Features of Cell Reactions during Implantation of Biodegradable Polymer and Polypropylene in the Experiment.

Quantitative and qualitative characteristics of cell infiltrates in male Wistar rats were studied from 14 days to 12 months after implantation of polypropylene and a biodegradable polymer obtained by electrospinning and consisting of 65% polycaprolactone and 35% polytrimethylene carbonate. It was found that a predominantly macrophage-giant cell reaction developed around the biodegradable polymer; it spread into the matrix and the number of cells in the infiltrate decreased, as the degradation progressed. Around polypropylene, mainly lymphocytic and leukocytic reaction was seen; it also decreased with time, but was characterized by a reverse increase in the number of lymphocytes. Immunohistochemical analysis showed that the proportion of CD38+ cells 12 months after implantation increased around polypropylene to a greater extent than around the biodegradable polymer, while the proportion of CD68+ cells decreased. These findings suggest that implantation of a biodegradable polymer caused no prolonged lymphocytic and plasma cell reaction in animals as in the case of polypropylene, which indicates that biodegradable polymer is a promising material for tissue engineering.

Morphogenetic Aspects of the Response of Vaginal Tissues to Polypropylene Implants as the Basis of Mesh-Associated Complications.

Morphometric and immunohistochemical examination of the vaginal mucosa before and 12 months after installation of polypropylene implants for the correction of stress urinary incontinence was performed in 20 patients with genital prolapse. The research results confirmed good biocompatibility of polypropylene and the formation of full-fledged connective tissue in the vaginal mucosa, but revealed the presence of a weak lymphocytic reaction to polypropylene 12 months after surgery. According to immunohistochemical study, increased contents of B lymphocytes and plasma cells responsible for the inductive and productive stages of the immune response were revealed in the vaginal mucosa around the implants 12 months after surgery. This reaction in the presences of provoking factors can lead to the development of inflammation and erosion, a type of mesh-associated complications.

Comparative Analysis of Connective Tissue Responses to Implantation of Biodegradable Material and Polypropylene in Experimental Animals.

We compared qualitative characteristics of the connective tissue at the site of implantation of polypropylene or a biodegradable polymer synthesized by electrospinning and consisting of 65% polycaprolactone and 35% polytrimethylene carbonate. Synthetic materials were implanted into the interfascial space of the muscles on the back of Wistar rats. The parameters of cellular and non-cellular structures of the forming connective tissue were studied in 1, 2, 3, 6, 9, and 12 months after implantation. It was found that the number of fibrocytes and fibroblasts around biopolymer and polypropylene increased during the period from 1 to 9 months, with a significant lag in case of biopolymer implantation; by 12 months, the number of fibrocytic cells did not significantly differ. The fibroplastic and angioplastic processes developed in the thickness of both materials, but with a one-month lag in case of biopolymer implantation due to degradation properties and nonporous structure of this polymer. Collagen fibers were actively synthesized around both materials, but in case of polypropylene, this process was more pronounced. In 6 months after implantation of polypropylene, dense regular connective tissue was formed; in 12 months after implantation of the biopolymer, the formation of dense irregular connective tissue was observed at the site of implantation. The biopolymer can be used to strengthen the core muscles.

Features of Remodeling of Prostate Stroma in Chronic Abacterial Prostatitis.

We performed a complex morphological study of biopsy samples of prostate gland from 30 men (mean age 46±11 years) with chronic abacterial prostatitis who were exposed unfavorable anthropogenic factors. The ultrastructural heterogeneity of smooth muscle cells was shown, among which cells with destructive changes in organelles predominated, solitary cells with signs of secretory function were revealed. Most endothelial cells in microvessels were characterized by low pinocytotic activity, destruction of organelles; focal hyperplastic ultrastructural changes were noted in some endotheliocytes. Along with fibroblasts, the stroma contained single mast cells; no inflammatory infiltration was revealed. The results of the study attested to complex mechanisms of remodeling of the prostate gland stroma in chronic abacterial prostatitis involving microvessels, smooth muscle cells, and probably mast cells, which determines the development of degenerative, destructive, and fibrotic processes.

Features of In Vitro Degradation and Physical Properties of a Biopolymer and In Vivo Tissue Reactions in Comparison with Polypropylene.

