The role of the anti-Müllerian hormone/anti-Müllerian hormone receptor type II signaling pathway in the eutopic and ectopic endometrium in patients with deep endometriosis: A cross-sectional study

Aim. To analyze the profile of anti-Mllerian hormone (AMH) and the expression level of the transmembrane AMH receptor type II (AMHRII) in the eutopic and ectopic endometrium of patients with deep infiltrative endometriosis (DIE). Materials and methods. A comparative analysis of AMHRII expression in epithelial and stromal cells of eutopic and ectopic endometrial samples and the level of serum AMH in patients of reproductive age with DIE (n=50) and tuboperitoneal infertility (n=9) was performed. Results. AMHRII expression in eutopic endometrial stromal cells of DIE patients was significantly higher compared to glandular cells in all study groups (p0.5). AMHRII expression was found to be significantly higher in glandular cells of the eutopic endometrium compared to the ectopic endometrium of pelvic peritoneal foci in DIE patients: 1.600.77 and 1.090.68 points, respectively (p=0.001). Conclusion. The inhibitory effect of AMH on cell proliferation and the proven expression of AMHRII by eutopic and ectopic endometrioid cells may indicate the role of AMH in the pathogenesis of endometriosis and endometriosis-associated infertility

Uterine leiomyosarcoma and disseminated peritoneal leiomyomatosis in the surgical treatment of uterine myoma: a retrospective analysis

Aim. To analyze the incidence and types of adverse outcomes and complications of laparoscopic myomectomies. Materials and methods. This work is a retrospective study based on data from the Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology. We analyzed 711 case histories of patients diagnosed with uterine myoma who received surgical treatment in the Department of Innovative Oncology and Gynecology from 2015 to 2019. The frequency of malignant neoplasms, verified by pathomorphological examination, and the characteristics of surgical interventions performed in these patients were comparatively evaluated. Results. Surgical interventions for uterine myoma are leading in gynecology due to the high prevalence of such disorders. Conservative myomectomy remains the "gold standard" in organ-sparing surgery. However, during surgeries for suspected benign neoplasms, there is a risk of morcellation of the malignant tumor, significantly worsening patient survival outcomes. In our study, the incidence of uterine leiomyosarcoma in suspected benign neoplasms was 0.98%. The probability of parasitic myomas or disseminated perineal leiomyomatosis after myomatous nodule morcellation is 0.19%. Conclusion. No reliable information about the malignant potential of the tumor and its proliferative activity can be obtained until a definitive pathomorphological examination. The above considerations warrant the routine use of prophylactic measures to prevent tumor cell dissemination

Reproducibility of cytological diagnoses in evaluating liquid cervical smears and immunocytochemical co-expression of p16/Ki-67 using manual and automatic methods

Aim. To assess the reproducibility of cytological diagnoses in evaluating liquid cervical smears and immunocytochemical co-expression of p16/Ki-67 using manual and automatic methods. Materials and methods. Cytological smears prepared using the liquid cytology method on the Becton Dickinson device (SurePath technology) were studied. An immunocytochemical study was carried out using a Ventana BenchMark Ultra automatic immunostainer with a commercial CINtec kit (determination of p16/Ki-67 co-expression). In total, 100 cytological slides (50 pairs of Pap-smears and immunocytochemical slides) were studied. The diagnostic kit was reviewed by five cytologists independently, and the cytologic slides were evaluated using four categories according to the Bethesda system (2014) and according to the categories of normal/abnormal. The co-expression of p16/Ki-67 was assessed per the manufacturer's recommendations (Roche) using the manual method (light microscope) and the automatic Vision Cyto Pap ICC system. Statistical processing of the results was performed using the SPSS software package version 26.0.0.0 with the calculation of the reproducibility indices of Cohen's kappa and Fleiss' kappa. Results. When assessing the reproducibility of four categories of cytological diagnoses according to the Bethesda system (2014), Cohen's kappa was 0.0480.265. The overall Fleiss' kappa between all cytologists was 0.103. When only two categories (normal/abnormal) were used, the reproducibility ranged from 0.058 to 0.377. When assessing the co-expression of p16 and Ki-67, Cohen's kappa reproducibility was from 0.196 to 0.574, while the overall Fleiss' kappa was 0.407. When comparing the evaluation results of each of the cytologists with the neural network, Cohen's kappa reproducibility ranged from 0.103 to 0.436. Conclusion. The reproducibility of cytological diagnoses according to the Bethesda system (2014) and two categories (normal/abnormal) based on the Pap smear study was low. Such results are primarily due to a large number of abnormal smears in the study. The immunocytochemical method has diagnosis reproducibility three times higher, indicating the need to measure the co-expression of p16 and Ki-67 to increase the sensitivity and specificity of the cytological method. Similar reproducibility when comparing the manual and automatic evaluation of the "double label" suggests that the neural network algorithm can currently help in decision support rather than replace the cytologist at the diagnostic stage

How can we treat vulvar carcinoma in pregnancy? A systematic review of the literature

According to our systematic literature review (PRISMA guidelines), only 37 vulvar squamous cell carcinomas (VSCCs) were diagnosed during pregnancy (age range: 17\u201341 years). The tumor size range was 0.3\u201315 cm. The treatment was performed after (14/37, 38%), before (10/37, 27%), or before\u2010and\u2010after delivery (11/37, 30%). We found that 21/37 (57%) cases were stage I, 2 II (5%), 11 III (30%), and 3 IVB (8%). HPV\u2010related features (condylomas/warts; HPV infection; high\u2010grade squamous intraepithelial lesion) were reported in 11/37 (30%) cases. We also found that 9/37 (24%) patients had inflammatory conditions (lichen sclerosus/planus, psoriasis, chronic dermatitis). The time\u2010to\u2010recurrence/progression (12/37, 32%) ranged from 0 to 36 (mean 9) months. Eight women died of disease (22%) 2.5\u201348 months after diagnosis, 2 (5%) were alive with disease, and 23 (62%) were disease\u2010free at the end of follow\u2010up. Pregnant patients must be followed\u2010up. Even if they are small, newly arising vulvar lesions should be biopsied, especially in women with risk factors (HPV, dermatosis, etc.). The treatment of VSCCs diagnosed in late third trimester might be delayed until postpartum. Elective cesarean section may prevent vulvar wound dehiscence. In the few reported cases, pregnancy/fetal outcomes seemed to not be affected by invasive treatments during pregnancy. However, clinicians must be careful; larger cohorts should define the best treatment. Definite guidelines are lacking, so a multidisciplinary approach and discussion with patients are mandatory

Serous papillary cystadenofibroma combined with extended external genital endometriosis

Ovarian cystadenofibroma (CAF) is a rare ovarian tumor originating both from epithelial and stromal components being, however, classified as epithelial tumors. CAF prevalence among all ovarian tumors does not exceed more than 1.7 %. CAFs are commonly asymptomatic, in extremely rare cases of large tumor or ovarian torsion pain sensation may be noted. External genital endometriosis (EGE) is a chronic gynecological disorder that occurs in women of reproductive age and cause infertility and pelvic pain. EGE prevalence comprises around 10 % in women of reproductive age, 20–50 % in women with infertility, and almost 90 % in women with chronic pelvic pain. Magnetic resonance imaging (MRI) is method of choice in diagnostics of such pathology due to the high natural soft tissue contrast and functional techniques such as diffusion-weighted images (DWI) and dynamic contrast enhancement (DCE). Surgery planning, necessity for systemic therapy or follow-up directly depend on imaging and diagnostic laparoscopy results. Here we present a clinical case of rarely combined serous papillary CAF with extended EGE accompanied with consequences of intra-tumoral hemorrhage. Case study demonstrates main visualization characteristics that provide correct differential diagnosis and exclude malignancy transformation

Difficulties in the differential diagnosis of tumors in the female reproductive system

