[An expert system for differential diagnosis of medullary and oxyphilic cell thyroid carcinoma].

OBJECTIVE: To reveal the quantitative regularities of pathological changes in the nuclei and aggregates of C and B cells and to build an expert system on their basis for the differential diagnosis of medullary and oxyphilic cell thyroid carcinoma. MATERIAL AND METHODS: Puncture smears with histologically verified medullary (C cell) carcinoma and oxyphilic cell (B cell) carcinoma were investigated. The nuclei and aggregates of C cells and B cells (Hürthle cells, oncocytes) were morphometrically examined with a computer color image analyzer on the basis of a light microscope and a digital photo camera. RESULTS: The quantitative regularities of the degree of C and B cell aggregation in medullary and oxyphilic cell thyroid carcinoma were found by morphometry. The threshold values for the aggregates in the comparison groups and their weight coefficients formed the basis for the expert system to differentially diagnose medullary and oxyphilic cell carcinoma at the initial stages of patient examination. The clinical trials showed the high efficiency of the developed expert system.

[The differentiated diagnostic of oxyphilous cellular cancer and oxyphilous cellular adenoma based on the expertise system].

The morphometry was applied to evaluate pathological alterations of degree of aggregation of Hürthle cells under oxyphilous cellular cancer and oxyphilous cellular adenoma of thyroid. The established regularities founded the expertise system on the basis of set of threshold values of 16 qualitative parameters of aggregates and their weighting coefficients. The application of expertise system will allow evaluating with effectiveness of 85.6% the malignant potential of oxyphilous cellular tumor of thyroid of follicular structure at the pre-surgery stage.

[Screening of plasmids in the bacteria of the genus Bacillus with antilysozyme activity].

In the study of the microbiocenosis of the distal section of the patients' large intestine Bacillus strains with antilysozyme activity (ALA) were isolated. In B. cereus strain 26 with pronounced expression of antilysozyme factor the plasmid sized approximately 100 kb was detected. The transformation of the isolated plasmid in cells of B. cereus non-plasmid strain IP5832 the localization of genes encoding ALA and resistance to kanamycin was determined. The production of ALA factor in the recombinant clone of B. cereus strain IP5832 corresponded to the clinical isolate of B. cereus 26. The replicon of the detected plasmid could be used for the determination of the coding sequence of the antilysozyme sign of bacilli. Genetic determinants of antilysozyme factors and kanamycin resistance may be used for the construction of vector systems of cloning in bacilli.

[Influence of cycloferon on the biological properties of bacterial intracellular pathogens].

The influence of cycloferon on some biological properties of pathogenic (Shigella spp., Salmonella spp., Francisella tularensis, Brucella spp.) and opportunistic (Escherichia coli, Staphylococcus spp.) microorganisms has been experimentally determined in vitro. As revealed in these experiments, the preparation used at concentrations under study considerably suppresses the antilysozyme and anticomplementary activity of Gram-negative intracellular parasites (shigellae, salmonellae, F. tularensis, Brucella). These data reveal one of the possible mechanisms of the action of cycloferon on intracellular parasites in acute and chronic bacterial infections.

[Persistence factors of Helicobacter pylori]. / Faktory persistentsii Helicobacter pylori.

Isolates of H. pylori from patients with chronic gastritis and peptic ulcer, were found to be capable of inactivating lysozyme and intercide (the bactericidal component of human leukocytic interferon). The expression and penetration capacity of their antilysozyme activity (ALA) and antiintercide activity was determined. The wide spread of ALA among H. pylori clinical isolates associated with inflammatory changes in bioptic specimens, confirmed the leading role of this microorganism in the pathogenesis of the gastric mucosal lesions. The retrospective analysis of clinical cases made it possible to recommend the use of the ALA sign as one of the criteria for choosing the scheme of eradication therapy even at the stage of the initial diagnostics of H. pylori infection.

[Some mechanisms of Helicobacter pylori persistence]. / O nekotorykh mekhanizmakh persistentsii Helicobacter pylori.

The mechanisms of the pathogenesis of Helicobacter pylori infection, ensuring the prolonged survival of these bacteria in the aggressive medium (gastric mucosa), are considered. A new approach to the systematization of the mechanisms of H. pylori persistence is proposed: the mechanisms ensuring the stability of H. pylori in the presence of aggressive physical and chemical factors, the mechanisms ensuring antagonistic effects in biocenosis and the mechanisms ensuring resistance to the protective factors of the host. Data on the persistence potential of H. pylori in accordance with the proposed classification are presented.

Thyroid carcinoma diagnosis based on a set of karyometric parameters of follicular cells.

