[Surgery for mediastinal teratoma containing pancreatic tissue]. / Khirurgiya teratomy sredosteniya, soderzhashchei tkan' podzheludochnoi zhelezy.

Surgery for mediastinal tumors is still one of the most difficult in modern medicine. This is due to vital organs and various nature of tumors in this area. Teratomas are relatively rare among mediastinal tumors. However, they have certain features that is important for treatment strategy and management of possible complications. This can complicate diagnostic algorithm, exclude transthoracic biopsy and contribute to active surgical approach even for benign process. Oncogenesis of teratoma has its own characteristics. Tissues of different organs are always present in this tumor. Among these, pancreatic tissue inclusions are rare. A few data in the world literature on the treatment of such patients do not allow to develop a universally accepted algorithm of diagnosis and treatment. The authors present two patients with mediastinal teratoma. The second patient had teratoma with pancreatic tissue. The authors discuss the diagnostic algorithm for similar cases. A special attention is paid to description of possible complications throughout long-term follow-up period. Surgical aspects including the choice of access and local spread of process (adhesions in the area of surgical interest) are considered. The report on the treatment of two patients with rare mediastinal tumors containing pancreatic tissue will be useful for primary care physicians, thoracic surgeons, oncologists and morphologists.

[The morphological and molecular biological signs of impaired endometrial receptivity in infertility in women suffering from external genital endometriosis]. / Morfologicheskie i molekuliarno-biologicheskie priznaki narusheniia retseptivnosti éndometriia pri besplodii zhenshchin, stradaiushchikh naruzhnym genital'nym éndometriozom.

OBJECTIVE: To study endometrial receptivity in infertile women with external genital endometriosis (EGE). SUBJECTS AND METHODS: Clinical, morphological, immunohistochemical, and molecular genetic examinations of endometrial aspiration pipelle biopsy specimens obtained on days 22-24 of the menstrual cycle from 94 infertile women with endometriosis: 50 women with Stage I-II EGE and 44 women with ovarian endometrioid cysts (OEC). A control group consisted of 54 women with tubal peritoneal factor of infertility (TPFI) and a successful attempt at IVF. Hematoxylin and eosin-stained sections were found to contain a number of endometrial surface epithelial cells containing mature pinopods. The expression levels of leukemia inhibitory factor (LIF), HOXA-10, glycodelin A, avß3 integrin, estrogen receptors (ER) and progesterone receptors (PR), aromatase in the superficial epithelium, glandular epithelium and endometrial stroma were immunohistochemically revealed. Forty-four patients, including 17 with Stage I-II EGE and 27 with TPFI, showed mRNA expression levels of leukemia inhibitory factor receptor (LIFR), LIF, ER1, PgR, HOXA-10, and PTEN by real-time quantitative polymerase chain reaction (PCR) with a preliminary reverse transcription PCR assay. RESULTS: It was established that in the infertile women with Stage I-II EGE and those with OEC, endometrial receptivity was impaired, which was manifested by a decline in the number of superficial epithelial cells containing mature pinopods, as well as a decrease in the endometrial level of the key receptivity markers: αvß3 integrin, LIF, glycodelin A, and HOXA10 and increases in the synthesis of aromatase and in the imbalance of endometrial stromal expression of ER and PR detected by immunohistochemistry (IHC). Molecular genetic study showed lower mRNA expression levels of the HOXA-10, LIFR, and PgR genes, which confirms the data obtained by IHC.

[Morphological substrate and pathogenetic mechanisms of pelvic pain syndrome in endometriosis. Part II. Peripheral nerve tissue remodeling in the foci of endometriosis]. / Morfologicheskii substrat i patogeneticheskie mekhanizmy sindroma tazovoi boli pri endometrioze. Chast' II. Remodelirovanie perifericheskoi nervnoi tkani v ochagakh endometrioza.

UNLABELLED: Endometriosis (EM) is morphologically characterized by the development of extrauterine endometrioid heterotopies, the major clinical symptoms of which is chronic pelvic pain, which is a serious problem not only in modern gynecology, but also in public health as a whole. AIM: to investigate neurogenic markers in the foci of EM of various sites and histological structure in women with and without pain syndrome. MATERIAL AND METHODS: The investigation was performed using the operative material (resected segments of the intestine, bladder, rectovaginal septum, and small pelvic peritoneum) obtained from 52 women with an intraoperative and morphologically verified diagnosis of EM and (Group 1) and without (Group 2) pain syndrome. Immunohistochemical examination was made on paraffin-embedded tissue sections in accordance with the standard protocols, by using the antibodies: 1) anti-PGP 9.5 polyclonal rabbit antibodies; 2) mouse anti-human neurofilament (NF) protein monoclonal antibodies (Clone 2F1); 3) mouse anti-nerve growth factor (NGF) monoclonal antibodies; 4) monoclonal mouse anti-human NGF receptor p75 (NGFRp75) antibodies (Dako, Denmark). RESULTS: Our findings demonstrate differences in the expression of PGP 9.5, NFs, NGF, and NGFRp75 in the foci and adjacent tissue in painful and painless EM irrespective of the locations of heterotopies. CONCLUSION: The found molecular features are a manifestation of the remodeling of nerve fibers and nerve endings in the foci of EM and PGP9.5, NGF, and NGFRp75 give rise to nerve fiber neoformation and pain syndrome in EM. At the same time, the immunohistochemical phenotype of EM foci does not depend on their site and reflects the presence or absence of pain syndrome.

