Chronic sinusitis is one of the most common pathologies in the structure of the incidence of ENT organs. The purpose — to study and compare the features of the histological structure of the sinus mucosa in normal and chronic pathological conditions. Material and methods. The study included 30 patients with maxillary sinus cyst and 30 patients with chronic maxillary sinusitis. Immunomorphological studies of the normal mucosa of the maxillary sinus, cyst membrane, hyperplastic mucosa of the maxillary sinus in chronic sinusitis were carried out. All samples were subjected to immunohistochemical staining with further comparison of the results obtained. Results. When comparing all samples, no statistically significant differences were found in the content of macrophages when comparing the normal mucosa and cyst membrane, as well as the content of T-lymphocytes and neutrophils when comparing the cyst membrane and mucosa in chronic sinusitis. All other parameters (the content of neutrophils, macrophages, T and B lymphocytes, mast and goblet cells, the area of non-cellular tissue structures) had significant differences when compared in all groups. Conclusions. Inflammatory changes are observed in the cyst shell, which have significant differences both from the normal mucous membrane and from the mucous membrane in chronic sinusitis.

Intra-articular administration of betamethasone is widely used in clinical practice. Its effect on articular cartilage, particularly, that of a knee joint, was studied in a number of both clinical and morphological studies. At the same time, the reactive changes of popliteal lymph nodes, which perform both a mechanical barrier-filtration function and determine the state of a local immunity, have not been studied. Morphological and morphometric analysis of popliteal lymph nodes of rabbits was performed on the 7th and 30th experimental day after one, three, and six betamethasone injections into a knee joint. Intra-articular injection of betamethasone into the knee joint leads to a reactive hyperplasia of regional popliteal lymph nodes in the absence of inflammatory reaction. After a single-drug injection on the 7th day, specific immunomorphological reactions were observed: follicular hyperplasia, paracortical hyperplasia, and sinus histiocytosis. On the 30th day, the histological structure returned to normal. After three and six injections of betamethasone, on the 7th day microcirculatory disorders, attenuated follicular hyperplasia, paracortical hypoplasia, and degenerative sinus histiocytosis were observed. On the 30th day, the histological structure of the lymph nodes showed structural and cellular composition. A single drug injection in the lymph nodes caused a complete histological structure restoration. After three and six injections of betamethasone, there was a violation of the T- and B-dependent zones and sinuses, up to the complete disappearance of the pattern or scleolipomatous transformation, which can complicate or make impossible a full-fledged immune response.

Diabetes mellitus is a top priority non-communicable disease with a high risk of developing complications with distinctive features. Diagnosis of the stage and types of damage to the foot functions in patients with diabetes is a complex task. In presented clinical case, we used several tests to identify the expression of diabetic angiopathy: pulse examination of the main arteries, level of glycated hemoglobin (HbA1c), ultrasound of the low extremities arteries, transcutaneous pulse oximetry, and oxygen partial pressure examination in tissues; carboxyangiography or contrast angiography were performed for all patients. The admitted patient was diagnosed with a diabetic foot syndrome. Based on the partial pressure and oxygen saturation in the tissues of the right lower limb, it was decided to minimize the extremities height amputation, thus preserving the knee joint.

Intra-articular injections of glucocorticosteroids, including triamcinolone, remain controversial, despite the treatment’s inclusion in the guidelines for the management of patients with large joint osteoarthritis. Only a few trials studied the effect of triamcinolone on joint structure in vivo; however, most of the obtained results cannot be applied to patients with osteoarthritis. To determine the effect of a single, three and six weekly intra-articular injections of triamcinolone acetonide on articular cartilage and other joint structures. Fifteen rabbits were divided into three groups with a single, three, and six weekly intra-articular injections. Intact left knee joint of all rabbits was used as a control group. After euthanasia, a morphometric study of histological preparations of the joints was performed using a random-step morphometric grid by SB Stefanov. A single intra-articular injection had no negative effect on the knee joint morphology. Three weekly drug injections led to edema and microcirculatory disorders of the synovial membrane, minor degenerative, and necrotic changes but did not affect articular cartilage. Six injections with a 1-week interval led to pronounced aseptic destruction of the synovial membrane, slight decrease in cartilaginous lining thickness, and dystrophic-necrotic changes. Single and three weekly intra-articular triamcinolone injections into the rabbit knee joint (total dose equivalent to 120 mg for humans) did not have a chondrotoxic effect. Six weekly injections of triamcinolone (total dose equivalent to 240 mg for humans) led to severe synovial membrane destruction and to minor changes in the articular cartilage without affecting the subchondral bone.

