the HOMA index (r = +0.26, p < 0.05). In addition, a wide range of reliable correlations between the level of vasopressin, ghrelin and the degree of anxiety-depressive, cognitive and autonomic disorders were found in patients with coronary artery disease in the long-COVID period.

Conclusions. The obtained results confirm common mechanisms between the development of hormonal and metabolic disorders and the occurrence of anxiety-depressive, cognitive disorders, vegetative imbalance against the background of overstrain of functional adaptation processes in patients with coronary heart disease in the long-COVID period.

Immunohistochemical evaluation of colorectal carcinoma: experience of a four-year study

2024-09-25T13:38:47+03:00

Colorectal carcinomas (CRC) is the third most common cause of death in developed countries. Invoking of primary site of carcinoma of unknown origin using immunohistochemistry is essential for accurate diagnosis, and also for targeted therapies.

Aim. This study aimed to assess immunohistochemical expression of CK7, CK20, and CDX2 in colorectal carcinomas, and to evaluate their diagnostic role.

Materials and methods. A retrospective study was performed on 36 paraffin blocks of documented colorectal carcinomas were stained by immunohistochemical technique using a tissue microarray with CK7, CK20 and CDX2 markers. The resulted data were statistically analyzed.

Results. There was a negative association between CDX2 expression and histologic grade (p = 0.03), as well as T-pathologic stage (p = 0.01). CK7-ve / CK20+ve immune profile showed a specificity of 95 % in predicting the colorectal adenocarcinomas, which was superior to that of CDX2. CDX2 loss is related to tumour grade and depth (T-stage).

Conclusions. Both CDX2 expression, and CK7-ve / CK20+ve are the most sensitive, and specific markers to diagnose the colorectal carcinoma. CK7-ve / CK20+ve expression is used as specific marker for colorectal carcinoma for targeted therapy.

Levels of circulating catestatin in different clinical variants of coronary heart disease in patients with chronic heart failure and concomitant type 2 diabetes mellitus and obesity

2024-10-17T12:54:27+03:00

The aim is to assess the levels of circulating catestatin and to establish relationships with various clinical variants of coronary heart disease (CHD) in patients with chronic heart failure (CHF) and concomitant type 2 diabetes mellitus (T2DM) and obesity.

Materials and methods. 154 patients were examined, divided into 4 groups according to the presence of metabolic disorders. Group 1 included patients with CHF with CHD and T2DM and obesity (n = 42). The second group consisted of patients with CHF on the background of CHD with T2DM (n = 46), the third group – with accompanying obesity (n = 36), the fourth group was formed from patients who had signs of heart failure of ischemic origin without metabolic disorders (n = 30). The control group consisted of 30 almost healthy persons of comparable age and sex. In addition, patients were divided into subgroups depending on the clinical form of CHD: stable angina, post-infarction cardiosclerosis (PICS) and diffuse cardiosclerosis.

Results. Comparing the levels of circulating catestatin in groups 1, 2, 3 and 4, significantly lower levels of catestatin were found in patients with stable angina, compared to patients with diffuse cardiosclerosis by 73.25 %, 66.56 %, 69.86 % and 58.22 %, respectively (р ˂ 0.05). Comparison of catestatin levels revealed a decrease in catestatin levels in patients with stable angina compared to patients with PICS by 64.33 %, 63.70 %, 69.25 %, and 52.02 % in groups 1, 2, 3, and 4, respectively (р ˂ 0.05). Comparison of subgroups of diffuse cardiosclerosis and PICS did not reveal significant changes (р ˃ 0.05) in any group of patients. The indicators of catestatin in the control group had significant differences in the form of an increase in the concentration of the peptide, compared to patients with stable angina pectoris, PICS and diffuse cardiosclerosis in all studied groups (р ˂ 0.05). Evaluation of relationships between serum catestatin levels and clinical variants of coronary heart disease demonstrated a stable inverse relationship between catestatin and stable angina pectoris (r = -0.67, p ˂ 0.05) and PICS (r = -0.42, p ˂ 0.05), and with regard to metabolic diseases, a medium-strength inverse relationship with type 2 diabetes was also established (r = -0.54, p ˂ 0.05).

