THE ROLE OF GROWTH FACTORS IN THE FORMATION AND PROGRESSION OF PTERYGIUM

Purpose. To determine a role of epidermal growth factors and vasal proliferative proteins in the pathogenesis of progressive pterygium based on data of immunohistochemical and morphological studies of tissues.Material and methods. The study included a main group of patients with primary pterygium of the progressive stage III-IV (30 eyes, 28 patients), the mean age was 57±7 years. The surgical procedure the pterygium removal was performed according to the Cermak method in all cases for therapeutic purposes and for a further morphological and immunohistochemical study of pterygium tissue. The clinical assessment of postoperative condition was carried out in the early postoperative period and in 6 and 12 months after surgery. The immunohistochemical study was made with the use of monoclonal antibodies and the visualization system (the DAKO company, Denmark): CD 31 (clone JC70A), CD 34 ClassII (clone QBEnd 10), Vascular Endothelial Growth Factor VEGF (clone VG1), Epidermal growth factor EGF (clone DAK-H1-WT). The intensity of coloration of objects was estimated by colorimetric index on a 4-point scale and reflected the quantity of the studied factors. For histological examination the removed pterygium with the tissues of the cornea and conjunctiva was stained with hematoxylin-eosin with a subsequent analysis and a micro-photographing.Results and discussion. The pterygium concerning the structure and function is characterized by an impaired homeostasis of the tissues of the conjunctiva and cornea, expressed in a change of epithelial-stromal relations, disorganization of the fibrous structures of connective tissue, violations in the microcirculatory bed. As a result of the immunohystochemical research, the expression of growth factors was identified in all cases of main group. The expression of epidermal factor was diagnosed in 27 objects with the index (++) and 3 objects with the index of (+). The CD31 expression was revealed: ++++ in 28 objects, in 1 object +++, and in 1 object ++. CD34 expression was revealed: ++++ in 26 objects, in 4 objects ++. The VEGF expression was revealed: ++++ in all 30 objects. In the control group the above-described changes were not revealed, that is the expression of epidermal and vascular growth factors were determined.Conclusion. Thus, the analysis of the peculiarities of growth of the conjunctive epithelium, angioarchitectonique in the tissues of the pterygium and underlying cornea allows assuming that the starting factor of the pathological process is the primary growth of conjunctive epithelium with the accompanying growth of vasculature. The expressive level of epidermal and vasoproliferative growth factors in pterygium can serve as a prognostic sign of pterigium recurrence. The identification of VEGF expression can be a condition on the use of anti-VEGF therapy in the prevention of recurrence

Proliferative activity of salivary tumor cells

Salivary carcinomas comprise 2-3 % of malignant tumors of the head and neck. The basic method of morphological study in early diagnostics is aspiration puncture with a fine needle (FNAB). Complex histologic structure and great diversity of morphological items complicate cytologic diagnostics of salivary tumors considerably. Immunocytochemical examination must be used to reduce the errors, it enables to reveal neoplastic cells at early stages of malignization. High proliferative activity of tumor cells is one of their biological peculiarities. Accuracy in differential diagnostics between benign and malignant tumors is improved through determination of mitotic index combined with a fine needle aspiration puncture

Autotransplantation of the kidney in surgery of retroperitoneal sarcomas

The paper presents the analysis of 5 clinical cases that demonstrate the potential of using organ-saving technologies in surgery of locally advanced retroperitoneal sarcomas. The clinical example shows step by step the technique of organ-preserving surgical intervention: an extended tumour nephrectomy followed by the extracorporeal precise dissection of the kidney from the tumor bulk with inducing a reversible pharmaco-cold ischemia and the isolated kidney autotransplantation into a heterotopic position with regard to intraoperative rapid cytology monitoring results. The article describes the characteristics of anesthesia, the early postoperative period, subsequent rehabilitation, and prophylactic medical screening of this group of patients

ЭПИДЕМИОЛОГИЯ ЗЛОКАЧЕСТВЕННЫХ ЛИМФОМ В РЕГИОНЕ С ВЫСОКОЙ ПРЕВАЛЕНТНОСТЬЮ ВИЧ-ИНФЕКЦИИ

A retrospective review of the incidence of malignant lymphomas in Irkutsk Region (Russia) during the period when the rate of accumulation of HIV cases in population was high (2001-2004) and a cohort study comparing the incidences of lymphomas among HIV patients and the general population are presented. After HIV epidemic started in 1999, HIV prevalence reached 1,4% in 2014. Starting from 2005, an increase in mortality attributed to non-Hodgkin lymphomas was registered, especially among men, which was associated with a decrease in mortality attributed to Hodgkin lymphomas. These changes correlated with HIV prevalence (r=0,96 and r=-0,90, respectively). The relative risk of NHL in HIV patient cohort increased from 2,1 to 25,1 in 2007-2012. A randomized case-control study suggests a higher risk of Burkitt’s lymphoma among HIV patients compared with the rest of population (OR=5,8).Проведено ретроспективное описание заболеваемости и смертности от злокачественных лимфом в Иркутской области (Россия) в период интенсивного накопления в популяции больных ВИЧ-инфекцией (2001-2014 гг.) и групповое исследование для сравнения заболеваемости лимфомами среди больных с ВИЧ-инфекцией и остальной части населения. После начала эпидемии в 1999 г. превалентность ВИЧ-инфекции в 2014 г. достигла 1,4%. Начиная с 2005 г., зарегистрирован рост смертности от неходжкинских лимфом (особенно мужчин) и снижение смертности от лимфомы Ходжкина что коррелировало с превалентностью ВИЧ-инфекции (r=0,96 и r=-0,90, соответственно при p<0,0001) Относительный риск (RR) заболевания НХЛ в когорте больных c ВИЧ-инфекцией за 2007-2012 гг. увеличился с 2,1 до 25,1. Рандомизированное исследование случай контроль выявило более высокие шансы заболевания лимфомой Беркитта больных ВИЧ-инфекцией в сравнении с остальной частью населения OR=5,8)