Morphology and novel classification of proximal humeral fractures.

Background: The morphology of proximal humeral fractures (PHFs) is complex, and the fixation and selection of implants need to be guided by the fracture type and classification, which requires an accurate understanding of the fracture line. This study had three purposes. 1) Define and analyze the fracture lines and morphological features of all types PHFs by three-dimensional (3D) mapping technology. 2) Determine the osteotomy position of the biomechanical model of the PHFs according to the fracture heat map. 3) Based on the analysis of the pathological morphology and distribution of a large number of consecutive cases of PHFs, propose a novel classification of PHFs. Methods: We retrospectively collected 220 cases of PHFs and generated a 3D fracture map and heat map based on computed tomography (CT) imaging. Through analysis of the fracture morphology of the 220 PHFs, a novel classification was proposed. The primary criterion for staging was the continuity between the humeral head and the greater tuberosity and lesser tuberosity, and the secondary criterion was the relationship between the humeral head segment and the humeral shaft. Results: The fracture line was primarily found around the metaphyseal zone of region of the surgical neck, with the most extensive distribution being below the larger tuberosity and on the posterior medial side of the epiphysis. We suggest that the osteotomy gap should be immediately (approximately 5-10 mm) below the lower edge of the articular surface. The most common type of fracture was type I3 (33 cases, 15.0%), followed by type IV3 fracture (23 cases, 10.4%), and type III2 fracture (22 cases, 10.0%). Interobserver and intraobserver reliability analysis for the fracture classification revealed a k value (95% confidence interval) of 0.639 (0.57-0.71) and 0.841, P < 0.01, respectively. Conclusion: In this study, the fracture line and morphological characteristics of PHFs were clarified in detail by 3D mapping technique. In addition, a new classification method was proposed by analysis of the morphological characteristics of 220 PHFs, A two-part fracture model for PHFs is also proposed.

Morphopathological Effect of Ferrihydrite Nanoparticles in an Experimental Model of Toxic Hemolytic Anemia.

We studied the effect of biogenic ferrihydrite nanoparticles synthesized as a result of the culturing of Klebsiella oxytoca on Wistar rats with experimental toxic hemolytic anemia. The pathology was simulated by single intraperitoneal injection of phenylhydrazine hydrochloride. On day 4, the functional parameters of erythrocytes in rats corresponded to the state of toxic hemolytic anemia. It is shown that ferrihydrite nanoparticles suspension has chronic toxicity and causes morphological changes in organs (mainly in the spleen), which are characterized by accumulation of nanoparticles. Administration of phenylhydrazine induced systemic vascular damage and the formation of extramedullary hematopoietic foci, which indicated a compensatory activation in hematopoiesis in the liver and spleen. Injection of nanoparticles reduced discirculatory and necrotic changes in the kidneys.

Influence of age, habitat elevation, and distance to a thermal power plant on pathomorphological findings in the European brown hare (Lepuseuropaeus P.).

The lifespan of the European hare (Lepus europaeus P.) is affected by a number of negative factors, including pollutants. In this paper, the individual and joint influence of age and habitat (elevation and distance from the thermal power plant - TPP) on pathomorphological findings of hares shot during three hunting seasons was investigated. Pathomorphological changes were found in 95.12% of hares. In hares up to 1 year of age, the changes were predominant in the lungs, and in older hares, in the kidneys. Degenerative changes in kidneys and liver and inflammatory changes in kidneys and lungs were considered important most in discussing the influence of chemical pollution. The proximity of TPP influenced the type of changes in the liver. A significant joint effect of age and elevation on the type of changes in the lungs of adult hares and on the heart of young hares was found. Elevation and distance from TPP had a joint effect on the occurrence of changes in the lungs, intestines, and heart in hares from the field farther from TPP. The results indicate that the hares were highly exposed to chemical pollutants that may affect their immunity, and lifespan.

Dedifferentiated Chondrosarcoma from Molecular Pathology to Current Treatment and Clinical Trials.

