Open Access
Access granted
Subscription or Fee Access
Vol 160, No 3 (2022)
- Year: 2022
- Articles: 6
- URL: https://j-morphology.com/1026-3543/issue/view/5574
- DOI: https://doi.org/10.17816/morph.20221603
Original Study Articles
Prognostic significance of the immunohistochemical status of the endometrium as markers of therapy for endometrial hyperplasia
Abstract
BACKGROUND: In patients of reproductive age with endometrial hyperplasia without atypia, hormonal treatment, and prognosis of response remain relevant issues.
AIM: To increase the effectiveness of hormonal therapy for endometrial hyperplasia in patients of reproductive age with abnormal uterine bleeding, considering the receptivity, and proliferative activity of the endometrium.
MATERIALS AND METHODS: A total of 179 patients of reproductive age with abnormal uterine bleeding and endometrial hyperplasia were examined. After the removal of the endometrial tissue, hormonal therapy was performed for 6 months: 101 patients received dydrogesterone 20 mg/day, and 78 patients received norethisterone acetate 10 mg/day. The expression levels of estrogen receptor-α (Erα), progesterone receptor (PR), and Ki67 in the endometrial tissue were determined by immunohistochemistry at baseline and 3 months after the treatment. The comparison group consisted of 18 women without gynecological pathology. Variation statistics methods were used to process the data, the differences between the indicators groups of patients were considered significant at p <0.05.
RESULTS: Before treatment, the expression levels of ERα, PR in both compartments, and Ki-67 in the glands were lower (p < 0.05) in the endometrial hyperplasia group than in the control group. Remission was achieved in 77 (76.24%) (dydrogesterone) and 62 (79.49%) (norethisterone acetate) patients. Initially, the expression level of ERα in the glands and stroma of endometrial hyperplasia was lower (p <0.05) than that in the comparison group; the resistant group had a lower (p <0.05) response to treatment. The expression of PR in the resistant group was lower (p <0.05) than that in the comparison group and remission group. The expression level of Ki67 in the response group was lower than that in the comparison group (p <0.05), and the expression in the stroma was lower than that in the resistant group (p <0.05). After treatment in both compartments, the expression levels of ERα and PR were lower in the resistant group than in the comparison group and response group (p <0.05). A logistic regression equation was obtained with a set of predictors: ERα (glands) + PR (glands and stroma) + Ki-67 (stroma) with a potential response to therapy of 93%.
CONCLUSIONS: The specified predictive model is promising. The therapy was effective in 93% of cases.
139-150
Regeneration of vital organs of mammals in fetal period
Abstract
BACKGROUND: This study is relevant owing to the importance of fetal regeneration of pathologically altered organs in mammals for fundamental science and practical medicine.
AIM: To elucidate the regenerative potential of the cardiac, brain, and liver tissues in fetuses during fetal development following mechanical trauma.
MATERIALS AND METHODS: As experimental animals, 12 mature female chinchilla rabbits weighing 3900–4350 g and 30 outbred female rats weighing 265–280 g were examined. Mechanical trauma to the heart and brain was inflicted on rabbit fetuses (n=50) and to the liver of rat fetuses. The operated fetuses (n=84) were withdrawn from the experiment 1, 3, 5, 7, 9, 11, 15, and 30 days after the operation. Histological, morphometric, electron microscopic, and immunohistochemical methods were employed.
RESULTS: Following the healing of mechanical trauma in the heart of rabbit fetuses, the necrotic area was completely restored. In rate fetuses, the liver did not fully regenerate, and the fibrotic area at the site of the dead tissue only decreased. The brain of rabbit fetuses did not fully recover, and a glial scar appeared in the place of the dead tissue. The difference in the healing outcomes of organ damage in fetuses is associated with the absence of an exudative reaction to injury in the heart of rabbit fetuses, whereas in rat fetuses, this reaction occurred during injury. In the nervous tissue, the activation of the protein synthetic function of neurocytes was recorded, which can be regarded as a sign of intracellular regeneration.
CONCLUSIONS: The results suggest that the vital organs of mammalian fetuses have high regenerative potencies.