Conclusions. The concentration of catestatin in blood serum had the lowest values in the group of patients with chronic heart failure of ischemic origin with concomitant diabetes mellitus type 2 and obesity, compared to the isolated course of chronic heart failure (p ˂ 0.05), which confirms the anti-inflammatory effects of catestatin and its connection with the insulin resistance progression. Among the clinical variants of coronary heart disease, the lowest levels of catestatin were demonstrated by patients with stable angina pectoris and post-infarction cardiosclerosis (r = -0.67 and r = -0.42, p ˂ 0.05, respectively), which indicates the association of this biomarker with various clinical variants of coronary heart disease.

Spectral, experimental-toxicological and quantum-chemical studies of predictors of biological activity of titanium-containing nanoparticles doped with silver

2024-07-03T06:24:54+03:00

The aim: to study the influence of structural, spectral and quantum-chemical parameters of the synthesized TiO₂, TiO₂/Ag (4 wt. %) and TiO₂/Ag (8 wt. %) nanosystems on biological activity.

Materials and methods. The structural-morphological, spectral, toxicological and cytotoxic properties of TiO₂ nanomaterials with silver content in the range from 0 wt % to 8 wt. % for the direction of human biosafety were investigated. The TiO₂/Ag composites were characterized by X-ray diffraction, transmission electron microscopy, Raman spectroscopy, and the results of high-level quantum chemical calculations.

Results. The optical activity of the TiO₂/Ag composite was determined by Raman spectroscopy, which is confirmed by the shift in the Eg₁ mode frequency from 143 cm^-1 to 157 cm^-1 and the FWHM in the range from 12 cm^-1 to 19 cm^-1 due to the decrease in the size of the TiO₂ crystallites. The mode shift in nano-TiO₂/Ag reflects a certain deformation of the anatase-modified titanium dioxide crystal lattice upon doping with silver. This leads to an increase in the ability to produce reactive oxygen species on the surface of the TiO₂/Ag nanoparticle and to an increase in biological activity (4 wt. % Ag; 8 wt. % Ag) compared to undoped TiO₂, providing an increase in their toxicity, which is confirmed by the values LD₅₀, CC₅₀ parameters, respectively. According to the results of quantum chemical calculations, it was established that during the adsorption of the Ag₂ dimer on the surface of anatase in the Ti₁₅O₄₁H₂₂Ag₂ adsorption complex, two Ag atoms are involved with the formation of four Ag–O bonds, the length of which with the two-coordinated oxygen atoms of the TiO₂ surface is 2.44 Å, and the Ag–Ag bond length increases to 2.75 Å, compared to the equilibrium distance in the diatomic Ag₂ molecule (2.53 Å). This indicates the vibrationally excited state of the Ag₂ diatomic fragment in the Ti₁₅O₄₁H₂₂Ag₂ adsorption complex. It should also be noted that the ionization potential of the adsorption complex decreased from 7.35 eV to 5.72 eV. The result of such changes is the increased reactivity of argentum atoms compared to their reactivity in the diatomic Ag₂molecule. Due to the fact that silver atoms adsorbed on the surface of anatase nanoparticles act as electron traps, the efficiency of separation of photogenerated electron-hole pairs (excitons) with interphase electron transfer increases, which increases the photocatalytic and biocidal properties of silver-doped anatase.

Conclusions. There is a certain objective relationship between the physicochemical parameters of nanoparticles and their biological activity, which can be characterized not only qualitatively, but also quantitatively. Thus, in the materials of our research, the influence of their size, specific surface area, the presence of hydroxyl groups on the surface of the nanoparticle, the size of crystallites, the size of interatomic bonds, and the ionization potential on the toxicity of nanoparticles has been demonstrated. These data are of great scientific importance not only in terms of their hygienic regulation, but also in terms of further synthesis of safer nanomaterials.

Features of liver damage in patients with coronavirus disease (COVID-19) with pneumonia in relation to indicators of inflammation taking into account oxygen dependence

2024-05-14T10:16:15+03:00

Aim. The purpose of the work is to analyze the biochemical indicators of liver function in relation to indicators of inflammation in patients with coronavirus disease (COVID-19) with pneumonia, taking into account the development of oxygen dependence.

