Panniculitis as a manifestation of metal-associated autoimmune/inflammatory syndrome induced by adjuvants: a case-based review.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is associated with a hyperergic response of the immune system. The spectrum of clinical changes in ASIA is extensive and difficult to diagnose. Panniculitis is a heterogeneous group of diseases characterized by lesions of the adipose tissue. Panniculitis may become one of the signs of ASIA progress.To describe the clinical signs and morphological changes in the subcutaneous fat as a manifestation of ASIA, developing after osteosynthesis with metal structures.In this case-based review, were searched for all articles published in PubMed and Scopus databases until March, 2021 using the following keywords "panniculitis", "erythema nodosum", "Weber-Christian Disease", "idiopathic lobular panniculitis", "Autoimmune/inflammatory syndrome induced by adjuvants", "Shoenfeld's syndrome", "metal allergy" "metal implants", "metal hypersensitivity" and reviewed them. Irrelevant items and duplicates were excluded.We report a case of an adult female patient presenting with a non-healing uninfected surgical wound following implantation of metal osteosynthesis construction and panniculitis developed after surgery. A comprehensive examination of the patient to check for ASIA was conducted. Considering the medical history of exposure to metals, tissue lesions, arthralgia, myalgia, low-grade fever, the disappearance of symptoms on the background of immunosuppressive therapy suggested the diagnosis of ASIA.Report affords clinicians and pathologists additional insight into the clinical and morphological picture of ASIA-associated panniculitis which, if remain unidentified, may cause severe complications. We recommend the removal of constructions with adjuvant activity in patients with suspected ASIA-associated manifestations.

Activation of oxygen molecules by 1070 nm laser radiation in aerated solvents.

Population of the chemically active singlet 1Δg(0) state of molecular oxygen occurring due to direct laser excitation of the 1Δg(1)←3Σg-(0) transition has been observed for the first time, to the best of our knowledge, in oxygen molecules dissolved in organic solvents saturated with air under natural conditions (room temperature and normal atmospheric pressure). The data were obtained in 1 cm spectrophotometric cells due to the application of a set of high-power IR fiber and diode lasers. The rate of laser generation of the singlet (1Δg(0)) states in oxygen molecules was monitored by a chemical trapping method. It was found that the action spectra of singlet oxygen generation have one distinct band with a maximum at 1070 nm and half-width of ∼10nm. The absorption coefficients at 1070 nm were shown to be 100-110-fold lower than those at the main oxygen absorption peak (1273 nm) corresponding to the 1Δg(0)←3Σg-(0) transition. Under excitation at 810-1061 nm, very low trapping rates were observed, which did not depend on excitation wavelengths being probably caused by thermal effects. There was no reliable increase in the trapping rate under irradiation at 810 and 920 nm corresponding to the 1Δg(2,3)←3Σg-(0) transitions. This fact suggests that absorbance corresponding to these transitions is much lower than that at 1070 nm. The obtained results are important for both spectroscopy of oxygen and mechanistic studies of biological and therapeutic action of laser radiation.

[Panniculitis in modern rheumatology].

AIM: To study clinical and laboratory features of panniculitis (Pn) in modern rheumatology. MATERIALS AND METHODS: The study included 690 patients with Pn (615 women and 75 men, average age 39.410.26) with the prevailing referral diagnosis of Erythema nodosum (59.2%), Pn (27.5%), Rheumatic disease Rd (9%), other diseases (4.4%),who had been on outpatient and/or inpatient treatment for 10 years. All patients were examined according to our diagnostic algorithm: general clinical, immunological and histological examinations, computed tomography of the chest organs, tuberculin tests. RESULTS: Pn with Rd was diagnosed in 140 patients (118 women and 22 men, average age 40.2114.87), average disease duration 31.06 [0.1; 541] months. In most cases (49%) patients had idiopathic lobular Pn which belongs to the group of systematic lesions of connective tissue (M35.6), as well as systemic lupus erythematosus and Behcet disease (13% each), rheumatoid arthritis (8%), dermatomyositis (6.4%), etc. Matching of the referral and final diagnoses was 35% in case of Rd. Among the examined patients prevailed those with a moderate (51.07%) degree of activity of the underlying disease. Within the study group Pn was represented by all forms, but mainly by nodular form (64.02%). Mesenteric form was characteristic only for idiopathic lobular Pn. The main features of Pn associated with Rd were identified. In modern clinical practice the type of Pn and the activity of the underlying disease determine the approaches to treatment.