BACKGROUND: In the works of various authors, performed with the help of morphometry, an assessment of cell changes was carried out, as a rule, by one sign of their atypia (e.g. area of cell nuclei). Moreover, the selective analysis of morphometric data for certain nosologic forms was performed. Such an approach allowed researchers to develop only additional diagnostic criteria of thyroid carcinoma. At the same time, the use of a set of quantitative signs of cell atypia as a criterion for tumor malignancy made it possible to improve oncologic diagnosis. In this study, which is a first step in the development of a quantitative approach to thyroid carcinoma diagnosis, a system of karyometric parameters was developed with the help of morphometry of cytologic material of patients with major nosologic forms of thyroid pathology (papillary and follicular carcinoma, follicular adenoma, autoimmune thyroiditis, and nodular colloid and diffuse toxic goiter). The significance of each parameter in thyroid carcinoma diagnosis was evaluated. METHODS: Thyroid cells of autopsy, operative, and aspiration biopsy material were the object of the study. One hundred fifty-two preparations with histologically verified diagnosis were studied. Light morphometry was performed with the help of a semiautomatic computer analyzer of images. One hundred fifty thyroid nuclei were assessed in each preparation. RESULTS: Among many karyometric parameters, six were selected: mean area of thyrocyte nuclei, ratio of frequencies, and number of classes on histograms of distribution of their area, coefficient and a free term of the regression equation to a scattered diagram of perimeter and nuclear area, and the discriminant index. Boundary values of these parameters between the malignant and benign pathology were united into an expert system for thyroid carcinoma diagnosis. Clinical trials of the system were performed. On the basis of the obtained results, the informativity (accuracy, sensitivity, specificity) of its karyometric parameters was assessed. The formula for calculation of the weighting coefficient for each parameter was derived, the diagnostic index being determined by the sum of their values. CONCLUSIONS: An expert system was created based on a set of karyometric parameters reflecting the regularities of pathologic changes in thyrocyte nuclei with malignant and benign pathology. The informativity and weighting coefficients included into the system of parameters have been assessed, which made it possible to perform the probabilistic diagnosis of thyroid carcinoma.

[The effect of inulin on the biological properties of enterobacteria]. / Vliianie inulina na biologicheskie svoistva énterobakterii.

The influence of inulin on some biological properties of Enterobacteriaceae, both pathogenic (Salmonella) and opportunistic (Klebsiella, Escherichia coli) was experimentally determined in vitro. The study revealed that inulin stimulated the production of colicin and suppressed the hemolytic activity in E. coli. The effect produced by inulin on the antilysozyme activity (ALA) of Enterobacteriaceae was different: in S. typhimurium ALA was decreased and in most K. pneumoniae strains the expression of this sign was enhanced.

[Effect of water-soluble vitamins on the anti-lysozyme activity of enterobacteria]. / Vliianie vodorastvorimykh vitaminov na antilizotsimnuiu aktivnost' énterobakterii.

The influence of vitamins of group B (B1, B6, B12) and vitamin C on the antilysozyme activity (ALA) of pathogenic and opportunistic bacteria (Salmonella, Klebsiella, Escherichia coli) has been determined in a number of in vitro experiments. In E. coli vitamins had different influence on ALA: vitamins B1 and C (at a concentration of 5 mg/ml) increased this activity in E. coli, while vitamins B12 and C (at concentrations of 0.5 and 0.05 mg/ml) decreased it. In Klebsiella vitamins B1, B12 and C (at a concentration of 0.05 mg/ml) decreased ALA, while after the addition of vitamin C at concentrations of 0.5 and 5 mg/ml into the medium ALA increased. In Salmonella vitamins of group B had no influence on ALA, ascorbic acid at a low concentration (0.5 mg/ml) decreased their capacity for inactivating lysozyme. In enterobacteria vitamin B6 produced no changes in ALA.

[Effect of bifidobacteria on the anti-lysozyme activity of enterobacteria]. / Vliianie bifidobakterii na antilizotsimnuiu aktivnost' énterobakterii.

The influence of the subinhibitory concentrations of bifidobacterial exometabolites on the capacity for inactivating lysozyme in pathogenic and opportunistic enterobacteria was determined. The supernatant of B. bifidum 1 suppressed antilysozyme activity (ALA) in most Klebsiella strains and in some pathogenic Escherichia coli strains, but increased ALA in some E. coli of indigenous flora and failed to influence ALA in Salmonellae. The stimulating effect of the vital activity products of bifidobacteria with respect to the antilysozyme sign in some S. enteritidis isolates and diarrheagenic E. coli was found. These properties should be taken into consideration while selecting strains for the construction of probiotics.

[A comparative morphometric analysis of the degree of thyrocyte aggregation in preoperative and postoperative cytological material from patients with the identical thyroid pathology]. / Sravnitel'nyi morfometricheskii analiz stepeni agregirovannosti tireotsitov v dooperatsionnom i posleoperatsionnom tsitologicheskom materiale patsientov s odinakovoi patologiei shchitovidnoi zhelezy.

The similarity of average parameters of thyrocyte aggregates and their distribution on histograms was revealed using comparative morphometric analysis of pre- and postoperative samples from thyroid glands of patients with identical histologic analyses. These regularities may be used as additional diagnostic criteria of thyroid cancer at both pre- and postoperative stages.