We compared in vitro degradation and physical properties of polypropylene and a biodegradable polymer synthesized by electrospinning and consisting of 65% polycaprolactone and 35% polytrimethylene carbonate as a possible alternative material for use in surgery for pelvic floor muscle failure. Samples of the studied polymers were implanted to 10 male Wistar rats into the interfascial space on the back (polypropylene on the right side and biodegradable polymer on the left side). The synthesized biopolymer was characterized by elongation and tear resistance, similar to those of polypropylene. During the period from the third to the sixth month after implantation, the area of fibrosis around individual polypropylene and biopolymer fibers increased by 16.7 and 107.9%, respectively, while remaining reduced compared to polypropylene. The total fibrosis area in 6 months after implantation of polypropylene and biopolymer samples significantly increased by 18% (p=0.0097) and 48% (p=0.05), respectively, i.e. fibrosing processes were more intense in case of biopolymer. Induction of more pronounced fibrosis can be an advantage of the synthesized biopolymer when choosing the material for fabrication of implants and their use for correction of incompetence of the ligamentous and muscular apparatus.

Ultrastructural Analysis of Urethral Polyps against the Background of Urogenital Infection.

We performed an electron microscopic study of samples of urethral polyps obtained from 90 women (mean age 52.5±4.9 years). According to PCR and culture studies, the most common infectious agent in patients with urethral polyps is U. urealyticum (100% cases). In 70% cases, this infectious agent was present as monoinfection, of these, clinically significant concentration (>106 CFU/ml) were found in 53.3% cases. In 30% cases, associations with C. trachomatis, T. vaginalis, and M. genitalium were found. We observed significant ultrastructural heterogeneity of the epithelial cells in urethral polyps, which manifested in a combination of hyperplastic and metaplastic changes and signs of cytodestruction. Detection of mycoplasma-like bodies in connective tissue mononuclear cells and viral particles in epithelial cells during ultrastructural study, including cases with negative PCR results, indicates the pathogenetic role of latent infection in the formation of urethral polyps.

[Outcomes of ER:YAG LASER treatment of stress urinary incontinence in women].

AIM: To evaluate the effectiveness of a new method of treatment for stress urinary incontinence in women using an ER: YAG laser in SMOOTH mode and investigate pathophysiological and pathomorphological changes induced by erbium laser. MATERIALS AND METHODS: This study comprised 98 women aged 37-63 years, who between 2014 and 2016 were diagnosed with SUI (type 1 and 2a, 2b) and grade 0-2 vaginal prolapse. The treatment was performed with a 2940 nm Er:YAG laser (Fotona, Slovenia) using a SMOOTH mode. Clinical assessment included PFIQ-7 and PISQ-12 questionnaires, uroflowmetry, laser Doppler flowmetry and biopsy of the anterior vaginal wall. The examination was carried out at baseline and 1-2 months after the treatment. RESULTS: The effectiveness of treatment was 73%. There was no deterioration after the procedure. Analysis of PFIQ-7 and PISQ-12 questionnaires showed that patients with mild incontinence had the greatest difference between pre- and posttreatment results. Uroflowmetry parameters improved in a majority of patients. Results of laser Doppler flowmetry demonstrated the improvement of blood flow in the microvascular bed. An important feature of the vaginal biopsy after laser exposure was an increase in neoangiogenesis. DISCUSSION: The findings of questionnaires and clinical evaluation of patients with SUI and vaginal prolapse before and after treatment with Er: YAG laser showed high therapeutic effectiveness of this treatment modality. CONCLUSION: Clinical effectiveness of ER: YAG laser in SMOOTH mode was 73%. Patients with type 1 and 2a SUI and mild or moderate incontinence have the best prognosis after treatment with this method.

Study of Proliferative Activity of Vaginal Epithelium in Women with Stress Urinary Incontinence Treated by Er:YAG Laser.

The expression of Ki-67 proliferation marker was studied in vaginal biopsy specimens from women with stress urinary incontinence treated using a Fotona nonablative erbium laser. Cells expressing Ki-67 were located in all cases in the parabasal and basal levels of stratified squamous epithelium, the index of labeled nuclei before Er:YAG laser exposure was 19.05±2.86%. After 1-2 months of laser therapy, the index of labeled nuclei in the epithelium increased significantly and reached 31.79±2.25%. These changes were interpreted as a result of epithelial-stromal interactions. Presumably, the increase in proliferative activity of the vaginal epithelium after exposure to Er:YAG laser was due to the presence of an appreciable level of synthetically active fibroblasts in the subepithelial stroma.

Structural Reorganization of the Vaginal Mucosa in Stress Urinary Incontinence under Conditions of Er:YAG Laser Treatment.

