Влияние Trichinella spiralis на структуру и иммуногистохимические показатели тканей экспериментальной глиомы и некоторых органов крыс

TRICHINELLA SPIRALISГЛИОМАГЛИАЛЬНЫХ КЛЕТОК ОПУХОЛИГЛИОМА ЗЛОКАЧЕСТВЕННАЯИММУНОГИСТОХИМИЯИММУННОГО ПОЗОЛОЧЕНИЯ И СЕРЕБРЕНИЯ МЕТОДИММУННОЙ МЕТКИ МЕТОДЫИММУНОГИСТОЦИТОХИМИЯKI-67 АНТИГЕНMIB-1 АНТИГЕНМОДЕЛИ НА ЖИВОТНЫХМОДЕЛИ НА ЛАБОРАТОРНЫХ ЖИВОТНЫХМОДЕЛИ НА ЭКСПЕРИМЕНТАЛЬНЫХ ЖИВОТНЫХКРЫСЫ ЛИНИИ WISTARКРЫСЫ ЛИНИИ ВИСТАРЦель – установить влияние инвазии Trichinella spiralis в дозе заражения 10 личинок на 1 г массы тела животного на иммуногистохимические показатели в тканях экспериментальной глиомы крыс в различные сроки наблюдения. В эксперименте использовали самок крыс линии Wistar. У животных первой серии эксперимента (1-4 группы) воспроизводили экспериментальную модель развития крысиной глиомы С6 in situ. Крыс второй серии эксперимента (5-8 группы) с моделированной крысиной глиомой заражали T. spiralis в дозе 10 личинок на 1 г массы тела животного. У животных всех групп на 14-е, 21-е, 28-е, 35-е сутки развития опухоли в опухолевом материале проводили макроскопическое, гистологическое и иммуногистохимическое исследования (определялась экспрессия GFAP – glial fibrillary acidic protein, S 100, вычислялся индекс пролиферативной активности Ki-67). Установлено, что инвазия T. spiralis в дозе 10 личинок на 1 г массы тела животного повышает экспрессию GFAP в биоптатах опухолевой ткани крысиной глиомы С6 in situ к 21-м и 28-м суткам после заражения в 3,08 и 3,8 раза соответственно; экспрессию S 100 к 7-м суткам развития инвазии в 3 раза, к 14-м – в 2,64 раза, к 21-м суткам после заражения – в 3,07 раза, к 28-м суткам – в 4,9 раза; индекс пролиферативной активности Ki 67 к 7-м суткам развития инвазии в 2,02 раза, к 14-м – в 1,69 раза, к 21-м суткам после заражения – в 3 раза, а к 28-м суткам – в 4,3 раза. Обнаружены метастатические очаги глиомы в легких крыс на 28 сутки развития трихинелл. В образцах ткани легких экспрессия GFAP к 28-м суткам оценивалась в 1+ (11%; 95% ДИ : 110,21Objectives. To determine the influence of Trichinella spiralis invasion in the dose of 10 larvae per 1 g of animal body weight on immunohistochemical parameters in the tissues of experimental glioma of rats in different periods of observation. Material and methods. Female rats of the Wistar line were used in the experiment. In animals of the first series of the experiment (groups 1-4) the experimental model of C6 rat glioma development in situ was simulated. Rats of the second series of the experiment (groups 5-8) with modelled rat glioma were infected with T. spiralis in the dose of 10 larvae per 1 g of animal body weight. In animals of all groups on the 14th, 21st, 28th, 35th days of tumor development in tumor material macroscopic, histological and immunohistochemical studies were performed (glial fibrillar acid protein (GFAP), S 100 expression were determined, Ki-67 proliferative activity index was calculated). Results. It has been found that the invasion of T. spiralis in the dose of 10 larvae per 1 g of animal body weight 3.08 and 3.8 times respectively increases GFAP expression in bioptates of tumor tissue of rat glioma C6 in situ by the 21st and the 28th days after infection; the expression of S 100 by the 7th day of invasion development – 3 times, by the 14th day of invasion – 2.64 times, by the 21st day after infection – 3.07 times, by the 28th day – 4.9 times; the index of proliferative activity Ki 67 by the 7th day of the invasion – 2.02 times, by the 14th day – 1.69 times, by the 21st day after infection – 3 times, and by the 28th day – 4.3 times. Metastatic foci of low-grade glioma have been revealed in the lungs of rats on the 28th day of Trichinella development. In lung tissue samples, GFAP expression by the 28th day was estimated to be 1+ (11%; 95% CI : 110.21-139.88; IRS=4). The expression of S 100 in the same samples was at the level of 1+ (15%; 95% CI : 123.27-132.12; IRS=4), and proliferative activity of the tumor (Ki-67) made up 40% (95% CI : 299.44-455.68). The expression of proteins S 100, GFAP, proliferative activity index Ki-67 in animals infected with T. spiralis was significantly higher than that in the groups with "pure" glioma in almost all periods of observation. On the 28th day after infection (35th the day of glioma growth) metastatic foci of glioma were found in the lungs

Intracranial Compliance and Secondary Brain Damage. Experimental and Clinical Studies in Traumatic Head Injury