The cell proliferative process in the larynx cancer is studied. Contrary to the classical mitotic index the Ki-67 and PCNA indices are reliable and reproducible on the clinical material by the proliferative cell activity indices of the larynx tumors. There is a reverse connection between the proliferation index in cells of the squamous larynx cancer and the tumor differentiation. The direct correlation of the cell proliferation index of the squamous laxynx cancer with the disease stage is revealed. The preoperative radiation therapy significantly decreases the cell proliferation rates of the squamous larynx cancer.

This is a comparative quantitative morphological study of the regeneration of paraosseous muscle tissue in the process of healing bone fractures using the preparation based on etidronate without lanthanoids and in conjunction with them. The fragments of the muscle tissue from the fracture region were investigated. These fragments were obtained in 45 outbred white rats at day 7, day 14, and day 30 after osteotomy in the zone of the middle third of the femoral shaft. Histological sections were prepared and investigated morphometrically. The areas of leukocyte-necrotic masses were determined, as well as those of granulation tissue, normally and necrotically changed muscle tissue, loose fibrous unformed and dense fibrous connective tissue, adipose tissue, blood vessels, and perivascular and interstitial edema. In addition, a quantitative analysis of the inflammatory cellular infiltration was performed by counting neutrophils, lymphocytes, macrophages, eosinophils, plasma, and mast cells. The data obtained were processed statistically. For a comparative study, three groups were identified: (1) control-a fracture without treatment; (2) after paraosseous infusion of etidronate with calcium ions without lanthanoids; (3) after paraosseous infusion of etidronate with calcium ions and lanthanoids. The best result of paraosseous muscle tissue restoration after injury was obtained when using etidronate in conjunction with calcium ions without lanthanoids. When lanthanoids were added, the reparative processes in soft tissues proceeded more slowly. However, in all respect, they were superior to the control group (fracture without treatment), especially at the final stage of regeneration (day 30). Thus, the areas of the leukocyte-necrotic masses, necrotically changed muscle tissue, and perivascular and interstitial edema were smaller significantly. At the same time, the level of the inflammatory cell infiltration of paraosseous tissues was lower substantially. Moreover, there were no such morphological changes, as calcinosis foci and epithelioid cell granulomas with the presence of giant multinucleated cells such as foreign bodies. In contrast to the control, there was no incomplete regeneration or substitution in the form of the parts of muscle replacement with dense fibrous connective tissue and adipose tissue. The area of unhanged muscle tissue, the most important criterion of regeneration, when using etidronate in conjunction with calcium ions and lanthanoids, was 10% more than that in the control group. Despite the fact that the use of etidronate without lanthanoids provides the best results in the repair of soft tissues, in the healing of fractures, the compounds containing them should be used. This is dictated by the fact that the restoration of bone is the priority of reparative regeneration after injury, and the use of lanthanoids in conjunction with etidronate and calcium ions for bone tissue healing is the most effective.

The aim of this study was a comparative morphological assessment of changes in the mucous membrane of the lip in the field of radio wave and cold plasma exposure in the experiment.MATERIAL AND METHODS:Experimental animals removed a portion of the mucous membrane of the inner surface of the lip with a Surgitron radio knife (group 1) and an electrode of the Coblator II cold plasma apparatus (observation group 2). Tissue was taken from the edge of the surgical wound as a trapezoidal flap containing mucous and submucous membranes immediately after the incision and 3 weeks after the surgery. Histological sections were prepared, which were stained with hematoxylin and eosin, as well as according to van Gieson.RESULTS:It was found that, both in cases of using a radio knife and a coblator along the edges and in the depth of the wound, coagulation tissue necrosis was observed, which was more evident in group 1 of observations. In addition, after the radio wave exposure, in the areas close to the defect, the epithelial lining was disrupted to one degree or another, which was not observed when using the coblator. After 3 weeks of the experiment, the stratified squamous non-keratinizing epithelium in both groups had a normal histological structure. At the same time, when using the coblator, the lamina propria of the mucous membrane was completely restored, and in cases with the use of a radio knife, sclerotic processes with the formation of scar tissue took place in the lamina propria of the mucous membrane in some areas.CONCLUSIONS:The use of a coblator should be recognized as a more gentle method, since a comparative analysis of histological changes immediately after the incision showed a more intense damaging effect of the radio knife on the surrounding tissues, which in later stages was accompanied by incomplete regeneration (substitution) of the lip mucosa.