[Morphometric analysis of the degree of thyrocyte aggregation in the preoperative diagnosis of thyroid cancer]. / Morfometricheskii analiz stepeni agregirovannosti tirotsitov v dooperatsionnoi diagnostike raka shchitovidnoi zhelezy.

Morphometric examination of puncture specimens of the thyroid showed that the distribution of parameters reflecting the degree of aggregation of follicular cells on the histograms depends on the type of thyroid disease. The detected regularities permit a preoperative differentiation of follicular and papillary cancer from follicular adenoma, autoimmune thyroiditis, nodular colloid and diffuse toxic goiter.

[Preoperative diagnosis of thyroid cancer by karyometry of thyrocytes]. / Dooperatsionnaia diagnostika raka pri shchitovidnoi zhelezy s pomoshch'iu kariometrii tirotsitov.

Karyometry revealed that the distribution of thyrocyte nuclei by the size of their area on histograms depends on the type of thyroid disease. If the ratio of the share of thyrocyte nuclei area in the second and third ranges on distribution histograms is more than 1, thyroid cancer is diagnosed, if it less than 1, it may mean follicular adenoma, autoimmune thyroiditis, nodular colloid or diffuse toxic goiter.

[Morphometric study of the degree of aggregation of thyrocytes as a function of the form of thyroid gland disease]. / Morfometricheskoe issledovanie stepeni agregirovannosti tireotsitov v zavisimosti ot formy zabolevaniia shchitovidnoi zhelezy.

It is determined morphometrically that histogram distribution of the parameters reflecting the degree of aggregation of follicular cells depends upon the nature of thyroid disease. In thyroid carcinoma, the distribution of values of such parameters as area, perimeter, minimal and maximal diameters, moment of inertia and number of cells in the aggregate has a dome-shaped shape, while for follicular adenoma as well as for nodular colloid and diffuse toxic goiter or for autoimmune thyroiditis exponential-like dependence was typical. For such parameters, as mean diameter, mean and mean maximal distance between the cells in the aggregate and coordinate deviation distribution had a dome-like shape with maximum in the 3rd range in malignant tumors and in the 2nd one for other diseases, the revealed phenomena can be used as an additional diagnostic criterion of malignant transformation of thyroid follicular cells.

[A morphometric study of the lymphoid cell population in biopsy material from patients with different thyroid pathologies]. / Morfometricheskoe issledovanie populiatsii limfoidnykh kletok v biopsiinom materiale patsientov s razlichnoi patologiei shchitovidnoi zhelezy.

Using cytometry of lymphocytes, prolymphocytes and lymphoblasts in touch smears of biopsy and autopsy samples of thyroid, it was revealed that in cancer the small lymphocytes, in the total population of these lymphoid cells, comprise 0-2%, and on distributional histograms of lymphoid cells, according to the average diameter, the maximum was in the range of 9.6-11.7 microns. In benign malformations, goiters and autoimmune thyroiditis, and in the norm the percentage of small lymphocytes varied in the range of 10-44, with the maximum in the range of 7.5-9.6 microns. Histograms, built according to the space occupied by lymphoid cells, evidenced that in malignant thyroid disease a cupola-shaped character of distribution was peculiar, whereas in other pathologies and in norm the exponential relationship was revealed.

[Cytometric estimation of lymphoid cell population in needle biopsy samples from patients with thyroid cancer]. / Tsitometricheskaia otsenka populiatsii limfoidnykh kletok v punktsionnom materiale bol'nykh rakom shchitovidnoi zhelezy.

Fine-needle aspiration cytological examination has established the small lymphocyte fraction in the total population of lymphoid cells in thyroid cancer patients to be at 0-2%, the frequency peak for lymphoid cells of an average size as shown on histographs being located in the 3rd interval. In follicular adenoma, cyst, autoimmune thyroiditis and goiter, the small lymphocyte percentage was found to rise to 9-20%, the frequency peak shifting to the 2nd interval. The lymphoid cells area distribution pattern for cancer was of a domed shape while an exponential relationship was observed in the other pathologies. The newly-developed criteria for thyroid cancer diagnosis are expected to increase the effectiveness and predictive value of aspiration technique by 25%.

[Karyometric analysis of pathologic changes in follicular cells of the thyroid gland]. / Kariometricheskii analiz patologicheskikh izmenenii follikuliarnykh kletok shchitovidnoi zhelezy.

Using cytometry it is shown, that distribution histograms of the values of follicular cell nuclear areas depend upon the nature of the thyroid disease. Dome-like distribution was observed in follicular and papillary cancer, while for follicular adenoma as well as for nodular colloid and diffuse toxic goiter or for autoimmune thyroiditis exponential-like dependence was typical. Distribution histograms under normal conditions had the form of a column. The phenomena observed can be used as an additional diagnostic criterion of malignant transformation of thyroid follicular cells.