Material and methods. 123 patients with COVID-19 with pneumonia were examined. The diagnosis was confirmed by isolation of RNA-SARS-CoV-2 from the nasopharyngeal mucus by polymerase chain reaction. The presence of pneumonia in all patients was confirmed by X-ray or computer tomography of the chest organs. The patients were divided into groups: I group – 32 patients with a moderately severe course without oxygen dependence; II group – 91 patients with a severe course with oxygen dependence. Exclusion criteria from the research were: the presence of infection with hepatotropic viruses and the presence of previously diagnosed other chronic liver diseases. Statistical data processing was carried out in the program Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J).

Results. In 45.5 % of patients with COVID-19 with pneumonia at the time of hospitalization by 9.0 [7.0; 12.0] days of the disease, liver damage with the development of cytolytic syndrome was confirmed. The frequency of liver damage in patients with COVID-19 with pneumonia increased with the appearance of oxygen dependence (25.0 % vs. 52.7 %, p = 0.007). Biochemical signs of the syndrome of intrahepatic cholestasis were weakly expressed, with the appearance of oxygen dependence, they were characterized by an increase the number of patients with an elevated level of gammaglutamyltranspeptidase (59.7 % vs. 24.0 %, p = 0.002) in the absence of statistically significant changes in the median indicators activity of gammaglutamyltranspeptidase and alkaline phosphatase (p > 0.05). The relationship between liver damage and the development of oxygen dependence in patients with COVID-19 with pneumonia is confirmed by the correlation between the activity index of alanine aminotransferase (ALT) and the oxygen saturation index (r = -0.31, p < 0.05). In patients with COVID-19 with pneumonia in the dynamics after a week in presence of oxygen dependence, a higher level of activity of ALT remained (p < 0.05) and the frequency of detection of increased activity of ALT remained higher (62.6 % vs. 37.5 %, χ²= 6.07, p = 0.01), the activity of aspartate aminotransferase is higher (p < 0.05), compared to patients with COVID-19 with pneumonia without oxygen dependence.

A higher frequency of liver damage in patients with COVID-19 with pneumonia in presence of oxygen dependence is combined with more pronounced changes in acute inflammatory parameters, namely a higher level of C-reactive protein (CRP) in blood serum (p < 0.01), more frequent (p = 0.001) and more pronounced (p = 0.004) absolute lymphopenia, a higher level of absolute neutrophilia (p = 0.03) and, accordingly, a higher coefficient of N/L ratio (p = 0.0001). The oxygen saturation indicator correlates with the indicators: CRP (r = -0.37, p < 0.05), relative (r = +0.36, p < 0.05) and absolute (r = +0.23, p < 0.05) number of lymphocytes, the absolute number of neutrophils (r = -0.32, p < 0.05) and the ratio of N/L (r = -0.42, p < 0.05).

Conclusions. Liver damage with the development of cytolytic syndrome was established in 45.5 % of patients with COVID-19 with pneumonia at the time of hospitalization. The dependence of the frequency of liver damage with the appearance of oxygen dependence, as well as the relationship with acute inflammatory indicators, was demonstrated.

Effect of cellular protein kinases blockade on the s100 retina expression in experimental diabetic retinopathy

2024-12-05T09:34:16+02:00

The positive effect of cellular protein kinases blockade in diabetes and diabetic retinopathy (DR) justifies the need to clarify molecular mechanisms, among which the trigger regulatory role belongs to calcium-binding proteins S100.

Aim: to establish the expression of S100 protein in retinal tissues and the effect of cellular protein kinases blockade with Sorafenib on it in experimental DR.

Materials and methods. Diabetic retinopathy was modeled in male Wistar rats. For this purpose, they were administered a single injection of streptozotocin at a dose of 50 mg/kg (Sigma-Aldrich, Co, China). Experimental rats were divided into three groups: control; with the administration of insulin 30 U (NovoNordiskA/S, Bagsvaerd, Germany); with the administration of insulin and sorafenib at a dose of 50 mg/kg (Cipla, India). Monoclonal antibodies against S100 (ThermoFisher Scietific, USA) were used during immunohistochemical studies.

Results. With the development of experimental DR, the expression of S100 protein significantly increased in the bodies and processes of astrocytes and Müller cells. The latter were mainly located in the inner nuclear layer, significantly increased in size and had a process-like shape (reactive gliosis). Intensely stained S100-positive astrocyte fibers were in close contact with microaneurysms that formed on the retina inner surface. The appearance of individual S100-positive cells in the outer layers of the retina was noted. Treatment of animals with insulin led to a decrease in the expression of the S100 protein, and the use of Sorafenib prevented the activation of the expression of the S100 protein, preventing the development of DR, reactive gliosis, and the formation of microaneurysms on the inner surface of the retina.