Dedifferentiated chondrosarcoma (DDCS) is a rare subtype of chondrosarcoma, a primary cartilaginous malignant neoplasm. It accounts for up to 1-2% of all chondrosarcomas and is generally associated with one of the poorest prognoses among all chondrosarcomas with the highest risk of metastasis. The 5-year survival rates range from 7% to 24%. DDCS may develop at any age, but the average presentation age is over 50. The most common locations are the femur, pelvis humerus, scapula, rib, and tibia. The standard treatment for localised disease is surgical resection. Most patients are diagnosed in unresectable and advanced stages, and chemotherapy for localised and metastatic dedifferentiated DDCS follows protocols used for osteosarcoma.

The Effects of Whole Body Gamma Irradiation on Mice, Age-Related Behavioral, and Pathophysiological Changes.

We designed a study with the objective to determine the long-term radiation effects of gamma rays, originating from a single shot of Co60 at a dose of 2 Gy on the 7-month-old male mice of the ICR line in 30 days after the irradiation. The aim of this study was to characterize the behavior of animals using the Open Field test, immuno-hematological status, and morpho-functional changes in the central nervous system of mice. Irradiated animals displayed significantly different behavior in the OF in comparison with the control group. The radiation damage was confirmed by assessing the ratio of leukocytes in the peripheral blood of mice at a later date after exposure to Co60. After irradiation, a decrease in the glioneuronal complex was observed in the irritated group as well as histological changes of brain cells. To sum up, not only was the hematological status of mice altered upon the total gamma irradiation, but also their behavior, which was most probably due to significant alterations in the CNS. Study of influence of ionizing radiation on female mice, comparison between different age groups. Open Field test on the 30 days after 2 Gy of γ-rays and histological analysis indicated changes in behavioral patterns, leucocytes, and brain tissue.

Morphological Characteristics of the Lacrimal Apparatus in its Obstruction of Various Genesis.

Secondary acquired lacrimal duct obstruction (SALDO) is one of the complications of radioiodine therapy. The material was obtained during endoscopic dacryocystorhinostomy with revision of Hasner's valve in patients with PANDO (n = 7) in the distal segments of the nasolacrimal duct and in patients with SALDO (n = 7) after radioactive iodine therapy. The material was stained with hemotoxylin and eosin, alcyan blue, and by Masson method. Morphological and morphometric analyses were performed in semi-automatic mode. The results of histochemical staining of sections were translated into points taking into account the area and optical density (chromogenicity). The differences were considered significant at p < 0.05. It was shown that the nasolacrimal duct sclerosis is significantly lower (p = 0.029) in patients with SALDO than in patients with PANDO while fibrosis in the lacrimal sac is the same in patients of the compared groups.

Morphological Effects of Cigarette Smoking on Respiratory System and Related Functions Based on AQPs Expression

SUMMARY: A great deal of attention of air pollution on respiratory health is increasing, particularly in relation to haze days. It is that exposure to cigarette smoke augments the toxicity of common air contaminants, thereby increasing the complexity of respiratory diseases. Although there are various mechanisms involved to respiratory diseases caused or worsen by cigarette smoking, in which the role of AQPs in the lung with regard to fluid homeostasis still remains elusive. In this paper, we copied the rat models based on smoke generator, and investigated the morphological changes of mucosa and related functions depending on the balance of lining liquid of alveoli via AQPs expression. Compared with normal group, weak labelling of AQP1 and AQP5 protein abundance were clearly detected in the corresponding part of smoke exposure groups compared with normal group. Hence, it is suggested that the contribution of AQPs in the lung is diminished, thereby causing perturbed balancing between resorptive and secretory fluid homeostasis under cigarette smoking.