Structural characteristics of the vaginal mucosa in stress incontinence and its correction by IncontiLase technology were studied. Studies of vaginal biopsy specimens before the exposure showed degenerative and atrophic changes in the stratified squamous epithelium, disorganization of fibrillar structures of the intercellular matrix, and microcirculatory disorders. Studies after Er:YAG laser exposure showed signs of neocollagenogenesis and elastogenesis, foci of neoangiogenesis, reduction of epithelial degeneration and atrophy, and an increase of the fibroblast population. Morphometry showed that the volume density of blood capillaries and the thickness of the epithelial layer increased by 61.1 and 64.5%, respectively. The use of IncontiLase technology in stress incontinence led to structural reorganization of the vaginal mucosa, improving its morphology and function and alleviating the symptoms of incontinence.

Structural Characteristics of Gastric Cell Populations in Chronic Gastritis and Chronic Hepatitis under Conditions of Helicobacter pylori Persistence.

Helicobacter pylori persistence in patients with chronic gastritis is associated with a complex of nonspecific structural reactions, the type of these reactions correlates with the severity of infection: catarrhal fibrotic changes in the gastric mucosa predominate in cases with manifest colonization, while the absence of H. pylori is associated with predominance of fibrotic process. Analysis of the incidence of some pathomorphological phenomena (degeneration, atrophy, metaplasia, and dysplasia of the surface epithelium) shows no relationship between the presence of H. pylori and colonization intensity. In all patients with chronic hepatitis, the gastric mucosa is involved in the pathological process; fibrosis (gastropathy) was the most common process. No appreciable correlations between the structural changes and hepatitis activity and the presence of H. pylori were detected.

Morphofunctional analysis of the prostate exposed to chemical manufacture factors.

The structural characteristics of the prostate and the blood flow in the organ were studied in chemical plant workers suffering from chronic prostatitis. The prostate echostructure was characterized by vast zones of fibrosis and calcinosis, the hemodynamic ultrasonic parameters were low. Degenerative changes in the acinar structures and stromal fibrosis predominated in the biopsy specimens, these shifts were the most pronounced in the peripheral and transitory zones. Foci of common and small-acinar degeneration of the glands, abundant concrements, and significant collagenization with periglandular and perivascular sclerosis without or with slight inflammatory infiltration were detected. We hypothesize that long exposure to adverse factors of sulfuric acid manufacture contributed to the development of pathological changes in the prostate.

Effect of esophagoplasty on structural reorganization of colon transplant.

We studied ultrastructural reorganization of the colon transplant in delayed period after esophagoplasty. It was found that during functioning of the artificial esophagus, a complex of adaptive and pathologic processes occurs in the mucosa. Focal sclerosis of the mucosa and slight epithelial degeneration with hyperplasia and hypersecretion of goblet cells were found in biopsy specimens with stenosis of the anastomosis. In case of colonopathy of the transplant, more pronounced epithelial degeneration and proliferation accompanied by abundant polymorphocellular stromal infiltration were seen. Deformation of the transplant was characterized by progressive atrophic and sclerotic reorganization of the mucosa. Goblet cells with ultrastructural signs of hypersecretion predominated in the population of epithelial cells of the colon transplant; oligomucus and poorly differentiated cell and colonocytes with signs of alteration and degenerative changes in cytoplasmic organelles were also found.

Ultrastructural study of cell populations in the gastric transplant after esophagoplasty.

Ultrastructural characteristics of cell populations in the gastric tube mucosa were studied after plastic surgery for benign esophageal disease. The foveolar epithelium mainly consisted of secretory active mucocytes with small changes in cytoplasmic organelles. Functionally immature parietal cells and gland cells in the epithelium of fundal glands were characterized by atrophy and degeneration. Ultrastructural features of the epithelial compartment attest to adaptive cellular hypersecretion of the mucoid against the background of impaired acid production and enzyme secretion. The stromal compartment was characterized by low pinocytotic activity of endothelial cells in blood vessels and polymorphism of smooth muscle cells. Hypertrophic leiomyocytes were shown to dominate in the population of these cells. Some cells had signs of biosynthesis and reduction of filaments. Single leiomyocytes were degenerated. The observed ultrastructural modification of epithelial and connective cells can be interpreted as structural adaptation of the gastric transplant.

Effect of esophagoplasty on the mucosa structure in the gastric transplant.