Conclusions. One of the mechanisms of the positive effect of Sorafenib in DR was discovered – the prevention of reactive gliosis, which prevented early manifestations of DR.

The impact of refractive technologies Femto Lasіk and ReLEx SMILE on the development of dry eye syndrome and the quality composition of tears in eyes with myopia and myopic astigmatism

2024-07-01T17:22:11+03:00

Aim. To improve the quality of surgical treatment of myopia and myopic astigmatism by refining the indications for the selection of the correction method based on the study of tear crystallography.

Materials and methods. The article presents the results of the surgical treatment of 45 patients (90 eyes) with mild and moderate myopia and myopic astigmatism, who underwent vision correction using ReLEx SMILE and Femto Lasіk methods at the Visus Clinic of Modern Ophthalmology (Zaporizhzhia). Among the patients, there were 20 (45 %) men and 25 (55 %) women aged between 19 and 38 years (mean age 27.28 ± 1.08 years). They were divided into two groups. The first group consisted of 25 patients (50 eyes) who underwent vision correction using the ReLEx SMILE method. The second group included 15 patients (30 eyes) who underwent vision correction using the Femto Lasіk method. All patients underwent standard ophthalmological examinations, refractive diagnostics, and tear crystallography.

Results. In the postoperative period, the location and number of salt crystals in the central zone slightly changed. In the first group, multiple randomly located quadrangular crystals appeared in 6 eyes (12.0 %) compared to 2 eyes (4.0 %) before surgery. In the second group, these crystals were observed in 4 eyes (13.3 %), indicating minor changes in the salt component of the tear fluid, slightly more pronounced in the second group.

Conclusions. The study showed a minor impact of Femto Lasіk and ReLEx SMILE refractive surgeries on the protein-electrolyte state of the tear. Within a month after refractive surgery, the protein-salt composition of the tear, according to crystallography data, fully recovered in 96.0 % of cases where the ReLEx SMILE method was used and in 86.7 % of cases where the Femto Lasіk method was used (statistically significant difference p < 0.05). This allows for a preference for the ReLEx SMILE method when choosing a correction method for refractive anomalies, especially in eyes showing signs of dry eye syndrome.

Influence of anticoagulant therapy on immune and inflammatory response in patients with community-acquired pneumonia associated with coronavirus infection

2024-10-17T10:11:51+03:00

The publication raises the issue of finding ways to reduce the level of thrombotic complications in patients with community-acquired pneumonia associated with COVID-19.

Aim. To determine the effect of anticoagulant therapy on the immune and inflammatory response in patients with community-acquired pneumonia associated with coronavirus infection.

Material and methods. An open, prospective, observational study was conducted in the period from January 2021 to February 2022 at the Kherson City Clinical Hospital named after Athanasius and Olga Tropin of the Kherson City Council, 143 patients with community-acquired pneumonia aged 46 to 65 years who tested positive for SARS-CoV-2 were observed. To participate in the study, patients signed a voluntary consent form.

Results. Patients with community-acquired pneumonia develop an immune-inflammatory response characterized by increased levels of interleukin-6 and C-reactive protein, with significantly higher values of these biomarkers in combination with COVID-19. Combination therapy is effective in reducing the levels of markers of the immune-inflammatory response Heparin at a dose of 1000 IU/h is more effective in reducing the risk of death in patients with community-acquired pneumonia associated with coronavirus infection than 100 IU anti-Xa/kg (1 mg/kg) twice daily.

Conclusions. The results of our study showed that therapy with heparin is more effective than enoxaparin in reducing interleukin-6 levels within 72 hours (by -12.93 % vs -4.75 %, respectively, p < 0.05). Multivariate regression analysis determined that changes in the levels of D-dimer, interleukin-6 and INR were independent predictors of adverse disease outcome.

Dynamics of regeneration following transplantation of octacalcium phosphate into an experimental defect in the rabbit mandibular bone: electron microscopic and morphometric study

2024-10-07T12:37:00+03:00

The relevance of this research lies in the in-depth exploration of bone tissue remodeling dynamics following the creation of a defect and its filling with osteoplastic material. Despite the known results of osteoplastic materials application in clinical practice, complete and high-quality regeneration of the maxillofacial bone, its mechanisms and dynamics remain incompletely understood, requiring further clarification and detailed study.

