Ultrasonic Dopplerometry in diagnosis of cervical injury in birth process

The goal was to carry out the comparative analysis of ultrasonic Doppler indices and data of morphometric methods of uterine cervix examination of women with prenatal moving of amniotic fluid depending on presence or absence of uterine cervix trauma in labor. Material and methods. 148 pregnant women with prenatal moving of amniotic fluid were examined. The main group included 64 pregnant women with uterine cervix ruptures; the comparison group consisted of 84 patients without any labor trauma. Ultrasonic and morphological examinations of uterine cervix were carried out. Results. Cavernous transformation of venous cervical bloodstream closely correlated (r = 0,67, p &lt;0.001) with the index of vascularization degree and labortrauma degree. Conclusion. The revealed echomorphological relationship in uterine cervix of pregnant women with various labor outcomes allowed using these data to predict uterine cervix rupture in labor process.</p

Pulmonary pathology of the new coronavirus disease (COVID-19). The preliminary analysis of post-mortem findings

Background. Currently, the patho- and morphogenesis of the new coronavirus infection (COVID-19) is being studied in depth. A comparative analysis of the morphological changes in the lungs of deceased patients is of importance, for various time periods after the onset of the first clinical symptoms. The clinical and morphological comparison should help to increase the qualified medical care for patients in the resuscitation profile and reduce the hospital mortality. The aim of the study was to formulate a working hypothesis for a conceptual scheme of clinical and morphological phases of development of the new coronavirus infection (COVID-19). Methods. An analysis of 80 fatal cases was carried out in the COVID-center of the Federal Research Clinical Center of FMBA of Russia. Along with the assessment of macro- and microscopic changes in the respiratory tract, additional histochemical van Gieson staining was applied and immunohistochemical studies were performed to assess the condition of the COVID-19-affected lungs. Results. The revealed features of diffuse alveolar damage in the case of the new coronavirus infection (COVID-19) made it possible to present a working hypothesis of the pathomorphogenesis of COVID-19 interstitial pneumonia. It proceeds through 3 phases: fulminant, persistent and fibrotic. Each phase is conditionally limited by certain time parameters and is characterized by certain morphological signs Dysregulatory activation of monocytic phagocytes, development of generalized microthrombosis, persistent signs of the exudative phase, pathological repair, progressive intraalveolar and interstitial fibrosis are the main links in the pathomorphogenesis of COVID-19 interstitial pneumonia. In response to the penetration of SARS-CoV-2, the T-cell immunity reactions prevail at the exudative and proliferative stages. At the fibrotic stage, the overall number of T-lymphocytes is drastically decreased, the cells of humoral immunity are not revealed. The CD8+ T-lymphocytes prevailing over CD4+ T-lymphocyte helpers is probably related to the autoimmune damage mechanisms. Conclusions. Damage to the lungs with the development of COVID-19 interstitial pneumonia is the main cause of the severe course of the disease and deaths. The revealed features of the pathomorphogenesis of the clinical and morphological phases of COVID-19 interstitial pneumonia will improve the quality of diagnosis and treatment of a new coronavirus infection (COVID-19)

Возможности метода зондовой конфокальной лазерной эндомикроскопии в диагностике холангиокарцином

Method probe confocal laser endomicroscopy can be crucial in case of inefficiency or a small informative other methods of diagnosis in diseases of the pancreato-biliary area. The article presents clinical observation of various diseases of the bile ducts, including cholangiocarcinoma, developed on the background of chronic diseases of the pancreato-biliary area. Reflects the complexity of instrumental diagnosis at an early stage of the disease. For the first time in this pathology diagnostic purpose method applied scanning probe confocal laser endomicroscopy, allowing in all cases to Refine and verify the diagnosis. The method of research, its results are compared with other diagnostic methods.Метод зондовой конфокальной лазерной эндомикроскопии может иметь решающее значение при неэффективности или малой информативности других методов диагностики при заболеваниях органов панкреатобилиарной зоны. В статье приведены клинические наблюдения различных заболеваний желчных протоков, в том числе и холангиокарциномы, развившихся на фоне хронических заболеваний органов панкреатобилиарной зоны. Отражены сложности инструментальной диагностики на ранней стадии заболевания. Впервые при данной патологии с диагностической целью применен метод зондовой конфокальной лазерной эндомикроскопии, позволивший во всех случаях уточнить и верифицировать диагноз. Описана методика исследования, ее результаты сопоставлены с другими методами диагностики