[The morphological substrate and pathogenetic mechanisms of pelvic pain syndrome in endometriosis].

OBJECTION: To study the origin and morphological substrate of pain syndrome in deep infiltrating endometriosis involving the bowel. SUBJECTS AND METHODS: The investigation was conducted using the intraoperative material (resected portions of the large and small bowels, appendix) obtained from 40 women diagnosed as having deep infiltrating endometriosis involving the bowel, which was accompanied by pain syndrome. Paraffin sections were immunohistochemically examined using the standard protocol. Antibodies to Ki-67, PTEN, ER, PR, ("Dako"), CD34 ("Cell Marque", USA), VEGF, EGF, EGFR, COX-2 ("Abcam"), and MMP 1 and 2 ("Abbiotec") were applied. Dako REAL EnVision Detection System kits ("Dako", Denmark) were used as secondary antibodies. RESULTS: The morphological substrate of pelvic pain syndrome in deep infiltrating endometriosis was established to be factors that acted in situ at the location of endometriotic foci and those caused by the infiltrative perivascular, intravascular, and perineural growth of endometrioid heterotopies. CONCLUSION: Inflammation and fibrosis in the endometriotic foci contribute to the accumulation of algogenes, which gives rise to somatogenic pain syndrome, and chronic nerve fiber injury as a source of nociceptive stimulation leads to neuropathic pain syndrome.

[Matrix metalloproteinases, their inhibitors and angiogenesis in different morphological types of lung precancer in persons who have long lived in the radioactive substance-polluted area of the Semipalatinsk Region, Kazakhstan].

The aim of the present investigation was to study a role of matrix metalloproteinases and their inhibitors in the pathogenesis of fibrosis and angiogenesis in lung precancer processes, which could be used to develop new pathogenetically substantiated lines in therapy. The investigation was conducted using intraoperative and biopsy specimens of the removed lungs and their parts from 113 patients with lung precancer changes with the diagnoses of lung cancer, chronic abscess, bronchoectatic disease, idiopathic fibrosing alveolitis, tuberculosis, of whom 41 patients had lived from childhood to 2002 in vicinity of a polygon and long exposed to radiation (annual radiation dose was greater than 0.1 Rem) (Group 1). The intraoperative and biopsy specimens from 72 patients who lived in the unchanged radiation areas of Kazakhstan (n = 32) and Moscow (n = 40) (Group 2) were used as a comparison group. The specimens were stained with hematoxylin and eosin, alcian blue, picrofuchsin as descried by van Gieson. The paraffin sections were immunohistochemically studied by the immunoperoxidase technique, by applying mono- and polyclonal antibodies to MMP-1, MMP-2, MMP-9, TIMP-1, VEGF, CD34, chromogranin, CD68, and Ki-67. Thus, lung precancer resulting from increased radiation is of high risk for invasive growth due to the imbalance between the expression of metalloproteinases and their inhibitors and the activation of antiblastomic defense mechanisms. Angionesis in the stroma of the adjacent tissues also creates favorable conditions for invasive epithelial growth. The relatively high level of metalloproteinases in radiation-induced precancer may be indirect evidence for the occurrence of precancer in the presence radiation-associated fibrosis and evidence for its high malignant potential.

[Cytogenetic variants of dysregenerative and precancerous epithelial changes in chronic inflammatory pulmonary diseases]. / Tsitogeneticheskie varianty disregeneratornykh i predrakovykh izmenenii épiteliia pri khronicheskikh vospalitel'nykh zabolevaniiakh legkikh.

Surgical material of the lungs and their parts from 31 patients and open biopsies were studied. Proliferative activity (Ki-67, PCNA) and oncomarkers expression (bcl-2, p-53, c-myc, b-TGF, chromogranin-A) were studied immunohistochemically in the foci of various epithelial changes. It is established that a wide spectrum of alterations in pulmonary tissue is associated with variability of precursor cells and may have nosological features.