Cada vez se presta más atención a la contaminación del aire en la salud respiratoria, particularmente, en relación con los días de neblina. En consecuencia la exposición al humo del cigarrillo aumenta la toxicidad de los contaminantes comunes del aire, lo que además aumenta la complejidad de las enfermedades respiratorias. Aunque existen varios mecanismos involucrados en las enfermedades respiratorias causadas o empeoradas por el tabaquismo, en las que el papel de las AQP en el pulmón respecto a la homeostasis de líquidos sigue siendo difícil de alcanzar. En este artículo, copiamos los modelos de rata basados en el generador de humo e investigamos los cambios morfológicos de la mucosa y las funciones relacionadas según el equilibrio del líquido de revestimiento de los alvéolos a través de la expresión de AQP. En comparación con el grupo normal, se detectó claramente un etiquetado débil de la abundancia de proteínas AQP1 y AQP5 en la parte correspondiente de los grupos de exposición al humo en comparación con el grupo control. Por lo tanto, se sugiere que la contribución de las AQP en el pulmón está disminuida, provocando así un equilibrio perturbado entre la homeostasis del líquido secretor y de reabsorción bajo el hábito de fumar cigarrillos.

Analysis of the three-year work of a digital pathomorphological laboratory built from the ground.

Digital pathology is a new stage in the development of pathomorphological diagnostics. This topic was most widespread during the COVID-19 pandemic. The advantages of digitization of diagnostics include the possibility of remote work of a pathologist, remote asynchronous consultation, and automation of business processes. They provide an increase in diagnostic quality and speed up the diagnosis process. These benefits are only a small part of what digital cancer diagnostics can provide. This article is written on our own experience of Russia's first fully digital pathomorphological laboratory UNIM. All advantages and disadvantages of digitization, peculiarities of using technology, differences from the conventional approach to diagnostics, the economics of the process, the importance of integration with LIS (laboratory information system) and MIS (medical information system), errors and principles of their solution, payback will be discussed, and every stage of laboratory work will be considered in detail: from logistics and registration to diagnosis and archiving. Due to the fact that all data has been digitized over several years, we will present a comprehensive analysis of statistics and observations on how to organize processes in a fully digital laboratory. A key feature of our experience is the high cost-effectiveness of the platform and approach, which allowed us to win the competition in the market. The result of the survey of doctors' attitudes towards digital pathology will also be presented.

On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen.

Photodynamic therapy (PDT) is an effective treatment for a number of solid malignancies. In this work, the antitumor efficacy of photodynamic therapy for murine B16 melanoma with intravenous administration of a new photosensitizer (PS) based on the chlorin e6 conjugate with a prostate-specific membrane antigen (PSMA) was studied in vivo. We have previously published the data obtained in the first part of the study: the dynamics of PS accumulation in the tumor and surrounding tissues and the antitumor efficacy of the photodynamic therapy, which was evaluated by the regression parameters and morphological characteristics of the tumors-including by the complete regression of the tumors, the absolute growth rate of the tumors among the mice with continued tumor growth, and an increase in life expectancy compared to the control. The criterion for a complete cure was the absence of signs of tumor recurrence within 90 days after therapy. The conducted studies demonstrated the high efficiency of the new photosensitizer for the photodynamic therapy of B16 melanoma. This article presents a continuation of this work, including histological studies of the zones exposed to laser irradiation on the 21st day after treatment and an assessment of the therapeutic potential of photodynamic therapy for the destruction of tumor cells. Pathological studies in the zones of photodynamic exposure revealed that the effectiveness of the PDT depended on the PS dose and the laser irradiation parameters.

Impact of Intragastric Balloon Placement on the Stomach Wall: A Prospective Cohort Study.

PURPOSE: Endoscopic intragastric balloon (IGB) placement is a minimally invasive treatment for morbid obesity that is sometimes used as a preparatory step before surgical intervention. This study was performed to analyze the changes in the stomach wall induced by IGB placement, with particular emphasis on pathomorphology, inflammatory markers, and tissue growth factors. MATERIAL AND METHODS: In total, 30 patients with morbid obesity were prospectively analyzed. A total of 16 patients with body mass index (BMI) ≥ 53 kg/m2 underwent two-stage treatment comprising IGB placement followed by laparoscopic sleeve gastrectomy (LSG) (IGB group), while 14 patients underwent one-stage LSG (non-IGB group). The gastric specimens removed during LSG were examined. The two groups were compared regarding the surgical results, microscopic structure and inflammatory process exponents of the stomach wall, and receptors for selected tissue growth factors. RESULTS: The IGB group had a longer median hospital stay than that of the non-IGB group. Compared with the non-IGB group, the IGB group had a thicker stomach wall, more submucosal fibrosis, and increased amounts of growth factors and inflammatory markers. CONCLUSION: Patients with IGB placement before LSG showed greater changes in the stomach wall than those of patients who received LSG alone. IGB placement was associated with stomach muscle layer thickening, submucosal fibrosis, and increased levels of inflammatory markers and tissue growth factors.