Эффекты ингаляционного и внутривенного введения аллогенных мезенхимальных стромальных клеток костного мозга в блеомицин-индуцированной модели легочного фиброза у кроликов

Aim: to perform a comparative analysis of the effi cacy of the inhaled and intravenous delivery of equivalent doses of bone marrow mesenchymal stem cells (BMMSCs) in rabbits according to the standard model of bleomycin pulmonary fi brosis.Materials and methods. After bronchoscopic instillation of bleomycin, 5 rabbits received intravenous transplantation of 2 × 106 allogeneic BMMSCs, other 5 rabbits – 2 × 107 MSCs inhaled via compressor nebulizer; control healthy and bleomycin group included 5 animals each.Results. Both groups treated with BMMSCs had a signifi cantly lower Ashcroft fi brosis index than the bleomycin control group. Expression of collagen in lung tissue in all groups with bleomycin injury was superior to healthy controls, but in animals underwent intravenous BMMSC transplantation collagen score was 0.74 points, and in inhaled treated group – 0.51 points, while in bleomycin controls – 2.1 point. Levels of TNF-α and TGF-β1 in BAL fl uids tended to decrease in treatment groups, but did not differ signifi cantly from control. A similar picture was observed in the cytological analysis of BAL.Conclusion. In general, both methods of delivering of BMMSCs to the lungs demonstrated similar therapeutic effects in inhibiting the development of experimental fi brosis, indicating that both intravenous and inhalational way of introduction can be used for subsequent clinical studies. Проведен сравнительный анализ эффективности ингаляционного и внутривенного пути доставки эквивалентных доз мезенхимальных стромальных клеток костного мозга у кроликов на стандартной модели блеомицинового легочного фиброза. После бронхоскопической инсталляции блеомицина в заднюю правую долю 5 кроликов получили внутривенную трансплантацию 2 × 106 аллогенных МСК, 5 – 2 × 107 МСК ингаляционно через компрессорный небулайзер; по 5 животных использовались в качестве здорового и блеомицинового контроля без лечения.Результаты. Обе группы, получавшие лечение МСК, имели достоверно более низкий индекс фиброза по морфометрической шкале Эшкрофта, чем контрольная группа блеомицинового фиброза. Экспрессия коллагена в ткани легких была существенно выше во всех группах с блеомициновой травмой, но у животных, подвергшихся внутривенной трансплантации МСК, она составила 0,79 балла, а при ингаляционном введении – 0,51 балла, тогда как группа блеомицина без лечения – 2,1 балла. Уровни TNF-α и TGF-β1в жидкости БАЛ имели тенденцию к уменьшению в группах лечения, но достоверно не различались от контроля. Похожая картина имела место при цитологическом анализе БАЛ.Выводы. В целом оба метода доставки клеточного материала в легкие продемонстрировали сходные терапевтические эффекты в отношении сдерживания развития экспериментального фиброза, существенно не отличаясь между собой, что свидетельствует о возможности использования как внутривенного, так и ингаляционного пути введения для последующих клинических исследований.

Rare case of gall bladder squamous cell carcinoma in pacient with cholelithic illness

The clinical case of the patient with squamous cell carcinoma of gall bladder in a combination with cholelithic illness is described. Presurgical diagnostics of gall bladder cancer is difficult, demands a complex and careful assessment of disease anamnesis, a clinical sings, results of laboratory and tool analysis. At impossibility to exclude gall bladder cancer in the presence of a cholelithic illness in all cases operative treatment is needed.</jats:p