Aim. Morphological study of the microvasculature of regional lymph nodes in relation to the cancer of the lymph nodes as possible additional or alternative metastasis pathways. Methods. The lymph nodes of 150 cancer patients (1263 nodes in total), regional to cancer of various localization, were studied. Histological sections staining with hematoxylin and eosin by Van-Giesons method, pyronine by Brachets method, toluidine blue and picro-Mallory were prepared. An immunohistochemical study was performed using monoclonal antibodies to pan-cytokeratins, CD31, type IV collagen, CD3, CD20, and CD68. The area of metastases to the lymph nodes was determined by using a morphometric grid and used to identify the four study groups. In addition, the immunomorphological reactions of the lymph nodes were taken into account in each group. Results. It was identified that the microvasculature of the lymph nodes can be involved in the metastatic process along with the lymphatic pathways. At the same time, there is a decrease in vascular wall function and violation of the rheological properties of blood, accompanied by the deposition of intra- and extravascular fibrin. Hematogenous metastasis is largely influenced by the state of lymph node sinuses, in which blood is found, and in some observations by the expression of CD31 (a marker of blood endothelium). Hematogenous dissemination of cancer often begins after the appearance of lymph node metastases. The greater the anatomical extent of lymph node metastases, the more often tumor cells are present in the blood vessels. In addition, an isolated lesion of the microvasculature with the presence of tumor cells in the extranodal vessels without metastases in the lymph node itself was revealed. It was observed that the invasion of tumor cells into the microvasculature depended on the immunomorphological reactions of the lymph nodes. Conclusion. The microvasculature of regional lymph nodes can be both an additional and an alternative lymphogenous metastasis pathway of cancer; at the same time, vascular invasion is accompanied by microcirculation disorders and depends on the volume of metastases and the immunomorphological reactions of the lymph nodes.

Characteristics of the subcapsular region of lymph nodes (LN) with reactive hyperplasia in various types of immunomorphological reactions. The LN were obtained after surgery and diagnostic lymphadenectomy from 50 patients with various types of reactive hyperplasia, and researched. As a control, LN were obtained from 10 almost healthy persons who died from accidental causes (forensic autopsies). The subcapsular regions of LN were investigated with histological, immunohistochemical, electron microscopic, and morphometric methods at different variants of immunomorphological reactions: (1) hyperplasia of the paracortical zone with a high content of T cells; (2) hyperplasia of lymphoid follicles with the presence of reactive centers, a high content of B cells, and plasmatization of the cortical plateau and cords; (3) sinus histiocytosis with an increase in the number of macrophages in the LN; (4) the combination of the first three reactions. The subcapsular region, which includes the subcapsular sinus and the adjoining cortical zone, reacts to antigenic stimulation in any variant of immunomorphological reactions in case of reactive hyperplasia of the LN. The most expressed changes in this area are observed in cases with a predominance of B cell humoral immune response in the LN, which is morphologically represented by hyperplasia of lymphoid follicles, high B cell content, and plasmatization of cords. With this pattern of LN in the subcapsular sinus, the total number of CD45(+) lymphocytes, CD20(+) B cells, BLA-36(+) of their activated forms, and CD10(+) immunoblasts increased. Both in the subcapsular sinus and in the adjoining cortical zone, the proliferative activity of cells, determined by Ki-67 expression, increased. It also contained a large number of plasma cells (10.6 ± 1.09%), which significantly exceeded this value, in both the control and other observed groups. Their high antibody-forming ability was confirmed immunohistochemically by detecting the λ- and κ-chains of immunoglobulins, as well as by electron microscopy, which revealed expanded tanks of the granular endoplasmic reticulum in the cytoplasm of these cells. The subcapsular region of the LN is mainly a B-dependent region that is responsible for the humoral immune response in any type of reactive hyperplasia of LN, as well as a traditional B-dependent zones (lymphoid follicles and cords).