Breast Cancer-Epidemiology, Classification, Pathogenesis and Treatment (Review of Literature).

Breast cancer is the most-commonly diagnosed malignant tumor in women in the world, as well as the first cause of death from malignant tumors. The incidence of breast cancer is constantly increasing in all regions of the world. For this reason, despite the progress in its detection and treatment, which translates into improved mortality rates, it seems necessary to look for new therapeutic methods, and predictive and prognostic factors. Treatment strategies vary depending on the molecular subtype. Breast cancer treatment is multidisciplinary; it includes approaches to locoregional therapy (surgery and radiation therapy) and systemic therapy. Systemic therapies include hormone therapy for hormone-positive disease, chemotherapy, anti-HER2 therapy for HER2-positive disease, and quite recently, immunotherapy. Triple negative breast cancer is responsible for more than 15-20% of all breast cancers. It is of particular research interest as it presents a therapeutic challenge, mainly due to its low response to treatment and its highly invasive nature. Future therapeutic concepts for breast cancer aim to individualize therapy and de-escalate and escalate treatment based on cancer biology and early response to therapy. The article presents a review of the literature on breast carcinoma-a disease affecting women in the world.

[Analysis of fatal outcomes of meningococcal infection in adults].

Clinical characteristics and pathomorphological manifestations in 69 patients aged 18 to 86 years with a fatal outcome of the disease were examined in order to analyze the causes of severe course and high mortality of generalized forms meningococcal infection. It was found that the main clinical form was meningococcemia (90%), in the majority in combination with meningitis (52%). The fulminant course in 77% of patients with meningococcal sepsis manifested itself as a sudden onset, rapid development of typical symptoms. Hemorrhagic exanthema was detected on the first day of meningococcemia. The leading complications and critical conditions were infectious-toxic shock, disseminated intravascular coagulation and acute adrenal insufficiency (Waterhouse-Friederiksen syndrome). The severe course of meningitis (in 10%) led to the development of cerebral coma, the morphological substrate of which was edema - swelling of the brain.

[The pathomorphology of urolithiasis and the chemical analysis of the stones by x-ray diffraction and infrared spectroscopy].

BACKGROUND: Stones consist of the organic, inorganic and amorphous part. The factors that affect the formation of stones can be divided into two categories; 1). Those that are in the urine and form the crystalline nucleus, agglomeration, which includes proteins, salts, glycoproteins, phospholipids, and 2). Changes in cell surface leading to crystal adhesion to epithelial cells. OBJECTIVE: The purpose of this study was to determine the composition of uroliths (stones), nucleus, envelope, core component and stone layer component. MATERIAL AND METHODS: The research was conducted with patients of the Urology Clinic, University Clinical Center of Kosovo, in Prishtina. The work was prospectivein our research were included 102 patients. After the intervention: endoscopic or surgery, we took the stone and did the chemical analysis of the stones with the method: X-ray diffraction and infrared spectroscopy. This will determine the components of the stones and their types. From the statistical parameters, the structure index, arithmetic mean, and standard deviation were calculated. Qualitative data testing was done with X2-test or Fisher test. Quantitative data testing with T-test., Test verification was done with a reliability rate of 99.7% (p<0.01) and a reliability of 95% (p<0.05). RESULTS: Our study included66.7% male and 33.3% female. With X2-test we gained a difference with statistically significant significance in the number of cases by gender (X2=11.3, p=0.001). The age group most attacked is 40-49 years. The chemical component of stone patients was: 58.8% Calcium oxalate monohydrate, 14.7% Calcium Phosphate, 10.8% Magnesium ammonium phosphate, 5.9% Calcium oxalate dihydrate, 4.9% Uric acid, 2.9% Cystinic, 1.0% Ammonium hydrogen urate and brush 1.0%. We have the group of children who are 8 cases or 7.84%. The chemical composition; Calcium oxalate monohydrate 2.94%, Cystinic; 1.96%, Calcium Ox.Dihydrate; 0.98%, Magnesium ammonium phosphate; 0.98%, uric acid; 0.98%. CONCLUSION: X-ray diffraction analyzes the crystalline components of the stone, while infrared spectroscopy is more sophisticated to identify non-crystalline materials, including amorphous substances and fat. In our adult research, calcium oxalate monohydrate, calcium phosphate stones appear more often, while in children, calcium oxalate monohydrate. The most common stone nucleus analysis is Ammonium hydrogen urate.