Spatial beam self-cleaning and supercontinuum generation with Yb-doped multimode graded-index fiber taper based on accelerating self-imaging and dissipative landscape.

We experimentally demonstrate spatial beam self-cleaning and supercontinuum generation in a tapered Ytterbium-doped multimode optical fiber with parabolic core refractive index profile when 1064 nm pulsed beams propagate from wider (122 µm) into smaller (37 µm) diameter. In the passive mode, increasing the input beam peak power above 20 kW leads to a bell-shaped output beam profile. In the active configuration, gain from the pump laser diode permits to combine beam self-cleaning with supercontinuum generation between 520-2600 nm. By taper cut-back, we observed that the dissipative landscape, i.e., a non-monotonic variation of the average beam power along the MMF, leads to modal transitions of self-cleaned beams along the taper length.

[Idiopathic lobular panniculitis: clinical and morphological correlations]. / Idiopaticheskii lobuliarnyi pannikulit: kliniko-morfologicheskie korreliatsii.

Panniculitis is a heterogeneous group of diseases that are characterized by a subcutaneous adipose tissue (SAT) lesion and frequently occur with involvement of the musculoskeletal system and viscera in the process. This is a chronic multiple organ disease. The gold standard for its diagnosis is noted to be a morphological study. The paper presents the current classification of panniculitis. OBJECTIVE: To study the morphological features of idiopathic lobular panniculitis (ILP) in accordance with the nature of the course and clinical forms of the disease. SUBJECT AND METHODS: Biopsy specimens were studied in 62 patients with various clinical forms of ILP. Biopsy and surgical materials were investigated by light optical morphological methods. The results were statistically processed using a statistical analysis software Statistica Version 10 package for Windows ('StatSoft Inc.', USA). The differences were considered statistically significant at an error level of p<0.05. Methods, such as Pearson's c2 test (analysis of contingency tables), Student's t-test, Z-test for comparison of proportions, nonparametric tests, such as Mann-Whitney U-test, Kruskal-Wallis test, were used to assess the results. RESULTS: The nature of the morphological parameters of the disease corresponded to the course of ILP. The acute course of the disease was characterized by the predominance of liponecrosis and inflammation concurrent with productive-destructive vasculitis. In the chronic course, there was a preponderance of lymphohistiocytic infiltrate with gigantic macrophages (lipophages) and granuloma-like structures. The above morphological changes were characteristic of the phagocytic morphological stage of node formation. The fibroplastic stage of panniculitis was absent in this study. The morphological features of the disease were shown depending on the form of idiopathic lobular panniculitis, which may be of diagnostic value in the differential diagnosis of panniculitis. CONCLUSION: The pathologist must first of all pay attention to the preferential localization of pathological changes (in the SAT septa or slices), the presence or absence of vasculitis and the nature of the infiltrate. The skin in panniculitis is typically intact or has minimal changes following the pattern seen in reactive ones. Panniculitis shows an undulatory course, and therefore all signs of this disease are present in biopsy specimens; however, morphological signs of the acute inflammatory, lipophagic or fibroplastic stage of the disease predominate depending on the stage and activity of the process.

Distributed Bragg reflector fiber laser directly written in a composite fiber manufactured by melting phosphate glass in a silica tube.

We demonstrate a single-frequency distributed Bragg reflector (DBR) fiber laser based on the novel erbium-doped composite fiber fabricated by melting phosphate glass in a silica tube. The fabricated composite fiber was single-mode at the wavelength of 1.55 µm; the measured cutoff wavelength was 1.4 µm. The composite fiber was photosensitive to irradiation at the wavelength of 193 nm. Using the phase mask method, the DBR fiber laser cavity with the total length of 21 mm was inscribed directly into the erbium-doped composite fiber. A stable single-frequency regime of the fabricated DBR laser at the wavelength of 1565 nm is demonstrated.

High-energy femtosecond pulse shaping, compression, and contrast enhancement using multicore fiber.

Nonlinear spatiotemporal dynamics of femtosecond pulses in a hexagonal seven-core silica fiber pumped by a sub-µJ 370 fs Er:fiber chirped pulse amplification (CPA) system were studied. Nonlinear pulse shaping and compression in the central core and pedestal coupling to the outer cores were directly measured by frequency-resolved optical gating. Further compression of the pulses spectrally broadened in the multicore fiber down to 53 fs was demonstrated. Two orders of magnitude contrast enhancement of the pulses after compression was observed.

[Idiopatic Lobular Panniculitis as a common clinical problem].