The comparative qualitative morphological study of bone fracture healing using etidronate-based preparation free of lanthanoids and in conjugation with them. The fragments of bone tissue from the facture zone were studied. They were obtained in 45 mongrel white rats on day 7, day 14, and day 30 after osteotomy in the zone of femoral shaft middle third. The investigation was performed by a morphological method in the three groups: (1) control, a fracture without treatment; (2) after paraosseous infusion of etidronate with lanthanoid and calcium ions; (3) after paraosseous infusion of etidronate with calcium ions without lanthanoids. The areas of leukocyte-necrotic masses with blood clots, those of granulation, connective and cartilaginous tissue, coarse-fibrous trabecular bone and lamellar bone, as well as those of necrotic bone parts were determined in the histological sections of the fracture zone with a morphometric grid. The data obtained were processed statistically. The best results of bone tissue healing for fractures were obtained when paraosseous infusing etidronate in combination with lanthanoids, and the effect of this was revealed just in the early periods after trauma. In this case, the intensity of injury-induced inflammatory reaction lowered and the volume of leukocyte-necrotic masses and traumatic edema decreased. The process of reparative regeneration accelerated as well with formation of granulation tissue and after that connective tissue and coarse-fibrous trabecular bone. Besides, indirect osteogenesis with bone formation through cartilaginous tissue was less common. As a result, there was uncomplicated fracture healing in most observations with the presented significant amount of formed compact and spongy lamellar bone. The combination of the etidronate-based preparation with lanthanoids is the most optimal, and its use is effective at all stages of bone fracture healing.

A case of abdominal tuberculosis, an isolated lesion of liver tuberculosis, is given. The diagnosis of this form of tuberculosis presented certain difficulties, the histological examination of the surgical material after atypical resection of the liver was of decisive importance. Clinical observation is of interest in view of the patient having a long period of low-grade temperature reaction with the absence of any changes according to the routine methods of laboratory diagnostics, as well as the difficulties of differential diagnosis, with the participation of doctors of various specialties.

The search for new more effective techniques to repair bone fractures and defects is an urgent task of healthcare. Objective To explore the efficacy of a preparation containing etidronates of lanthanide and calcium ions in regenerative repair of bone defects. Material and methods The osteoblastic MC3T3-E1 and the osteoclastic RAW 264.7 cell lines were used in in vitro experiments at the first stage of the research. The agent was postoperatively injected in a bone defect of 36 rabbits on days 3 and 5 to assess the preparation’s effect on regenerative repair of small defects with diameter of 2.5 mm. Radiometric and reactive morphological characteristics of bone tissue were evaluated at the fracture site at the beginning, middle and end of experiment. Results The above preparation was found to enhance osteogenic differentiation and stimulate accumulation of intracellular calcium in MC3T3 E1 cells. However, the preparation was not shown to inhibit RANKL-induced osteoclast differentiation in vitro. Histological and computed tomography findings demonstrated statistically significant differences between control and experimental animals (p < 0.01) and indicated to the preparation’s effect of promoting regenerative repair of small bone defects. Conclusion The series was the first to show the effect of the preparation containing etidronates of lanthanide and calcium ions as stimulating osteoblast activity in vitro and promoting early regenerative repair of small bone defects.

While various techniques for analyses of the bone/implant interface are developed, most of them do not show the osseointegration process in details. In this article, we present a new inverted approach to explore the osseointegration of the dental implants, based on the chemical deep etching of titanium implants. An approach was tested on 18 implants inserted in 6 dogs. Bone/implant blocks were taken after 1, 3, and 6 months after implantation. The titanium was chemically removed from the interface, leaving the bone tissue intact. Once metal was removed, bone tissue was analyzed macroscopically and with a scanning electron microscope, afterwards decalcified and used for histological analysis. The clear patterns of implant integration into the bone tissue were obtained after 1, 3, and 6 months after implantation. After 1 month, the bone/implant interface was still very immature. After 3 months, the bone was already quite mature and organized. After 6 months, the external bone layer on the bone/implant interface appeared in its final osseointegrated form. The presented inverted method for the osseointegration analysis offers new insight into the healing process of the bone/implant interface after implantation, as well as integrative processes occurring around implants with different surfaces and designs.

Aim. Multiparameter analysis of the state of regional lymph nodes of stomach cancer to reveal prognostic criteria of patients’ 5-year survival. Methods. The regional lymph nodes removed during surgery for stomach cancer in 170 oncologic patients were studied by means of histologic, immunohistochemical, electron microscopy and morphometric methods. The 5-year survival was calculated by the direct method. Results. It was revealed that 5-year survival directly depends on the amount of involved lymph nodes. Detection of even single tumor cells in one regional lymph node worsens the prognosis for a patient’s life. The more metastases there are in lymph tissue, the worse the prognosis is. Immunomorphologic reactions and ultrastructural changes are of substantial significance. High 5-year survival was characteristic for hyperplasia of paracortical area with increased number of CD3(+) T-cells, the ultrastructure of which corresponds to activated (immune) lymphocytes, and for sinus histiocytosis as well with increased number of CD68(+) free macrophages in regional lymph nodes with pronounced phagocytic activity. Prognosis is worse in lymphoid follicular hyperplasia with high content of CD20(+) B-cells and plasmocytes. The lowest 5-year survival was accompanied by degenerative sinus histiocytosis, atrophy or sclerolipomatosis transformation of lymphoid tissue with hypoplasia of paracortical area and lymphoid follicles. Under an electron microscope active fibroblasts are seen synthesizing collagen and large number of degenerating cell forms, particularly, lymphocytes. Conclusion. The 5-year survival of oncologic patients with stomach cancer is determined by the amount of metastatic regional lymph nodes, presence or absence of metastases, their volume in lymphoid tissue, histologic pattern and ultrastructural cell changes; comparative analysis of these criteria allows developing prognostic algorithm.