Structural modifications of the gastric tube transplant were studied during the delayed period after esophagoplasty carried out for benign diseases of the esophagus. Adaptive and pathological reactions manifesting in atrophic and sclerotic changes in the mucosa formed the basis for transplant reorganization. The leading morphological markers were degeneration and hypersecretion of the foveolar epithelium, focal atrophy of the fundal glands with foci of pyloric metaplasia, hypertrophy and fibrosis of the muscle plate, and stromal sclerosis. Abundant polymorphonuclear infiltration of the mucosa with lymphoid follicular hyperplasia were observed in H. pylori contamination of the gastric transplant.

Structural and functional modification of hollow organs (urinary bladder and stomach) in vibration syndrome.

Exposure to total and local vibration leads to the formation of specific forms of hollow organ diseases: vibration cystopathy and gastropathy. Their characteristic signs are organ dysfunction, thinned wall, atrophy of the mucosa, reduction of the capillary bed, and degenerative atrophic changes in the epithelium, associated with reduction of the protein-producing function and focal metaplasia. Vibration cysto- and gastropathies are systemic manifestations of microangio- and visceropathies of vibration origin.

Structural and functional changes in gastric epithelium in Helicobacter pylori-associated chronic gastroduodenal pathologies.

Complex structural analysis of the gastric mucosa was carried out in patients with Helicobacter pylori-associated chronic gastroduodenal ulcers, chronic gastritis, and vibration gastropathy. Microscopic examination showed stereotypical changes in the epithelium in all diseases: degeneration, focal intestinal metaplasia, dysplasia, and glandular atrophy. The severity of these changes depended on the disease entity. The most typical ultrastructural modifications of epitheliocytes were damage to the apical plasmalemma, heterogeneity of the secretory compartment of the cytoplasm, dilatation of the cytoplasmic reticulum, vacuolation, and signs of cytolysis. Plastic reactions of the gastric epithelium reflected disproportional changes in all cell metabolites caused by increased proliferative activity of the epithelium under conditions of uneven inhibition of intracellular protein synthesis.

Ultrastructural characteristics of cell populations in the gastric and duodenal mucosa during psoriasis.

In biopsy specimens of the gastric and duodenal mucosa from patients with psoriasis we revealed severe degenerative and dystrophic changes in cells of the surface and glandular epithelium with destruction of functionally important cytoplasmic organelles. The stroma of the gastric mucosa was characterized by hyperplasia of the lymphoid tissue, formation of numerous lymphoid follicles, and destruction of the endothelium in microvessels. These changes are interpreted as the syndrome of regenerative and plastic insufficiency.

Psoriasis concomitant with chronic opisthorchiasis: ultrastructural changes in cell populations of gastroduodenal mucosa.

Pathological changes based on degeneration of epithelial structures predominantly with preserved typical cell differentiation, but with unstable epithelial secretory function were detected in biopsy specimens of gastroduodenal mucosa from patients with psoriasis associated with chronic opisthorchiasis. The progress of the disease led to atrophy of glandular components and augmented stromal sclerosis. The compensatory adaptive reactions were realized via hyperplasia and hyperfunction of preserved glandulocytes, appearance of mix-cells with polypotent secretory cycle, and high functional activity of capillaries.

Pathomorphological and biosynthetic changes in gastric epithelium during chronic duodenal ulcer.

We studied structural changes and biosynthetic processes in the gastric epithelium in patients with chronic duodenal ulcer. The severity of alterative ultrastructural changes in surface epithelial and glandular cells progressively increased from proximal to distal portion of the stomach. Biosynthesis of nucleic acids within the epithelium depended on the morphofunctional state of epitheliocytes. DNA biosynthesis in the fundus was less intensive. The intensity of RNA synthesis did not differ between various gastric regions. Our results suggest that structural and metabolic dimorphism of the fundic and pyloric epithelium underlies pathological changes in the mucosa during ulcer disease.

[Clinical endoscopic and pathomorphologic study of the stomach in vibration disease]. / Kliniko-éndoskopicheskie i patomorfologicheskie issledovaniia zheludka pri vibratsionnoi bolezni.

The authors present results of manifold evaluation of stomach in 109 patients with vibration disease caused by various vibration characteristics. The evaluation covered clinical signs, laboratory studies, endoscopic and pathomorphologic methods with light and electronic microscopy, in vitro radioautography and morphostereologic analysis. Features of gastric disease in vibration disease are asymptomatic course, depressed gastric secretion, prevalent atrophic changes of mucosa on endoscopy. Morphologic analysis of gastric biopsies revealed marked dystrophy and atrophy of the lining, glandular atrophy, diffuse stromal sclerosis and in most cases no signs of gastritis. The findings are termed vibration gastropathy.