151-159
Supporting morphometric determinants as a basis for the physical culture safety
Abstract
BACKGROUND: Connective tissue failure is a predisposing factor for retraumatism, post-traumatic musculoskeletal diseases, and disability. The variety and polysystem clinical manifestations of this pathology hinder its prompt identification.
AIM: To identify pathognomonic morphometric determinants of high injury risk and apply them in the examination of individuals engaged in physical culture and sports.
MATERIALS AND METHODS: In the period from October 2018 to March 2023, 117 patients with recurrent musculoskeletal injuries who underwent clinicо-somatometric examination and connective tissue assessment at Sechenov University and the European Osteopathic Clinical Center were recruited. Statistical data analysis was performed using IBM SPSS Statistics for Windows version 20.0 (IBM Corp., Armonk, NY, USA) and MedCalc 11.5.00 (Medcalc Software, Belgium).
RESULTS: The rates of dysplastic features were higher in patients with recurrent musculoskeletal injuries than in healthy controls. The morphometric determinants of a high injury risk were determined. In women, these included an asthenic build, joint hypermobility, soft auricles, hyperelastic skin, atrophic striae, telangiectasia, and varicose veins of the lower extremities. In men, these included chest deformities, arachnodactyly, dolichostenomelia, flat-valgus feet, and abdominal muscle diastasis. In the ontogenesis, a significant modification, and accumulation of dysplastic stigmas were noted. Of particular diagnostic value are universal, sex-, and age-independent predictors, which included a gothic palate, kyphoscoliosis, temporomandibular joint crunching during movements, O- or X-shaped legs, and moderate, or high myopia.
CONCLUSIONS: Biomedical support of sports activities should include the mandatory screening of the connective tissues. Timely and rapid diagnostics of the established pathognomonic morphometric determinants of a high risk of injury will help prevent musculoskeletal injuries, post-traumatic diseases, and disability, which are important for the physical culture safety and preservation of public health.
161-170
Quantitative analysis of the structure of the portal vein of the liver and splenic vein in people with different somatotypes in portal hypertension
Abstract
BACKGROUND: Heath–Carter somatotyping using bioimpedance analysis is one of the most common methods of somatotyping because of its non-invasiveness, portability, comparative reliability of the data, and ease of use. Knowledge of the relationship between portal hypertension and somatotype may lead to the development of effective approaches to the diagnosis, treatment, and prevention of this disease.
AIM: To examine the frequency of various somatotypes in people with portal hypertension.
MATERIALS AND METHODS: The study included 46 patients with cirrhosis of the liver who were treated at the University Clinical Hospital N 2 Sechenov University. The calculation of endo- (ENDO) and mesomorphy (MESO) scores, assessment of the somatotype by Heath–Carter, and data visualization on the somatogram were carried out using the ABC-01 “MEDASS” software (STC “MEDASS,” Russia). Portal hypertension was diagnosed by ultrasonography of the abdominal cavity and retroperitoneal space.
RESULTS: The diameter of the splenic vein was >7 mm in 17/18 men and 23/28 women. The diameter of the portal vein was >13 mm in 8/18 men and 12/28 women. The mesoendomorphic somatotype was the most common among women and endomesomorphic among men. More than half (n=9; 52.9%) of men had splenic vein diameter large than normal and the endomesomorphic somatotype, whereas the predominant part of women (n=18; 78.3%) had the mesoendomorphic somatotype. Similar results were obtained in patients with portal vein diameter larger than normal, and the endomesomorphic somatotype prevailed among men (n=5; 62.5%) and mesoendomorphic among women (n=10; 83.3%).
CONCLUSIONS: The frequency of portal hypertension in patients with different somatotypes varied. It was higher in patients with a pronounced endomorphic component than in those with other somatotypes. In general, our results underline the complexity of the association of portal hypertension with somatotypes and indicate the need for a deeper analysis of this problem and further research. Future studies should include larger numbers of both healthy individuals and patients with chronic liver disease, different age groups, and a broader set of parameters for analysis. Understanding the relationship between portal hypertension and somatotypes can help develop more effective strategies for the prevention and treatment of this syndrome.