Photodynamic Therapy of Melanoma B16 with Chlorin E6 Conjugated with a PSMA-Ligand.

The efficacy of a new photosensitizer of chlorin E6 conjugated with a prostate-specific membrane antigen (PSMA) in photodynamic therapy of murine melanoma B16 was studied in in vivo experiments. The dynamics of photosensitizer accumulation in the tumor and surrounding tissues was evaluated and antitumor efficacy of photodynamic therapy was assessed by parameters of regression and morphological characteristics of experimental transplanted melanoma B16. The inhibitory effect of photodynamic therapy on melanoma was evaluated by complete regression of the tumor, absolute tumor growth coefficient in animals with continuation of tumor growth, and the increase in life span in comparison with the control; the criterion of cure was the absence of signs of tumor recurrence in mice within 90 days after therapy. The therapeutic potential of photodynamic therapy was determined by devitalization of tumor cells (histological examination of the zones of laser exposure on day 21 after treatment). The photosensitizer with PSMA-ligand exhibited high antitumor activity in photodynamic therapy for melanoma B16. Photodynamic therapy carried out at the optimum time after photosensitizer injection with experimentally determined parameters of laser exposure allows achieving the maximum inhibitory effect on melanoma. Pathomorphological study in the zones of exposure detected no survived tumor cells.

Pathomorphological Changes in the Brain in Dynamics of Long-Term Dust Exposure.

Histological and morphometric studies of brain autopsy material showed that the development of hypoxic changes in miners starts at the early stages of working in the dusty atmosphere. Edema of the pericellular and perivascular zones and the pia mater, degenerative changes in some nerve cells and even their loss and formation of gliosis foci were identified. The revealed changes in neurons progressed with increasing the duration of working under hazardous conditions.

[Clinical and anatomical analysis of mortality from COVID-19 in sudden death and in those who died in health care facilities]. / Kliniko-anatomicheskii analiz letal'nosti ot COVID-19 pri skoropostizhnoi smerti i u umershikh v lechebno-profilakticheskikh uchrezhdeniyakh.

OBJECTIVE: Assessment of pathological and morphological changes in those who died from COVID-19 including persons received therapy in medical and preventive institutions (LPI) and who died suddenly from this pathology at home. The analysis data of the pathological and anatomical changes in 57 deaths from COVID-19 in hospitals and 74 forensic medical examinations where infectious pathology was established as the main cause of death are presented. For microscopy the sections were stained with hemotoxylin and eosin, OCG, immunohistochemical study with markers for CD3, CD 4, CD 20, SK-7. The mixed viral and bacterial lesions of the lungs were detected more often than pure viral infection in those who died suddenly from COVID-19 compared with people whose death occurred in medical facilities. This allows speaking about the lack of adequate antibiotic therapy out-patiently. Features of mononuclear lung infiltration in COVID-19 with a predominance of a moderately pronounced reaction of T-lymphocytes and a mild B-lymphocytic reaction indicate a decrease in immunological reactivity. Conducting clinical and anatomical analysis allows determining the features of pathogenesis and morphogenesis in each specific fatal case and informing the clinicians of health facilities (clinics and hospitals) allows the autopsy doctor (pathologist, forensic physician) to provide significant assistance in improving the quality of diagnosis and treatment of patients with this highly contagious severe viral disease.