Introduction. Most pelvic tumors originate from reproductive organs. Even using the up-to-date imaging techniques, radiologists experience difficulties in determining the source of the lesion since a wide range of tumors look similar to each other on the distorted backdrop of pelvic anatomy, large invasive formations, and an active inflammatory reaction of the pelvic peritoneum.Aim: to evaluate “pitfalls” in the preoperative noninvasive diagnosis of female pelvic tumors by applying the clinical diagnostic tools.Materials and methods. Four rare clinical cases were analyzed; all of them posed difficulties in interpreting the diagnostic examination due to their atypical characteristics. There were 2 cases of ovarian cancer, initially identified by an experienced team of radiologists as benign pelvic pathology. Also, there were fibroids with degeneration, marked proliferative activity, and a massive inflammatory reaction of the peritoneum – that was diagnosed as a malignant ovarian tumor. Tumor biopsies were examined using morphological and immunohistochemical methods (with the р16, Ki-67, p53, CD 117, S 100, CD 34 markers). Immunohistochemical (IHC) studies were performed with formalin-fixed paraffin materials using the avidin-biotin-peroxidase method. Antibodies to estrogen receptor (ER), progesterone receptor (PR), cytokeratin 7 (CK7), cytokeratin 20 (CK20) and Wilms tumor protein 1 (WT1) were also used.Results. A thorough analysis of the clinical picture and a joint multidisciplinary discussion (gynecologist, oncologist, radiologist, etc.) made it possible to avoid diagnostic errors.Conclusion. These observations demonstrate the difficulties of differential diagnosis between ovarian metastases of uterine cancer and primary multiple ovarian and uterine cancer, as well between leiomyosarcoma and uterine myoma with high mitotic activity. Obviously, the change in diagnosis calls for a change in the treatment strategy

Entomopathogenic activity of bacterial and viral strains from the bioresource collection “State Collection of Entomoacariphages and Microorganisms”

As a result of a series of experiments to study the entomopathogenic activity of bacteria and viruses from the “State Collection of Entomoacariphages and Microorganisms”, it was revealed that the large wax moth Galleria mellonella L. it is sensitive to new strains of bacteria and viruses. In the future, the strains can be used in the subsequent stages of screening of microorganisms that are promising as agents of biological pest control. The maximum biological efficacy on the fifth day against the tested insect was observed when using bacterial strains Bacillus spp. BZR 1159 (94.6%) and BZR 936 (95.0%) and a granulovirus strain of the codling moth (CpGV) BZR L-5 (100%). Larvae of G. mellonella L were susceptible to melanization in the process of infection with new bacterial and viral agents

Получение композиционных материалов на основе наночастиц серебра и водорастворимых полимеров и исследование их биологической активности

The chemical synthesis of silver nanoparticles in aqueous solutions of polyvinyl alcohol, carboxymethylcellulose and gelatin was performed. The prepared compositions were characterized by electron microscopy and UV-vis spectroscopy. It was shown that the structure of polymer significally influences on the size of silver particles and on the biological activity of the prepared compositions.Осуществлен химический синтез наночастиц серебра в водных растворах поливинилового спирта, карбоксиметилцеллюлозы и желатина. Полученные композиции охарактеризованы при помощи электронной микроскопии и оптической спектроскопии поглощения. Показано, что природа стабилизирующего полимера оказывает существенное влияние на размер образующихся частиц и биологическую активность полученных композиций

Clinical observation: giant uterine myoma. The tactic of surgical treatment and postoperative management

The article deals with the clinical case of a patient with giant uterine myoma. It presents the features of surgical intervention and postoperative management of the patient. In the publication, the authors discuss the issues concerning the scope of the surgery in patients with large and giant uterine myomas and prognosis of reproductive outcomes in this cohort of women

Assembly and Genome Annotation of Different Strains of Apple Fruit Moth Virus (<i>Cydia pomonella</i> granulovirus)

Cydia pomonella granulovirus is a natural pathogen for Cydia pomonella that is used as a biocontrol agent of insect populations. The study of granulovirus virulence is of particular interest since the development of resistance in natural populations of C. pomonella has been observed during the long-term use of the Mexican isolate CpGV. In our study, we present the genomes of 18 CpGV strains endemic to southern Russia and from Kazakhstan, as well as a strain included in the commercial preparation “Madex Twin”, which were sequenced and analyzed. We performed comparative genomic analysis using several tools. From comparisons at the level of genes and protein products that are involved in the infection process of virosis, synonymous and missense substitution variants have been identified. The average nucleotide identity has demonstrated a high similarity with other granulovirus genomes of different geographic origins. Whole-genome alignment of the 18 genomes relative to the reference revealed regions of low similarity. Analysis of gene repertoire variation has shown that BZR GV 4, BZR GV 6, and BZR GV L-7 strains have been the closest in gene content to the commercial “Madex Twin” strain. We have confirmed two deletions using read depth coverage data in regions lacking genes shown by homology analysis for granuloviruses BZR GV L-4 and BZR GV L-6; however, they are not related to the known genes causing viral pathogenicity. Thus, we have isolated novel CpGV strains and analyzed their potential as strains producing highly effective bioinsecticides against C. pomonella