171-176
Receptive status of the endometrium in patients of reproductive age with serous and mucinous ovarian cystadenoma before and after unilateral adnexectomy
Abstract
BACKGROUND: Currently, the incidence of benign ovarian tumors has increased, and numerous studies have reported its negative effect on women’s reproductive health. In modern literature, approximately 30% of patients with ovarian neoplasms have reproductive problems. In the presence of ovarian diseases, changes in the endometrium alter its receptivity, thereby reducing the chances of successful conception and gestation and gaining increasing attention. Patients seeking to preserve their reproductive function prefer organ-preserving surgical interventions; however, in clinical practice, adnexectomy is often necessary because of damaged ovarian tissue.
AIM: To analyze the morphofunctional state of the endometrium and its receptivity in patients with serous and mucinous ovarian cystadenomas before and after surgical treatment.
MATERIALS AND METHODS: The prospective study included patients of reproductive age with benign epithelial tumors (serous/mucinous cystadenomas) who had not received hormonal drugs for 6 months before surgical treatment. Group 1 included 32 patients with serous cystadenoma, and group 2 included 30 patients with mucinous cystadenoma. Before and 6–12 months after unilateral salpingo-oophorectomy, a pipelle biopsy of the endometrium was performed during the “implantation window.” The qualitative and quantitative parameters of pinopodes were examined, and the expression levels of estrogen (ER) and progesterone (PR) receptors in the glands and stroma of the endometrium were evaluated.
RESULTS: Preoperatively, the number of pinopodes decreased in patients with serous cystadenoma, and the expression level of ER in the stroma and those of PR in the stroma and glands was reduced. Postoperatively, the number of mature pinopodes increased, and the expression levels of ER in the stroma and PR in the stroma and glands was increasing. Preoperatively, in patients with mucinous cystadenomas, the expression levels of ER in the stroma and glands and PR in the stroma and glands decreased, and the number of pinopodes reduced. Postoperatively, compared with patients with serous cystadenomas in the glandular component of the endometrium, those with mucinous cystadenoma had lower expression levels of both ER and PR, lower PR expression level in the stromal component, and increased number of pinopodes.
CONCLUSIONS: The results of this study showed that benign ovarian tumors are accompanied by impaired morphofunctional state and receptivity of the endometrium, and timely surgical intervention positively affects these indicators and increases the reproductive potential of women.
177-188
Anatomical observation of the sinoatrial node artery of the cardiac conduction system in adult humans
Abstract
BACKGROUND: Anatomical investigations of atrial blood vessels are limited. Knowledge of the anatomical variants of the sinoatrial node artery is important to enhance cardiac surgery and elucidate the pathogenesis of supraventricular arrhythmias.
AIM: To explore and clarify the number, variants, location, and course of sinoatrial node arteries in the heart of middle-aged and older individuals.
MATERIALS AND METHODS: In 62 formalin-fixed hearts of humans who died from noncardiac causes, the sinoatrial node arteries were dissected and measured using an electronic caliper. Histologically, the location of the artery into the sinoatrial node was clarified through hematoxylin and eosin and Masson trichrome staining.
RESULTS: The number of sinoatrial node arteries varied from 1 (86.6%) to 3 (1.7%). Commonly, sinoatrial node arteries arose from the right coronary artery (66.7%) between the aortic root and right atrial appendage or from the proximal part of the left circumflex artery (28.3%). Rarely, sinoatrial node arteries originated from the orifice of the right coronary artery, from the left coronary artery bifurcation, and on the diaphragmatic surface of the heart from the distal parts of the right coronary artery or left circumflex artery. Sinoatrial node arteries appeared to have subepicardial and intramyocardial components. The sinoatrial node artery that originated from the right coronary artery traveled mainly subepicardially; however, the sinoatrial node artery from the left coronary artery showed a predominantly intramyocardial course. The diameter of the sinoatrial node artery that originated from the right coronary artery varied from 0.7 to 2.8 mm and that from the left coronary artery system varied from 1.1 to 2.5 mm (median, 1.7 mm; p=0.96). The right coronary artery and sinoatrial node artery that branched from that formed a correlation pair in diameter values (Rs=0 .44; р=0.005).
CONCLUSIONS: The sinoatrial node artery has common and rare variants, which differ in the number, origin, and topography of the artery.
189-198
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор). Регистрационный номер и дата принятия решения о регистрации СМИ: № 0110212 от 08.02.1993.