Дослідження остеорегенераційної активності окістя нижньощелепних кісток, уражених кістами різного ґенезу

In response to the prolonged increasing influence of the radicular cyst, there is an adaptive compensatory reaction of the adjacent bone tissue and periosteum located in the area of damage. However, in the available professional literature there is no data on the activity of the marker of osteoregeneration-alkaline phosphatase in the periosteum of the mandible, which is in the growth zone of osteoblastoclastoma. The purpose of the study: to study in a comparative aspect osteoregenerative activity of the periosteum of the mandibular bones affected by radicular cyst and cystic form of osteoblastoclastoma by using the histochemical method. Histochemical studies were performed in 10 patients with large radicular cysts (d>3.0 cm) located on the mandibles – 1st clinical group, and in 9 patients with cystic forms of osteoblastoclastomas, localized on the mandibles - 2nd clinical group. Determination of alkaline phosphatase in periosteal tissues of the mandible was performed by the method of simultaneous azo combination according to Kaplow. Prepared samples of histochemicals were studied under a light microscope, the received images were photographed. Digitized images of histochemicals were analyzed using the computer program ImageJ. The accumulation of alkaline phosphatase in the periosteum of the mandibular areas affected by osteoblastoclastomas is less intense compared to the process of synthesis of this enzyme in the periosteum of the mandible, which is affected by radicular cysts of large size. Osteoregenerative potential of periosteum of mandibular bones affected by radicular cysts is much greater than in the periosteum located in the growth zone of the cystic form of osteoblastoclastoma.

Possibilities of the early diagnosis and prognosis of complicated clinical forms of chronic pancreatitis

AIM: This study aimed to improve the methods for the diagnosis of complicated clinical forms of chronic pancreatitis (CP) by evaluating the clinical significance of the polymorphisms of the genes of cationic trypsinogen (PRSS1), pancreatic secretory trypsin inhibitor (SPINK1), transmembrane regulator of cystic fibrosis (CFTR), and alcohol dehydrogenase (ADH) in patients with complicated and uncomplicated forms of CP. MATERIALS AND METHODS: The study was carried out on the clinical base of the Department of Hospital Surgery, Ryazan State Medical University, Center for Surgery of Liver, Pancreas, and Biliary Tract in Ryazan in 20142019. A total of 108 patients of both genders aged 2565 years were examined. Of these patients, 38 were surgically treated for complicated CP, 20 had complicated CP without surgery, and 50 had uncomplicated CP (control group). A comparative clinical study with the control group of patients was performed, and the genotype was simultaneously determined on days 1 and 10 under controlled laboratory parameters. DNA was isolated from the leukocytes of the whole blood by using a DNA-expressing blood reagent (OOO NPF Litekh, Russia) for further analysis. RESULTS: No polymorphism of cationic trypsinogen PRSS1 gene and cystic fibrosis-2 CFTR2 gene was found. The predictive value of these polymorphisms was insignificant. For the polymorphism of CFTR1 cystic fibrosis-1 gene, the odds ratio was 0.444, but this finding was not significant. Among patients with the complicated clinical forms of CP, mutations were observed in the PRSS1 cationic trypsinogen gene (c2 = 6.453, p = 0.012) and ADH (c2=14.176, p = 0.001). Conversely, they were not detected in the CFTR-1 gene (c2 = 0.873, p = 0.351), CFTR-2 (c2 was not determined), and SPINK1 (c2 = 0.873, p = 0.351). The polymorphisms of the ADH and PRSS1 genes of cationic trypsinogen were associated with more evident structural changes in the parenchyma and ductal system of the pancreas. They also had a higher likelihood of complications, severe disease course, and a lower efficiency of conservative treatment. The polymorphism of the ADH gene increased the risk of the development of the cystic form of CP (c2 = 5.898, p = 0.016). CONCLUSION: The polymorphism of ADH and cationic trypsinogen genes should be determined and used for the complex diagnosis of CP to specify indications for the surgical treatment of patients with CP.

Liver metastasis mimicking an abscess

Hepatic metastases from carcinoid tumours are typically solid, hypervascular lesions on imaging. The cystic form, mimicking an abscess, is extremely rare. We report a case of a 48-year-old female presenting with a large hepatic mass that was diagnosed as a hepatic abscess, but the ultrasound-guided biopsy showed well-differentiated grade 1 neuroendocrine tumour. CT scan of chest, abdomen and pelvis was performed, looking for the primary tumour, it revealed an endobronchial mass of the right inferior lobe. Lung biopsy by rigid bronchoscopy was taken confirming the diagnosis of a typical carcinoid tumour.

Unusual treatment for calcifying odontogenic cyst using decompression tube to prevent pathological fracture

The calcifying odontogenic cyst (COC) is an uncommon lesion, with variable clinical and histopathological behavior. The cystic form is the most frequent and the most common histological characteristic is the presence of a variable number of phantom cells in the epithelial component. The standard treatment for this injury is enucleation followed by curettage or excision. However, when other factors are associated, this single-step approach can lead to complications such as pathological fractures. A common treatment for keratocysts and dentigerous cysts, but uncommon for COC has been showing high effectiveness. Thus, a two-stage approach using a tubular object to perform initial decompression of the lesion and later excision of the lesion can be performed in order to prevent complications. Here we report a two-stage treatment, through initial surgical decompression, of a COC associated with a lower second molar in the mandibular basilar region, using a tubular device, in which a pathological fracture was prevented. The results of this case corroborate the use of decompression applied to the treatment of COC.