AIM: To present clinical and laboratory characteristics of various forms of idiopatic lobular panniculitis (ILP) in modern rheumatology practice. MATERIALS AND METHODS: The study included 67 people (58 women and 9 men aged 20 to 76) with the referral diagnosis of "Erythema nodosa? Undifferentiated panniculitis?" in 76.2% of cases with a median disease duration of 78.91 [48; 540] months observed in the V.A. Nasonova Research Institute of Rheumatology. In 2007-2017 in addition to general clinical examination immunological, histological and immunohistochemical studies, computed tomography (CT) of the chest organs and tuberculin tests were performed. RESULTS: Analysis of clinical manifestations allowed to distinguish four forms of ILP: nodular (n=30), plaque (n=10), infiltrative (n=15) and mesentric (n=12). The minimum median duration of the disease was detected in plaque form (8 [5; 11.5] months), while the median duration in case of infitrative form was 8.25 times longer (66 [36; 102] months, p38 °C and a small number (up to 5) of drain nodes; infiltrative - fever >38 °C, ulceration of nodes with the expiration of oily mass and scarring; mesenteric - pain in the abdominal area, the number of nodes less than 5 and the abdominal cavity CT results (inflammation of the adiopose tissue of the intestinal mesentery, omentum, adipose tissue of the pre - and retroperitoneal areas). CONCLUSION: The forms and activity of the disease determine the approaches to treatment in modern clinical practice. There is an obvious need to expand knowledge about this pathology among doctors and conduct further research in order to timely diagnose and search for the most effective methods of ILP treatment.

[Scleromyxedema as a systemic disease of glycosaminoglycan accumulation]. / Skleromiksedema kak sistemnaia bolezn' nakopleniia glikozaminoglikanov.

Scleromyxedema is a rare mucinosis with a primary skin lesion due to diffuse mucin deposition, sclerosis, and lichenoid eruptions in the absence of hypothyroidism. The paper describes scleromyxedema cases and gives recommendations for the histological diagnosis of the disease by histochemical reactions to detect acid and neutral glycosaminoglycans.

Panniculitis in rheumatology: features of course and outcomes.

AIM: The study of the course and outcomes of panniculitis (PN) in modern rheumatology practice. MATERIALS AND METHODS: We observed 209 patients (pts) (f-185, m-24 in age 17 to 80 years) with the input diagnosis "Erythema nodosum? Undifferentiated panniculitis?" and duration of illness in from 1 week to 25 years, observed in V.A. Nasonova Research Institute of Rheumatology in 2009-2016 years. Along with the general clinical examination, serological, immunological histological and immunohistochemical studies, CT scan of the chest, Doppler (Doppler ultrasound) of the veins of the lower extremities, tuberculin tests and consultations with doctors of other specialties were conducted. Outcomes were assessed after 1-6 years. RESULTS: In 23 pts a secondary character of PN was identified and discovered non-rheumatic underlying disease. Of the remaining 186 cases, the most frequent were pts with erythema nodosum (EN) (n=121), lipodermatosclerosis (LDS) (n=38) and panniculitis of Weber-Christian (PWCh)(n=18). For EN average age (AA) amounted to 38.9±12.6 years, the nodes the nodes were located symmetrically in 93% of cases on all surfaces of the lower and upper extremities (LUE). For LDS AA of the pts was 54±13 years, 68% of the pts noted the increase in the average body mass index (BMI), 79% - showed signs of chronic venous insufficiency (CVI). In 60% of the pts the items were located asymmetrically, localized mainly in the medial (92%) of the surface of the tibia (s). For PWCh AA amounted to 48.4 ± 17.6 years, seals were located on all surfaces of LUE and in 14 cases - on the trunk. CONCLUSION: To clarify the nature of PN it is necessary to conduct a comprehensive survey. The EN is characterized by symmetric defeat of all surfaces LUE more common in people of young age. A distinctive feature of LDS is asymmetrical lesions of the lower extremities in patients with increased BMI and signs of CVI. For PWCh seals are often localized on the trunk.

[Subcutaneous panniculitis-like T-cell lymphoma: The authors' experience of diagnosis and treatment]. / Podkozhnaya pannikulitopodobnaya T-kletochnaya limfoma. Sobstvennyi opyt v diagnostike i lechenii.

The paper gives the data of clinical, histological, immunohistochemical, and molecular studies and the results of positron emission tomography in 3 cases of subcutaneous panniculitis-like T-cell lymphoma (SPTCL). It shows the high efficiency of a GEM-P regimen in the treatment of patients with SPTCL.