In Vivo Studies of a Liquid Embolic Compound.

A composition in the form of liquid polymer substance intended for embolization procedures was studied in in vivo experiment. The preparation was injected to rabbits into the femoral artery and abdominal aorta. The polymer composition exhibited properties previously demonstrated in vitro: strong adhesion to the vascular wall, high plasticity sufficient for embolization of the blood vessels, distal distribution, and the absence of toxic effects. The contrast substance remained in the embolus, which simplified its further localization. The agent underwent nether resorption nor organization. Injection of the agent in a volume of 0.1 ml was sufficient for embolization of an artery with a diameter of 0.1 cm. The polymer composition completely obstructed the vessel without inducing perforation of its wall. During the first day of the experiment, a slight infiltration of surrounding tissues with lymphoid cells was observed. By day 7, total dry necrosis of pelvic limb distal to the injection site was diagnosed. Inflammation of the surrounding tissues was shown histologically and was considered as the body response to impaired circulation and necrosis.

Iniencephaly: radiologic and pathomorphologic perinatal observation.

Iniencephaly (IE) is a rare neural tube malformation involving severe head retroflexion and deformity of the spine. IE is typically accompanied with other congenital abnormalities and carrying a poor fetal prognosis. This report presents radiological findings in a rare case of IE associated with multiple malformations of the skull, spine, face, heart, and body. A 44-year-old pregnant female underwent an obstetric ultrasound examination on the 26th week of gestation followed by fetal magnetic resonance imaging on the 36th week. Imaging revealed complex developmental anomalies, which led to the diagnosis of IE with a large cervical meningocele, occipital bone defect, spina bifida of the cervical vertebrae, multiple malformed vertebra, deformed face, coarctation of the aortic arch, and hypoplastic lungs. Based on these findings, a decision to terminate pregnancy was made. Pathological examination of the fetus showed close agreement with imaging. The presented case underscores the importance of multimodal imaging for clinical decision making in the management of complex neural tube malformations.

[Structural heterogeneity of epileptic foci in local drug-resistant epilepsy]. / Strukturnaya geterogennost' epilepticheskikh ochagov pri lokal'noi farmakorezistentnoi epilepsii.

BACKGROUND: To study etiopathogenesis is one of the most important tasks of modern neurology. Various types of structural changes occur in drug-resistant epilepsy (DRE); however, they are described as distinct phenomena. OBJECTIVE: To provide a comprehensive characterization of structural changes in the cortex and adjacent white matter in the electrophysiological activity zone (in the epileptic focus) in patients undergoing surgery for DRE. MATERIAL AND METHODS: Biopsy material of fragments of the temporal lobe and hippocampus from 16 patients aged 21 to 54 years (mean age, 25 years) with DRE were intraoperatively obtained at the Prof. A.L. Polenov Russian Research Institute of Neurosurgery. The investigators studied histological sections stained with H&E, toluidine blue according to the Nissl method and the Spielmeyer method, as well as the results of immunohistochemical reactions with glial fibrillary acidic protein (GFAP), vimentin, and neurofilaments (NF) (Dako antibodies, Denmark). RESULTS: Histological examination revealed a set of heterogeneous changes, reflecting the complex pathogenetic interactions that developed during the formation of an epileptic focus. Structural brain damage involved both gray and white matter. Focal cortical dysplasia was diagnosed in 14 (87.5%) cases; white matter neuronal heterotopia in 100%; neuronal reactive and destructive changes in 100%; epileptic leukoencephalopathy (vascular demyelination, microcysts, sclerosis and dystonia, gliosis) in 100%, cortical atrophy in 12.5%, and hippocampal sclerosis in 20% (in 2 out of the 10 examinees). CONCLUSION: The morphopathological heterogeneity in the structure of epileptic foci reflects the complexity of etiopathogenetic interactions, the polymorphism of epileptic manifestations, and the individual nature of formation of the epileptic system, which requires an integral approach to understanding the pathogenesis and morphogenesis of formation of the epileptic system and provides a direction for a personalized approach to epilepsy treatment.