Tubulocystic renal cell carcinoma: Two-case report and literature review

Tubulocystic renal cell carcinoma is a rare neoplasm of kidney with low metastatic tendency. There has only been a relatively small collection of literature dedicated to this subtype. Here we present two cases diagnosed in our center with detailed clinical information. Along with literature review, we aim to paint a comprehensive profile of TC-RCC. Hematuria and asthenia could be the chief complaints although most patients are asymptomatic. This lesion has a signature multilocular cystic form on radiology and enhancement of septa should reveal malignancy. Histologically, the cysts are lined by a single layer of flattened, cuboidal/columnar, and hobnail epithelium with enlarged nuclei and intermediate to large nucleoli. PAX8 and AMACR are most commonly positive while CD10 or CK7 could be focally stained in some cases. Overall, the diagnosis of TC-RCC should be based on comprehensive clinical and molecular results because early determination of the lesion could prelude a timely intervention and favorable prognosis.

Unicellular Eukaryote as a Bio-cellular Model for Studying Effect Benzimidazole: Ultrastructural Analysis

The search for new derivatives of benzoimidazole with an active center that have a wide range of biological effects (antifungal, antiflammatory, antibacterial, antiviral, antitumor, antidiabetic, etc.) is the subject of modern pharmaceutical science. To determine the mechanism of action of benzoimidazole, a search is underway for more. We have previously carried out the Ultrastructural characterization of various prokaryotes and protists, as well as the mechanism of action of antibiotics and chemical preparations on them. From a series of heterocyclic drugs, a drug with a wide spectrum of action was chosen as derivatives of benzimidazole and a model of a free-living unicellular eukaryote Endameba moshkovskii with a vegetative and cystic form. The purpose of this work is the nature of the action of drugs of the benzimidazole series and in the ultrastructural visualization of the mechanism of action of benzimidazole using electron microscopic and electron-cytochemical methods on the model of polyxenic cultures of unicellular eukaryotes Entamoeba moshkovskii. We have established for the first time the excising effect of benzimidazole and the functional-ultrastructural mechanism of the action of benzimidazole on entameoba cells. As a result, the ultrastructural and functional morphology of benzimidazole action in the process of excysting entamoeba was established.

Cystic form of biliary atresia. Treatment experience

Background. The cystic form of biliary atresia is a rare form of atresia of the biliary tract, which is a relatively favorable variant of the defect and can be diagnosed antenatally. In practice, it is important not only to suspect this diagnosis, but also to differentiate this variant of impaired development of the external bile duct from the cyst of the common bile duct. This is due to the difference in approaches and methods of surgical treatment of choledochal cysts and biliary atresia. Obliteration (atresia) of the bile ducts in the absence of timely surgical intervention quickly leads to the progression of cirrhosis and the development of liver failure. The method of choice in the treatment of AD is Kasai surgery, often palliative in nature, but allowing to delay the time until liver transplantation. The cyst of the common bile duct rarely requires early surgical treatment, and the risk of cirrhosis is significantly lower. Surgical intervention is aimed at removing the cyst and restoring the flow of bile by anastomosing the external bile ducts with the intestines, which is a radical method of treatment and leads to the recovery of the child. External similarity in ultrasound examination of the fetus and newborn baby of the cystic form of biliary atresia of the bile ducts with a cyst of the common bile duct does not always allow differentiation of one defect from another, which can lead to untimely correction of the defect and an unfavorable outcome. Aim. Demonstrate a rare type of biliary atresia. Materials and methods. Between 2001 and 2019, 33 patients with biliary atresia were treated in the Childrens City Multidisciplinary Clinical Specialized Center for High Medical Technologies in St. Petersburg, only two patients had a cystic form. Both children were initially treated as patients with bile duct cyst. Children were operated on at the age of 2 and 3.5 months. The first patient underwent surgery Kasai, the second hepaticoyunoanastomosis. Results. During the observation period (9 years and 4 years), the synthetic function of the liver is normal, and there are currently no indications for transplantation. Conclusion. If a fetus or a newborn with neonatal jaundice is detected during ultrasound examination of a cystic formation in the gates of the liver, it is very important to correctly and quickly make a differential diagnosis between the cystic form of biliary atresia of the biliary tract and the common bile duct cyst.

Deletion of Yy1 in mouse lung epithelium unveils molecular mechanisms governing pleuropulmonary blastoma pathogenesis

ABSTRACTPleuropulmonary blastoma (PPB) is a very rare pediatric lung disease. It can progress from abnormal epithelial cysts to an aggressive sarcoma with poor survival. PPB is difficult to diagnose as it can be confounded with other cystic lung disorders, such as congenital pulmonary airway malformation (CPAM). PPB is associated with mutations in DICER1 that perturb the microRNA (miRNA) profile in lung. How DICER1 and miRNAs act during PPB pathogenesis remains unsolved. Lung epithelial deletion of the Yin Yang1 (Yy1) gene in mice causes a phenotype mimicking the cystic form of PPB and affects the expression of key regulators of lung development. Similar changes in expression were observed in PPB but not in CPAM lung biopsies, revealing a distinctive PPB molecular signature. Deregulation of molecules promoting epithelial–mesenchymal transition (EMT) was detected in PPB specimens, suggesting that EMT might participate in tumor progression. Changes in miRNA expression also occurred in PPB lung biopsies. miR-125a-3p, a candidate to regulate YY1 expression and lung branching, was abnormally highly expressed in PPB samples. Together, these findings support the concept that reduced expression of YY1, due to the abnormal miRNA profile resulting from DICER1 mutations, contributes to PPB development via its impact on the expression of key lung developmental genes.This article has an associated First Person interview with the joint first authors of the paper.