Aim. The aim of this study is to determine the dynamics of histoarchitectural changes in the bone-ceramic regenerate after transplantation of octacalcium phosphate into an experimental defect in the rabbit mandible.

Materials and methods. Adult male rabbits aged 6–7 months and weighing 2.5–3.0 kg were used for the study. The control group consisted of animals with a bone defect that healed under a blood clot. The experimental group consisted of rabbits in which the bone defect was filled with an osteotropic material containing octacalcium phosphate. Post-traumatic bone tissue status within the defect area was monitored for 84 days. Ultrastructural changes were studied using transmission and scanning electron microscopy. To determine changes in the regenerate composition, three parameters were counted. The data was analyzed using the Student’s t-test, and a difference at p < 0.05 was considered statistically significant.

Results. Studying the surface relief characteristics of the experimental bone defect in the lower jaw after implantation of the octacalcium phosphate material revealed numerous regenerative changes that occurred after the injury and correlated with the dynamics of changes in the relative area of bone tissue, osteoplastic material, and connective tissue in the regenerate. Morphometric analysis of the relative area of the regenerative components of the experimental defect established a phased nature of the dynamics of the studied changes. It was established that the osteocytic lacunar-canalicular system formed after implantation of the material acquired features of typical structure. Foci of incomplete osteogenesis were not visualized. Unlike control animals, in the zone of the outer bone plate after application of the octacalcium phosphate material, the osteons of the regenerate in their structure and geometry did not differ from the typical structure of the maternal bone.

Conclusions. It was established that in the experimental group of animals where the defect was filled with octacalcium phosphate material, a regular increase in the relative area of bone tissue in the regenerate was observed, which in terms of dynamics was similar to that in the control group, however, in terms of intensity of changes it significantly differed from the control, approaching the norm in terms of the studied indicators.

Serum zinc concentrations and indices of inflammatory response and serum IgA in children with infectious diarrhea

2024-06-17T15:24:05+03:00

Аim. The objective of this study was to give a comparative characteristic of laboratory manifestations for the inflammatory process and the level of serum IgA in infectious diarrhea in young children, depending on serum zinc concentrations.

Materials and methods. The study included 99 children aged 1 to 36 months with the clinical picture of infectious diarrhea. The main group was divided into the first subgroup comprising 77 children with normal blood zinc level during hospitalization; the second contained 22 children with reduced blood zinc level. On the day of hospitalization, the level of C-reactive protein (CRP), zinc (Zn) and the presence of fecal calprotectin (FC) and lactoferrin (LF) were determined. The level of interleukins and serum IgA was determined in 34 children of the main group (16 for the first subgroup, and 18 for the second one) on the 1st, 3rd and 5th days. The comparison group consisted of 10 children without signs of infectious pathology.

Results. There were no significant differences between the subgroups in terms of the frequency of registering an increase in blood CRP level (in 21 children (27.27 %) of the first subgroup, and 7 children (31.81 %) of the second one) and its level. Qualitatively determined FC and LF did not demonstrate any significant difference between the comparison subgroups. The level of IL-10 in the blood serum of children of both subgroups was higher than that of the comparison group (p = 0.001 for the first subgroup and p = 0.04 for the second). In the dynamics, the concentration of IL-10 tended to decrease in patients with a reduced blood Zn level. The level of IL-1β in the first subgroup (0.28 (0.12; 0.68) pg/ml) corresponded to the indicators of healthy children (0.32 (0.12; 0.78) pg/ml). Patients of the second subgroup had lower concentrations of IL-1β (p = 0.05). In the dynamics, a significant increase in the concentration of this cytokine was noted in patients of the second subgroup, but it remained significantly lower than in healthy subjects (p = 0.01). The concentration of IL-6 in the serum of children in the comparison subgroups did not differ statistically both at the onset of the disease and in the dynamics. The level of serum IgA on the fifth day of treatment was significantly reduced in children with a reduced blood Zn level (p = 0.03).

Conclusions. Blood CRP, PC, and GFR did not show dependence on serum Zn concentration in children with infectious diarrhea. Children with low Zn levels at the onset of the disease have an imbalance in the inflammatory response system. In children with low blood Zn concentration, a decrease in the concentration of serum IgA on the fifth day of treatment was determined.