Aim. To study regional lymph nodes ultrastructure at different cancer stages, determine the reactive changes dynamics and identify the factors contributing to the inadequate local immune response and spread of tumor.Methods. The regional lymph nodes obtained from 149 cancer patients during surgery for cancer of various localization were studied. Lymph nodes obtained from 32 apparently healthy individuals who died of accidental causes were used as a control. One part of lymph node, cut in two parts along the major axis, was used for the histological sections preparation, the second - for electron microscopy. A comparative study of the following groups of preparations was conducted: (1) lymph nodes of the control group; (2) lymph nodes without metastases in stage I cancer; (3) lymph nodes without metastases in stage II cancer; (4) the affected lymph nodes in the II and III stages with various volume metastasis.Results. Ultrastructural changes in the regional lymph nodes in the process of cancer development have a certain dynamics: amid increasing microcirculation disorders and sclerotic processes, redistribution of immune cells and the immune reactions shift to B-cell humoral immunity occurs, resulting in the later stages to inactivation of T-cell-mediated immune reactions and macrophage-monocyte system, while maintaining plasmacytic reaction with high antibody-producing ability of the cells.Conclusion. Factors, contributing to inadequate local immune response are: (a) a progressive decrease in the number of activated (immune) lymphocytes - main cytotoxic anticancer elements, in cancer development; (b) high amount of antibody-producing plasma cells, which can block T-cell cytotoxic effect by humoral antibodies, at all stages of cancer development; (c) decrease of the number of migrated (free) macrophages of monocytic origin and the fixed macrophages - sinuses reticular cells, phagocytic activity decrease; (d) the sclerotic processes and microcirculatory disorders that impede tumor cells and cytotoxic lymphocytes contact.

The article presents data on the main stages of formation and development of the pathological anatomy department of Kazan (Imperial) University from department approval under the auspice of Professor A.V. Petrov in December, 1965 to its reorganization by merging of two departments - Pathological Anatomy and Pathological Physiology in June, 2014. Data on the department heads for the 150-year history are summarized, the main directions of scientific research conducted under the department heads supervision are described. Particular consideration is given to the Kazan scientists-pathologists achievements and contribution in fundamental and practical pathological anatomy, related subjects, clinical practice, social sciences, students’ education and doctors of various specialties training. Joint General Pathology department faculty new challenges are identified, namely transition plan generation, educational process radical restructuring in order to optimize it according to modern requirements for the higher and postgraduate education system. Initiated and conducted measures in connection with the department reorganization in the framework of new General Pathology discipline allowing to preserve the pathological anatomy structural and organizational integrity as a basic science, which is also of great practical importance, are presented.

Aim. To perform comparative and morphological assessment of the reparative processes in the bone and the surrounding soft tissues during intramedullary osteosynthesis using stainless steel implants and titanium nitride coated stainless steel implants. Methods. 40 rabbits who underwent open tibial osteotomy followed by retrograde insertion of the implant into the medullary canal served as an experimental model. 2 mm diameter nails of 12X18H9T steel coated with titanium and hafnium nitrides were used. In the control group, similar nails without coating were used. Histological sections of bone fragments and postoperative wounds, which were taken for morphological study on the 10th, 30th, 60th and 180th day from the beginning of the experiment, were stained with hematoxylin and eosin and with picrofuchsin by Van-Gieson method. Results. The percentage of leukocyte-necrotic masses on the 10th day was 3.5±0.2% in the experimental group and 6.0±0.4% in the comparison group (p Conclusion. Osteosynthesis using nails coated with titanium and hafnium nitrides contributes to reduction of the inflammatory response in the surrounding tissues, accelerates the process of reparative regeneration, providing an earlier wound epithelialization and reducing the likelihood of complications development such as incomplete closure of bone defect.