High-beam quality, high-efficiency laser based on fiber with heavily Yb(3+)-doped phosphate core and silica cladding.

We have fabricated and tested a composite fiber with an Yb(3+)-doped phosphate glass core and silica cladding. Oscillation with a slope efficiency of 74% was achieved using core pumping at 976 nm with fiber lengths of 48-90 mm in a simple laser configuration, where the cavity was formed by a high-reflectivity Bragg grating and the cleaved fiber end. The measured M(2) factors were as low as 1.05-1.22 even though the fiber was multimode at the lasing wavelength.

[Panniculitides in an internist's practice].

By panniculitides is meant a group of heterogeneous inflammatory diseases characterized by the involvement of subcutaneous adipose tissue. A diversity of their forms and variants of their course determines the need for careful patent examination to verify the diagnosis. The lecture gives a diagnostic algorithm and outlines principles in the differential diagnosis of panniculitides and its treatment approaches in current clinical practice.

Multicore fiber with rectangular cross-section.

We have fabricated, to our knowledge, the first rectangular cross-section multicore fiber with eight cores arranged in a line. We have shown that the rectangular cross-section remains practically unchanged during the fiber-drawing process. The heterogeneous version of the proposed fiber design could be beneficial for crosstalk reduction because of the low influence of fiber bends on crosstalk between neighboring cores.

Phosphate-core silica-clad Er/Yb-doped optical fiber and cladding pumped laser.

We present a composite optical fiber with a Er/Yb co-doped phosphate-glass core in a silica glass cladding as well as cladding pumped laser. The fabrication process, optical properties, and lasing parameters are described. The slope efficiency under 980 nm cladding pumping reached 39% with respect to the absorbed pump power and 28% with respect to the coupled pump power. Due to high doping level of the phosphate core optimal length was several times shorter than that of silica core fibers.

[Interferons and other cytokines in rheumatic diseases].

With the growth of rheumatic morbidity the spectrum of medicines for its management needs to be extended. Selected aspects of etiology and clinical course of rheumatic diseases are discussed with reference to prospects of their application for etiopathogenetic therapy.

Single-mode all-silica photonic bandgap fiber with 20-microm mode-field diameter.

An all-silica photonic bandgap fiber with a cladding index difference of approximately 2 % and diameter-to-pitch ratio (d/wedge) of 0.12 was fabricated and studied. To our knowledge, this is the first report on the properties of photonic bandgap fiber with such a small d/wedge. The fiber is single-mode in the fundamental bandgap. The mode field diameter in the 1000-1200 nm wavelength range is 19-20 microm. The minimum loss in the same range is 20 dB/km for a 30-cm bending diameter. In our opinion, all-silica photonic bandgap fiber can serve as a potential candidate for achieving single-mode propagation with a large mode area.

[Application of preparations--analogues of somatostatin in surgical pancreatology].

The experience of application of shortly acting and durably acting preparations--analogues of somatostatin in complex therapy of various pancreatic diseases was summarized. There was established similar efficacy of the preparations in blockade of the pancreatic external secretion and the various duration of their inhibiting influence on the blood flow. The trustworthy differences in the complications frequency and lethality while application of various preparations--analogues of somatostatin were not revealed.

[The splanchnic blood flow indices in the patients, suffering external pancreatic fistula, and their dynamics under the influence of sandostatin and somatulin according to the ultrasonographic duplex scanning data].

Hemodynamical effects of the somatostatin analogues were studied in the patients with external pancreatic fistula. There were examined 29 patients, using ultrasonographic duplex scanning, for investigation of the blood flow indices in a. mesenterica superior, truncus coeliacus and its branches, v. lienalis, v. portae and pancreatic intraorgan arteries. Initial indices of splanchnic blood flow were compared with such while administration of octreotide. The main splanchnic blood flow indices in patients, suffering external pancreatic fistula, did not differ from that in controls, the lowering of the pulsation and resistance indices was noted as well as enhancement of the vessels quantity in pancreatic surgical margin. Under the influence of somatostatin the quantity of visualized vessels had reduced, the pulsation and resistance indices increased, the blood flow velocity along a. mesenterica superior, a. lienalis and pancreatic intraorgan arteries lowered, causing reduction of the blood flow linear and volumetric velocity along v. mesenterica superior and vv. intrapancreatici. Inhibitory action of the preparation on splanchnic blood flow was maximal in terms from 6 till 24 h after its infusion and had lowered step by step during all the follow-up period.