Traumatic brain injury (TBI) renders the brain more vulnerable to secondary insults. The increased vulnerability can probably be explained by a combination of disturbances in hemodynamics, metabolism and craniospinal dynamics. Reduced ability to compensate for added intracranial volume, i.e. reduced intracranial compliance (IC), is one possible mechanism. The aim of this thesis was to study the role of IC on the effect of secondary insults after TBI. A rat TBI model was developed where IC could be altered without causing pathological increases in intracranial pressure (ICP). Reduction of IC was made by placing rubber film between the dura mater and bilateral bone flaps. A reduction of IC in terms of reduced Pressure Volume Index was confirmed. Microdialysis (MD) of extracellular fluid was used to monitor neurochemical changes. Reduced IC after TBI proved to increase the vulnerability of the brain to secondary intracranial volume insults according to neurochemical microdialysis markers. Reduced IC or intracranial volume insults alone did not cause any metabolic changes as compared to controls. Moderate posttraumatic hypotension (50mmHg for 30 min) induced 2 hrs after TBI, did not aggravate posttraumatic extracellular neurochemical changes significantly, irrespective of the level of IC. Although controversial, a mild to moderate hypotensive insult after initial posttraumatic stabilization may not be as detrimental as earlier believed. The Spiegelberg Compliance Monitor and MD were simultaneously used in 10 TBI patients to get an impression of the clinical value of IC monitoring and the relationship between IC, temperature and MD Lactate/Pyruvate ratio. IC and MD could be monitored simultaneously in TBI patients. Higher L/P ratios were seen when IC was low. Patients with induced coma treatment had significantly higher average L/P ratios, possibly due to their poorer neurological condition. An indication was also found that in TBI patients with high temperatures, L/P ratio rose as IC decreased, but in patients with low temperature there was no effect of IC on L/P ratio. These data suggest the importance of avoiding hyperthermia in TBI patients, especially in patients with low or decreased IC (monitored or anticipated)

Blood Loss in Surgery for Aggressive Vertebral Haemangioma with and without Embolisation

Despite their benign nature some symptomatic aggressive vertebral haemangiomas (AVH) require surgery to decompress spinal cord and/or stabilise pathological fractures. Preoperative embolisation may reduce the considerable blood loss during surgical decompression. This systematic review investigated whether preoperative embolisation reduced surgical blood loss during treatment of symptomatic AVH. PubMed Medline, Web of Science, and Ovid Medline were searched for case reports and clinical studies on surgical AVH treatment. Included were cases from all publications on surgical treatment of AVH where the amount of surgical blood loss and the use of preoperative embolisation were documented. 51 cases with surgically treated AVH were retrieved from the included studies. Blood loss in the embolised treatment group (980±683 mL) was lower than the non-embolised control group (1,629±946 mL). This systematic review found that embolisation prior to AVH resection reduced surgical blood loss (level of evidence, very low) and can be recommended (strong recommendation)

Management of symptomatic sacral perineural cysts with microsurgery and a vascularized fasciocutaneous flap

Background: The optimal treatment of symptomatic perineural (Tarlov) cysts is controversial. Numerous surgical techniques have been proposed with conflicting results. A series of Tarlov cysts treated with a novel surgical approach is presented.Methods: Patients with surgically treated symptomatic perineural cysts during 2013-2016 were included. The main indications for surgery were persistent radicular symptoms, pelvic pain, urinary and/ or bowel disturbances. At surgery, the cyst was opened and fenestrated. The cyst wall was then closed with packing, fibrin glue and a pedicled vascularized fasciocutaneous flap rotated into the area for obliteration of the dead space. Patients were followed-up with clinical visits and repeat magnetic resonance imaging (MRI) scans.Results: Seven consecutive patients were included. The mean age was 50.3 years (range, 25-80 years) and the mean duration of symptoms was 49.3 months (range, 3-130 months). With one exception, all patients had urine and/or bowel problems (incontinence) preoperatively. A lumbar drain was inserted in five patients. The mean follow-up period was 15.4 months. Symptoms improved in 4/7 patients, in two cases no clinical difference was noted while one patient deteriorated. In two cases, a spinal cord stimulator was eventually implanted. In all seven cases, a significantly decreased cyst size was noted on MRI.Conclusions: Cyst fenestration and the use of a vascularized fasciocutaneous flap successfully obliterated all cysts, with satisfactory clinical efficacy. Larger and comparative studies are warranted to clarify the long-term effects of this surgical technique in patients with symptomatic Tarlov cysts

Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration

Background Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients. Objective We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms. Methods We prospectively enrolled 12 patients with spinal cord tethering and measured glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and phosphorylated Neurofilament-heavy (pNF-H) in CSF and blood. Seven patients with benign lumbar intradural tumors and 7 patients with cervical radiculopathy without spinal cord involvement served as controls. Results All evaluated biomarker levels were markedly higher in CSF than in plasma, without any correlation between the two compartments. When compared with radiculopathy controls, CSF GFAP and pNF-H levels were higher in patients with spinal cord tethering (p <= 0.05). In contrast, CSF UCH-L1 levels were not altered in chronic SCI patients when compared with either control groups. Conclusions The present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration