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Introduction Eosinophilic otitis media is an intractable otitis media and a fairly common middle ear disease. However, the pathogenesis of eosinophilic otitis media is obscure. Objective To observe the pathological and ultrastructural changes of the Eustachian tube mucosal epithelium in rats with eosinophilic otitis media and further explore the pathogenesis of eosinophilic otitis media. Methods Animals were intraperitoneally injected with 2000 mg ovalbumin and 100 mg aluminum hydroxide (alum) on day 0, followed by 100 mg ovalbumin and 100 mg alum injection on days 7 and 14. Next they were topically boosted by daily application of 100 mg ovalbumin solution via nasal drip and intratympanic injection of 0.1 mL ovalbumin (1000 mg/mL) in the right ear (group A, n = 80) and 0.1 mL saline in the left ear as control (group B, n = 80) starting on day 21 and continuing for 14 days. The temporal bones were dissected on the 35th, 38th, 41st and 43rd day separately under anesthesia. Scanning electron microscopy, hematoxylin-eosin and toluidine blue staining were used to observe the pathological and morphological changes of Eustachian tube mucosa stained samples. Moreover, inflammatory cells and cilia were counted. Results The epithelium of the Eustachian tube in group A was swollen and thickened. The cilia were arranged in a disorderly manner and partially detached. Eosinophils infiltrated the submucosal layer of the Eustachian tube, and their number increased significantly compared with that in group B (p< 0.05). Simultaneously, mast cell degranulation was observed in group A. Scanning electron microscopy revealed that the cilia were lodged and gathered along the whole length of Eustachian tube in group A. Ciliated cell density was significantly lower than that in Group B (p< 0.01). Conclusion In the eosinophilic otitis media model, allergy caused significant changes in pathology and morphology of the Eustachian tube mucosa, affecting the normal function of the Eustachian tube which played an important role in the occurrence and development of eosinophilic otitis media.

There are several types of morphea with different levels of connective tissue involvement and morphological manifestations. In this mini review, it was pointed out the most important morphological and clinical aspects of localised scleroderma in the oral cavity. The case presented in this article supports the scientific information and is described with details. The morphea of mucous membrane which was clinically suspected, was proved by histopathological examination of the sample. The unusual location of the local findings posed a diagnostic challenge. The case history should be significant due to the low number of studies. The special attention should be taken to match the clinical with pathomorphological picture in localised scleroderma diagnosis and treatment when the involvement of skin and oral mucosa is.

Background/purpose Mucous membrane pemphigoid (MMP) is a rare autoimmune disease affecting mucous membrane of the body. Oral involvement is common causing chronic and painful lesions. This study aimed to characterize oral MMP in a group of Thai patients and to analyze treatment regimens. Materials and methods The files of patients attending Oral Medicine Clinic were retrospectively studied. Patients fulfilled diagnostic criteria of MMP were included. Chief complaints, medical and dental history, oral manifestations and investigations of individual patients were summarized. Treatment regimens and efficacy were also analyzed. Results There were fourteen patients (age range 33–70 years) with a diagnosis of MMP. The prevalence of oral MMP was 0.51%. The lesions presented as vesicles, blood blisters, erosions, ulcers, erythema, either one type or in combination. Common complaints were chronic painful and bleeding gums. Gingival lesions were found in 13 of 14 patients (92.86%). The most common direct immunofluorescence findings were linear C3 at basement membrane zone (92.31%) followed by linear IgG deposition (84.62%). Most lesions were successfully managed with topical and/or systemic corticosteroids. The average time to control disease was 1.97 months (IQR, 0.69–12.73 months). Conclusion Gingival lesions are very common in MMP. Mainstay of treatment is combination of systemic and topical corticosteroids. Multidisciplinary care including oral hygiene maintenance is necessary.

The mucosal immune system prevents microorganism invasion through mucosal surfaces and consists of inductive and effector sites. Nasopharynx-associated lymphoid tissue (NALT) functions as an inductive site, inducing mucosal immune responses in the upper respiratory tract. It follows that intranasal vaccines may prevent upper respiratory infections. To induce and enhance the immune response by administering inactivated antigens intranasally, mucosal adjuvants have been developed, including mutant cholera toxin and cationic cholesteryl pullulan nanogel, which do not accumulate in the central nervous system. Moreover, multivalent pneumococcal polysaccharide conjugate vaccines are used to prevent invasive pneumococcal infections and otitis media, although they only provide moderate protection against acute otitis media because non-vaccine serotypes of Streptococcus pneumoniae and Haemophilus influenzae also cause this infection. To address this problem, pneumococcal surface protein A of S. pneumoniae and P6 of H. influenzae are used as broad-spectrum vaccine antigens. Alternatively, phosphorylcholine (PC) is present in the cell walls of both gram-positive and gram-negative bacteria and induces immune responses through antigenic activity. The significant effects of PC as a mucosal vaccine have been demonstrated through intranasal and sublingual immunization in mice. Furthermore, intranasal administration of PC reverses increases in IgE levels and prevents allergic rhinitis. After immunization with pneumococcal polysaccharide conjugate vaccine, intranasal immunization with PC boosts immune responses to vaccine strains and to PC itself. Thus, PC may be useful as a mucosal vaccine to prevent upper respiratory infections and allergic rhinitis, and it could be used as a booster to the currently used pneumococcal vaccine as it protects against non-vaccine strains.

Objective: to determine the characteristics of gastrointestinal allergy in children with allergic and somatic pathology.Patients and Methods. 106 children were examined: study group — 60 patients with an allergy, comparison group — 46 children with digestive diseases alone. Clinical, laboratory (total immunoglobulin E) and endoscopic morphological methods were used.Results. Cow’s milk proteins, citrus fruits, chocolate, strawberry were the most frequent causes of food allergies. Gastrointestinal symptoms in allergy manifested by pain and dyspeptic syndrome (nausea, heartburn), altered bowel elimination. 28 % of patients hadn’t abdominalgia. Blood eosinophilia has been detected in 61.7 % of children. Endoscopically, motor function was characterized by dysmotility of the stomach, esophagus or duodenum, in most cases by refluxes. Incompetence of cardia was diagnostically significant (χ2(1) = 14.095, φ = 0.374) in food allergies. Visual features of the mucous membrane (lymphoid hyperplasia, multiple small white patches) of the upper gastrointestinal tract had no significant correlation in patients from study and comparison groups (χ2 not higher than the critical value). Cases of the combination of bronchial asthma, allergic rhinitis and food allergy with normal IgE level were detected, which is caused by not-IgE-dependent reactions.Conclusions. Endoscopic and morphological study should be applied in the differential diagnosis of allergic and non-allergic lesions of the mucous membrane of the alimentary canal.

Background. Over-the-counter use of nonsteroidal anti-inflammatory drugs leads to their uncontrolled consumption among the population, which in some cases makes it impossible to prevent and timely detect adverse drug effects, and their effectiveness does not always satisfy clinicians. The purpose was to characterize the cytoprotective properties of cryopreserved placenta extract according to the condition of the mucous membrane of the proximal (esophagus and stomach) and distal (small and large intestine) parts of the gastrointestinal tract on the model of ibuprofen-induced esophagogastroenterocolonopathy. Mate­rials and methods. In vivo experimental studies were performed on 28 male rats. Subchronic ibuprofen-induced gastrointestinal lesions were reproduced by intragastric administration of ibuprofen to rats at a dose of 310 mg/kg. The condition of the gastrointestinal tract mucous membrane was assessed macroscopically on a scale. Results. The therapeutic and prophylactic efficacy of esomeprazole statistically significantly (р < 0.05) took place in the proximal parts of the gastrointestinal tract but had little effect on the prevalence of ulcerative lesions in the intestine. At the same time, unlike esomeprazole, which is known to have only gastroprotective activity, cryopreserved placenta extract had a cytoprotective effect both in the stomach and in the distal parts of the gastrointestinal tract — small and large intestine. Thus, the prevalence of ibuprofen-induced both entero- and colonopathy on the background of the study of the extract was almost twice lower than in rats that did not receive correction drugs. Conclusions. It is established that the use of cryopreserved placenta extract in the treatment-and-prophylactic mode has comparable to esomeprazole gastroprotective activity. In addition, it was found that the use of the studied cryoextract was accompanied by a decrease in the multiplicity of ulcerative defects in the small and large intestine of rats, by 4.6 and 3.8 times, respectively, compared to the control animals., Актуальність. Безрецептурне призначення нестероїдних протизапальних препаратів (НПЗП) призводить до безконтрольного їх застосування серед населення, що в низці випадків робить неможливою профілактику та своєчасне виявлення небажаних лікарських реакцій. На сьогодні з метою корекції ульцерогенної дії НПЗП застосовують дуже широке коло лікарських засобів, однак всі вони не позбуті власних побічних ефектів, а їх ефективність не завжди здатна задовольнити клініцистів. Мета: охарактеризувати цитопротективні властивості кріоконсервованого екстракту плаценти за станом слизової оболонки проксимальних (стравохід і шлунок) і дистальних (тонка та товста кишки) відділів шлунково-кишкового тракту на моделі ібупрофен-індукованої езофагогастроентероколонопатії. Матеріали та методи. Експериментальні дослідження in vivo проведені на 28 щурах-самцях. Субхронічне ібупрофен-індуковане ураження травного тракту відтворювали шляхом внутрішньошлункового введення щурам ібупрофену в дозі 310 мг/кг. Стан слизової оболонки травного тракту оцінювали макроскопічно за бальною шкалою. Результати. Профілактично-лікувальна ефективність езомепразолу вірогідно мала місце в проксимальних відділах травного тракту, однак практично не впливала на поширеність виразкових ушкоджень у кишечнику. В той же час, на відміну від езомепразолу, який, як відомо, має тільки гастропротективну активність, кріоконсервований екстракт плаценти проявляв цитопротективну дію як у шлунку, так і в дистальних відділах травного тракту — тонкій та товстій кишці. Так, поширеність ібупрофен-індукованої як ентеро-, так і колонопатії на тлі застосування досліджуваного екстракту була майже вдвічі нижчою, ніж у щурів, які не отримували препаратів корекції. Висновки. Встановлено, що застосування кріоконсервованого екстракту плаценти у профілактично-лікувальному режимі має співставну з езомепразолом гастропротективну активність. Крім того, встановлено, що застосування досліджуваного кріоекстракту супроводжувалось зниженням множинності виразкових дефектів у тонкій і товстій кишці щурів у 4,6 та 3,8 раза відповідно відносно показників тварин контрольної групи.

Mucous membrane pemphigoid (MMP) is an autoimmune condition characterized by subepithelial separation and deposition of autoantibodies and complement along the basement membrane zone. The disease results in the development of vesiculobullous lesions of the mucous membranes and skin. This report discusses the surgical treatment and management and the prosthetic implant rehabilitation of a patient with mucous membrane pemphigoid. The rationale for this treatment was to fabricate a prosthesis that was stable and did not rub against the gingival tissues and that was easily cleaned. The overdenture attachment system used provides more stability than other attachment systems while allowing the prosthesis and abutments to be easily cleaned.

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious adverse cutaneous drug reactions, characterized by epidermal detachment and mucous membrane involvement. SJS/TEN is more common in female patients, with unique findings in the ocular and vulvar regions. Early recognition and intervention, as well as long-term follow-up, are crucial to prevent devastating scarring and sequelae. This review examines the vulvar and ocular manifestations of SJS/TEN and describes the current treatment recommendations for female patients, requiring close consultation and collaboration among dermatology, ophthalmology, and gynecology.

Performing not only respiratory, but also protective, olfactory, aesthetic and a number of other functions, the nose is an important part of the upper respiratory tract. The mucous membrane of the nasal cavity is the first protective barrier of the body that protects against the effects of adverse environmental factors, carrying out warming, purification and neutralization of the inhaled air. This mission is provided by the activity of the multilayered columnar ciliated epithelium, consisting of three main types of cells: ciliate, goblet and basal. The main protective mechanism in the nasal cavity is mucociliary clearance, carried out by means of nasal mucus and beating of cilia unidirectional towards the nasopharynx with a frequency of up to 1000 per minute. Violation of the integrity and disruption of the physiological functions of the mucous membrane of the nasal cavity leads to the development of pathological processes, which in turn can lead to a failure in the work of other organs and systems of the body. To date, about 16-18% of all diseases of the ENT organs are chronic forms of rhinitis. According to the ICAR classification, which is based on the pathophysiological mechanisms of the development of rhinitis, allergic and non-allergic forms are distinguished. Common to various forms is the effect of certain factors on the mucous membrane of the nasal cavity and, as a consequence, a violation of the mechanisms of its work.One of the forms of chronic rhinitis, caused by thinning of the mucous membrane and severe disorders of mucociliary transport, is atrophic rhinitis. The main symptoms of the disease are dryness, the formation of crusts in the nasal cavity, periodic bleeding. The approach to the treatment of acute and chronic processes against the background of atrophic changes in the nasal cavity should be comprehensive and aimed at restoring the physiological functions of the mucous membrane and the mechanisms of mucociliary transport.

Labia contour plasty is intended for the aesthetic and functional correction of the external genitalia. Labia filling procedure or external genital plastic surgery as an injection contour correction technique is one of the most popular methods for non-surgical correction. The article describes the assessment of the tolerance of aesthetic labia correction procedure, which was performed under the preliminary application of local anesthesia with the lidocaine 2.5% and prilocaine 2.5% cream. 42 women aged 32–50 years were observed over the period of 2019–2021. Before the labia correction procedures, all patients received the local application anesthesia with lidocaine 2.5% and prilocaine 2.5% cream. To identify the main complaints and assess the quality of life of the study participants, the patients were interrogated using the international quality of life questionnaires FSFI (Female Sexual Function Index). The questionnaire survey showed that 84% of patients who were ready for the injection contour plasty were afraid of pain during the procedure. 86% of patients assessed the local application anesthesia as effective and underwent the procedure comfortably and without pain, 14% of patients indicated insignificant sensitivity, which was associated with an overall low pain tolerance threshold. The use of local application anesthesia with the lidocaine 2.5% and prilocaine 2.5% cream helped perform the labia contour correction procedure comfortably and without pain, which was confirmed by the results of a repeated questionnaire survey assessing the effectiveness of the local application anesthesia.

Gastric and duodenal peptic ulcer disease is a multifactorial pathology, in the etiopathogenesis of which the general and local reactions of the body to external and internal risk factors play a role. Psychoemotional stress is the main cause of the pathology of nervous and humoral regulation (general reaction), and the local reaction is expressed in a violation of the ratio between the factors of aggression and protection factors in the mucous membrane of the stomach and / or duodenum. The combined action of these components leads to the formation of an ulcerative defect.

Objectives The objective of this trial was to compare outcomes of electrocoagulation tuboplasty and continued medical therapy for treating persistent Eustachian tube dysfunction (ETD) with hypertrophic mucosa disease in the Eustachian tube (ET) orifice. Study Design Prospective, case-control trial. Material and Methods Patients with persistent ETD were recruited and allocated to electrocoagulation tuboplasty and continued medical therapy groups. The ETD questionnaire-7 (ETDQ-7) score and objective parameters were compared between the groups at 6 and 12 months. Results The proportion of patients with a decrease in ETDQ-7 scores was greater in the electrocoagulation group than in the medical therapy group at the 6-month follow-up (53.49% and 34.38%, respectively; p = .158), but the difference was not statistically significant. However, at the 12-month follow-up, there was a significantly higher proportion of patients with a decrease in ETDQ-7 scores in the electrocoagulation group (88.37% and 40.63%, respectively; p = .001). Additionally, a significant difference was observed between the groups in terms of the proportion of patients who improved 12 months after the treatment (tympanometry: 72.09% and 9.38%, respectively; p = .001; air-bone gap: 79.07% and 25.00%, respectively; p = .001; tympanic membrane status: 62.79% and 0.00%, respectively). In addition, the proportion of patients with improvements in the ET inflammation score was significantly different between the groups at 6-month (67.44% and 34.38%, respectively; p = .009) and 12-month (93.02% and 34.38%; p = .001) follow-ups. No device- or procedure-related serious adverse events were reported in any patients. Conclusions Electrocoagulation Eustachian tuboplasty appears to be a safe and feasible procedure for adult persistent ETD with hypertrophic mucosa disease in the ET orifice, and is superior to continued medical management alone. The improvements in ETDQ-7 and objective parameters persisted for 12 months.

Aims Multisystemic inflammatory syndrome in children (MIS‐C) is a condition noted in some children asymptomatic but positive to Sars‐cov‐2 antibody and it presents clinical and laboratory changes similar to Kawasaki disease (KD). Oral changes have also been observed. This systematic review evaluated oral manifestations detected in children with MIS‐C and KD associated to COVID‐19. Methods and Results This work was registered at PROSPERO (#CRD42020225909), following PRISMA guidelines. A comprehensive research was conducted in MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Grey Literature through August 2021, based on original research evaluating children diagnosed with MIS‐C or KD related to COVID‐19. Two authors independently screened all retrieved references. Twenty five selected studies evaluated 624 children, mean age 8.78 years. The assessment of the risk of bias (ROB) showed that most of them presented low ROB. Oral manifestations were erythematous mucous membrane, oral ulcers lesions, dry, swollen and cracked lips, and strawberry tongue. Conclusion MIS‐C and KD share the same oral manifestations and their identification may lead to an early diagnosis.

Introduction. The difficulty in diagnosing different clinical forms of bronchitis is due to the fact that their clinical manifestations have a number of similar symptoms, despite the fact that these diseases may be as-sociated with different forms according to the classification. Diagnosis can be often complicated by the pre-disposition of very young children to recurrent respiratory diseases, which often mark the formation of a pro-longed and recurrent course of the disease caused by viral and bacterial contamination of the respiratory tract. The aim of this study is to investigate viral and microbial contamination of the respiratory tract in vari-ous clinical forms of bronchitis of infants and to clarify their etiological significance in parallel with the as-sessment of the intestinal microflora. Materials and methods. 578 children aged from 6 months to 3 years with various clinical forms of bronchitis were monitored. Virological examination was performed by the direct Coons method, which detected viral antigens in the cells of the mucous membrane of the lower nasal si-nuses. Bacteriological examination was performed by bacterial inoculation of nasopharyngeal mucus, spu-tum and feces in a nutrient medium. Results. Clinical and laboratory examination of young infants made it possible to identify the influence of detected viral antigens and pathogenic microflora in the throat, sputum and feces on the formation of various clinical forms of bronchitis and their clinical peculiarities not only in the period of exacerbation, but also in a remission period that indicates the persistence of viruses and bacteria. Conclusion. Detection of viral antigens, dysbiosis and microbial aggression of the upper and lower respira-tory tract gives grounds for substantiating the indications for staged rehabilitation therapy for infants with various clinical forms of bronchitis.

Urethral pain syndrome (UPS) is characterized by the occurrence of persistent or recurrent pain in the urethra in the absence of a confirmed infection and other obvious local pathological changes. The study of its pathogenetic aspects is important first of all for understanding the causes of the disease, to prescribe effective treatment, specific recommendations for the prevention and treatment of this disease are also absent. This paper presents the advanced experience of our research group on the study of the urethral state by the in vivo cross-polarization optical coherence tomography (CP OCT) method, and also the results of the microbiota analysis in the urethral tissues. The purpose of the study is to search for the risk factors for UPS and the character of changes in the urethral tissues, using the data of: 1) concomitant pathology, 2) structural changes in the urethral wall in UPS in comparison with chronic cystitis of bacterial etiology 3) studying the microbiota of urethral tissues. Materials and methods The condition of the urethra was studied in 109 patients: 55 of them with UPS (group "US"), without clinical manifestations of inflammation; 41 - with chronic inflammation of the lower urinary tract of various origins (group "Inf"); in 14 patients with stones of the upper urinary tract without pyelonephritis, the urethra was taken as the norm (group "N"). All performed a clinical minimum of studies, also cystoscopy with the study of the bladder triangle, the neck of the bladder and the urethra by the method of in vivo tissue imaging - CP OCT. The device "OCT-1300U" with wavelength of 1300 nm is used. To determine the possible role of UPS disease background, the analysis of concomitant pathology preceding the development of UPS was performed. To analyze the relationship of changes in the urethral tissues with the composition of its microbiota, a PCR study of biopsies from the proximal segment of the urethra was performed in 13 patients with UPS. Results Qualitative comparison of the thickness and character of the OCT signal of the urethral wall layers observed using CP OCT in the studied groups of patients allowed us to establish that the state of the epithelium and connective tissue structures of the mucous membrane in patients with UPS is not the norm, changes are similar to those in chronic inflammation. Changes in the character of the OCT signal were recorded in all parts of the urethra, but in the middle third they are most pronounced and most critical. In UPS, there is a brightly pronounced reorganization of the connective tissue stroma components. Pronounced fibrosis of subepithelial structures (increased signal brightness in the cross-channel compared to the norm) with their thickening was recorded in 48.2% of cases, and thinning/lack of visualization of the epithelial layer was detected in 20.5%, and in chronic inflammation 55.5% and 40.6% of cases, respectively. According to the results of PCR, only one patient had significant total bacterial contamination of the biopsy (TB=104.7). In all other cases, the total bacterial mass of the biopsies was at the level of negative control. Conclusions In patients with UPS, the presence of several concomitant, often chronic, diseases was revealed, which may be a premorbid background and one of the risk factors for the occurrence and maintenance of UPS. Pilot PCR studies of biopsies from the proximal segment of the urethra indicate that low values of bacterial contamination in the majority of patients with UPS do not exclude the possible role of bacteria in the development of the disease in some patients. The CP OCT method used in this study is currently the only one in vivo method of visualization of the urethral mucosa, which provides real-time images of structural changes in the epithelial (atrophy or hyperplasia) and connective tissue (active or latent inflammation with cellular infiltration or fibrosis) layers of the urethra, allowing better understanding of the pathogenesis of the disease and monitoring of therapy.

Background/Objectives Obesity increases colorectal cancer (CRC) risk. However, the effects of weight loss on CRC risk are unclear. Epigenetic mechanisms involving microRNAs that lead to dysregulated gene expression may mediate the effects of obesity and weight loss on CRC risk. We examined the effects of obesity and weight loss following Roux-en-Y gastric bypass (RYGB) on microRNA expression in the human rectal mucosa. Subjects/Methods We collected rectal mucosal biopsies from obese patients (n = 22) listed for RYGB and age- and sex-matched healthy non-obese Controls (n = 20), at baseline and six months post-surgery. We quantified microRNA expression in rectal mucosal biopsies using Next Generation Sequencing and bioinformatics analysis to investigate the likely functional consequences of these epigenetic changes. Results Compared with non-obese individuals, obese individuals showed differential expression of 112 microRNAs (p p p Conclusion Our findings show, for the first time, that obesity is associated with dysregulated microRNA expression in the human rectal mucosa. Further, surgically-induced weight loss may normalise microRNA expression in this tissue.

Aim The aim of this study was to evaluate the efficacy of a xenogeneic collagen matrix to augment the width of keratinized mucosa (KM), concomitantly to the surgical treatment of peri-implantitis, when compared to the use of an autologous soft tissue graft. Material and methods In this 12-month parallel-arm randomized controlled clinical trial, patients with peri-implantitis were randomly assigned, one month after non-surgical therapy, to surgical resective treatment of peri-implantitis consisting on an apically positioned flap (APF) in combination with a KM augmentation procedure, either with an autologous free gingival graft (FGG) or a collagen matrix (CM). Primary outcomes were the increase in the width of KM and probing pocket depth (PPD) reduction at 12 months. As secondary outcomes, peri-implant radiographic and patient-reported outcomes were assessed. Results The intention-to-treat population consisted of 49 subjects, assigned to either the APF + FGG (n = 23) or APF + CM (n = 26) group. PPDs were reduced by 1.6 mm (SD 1.0) and 1.7 mm (SD 1.2), respectively, being these differences non statistically significant (p = .782). However, the increase in KM was significantly higher in the APF + FGG compared with APF + CM (2.5 mm [SD 1.6] vs. 1.6 mm [SD 1.2], respectively (p = .033). Conclusion The tested surgical modalities resulted in similar improvements of the clinical parameters. Both free gingival graft and collagen matrix significantly increased the peri-implant keratinized mucosa, but this KM gain was significantly higher with the free gingival graft. Use of CM, however, was better appreciated by the patients, in terms of pain perception and analgesic consumption, although the surgical time was similar.

OBJECTIVES Endoscopic resection (ER) is indicated for a wide range of superficial esophageal squamous cell carcinomas (ESCCs). We examined the long-term outcomes in patients with pathological (p) invasion of ESCC into the T1a-muscularis mucosae (MM) and T1b-submucosa (SM) after ER, for which data on prognosis are limited. METHODS Of the 1217 patients with superficial ESCC who underwent ER, 225 patients with a pathological diagnosis of ESCC invasion into the MM, minute submucosal invasion ≤200 µm (SM1), or massive submucosal invasion (SM2) were included. In patients with lymphovascular invasion, droplet infiltration, or SM2 invasion, additional treatments, including chemoradiation (CRT) or esophagectomy with two- to three-field lymph node dissection, were recommended. The median observation period was 66 months (interquartile range 48-91 months). RESULTS In total, there were 151, 28, and 46 pT1a-MM, pT1b-SM1, and pT1b-SM2 cases, respectively. Metastatic recurrence was observed in 1.3%, 10.7%, and 6.5% patients with pT1a-MM, pT1b-SM1, and pT1b-SM2 ESCCs, respectively. Of the eight patients with metastatic recurrence, six were successfully treated, and two died of ESCC. The 5-year overall survival rates were 84.1%, 71.4%, and 67.4%, the 5-year relapse-free survival rates were 82.8%, 64.3%, and 65.2%, and the 5-year disease-specific survival rates were 100%, 96.4%, and 99.1% in patients with pT1a-MM, pT1b-SM1, and pT1b-SM2 ESCCs, respectively. Multivariate analysis showed that additional CRT and esophagectomy, and T1b-SM2 were positively and negatively associated with overall survival, respectively. CONCLUSIONS Endoscopic resection preceding appropriate additional treatments resulted in favorable outcomes. Many cases of metastatic recurrence in this cohort could be successfully treated.

Objectives to assess the features of the inflammatory process of the nasal mucous membrane and sinuses in patients with сhronic rhinosinusitis with nasal polyps (CRSwNP). Material and methods. We analyzed the results of examination of 44 patients with CRSwNP. The objects of investigation were smears-reprints from the mucous membrane of the middle turbinate (rhinocytograms) and the intensity of the extracellular peroxidase activity of the lavage fluids of the maxillary sinuses. The data obtained were processed using the Statistica 8.0 software. Results. When analyzing rhinocytograms of the mucous membrane of the middle turbinates, the epithelial type of rhinocytogram was most often detected in 65.9% of cases (epithelial cells more than 50%); the eosinophilic type in 22.7% (eosinophils more than 1%) and smears with mast cells in 4.6% of cases; the neutrophilic type was less frequent (neutrophils more than 50%) 6.8% of cases. In 34.1% of patients, the cells of the columnar epithelium had pronounced changes in the cytoplasm (vacuolization and enzymatic activity); and in 38.6% of cases the gross pathology was recorded directly in the nucleus of the cells (nucleoli, granules, destruction of the nucleus). The revealed pathology of the cell nucleus suggests the viral etiology of the development of productive inflammation in the nasal cavity and sinuses In the lavage fluids of the maxillary sinuses, a high intensity of extracellular peroxidase activity was recorded (1777.9132.4 a.u. compared to 1225.0190.9 a.u. in patients with chronic purulent rhinosinusitis and 1245.0362.3 a.u. in patients with purulent-polypous rhinosinusitis). Conclusion. Chronic rhinosinusitis with nasal polyps is accompanied by a pronounced inflammatory process of the nasal mucous membrane and paranasal sinuses in the form of structural and functional changes in the cells of the columnar epithelium and a high intensity of extracellular peroxidase activity. The epithelial nucleus damage (the presence of nucleoli, granules, destruction of the nucleus) suggests a viral nature with the development of productive inflammation in the nasal cavity and sinuses.

Purpose of the study: to conduct a morphological study of experimental material to assess the features of wound healing in the anal sphincter area when using the domestic drug “Heprocel” as a hemostatic agent. Material and methods. The study was carried out in the Department of experimental surgery and the department of pathological anatomy of the Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov. The state of experimental models of wounds with the application of a hemostatic agent in the form of a gel was studied. The experiments were carried out on 72 white male rats weighing 210-250 g. Two series of 36 animals each were produced. All animals were divided into groups: norm - experiment in the absence of drug hypocoagulation; control - an experiment with intravenous heparin to achieve drug hypocoagulation; experience - an experiment with intravenous administration of heparin to achieve drug hypocoagulation using an application on a model of a skin wound and a dissected anal sphincter of the hemostatic agent "Heprocel". Results. Morphological differences in the process of wound healing were most pronounced after 3 days of the study. In the control group of animals with hemostasis using an electrocoagulator, necrotic and exudative processes of inflammation in the stratified squamous epithelium and mucous membrane of the glands in the anal region were evident. In the experimental group, on the 3-5th day of the experiment, the proliferative process of inflammation predominated morphologically. A special feature is that the hemostatic gel is absorbed into the wound, forming a thin uniform layer. On the 10th day of the experiment, the above difference became more obvious. In the control group, chaotic squamous epithelial cells and fibroblasts were formed. The fibrin-necrotic layer is preserved. Focal infiltration of macrophages-lymphocytes was observed. In the experimental group, the intestinal layers began to change. In the area of the surgical incision, the hemostatic layer is preserved; in this area, the growth of thin fibrous connective tissue is observed. Differentiation and transformation of cells led to the regeneration of the epithelial layer and parakeratosis of the flat cell. Signs of complete remodeling were evident over a long period of time, such as 14 days. Conclusion. The use of a hemostatic agent in the form of a gel provides not only an increase in the processes of local hemostasis, but a decrease in the activity of inflammatory reactions and infection, as well as the risk of developing post-traumatic cicatricial deformity of the anus.

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are dermatologic emergencies. There is a lack of consensus regarding appropriate management of SJS/TEN. The aim of this study was to evaluate demographic and clinical features, management and outcomes of SJS/TEN patients. Materials and Methods: The data of patients who were ≥18 years old and hospitalized with the diagnosis of SJS, SJS-TEN overlap and TEN at Hacettepe University, between 1992 and 2018 were analyzed retrospectively. Patient demographics, medications, time between the first causative drug intake and the onset of symptoms, mucous membrane involvement, treatment modalities including supportive measures, intravenous immunoglobulin, cyclosporine and systemic corticosteroids, duration of hospitalization, and mortality outcomes were recorded from patient charts. Results: A total of 23 patients (11 men; 12 women) with a mean age of 46.4 ± 19.5 years were included in the study. Twelve patients (52.2%) had SJS, 8 patients (34.8%) had SJS/TEN overlap and 3 patients (13%) had TEN. Mean duration of hospitalization was 12.6 ± 6.5 days. Twenty-two patients (95.7%) were attributed to a specific medication, whereas triggering factor was not detected in 1 patient (4.3%). More than one drug was responsible for 9 patients, including antimicrobials (n=11, 47.8%), anticonvulsants (n=8, 34.8%) and/or non-steroid anti-inflammatory drugs (n=5, 21.7%). The median time between the intake of medication and the onset of symptoms was 20 days (IQR 5.5-30). Sixteen patients used systemic corticosteroids (69.6%) and 4 patients used intravenous immunoglobulin (17.4%) whereas 3 patients used systemic corticosteroids in combination with intravenous immunoglobulin (n=2, 8.7%) or cyclosporin (n=1, 4.3%). The median time between the onset of symptoms and the onset of the rash to the treatment was 5 days (IQR 3-7). Mortality was not observed in our cohort. Conclusion: SJS/TEN was most commonly developed because of drugs, mainly antimicrobials, anticonvulsants and/or non-steroid anti-inflammatory drugs. The absence of mortality in our cohort was considered to be associated with younger age, low rate of TEN, prompt initiation of treatment (mainly corticosteroids) following the rapid discontinuation of the suspected drug.

The paramedian forehead flap provides excellent aesthetic and functional results for the reconstruction of full-thickness maxillary defects. However, previous radiation therapy reduces elasticity of tissues and their healing capacity. We describe the use of Lyoplant, an absorbable biocompatible membrane derived from bovine pericardium, for full-thickness maxillary reconstruction after maxillectomy in an irradiated patient, providing a step-by-step description of the procedure. The Lyoplant membrane was sutured to the internal edge of the refreshed borders of the maxillary defect, to achieve a complete closure of the loss of sinonasal mucous membrane and to guarantee a support to the forehead flap. It can drive sinonasal mucosa regeneration with early resolution of nasal crusting. No complications, such as infection, extrusion, or subsidence of the flap, were observed. Lyoplant can be considered a safe and easily available support for locoregional flap and mucosa regeneration in post-operative defects of nasal cavity and central face in irradiated patients.

Актуальность. Согласно данным литературы, частота гастроэзофагеальной рефлюксной болезни (ГЭРБ) в популяции составляет от 7 до 60 %, а у детей, по данным различных авторов, колеблется от 2–4 до 8,7–49 %. У детей ГЭРБ часто формируется на фоне хронической гастродуоденальной патологии. Цель. Изучение эндоскопической картины верхних отделов пищеварительного тракта при их сочетанном поражении у детей. Материалы и методы. Под наблюдением находилось 120 детей с сочетанными ГЭРБ и хронической гастродуоденальной патологией. Диагнозы верифицированы с помощью эзофагогастродуоденоскопии. Дети были разделены на группы в зависимости от характера поражения слизистой пищевода. В I группу вошли 35 детей с эрозивным и язвенным эзофагитом; во II группу включены 43 ребенка с катаральным эзофагитом; III группу составили 42 ребенка с ГЭРБ без эзофагита. Результаты. Частота гастроэзофагеального рефлюкса III степени достоверно чаще встречается у детей с ГЭРБ и эрозивно-язвенным эзофагитом. При умеренно выраженной гиперемии и отеке слизистой оболочки желудка у детей достоверно чаще (p < 0,05) формируется ГЭРБ без эзофагита. При ярко выраженных воспалительных изменениях слизистой желудка достоверно чаще (p < 0,05) имеет место гастроэзофагеальный рефлюкс с воспалительным поражением слизистой пищевода и формированием как катарального, так и эрозивного эзофагита. Деструктивные изменения слизистой в пищеводе и в луковице двенадцатиперстной кишки (ДПК) не коррелируют между собой. Выводы. При сочетанных ГЭРБ и хронической гастродуоденальной патологии степень выраженности эзофагита зависит от характера поражения слизистой желудка и ДПК.

An early and accurate pregnancy diagnosis method is required to improve the reproductive performance of cows. Here we developed an easy pregnancy detection method using vaginal mucosal membrane (VMM) with application of Reverse Transcription-Loop-mediated Isothermal Amplification (RT-LAMP) and machine learning. Cows underwent artificial insemination (AI) on day 0, followed by VMMcollection on day 17-18, and pregnancy diagnosis by ultrasonography on day 30. By RNA sequencing of VMM samples, three candidate genes for pregnancy markers (ISG15 and IFIT1: up-regulated, MUC16: down-regulated) were selected. Using these genes, we performed RT-LAMP and calculated the rise-up time (RUT), the first-time absorbance exceeded 0.05 in the reaction. We next determined the cutoff value and calculated accuracy, sensitivity, specificity, positive prediction value (PPV), and negative prediction value (NPV) for each marker evaluation. The IFIT1 scored the best performance at 92.5% sensitivity, but specificity was 77.5%, suggesting that it is difficult to eliminate false positives. We then developed a machine learning model trained with RUT of each marker combination to predict pregnancy. The model created with the RUT of IFIT1 and MUC16 combination showed high specificity (86.7%) and sensitivity (93.3%), which were higher compared to IFIT1 alone. In conclusion, using VMM with RT-LAMP and machine learning algorithm can be used for early pregnancy detection before the return of first estrus. (c) 2021 Published by Elsevier Inc.

Background. Ulcerative colitis is a chronic inflammatory disease of unknown origin, characterized by a clinically recurrent course with periods of bloody diarrhea and pathomorpholo­gical-diffuse inflammatory process in the colon. The problem of ulcerative colitis requires further study of the clinical features of the disease, taking into account the localization, degree of activity of the inflammatory process, changes in the structure of the mucous membrane that will help increase the efficiency of ulcerative colitis diagnosis in childhood. Materials and methods. On the basis of clinical and statistical analysis of 116 case histories of children aged 4–18 years with ulcerative colitis, the features of its clinical forms — total, segmental and distal — were studied during the period of exacerbation of the disease. Four hundred and forty-five biopsy specimens obtained during colonoscopy were histologically examined. After biopsy sampling, specimens were fixed in 10% formalin and were processed according to the generally accepted histological method with section staining using hematoxylin-eosin and according to Van Gieson. Results. Changes in the architecto­nics of the large intestine mucosa, which reduce the resistance of the mucous barrier, as well as impaired blood supply — a factor in the development of hemic hypoxia — are significant for the mechanisms of ulcerative colitis exacerbation.

Actuality. Diseases of the stomach and duodenum in children tend to continual growth, and the pathology itself is characterized by a group of features that are absent in adults. Aim: to identify the features of blood serum cytokine profile in children with chronic gastroduodenal pathology (CGDP). Material and methods. The main clinical group consisted of 54 children aged 8–18 years with CGDP. The comparison group consisted of 24 apparently healthy children matched for age and sex with the main clinical group. Results. 88.9% of children with CGDP had an increase of interleukin‑4 (IL‑4) as opposed to the indicators in comparison group of children. In case of combination with H.pylori, the level of IL‑4 decreased. The concentration of tumor necrosis factor alpha (TNF-α) was not significantly different from that of the comparison group of children in all types of infection, but its slightly higher values were at parasitosis. The highest IL‑4 has been registered in ulcerative lesions of the mucous membrane of the stomach and duodenum. These patients had the highest level of TNF-α. Conclusion. In children with ulcerative lesions of the mucous membrane, increased acid-forming function of the stomach, the significant prevalence of lesions (pangastritis), we have detected significantly higher values of IL‑4 and TNF-α.

Food Allergy (FA) is now one of the most common chronic diseases of childhood often lasting throughout life and leading to significant worldwide healthcare burden. The precise mechanisms responsible for the development of this inflammatory condition are largely unknown; however, a multifactorial aetiology involving both environmental and genetic contributions is well accepted. A precise understanding of the pathogenesis of FA is an essential first step to developing comprehensive prevention strategies that could mitigate this epidemic. As it is frequently preceded by atopic dermatitis and can be prevented by early antigen introduction, the development of FA is likely facilitated by the improper initial presentation of antigen to the developing immune system. Primary oral exposure of antigens allowing for presentation via a well-developed mucosal immune system, rather than through a disrupted skin epidermal barrier, is essential to prevent FA. In this review, we present the data supporting the necessity of 1) an intact epidermal barrier to prevent epicutaneous antigen presentation, 2) the presence of specific commensal bacteria to maintain an intact mucosal immune system and 3) maternal/infant diet diversity, including vitamins and minerals, and appropriately timed allergenic food introduction to prevent FA.

BACKGROUND: The mucous membrane of the maxillary sinus is sensitivis susceptible to infection or inflammation adjacent to it, which may contribute to mucous membrane thickening (MMT). Residual alveolar bone quality (RABQ) is considered a quality of the remaining bone apical to periodontal defect adjoining to the floor of the maxillary sinus. OBJECTIVE: The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using cone-beam computed tomography (CBCT). METHODS: In this retrospective observational study, 240 sinus exposure CBCT records of 146 patients were evaluated. Patients with at least one sinus exposure were included. RABQ and MMT were calculated using CBCT inbuilt tools. RABQ was divided into four groups based on gray scale values (GSV). Statistical analysis was performed using one way ANOVA and independent sample t-tests. Correlation was completed applying Pearson’s correlation coefficient. RESULTS: A significant difference (p< 0.05) was observed between the MMT values of the four RABQ groups. Inverse correlation was observed between mean MMT and GSV values. Mean MMT was higher than pathological MMT range (> 2 mm), with significant differences in groups A and B, where mean GSV values are less than 500. Mean GSV greater than 500 in groups C and D show non-pathological MMT. Prevalence of MMT is 91.4% if GSV is < 500 and 7.5% if GSV is > 500. CONCLUSIONS: Our study suggests that MMT is present if RABQ has GSV values < 500. Maxillary sinusitis and its etiology from periodontal pathology can be excluded based on RABQ adjoining periodontal lesion. Early detection and prompt treatment along with appropriate regenerative protocols can be performed to increase the RABQ. Further microbiological investigation is required to support the present results.

Актуальность. Важность проблемы хронических заболеваний кишечника на сегодняшний день не подлежит сомнению. Это подтверждается этиологией неизвестного генеза, отсутствием специфического лечения, развитием ­угрожающих жизни осложнений, необходимостью проведения длительной, часто пожизненной, дорогой терапии и неблагоприятным прогнозом. Большую часть больных составляют лица молодого трудоспособного возраста, средний возраст которых — 20–35 лет. Но в 30–50 % случаев заболевание может проявиться в любом возрасте. Цель: оценить особенности морфологического состояния слизистой оболочки толстой кишки больных при хронических воспалительных заболеваниях кишечника в зависимости от возраста и пола. Материалы и методы. Для исследования были использованы биоптаты слизистой оболочки толстой кишки больных, находившихся на лечении в отделении заболеваний кишечника ГУ «Институт гастроэнтерологии НАМН Украины» и распределенных по полу и возрасту. Результаты. При анализе морфофункционального состояния слизистой оболочки больных были выявлены признаки хронического неспецифического воспаления умеренной и четко выраженной степени выраженности при неспецифическом язвенном колите. При болезни Крона как у мужчин, так и у женщин отмечались признаки хронического неспецифического воспаления первой степени. Аллергический компонент воспаления, представленный эозинофилами, был отмечен во всех случаях. Также отмечались нарушение архитектоники крипт, истощение муцинового слоя и нарушение целостности эпителия. Выводы. Пациенты молодого возраста имели более четко выраженную морфологическую картину хронического воспаления слизистой оболочки толстой кишки при неспецифическом язвенном колите. Мужчины, больные неспецифическим язвенным колитом, имеют большее истощение слоя муцина и нарушение архитектоники крипт в молодом и среднем возрасте, а при болезни Крона такие признаки чаще встречаются у женщин., Актуальність. Важливість проблеми хронічних захворювань кишечника на сьогодні не підлягає сумніву. Це підтверджується етіологією невідомого генезу, відсутністю специфічного лікування, розвитком загрозливих для життя ускладнень, необхідністю проведення тривалої, часто довічної, дорогої терапії і несприятливим прогнозом. Велику частку хворих становлять особи молодого працездатного віку, середній вік яких — 20–35 років. Але в 30–50 % випадків захворювання може проявитися в будь-якому віці. Мета: оцінити особливості морфологічного стану слизової оболонки товстої кишки хворих на хронічні запальні захворювання кишечника залежно від віку та статі. Матеріали та методи. Для дослідження було використано біоптати слизової оболонки товстої кишки хворих, які перебували на лікуванні у відділенні захворювань кишечника ДУ «Інститут гастроентерології НАМН України» і були розподілені за статтю та віком. Результати. При аналізі морфофункціонального стану слизової оболонки хворих було виявлено ознаки хронічного неспецифічного запалення помірного і чітко вираженого ступеня вираженості при неспецифічному виразковому коліті. При хворобі Крона і в чоловіків, і в жінок відмічались ознаки хронічного неспецифічного запалення першого ступеня. Алергічний компонент запалення, представлений еозинофілами, був відмічений у всіх випадках. Також відмічались порушення архітектоніки крипт, виснаження муцинового шару та порушення цілісності епітелію. Висновки. Пацієнти молодого віку мали більш чітко виражену морфологічну картину хронічного запалення слизової оболонки товстої кишки при неспецифічному виразковому коліті. Чоловіки, хворі на неспецифічний виразковий коліт, мають більше виснаження шару муцину та порушення архітектоніки крипт у молодому та середньому віці, а при хворобі Крона такі ознаки частіше зустрічаються в жінок., Background. The importance of the problem of chronic bowel diseases is beyond doubt today. This is confirmed by unknown origin, lack of specific treatment, the development of life-threa­tening complications, the need for long, often life-long, expensive therapy and adverse prognosis. The majority of patients are persons of young working age, whose average age is 20–35 years. But in 30–50 % of cases, the disease can manifest at any age. Purpose was to conduct morphological evaluation of the mucous membrane of the colon in patients with chronic inflammatory bowel diseases depending on the age and gender. Materials and methods. We have examined biopsy specimens of the mucous membrane of the colon in patients who were treated at the department of intestinal diseases of the State Institution “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine” and were distri­buted by gender and age. Results. When analyzing the morphological and functional state of the mucous membrane of patients, signs of moderate and clearly pronounced chronic nonspecific inflammation were revealed in nonspecific ulcerative colitis. In Crohn’s disease, manifestations of chronic nonspecific inflammation of the first degree were observed in both men and women. The allergic component of inflammation represented by eosinophils was noted in all cases. An impaired crypt architectonics, depletion of the mucin layer and a breach in the integrity of the epithelium were also noted. Conclusions. Young patients had a more pronounced morphological picture of chronic inflammation of the mucous membrane of the colon in nonspecific ulcerative colitis. Men with nonspecific ulcerative colitis experience greater depletion of the mucin layer and impaired crypt architectonics in young and middle age, and with Crohn’s disease, such signs are more common in women. Also in patients with Crohn’s disease, fibrosis of the colon mucosa was noted.

Актуальность. Нестероидные противовоспалительные средства (НПВС) ежедневно применяют более чем 30 млн человек, а их арсенал насчитывает свыше 80 препаратов и около 1000 созданных на их основе лекарственных форм. Они широко используются во многих сферах медицины и являются одной из наиболее клинически значимых групп лекарственных средств. Однако при использовании НПВС достаточно часто могут возникать побочные реакции, наиболее распространенными из них являются повреждения желудочно-кишечного тракта. Цель: охарактеризовать со­временное представление о механизмах повреждения пищеварительного тракта НПВС, оценить недостатки существующих препаратов патогенетического лечения и перспективы биологической терапии НПВС-индуцированной эзофагогастроэнтероколонопатии криоконсервированным экстрактом плаценты человека. Материалы и методы. Проведен анализ работ, опубликованных в 2010–2020 гг., в которых освещались сведения об эпидемиологии, патогенезе, диагностике и тактике лечения поражений пищевода и желудочно-кишечного тракта, индуцированных НПВС, а также биологические свойства криоконсервированного экстракта плаценты человека как средства биологической терапии. Результаты. Лечение НПВС-индуцированной эзофагогастроэнтероколонопатии классически направлено на кислотосупрессивную терапию (ингибиторы протонной помпы, Н2-гистаминоблокаторы и др.), применение гастроцитопротекторов (де-нол, сукральфат и др.) и препаратов, восстанавливающих содержание простагландинов в слизистой оболочке (мизопростол, ребамипид и др.). Однако все указанные группы лекарственных средств недостаточно удовлетворяют клиницистов, поскольку направлены преимущественно на лечение НПВС-гастропатии и имеют побочные эффекты. Новым перспективным направлением повышения безопасности НПВС на сегодняшний день является применение средств биологической терапии, источниками которых выступают микроорганизмы, органы и ткани растительного или животного происхождения, клетки или жидкости (в том числе кровь и плазма) человеческого или животного происхождения и биотехнологические клеточные конструкции. Выводы. Использование НПВС значительно ограничивается присущими им побочными эффектами, наи­более распространенными являются нарушения со стороны желудочно-кишечного тракта. Криоконсервированный экстракт плаценты человека является перспективным средством биологической терапии ульцерогенных повреждений желудочно-кишечного тракта, индуцированных НПВС.

Background. The microbiome of the pre-epithelial biofilm of the large intestine in direct contact with the body also interacts with the immune and other systems that emphasizes the urgency of its study in various diseases. The purpose of the study was to determine the taxonomic composition, population level, analytical microecological indicators and the degree of microecological disorders of the pre-epithelial biofilm of the large intestine in albino rats with thyrotoxicosis. Materials and methods. Experiments were carried out on 25 mature male albino rats weighing 220–240 g, of which 15 animals were included to the control group (intact animals), and 10 rats — to the main group. The experimental thyrotoxicosis was simulated by intragastric administration of L-thyroxine for 14 days. Under sterile conditions, a laparotomy was performed, a segment (up to 3 cm) of the large intestine with its contents was taken. The washed portion of the intestine was homogenized with a sterile 0.9% NaCl solution. A series of ten-fold dilutions with 10 –2 to 10 –7 concentrations of the initial mixture were prepared. From each tube, 0.01 ml were seeded on solid optimal nutrient media with subsequent isolation and identification of microbes according to morphological, tinctorial, cultural and biochemical properties. Results. In some animals, bifidobacteria and lactobacilli, as well as bacteroides and escherichia, are eliminated. A significant deficiency of not only bifidobacteria by 48.50 % and lactobacillus by 94.59 %, but also of bacteroides by 44.85 % was established. Determination of the quantitative dominance of each taxon showed that the dominant role of bifidobacteria in the microbiocenosis is reduced by 82.76 %, lactobacillus — by 2.20 times, and the role of bacteroides in the microbiocenosis of the epithelial biofilm of the large intestine of albino rats with the experimental thyrotoxicosis — by 43.04 %, E.coli — by 7.18 %, but the role of opportunistic enterobacteria and staphylococci, which contaminated and colonized the mucosa of the large intestine, increased substantially. Conclusions. Experimental thyrotoxicosis is accompanied by a partial elimination from the biotope of the pre-epithelial biofilm of the large intestine of bifidobacteria and lactobacilli, as well as bacteroides. There comes elimination from the colic mucous membrane in all experimental animals of peptostreptococcus, clostridia and enterococci, as well as colonization of the biotope with opportunistic enterobacteria (proteus, klebsiella) and staphylococci.

The morphology and histology of the soft tissue around the implant are different from the periodontal tissue, but the difference in the regulation of blood flow is not known. The aim of the study was to compare the resting blood flow and the vasodilatation capacity of the gingiva between implants and teeth. Twenty-six healthy volunteers with single-tooth implants were involved. The implant-borne crown was retained on either a zirconia or titanium abutment. The vasodilatation capacity of the gingiva was assessed by a postocclusive reactive hyperemia test. Blood flow was measured by a laser speckle contrast imager at the buccal gingiva of the implant-borne crown and an analog natural tooth. No significant differences in baseline gingival blood flow were observed between the different abutments and the teeth in either region. The hyperemia after compression was significantly attenuated at the zirconia abutments in all regions during the entire investigation period (20 minutes) compared to the titanium abutments and the teeth. No differences were observed between titanium abutments and the teeth. The resting microcirculation seems to be the same at implants and teeth. However, the vascular reactivity might be disturbed at the zirconia, but not at the titanium, abutment.

To quantify the urinary bladder wall T1 relaxation time (T1) before and after the instillation contrast mixture in rats previously subjected to water avoidance stress (WAS) and/or acute exposure to protamine sulfate (PS). Female Wistar rats were randomized to receive either sham (control) or 1 h of WAS for ten consecutive days before the evaluation of nocturnal urination pattern in metabolic cages. T1 mapping of urinary bladder wall at 9.4 T was performed pre- and post- instillation of 4 mM Gadobutrol in a mixture with 5 mM Ferumoxytol. Subsequently, either T1 mapping was repeated after brief intravesical PS exposure or the animals were sacrificed for histology and analyzing the mucosal levels of mRNA. Compared to the control group, WAS exposure decreased the single void urine volume and shortened the post-contrast T1 relaxation time of mucosa- used to compute relatively higher ingress of instilled Gadobutrol. Compromised permeability in WAS group was corroborated by the urothelial denudation, edema and ZO-1 downregulation. PS exposure doubled the baseline ingress of Gadobutrol in both groups. These findings confirm that psychological stress compromises the paracellular permeability of bladder mucosa and its non-invasive assay with MRI was validated by PS exposure.

Objective To investigate the expression of chromobox 2 (CBX2) in colorectal adenoma (CRA) and colorectal cancer (CRC), and analyse its correlation with various clinicopathological parameters. Study design Observational study. Place and duration of study Pathology Department, Huashan Hospital, Fudan University, from December 2019 to December 2020. Methodology The mRNA level of CBX2 in colorectal mucosa, CRA and CRC was evaluated in gene expression profiling interactive analysis (GEPIA) and gene expression omnibus (GEO) dataset, then verified by quantitative real-time PCR (qRT-PCR). CBX2 expression by immunohistochemistry was determined in 122 samples, then its correlation was analysed with various clinicopathological parameters. Diagnostic value of CBX2 was estimated by the receiver operating characteristic curve (ROC). Prognostic value of CBX2 mRNA expression was evaluated via the Kaplan-Meier method in GEPIA. Results CBX2 expression rate in CRC (89.8%) was greater than adenoma (37.74%) and mucosa (20%). CBX2 protein levels were highest in adenocarcinoma and lowest in mucosa with intermediate level in adenoma. The area under curve (AUC) of CBX2 was 0.810 and 0.734, respectively, in distinguishing CRA from mucosa and CRC from CRA. CBX2 hyperexpression was not significantly correlated with clinicopathological variables, either in CRA or CRC. Kaplan-Meier survival analysis revealed that CBX2 mRNA hyperexpression was not associated with overall survival (OS) of CRC. Although the disease-free survival (DFS) of high CBX2 patients was shorter than those with low expression, but no obvious significance was found in colon adenocarcinoma (COAD, p=0.052) and rectal adenocarcinoma (READ, p=0.097). Conclusion CBX2 expression progressively increased in the sequence of mucosa-adenoma-carcinoma, which may be used as a diagnostic biomarker and therapeutic target for CRA and CRC. Key Words: CBX2, Colorectal adenoma, Colorectal cancer, Biomarker.

The 2007 Banff working classification of skin-containing Tissue Allograft Pathology addressed only acute T cell-mediated rejection in skin. We report the longitudinal long-term histological follow-up of six face transplant recipients, focusing on chronic and mucosal rejection. We identified three patterns suggestive of chronic rejection (lichen planus-like, vitiligo-like and scleroderma-like). Four patients presented lichen planus-like and vitiligo-like chronic rejection at 52 ± 17 months posttransplant with severe concomitant acute T cell-mediated rejection. After lichen planus-like rejection, two patients developed scleroderma-like alterations. Graft vasculopathy with C4d deposits and de novo DSA led to subsequent graft loss in one patient. Chronic active rejection was frequent and similar patterns were noted in mucosae. Concordance between 124 paired skin and mucosal biopsies acute rejection grades was low (κ = 0.2, p = .005) but most grade 0/I mucosal rejections were associated with grade 0/I skin rejections. We defined discordant (grade≥II mucosal rejection and grade 0/I skin rejection) (n = 55 [70%]) and concordant (grade≥II rejection in both biopsies) groups. Mucosal biopsies of the discordant group displayed lower intra-epithelial GranzymeB/FoxP3 ratios suggesting a less aggressive phenotype (p = .08). The grading system for acute rejection in mucosa may require phenotyping. Whether discordant infiltrates reflect a latent allo-immune reaction leading to chronic rejection remains an open question.

Background Autoimmune bullous diseases in childhood are a diagnostic challenge. Case We present the case of an 11-year-old girl with recurrent vulvar erosions since early childhood. She had been referred to a child abuse unit under the suspicion of sexual abuse. She responded well to dapsone and topical corticosteroids. Summary and conclusion Our review focuses on previously reported cases of pemphigoid (bullous or mucous membrane) in childhood with exclusively genital involvement as well as summarizes mucous membrane pemphigoid cases diagnosed during childhood. There seems to be a differentiated form of pemphigoid predominantly affecting girls with exclusively vulvar involvement and with good prognosis. Dermatologic evaluation and a skin biopsy with direct immunofluorescence are key to diagnosing a mucous membrane pemphigoid. Further antigenic studies are needed to nosologically classify the disease properly.

Gallbladder polyps are an elevation of the mucous membrane that protrudes into the lumen of the gallbladder cavity. Pathology, according to world literature, occurs with a frequency of 0.3% to 13.8%. Currently, the diagnosis of polypoid formations of the gallbladder is based on the routine use of ultrasound, without further clarifying research, which often leads to errors in treatment tactics. In the domestic literature, there are very few studies on this topic, despite the relevance of this area.

The rapid spread of the 7 th cholera pandemic over Asia in the 1960s led to several large field studies that revealed that the traditional injectable cholera vaccines had poor efficacy, usually less than 50% for only 3-6 months, which led WHO in the 1970s to stop recommending cholera vaccination. At the same time, it stimulated research that has led to the development of the effective orally administered cholera vaccines (OCVs) that today are a cornerstone in WHO´s strategy for "Ending Cholera - A Global Roadmap to 2030". The first effective OCV, Dukoral™, containing a mixture of inactivated Vibrio cholerae bacteria and cholera toxin B subunit, was licenced in 1993 and is together with two similar inactivated whole-cell OCVs, Shanchol™ and Euvichol™/Euvichol-Plus™, the OCVs currently prequalified and recommended by WHO. This brief review is a personalized account of the "modern history" of the development of these now universally recognized effective tools for the control and ultimate elimination of cholera, and of the pivotal role of icddr,b and Bangladesh for this development.

BACKGROUND AND AIM The proper visibility of mucosa during esophagogastroduodenoscopy (EGD) is crucial for the detection of early upper gastrointestinal tract lesions. In contrast to colonoscopy, no validated scoring system for the assessment of upper gastrointestinal mucosal cleanliness has been developed so far. The aim of the study was to create and validate standardized grading system (POLPREP) to assess the mucosal cleanliness during EGD. METHODS To assess the visibility of mucosa during EGD, 4-point scale was developed (0-3). Twelve operators assessed 18 images of esophagus, stomach, and duodenum twice (in 2 weeks interval). In validation round, the images and endoscopy reports of 443 EGDs performed in six centers were assessed. RESULTS The inter-observer accordance of POLPREP was 0.8 (intra-class correlation coefficient; 0.79 consultants, 0.85 trainees). The intra-observer repeatability was 0.64 (Fleiss kappa value; 0.64 consultants, 0.64 trainees). The lesions detection rate was significantly higher in clean (scores 2 and 3; 19.7%) than in "unclean" segments (score 1; 7.7%, P = 0.049). Score 3 was associated with over three-fold higher lesion detection than score 1 (odds ratio 3.2, 95% confidence interval 1.1-9; P = 0.03). CONCLUSIONS The proposed POLPREP scale allows for unified assessment of upper gastrointestinal tract mucosal cleanliness. The higher cleanliness scores are related with greater upper gastrointestinal pathologies detection.

Endoscopic resection (ER) is performed for early esophageal squamous cell carcinoma (ESCC) cases. Additional esophagectomy or chemoradiotherapy is recommended for non-curative resection (NCR) even with pathologically negative vertical margins (pVM0); however, their clinical outcomes remain unknown. We examined the long-term clinical outcomes of NCR for ESCCs according to additional treatments.We retrospectively analyzed the data of patients who underwent ER for cT1N0M0 ESCC between 2009 and 2017 judged to have NCR, which defined when pathologically diagnosed as invading the submucosa (SM) or muscularis mucosae (MM) involving lymphovascular invasion (LVI), pVM0, and endoscopically judged as negative horizontal margin. Additional esophagectomy (involving three-field lymphadenectomy), chemoradiotherapy [mainly cisplatin and 5-fluorouracil with concurrent radiotherapy (41.4 Gy)], or observation was undertaken. Thereafter, computed tomography was performed every 6-12 months. The cumulative recurrence (CRR) and recurrence-free survival (RFS) rates were evaluated.Eighty-nine patients were included. Among them, 14 had pathologically diagnosed pMM with LVI; 9 and 6, and 32 and 28 patients had pSM1 and pSM2 without and with LVI. Twenty-one patients underwent observation, whereas 18 and 50 underwent esophagectomy and chemoradiotherapy. During the 60.6-month median follow-up period, nine patients had recurrence; among them, six patients had occurrence at 4 years after ER. The 5-year CRR/RFS rates were 35.7%/48.1%, 13.4%/80.4%, and 0.0%/98.0% in the observation, esophagectomy, and chemoradiotherapy groups, respectively (observation vs. chemoradiotherapy; P 0.001).Additional treatments showed better long-term outcomes than observation for patients with NCR. As recurrence may occur at 4 years after ER, careful long-term follow-up examinations are needed.

The article presents some information about xanthomatosis, as well as about xanthomas of the stomach, which are benign formations, but their etiopathogenesis is unknown. Some believe that there is a relationship between xanthomas of the stomach and hyperlipidymia, diabetes, preneoplastic changes in the mucous membrane, age-related features of the gastric mucosa.The clinical case described in this report confi rms the existing point of view about xanthomas as markers of preneopastic changes in the gastric mucosa and its precancerous diseases.

The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea.Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection.The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents.The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better.In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.Обоснование. Новая коронавирусная инфекция COVID-19 может проявляться поражением органов желудочно-кишечного тракта (ЖКТ). Повреждение ЖКТ вирусом SARS-CoV-2 приводит к нарушению микробно-тканевого комплекса слизистой оболочки пищеварительного тракта. Частым гастроэнтерологическим проявлением COVID-19 является диарея. Цель. Изучение клинических особенностей гастроэнтерологических расстройств и возможности оптимизации терапии диарейного синдрома у пациентов с COVID-19 с легкой формой вирусной инфекции. Материалы и методы. Группу наблюдения составили 230 больных COVID-19 легкой степени тяжести: К-группа (n=115) с респираторными симптомами, I группа (n=115) с гастроинтестинальными проявлениями в сочетании и без признаков поражения органов дыхания. С целью сравнения эффективности лечения диарейного синдрома пациенты I группы рандомизированы в 2 подгруппы: Iа (n=58) лечение пребиотиком (Закофальк) и Iб (n=57) энтеросорбентами. Результаты. Развитие желудочно-кишечных симптомов при инфицировании SARS-CoV-2 достоверно чаще отмечено у коморбидных пациентов (67%). Среди гастроинтестинальных симптомов доминировали диарея (93,9%) и метеоризм (76,5%), у 1/3 пациентов они были первыми манифестами инфекции. Установлено, что у 98,4% больных I группы (против 42,6% К-группы) выявлялись признаки инфекционной интоксикации. У пациентов с поражением ЖКТ отмечены удлинение лихорадочного периода на 91,5 дня, более поздняя (на 6 дней) верификация вирусной этиологии заболевания. Установлено, что у пациентов I группы регресс клинических симптомов, длительность вирусного заболевания, динамика формирования антител, прогноз развития расстройств, подобных синдрому раздраженного кишечника (СРК), в постинфекционном периоде зависели от проводимого лечения. У пациентов, принимавших Закофальк, эти показатели были достоверно лучше. Заключение. В легких случаях для снижения тяжести вирусного поражения кишечника, эффективного купирования кишечных симптомов, снижения риска формирования СРК-подобных симптомов целесообразно назначение Закофалька в начальной дозе 3 таблетки в сутки.

As the gastrointestinal tract may also be a crucial entry or interaction site of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the role of the gut mucosal immune system as a first-line physical and immunological defense is critical. Furthermore, gastrointestinal involvement and symptoms in coronavirus disease 2019 (COVID-19) patients have been linked to worse clinical outcomes. This review discusses recent data on the interactions between the virus and the immune cells and molecules in the mucosa during the infection. By carrying out appropriate investigations, the mucosal immune system role in SARS-CoV-2 infection in therapy and prevention can be established. In line with this, COVID-19 vaccines that stimulate mucosal immunity against the virus may have more advantages than the others.

Melanoma is derived from melanocytes, which are located in multiple regions of the body. Cutaneous melanoma (CM) represents the major subgroup, but less common subtypes including uveal melanoma (UM), mucosal melanoma (MM), and acral melanoma (AM) arise with distinct genetic profiles. Effective treatments for CM are ineffective in UM, AM, and MM, and patient survival remains poor. As reprogrammed cancer metabolism is associated with tumorigenesis, the underlying mechanisms are well studied and provide therapeutic opportunities in many cancers; however, metabolism is less well studied in rarer melanoma subtypes. Here, we summarize current knowledge of the metabolic alterations in rare melanoma and potential applications of targeting cancer metabolism to improve therapeutic options available to UM, AM or MM patients.

Background . At present, the role of cytomegalovirus infection in the disruption of acental formation and associated pathological conditions of the fetus is bvious, which are based on oxidative and inflammatory reactions that cause disruption of igration and invasion of trophoblasts, angiogenic modulation of placental and uterine vessels. Objective: To analyze the quantitative indicators of hypoxia-inducible factor 1α, α-tocopherol and docosahexaenoic acid in the peripheral blood in comparison with morphological changes in the placenta and uterine mucosa in seropositive women with spontaneous abortion associated with reactivation of ytomegaloviral infection. Methods: Studies were carried out at 7-9 weeks of gestation. 67 observations were analyzed, including 35 seropositive women in the first trimester with spontaneous abortion associated with reactivation of cytomegaloviral infection and 32 healthy seronerative women with voluntary termination of pregnancy. Stabilized blood from vein, epithelium of the inner surface of the cheek, cervical canal, urine, villous chorion, and uterine mucosa were used as the test material. Enzyme immunoassay was used to detect serological markers of cytomegaloviral infection (CMV-IgG/IgM antibodies, CMV-IgG avidity), hypoxia-induced factor 1α, α-tocopherol – by fluorometric method, PCR (polymerase chain reaction) in real time – DNA CMV, the method of gas-liquid chromatography – docosahexaenoic acid, histological methods – the general plan of the structure of the chorionic villus and the mucous membrane of the uterus. Results: In seropositive women with spontaneous abortion associated with reactivation of cytomegaloviral infection, the average of hypoxia-induced factor 1α was 1.54 times higher, α-tocopherol and docosahexaenoic acid were 1.71 times lower and 1.40 times lower (p < 0.001, respectively) than in the group of eronegative women. Strong inverse correlations were revealed. Morphologically, there were signs of delayed formation of villi, decidualization of the endometrial stroma and the formation of uteroplacental vessels. Conclusion. In seropositive women with spontaneous abortion associated with reactivation of cytomegaloviral infection, a strong association of high HIF-1α values with decrease in α-tocopherol and docosahexaenoic acid in the peripheral blood was revealed, which can be considered as an unfavorable factor in the disruption of placenta formation.

Objectives The aim of the present retrospective study was to evaluate papillae filling rate and buccal margins coronal growth in implant‐supported prostheses which were over‐contoured at the apical buccal third to form a rearmost collar zone, thus mimicking a false root. Material and methods The influence of adjacent elements, teeth, implants, or pontics was examined. One‐hundred and three crowns have been assessed in photographs taken on 61 patients after prosthesis delivering and at last follow‐up (mean 2.8 years). The Jemt index was adopted to evaluate papillae growth at the baseline and follow‐up as follows: 0, absence of papilla; 1, less than half of interdental embrasure height; 2, more than half of interdental embrasure height; 3, fully papilla filled interdental embrasure. Index score 4, papilla hyperplasia was not included. Moreover, the coronal growth (or recession) of buccal mucosa in implant‐supported crowns was assessed. Results At baseline, a total of 29 papillae had a 0 score, while only two scored 3 with complete papilla formation. On follow‐up, only one papilla scored 0, while 46 scored 3 with complete interdental embrasures filling. The highest papilla score was registered from first year crown insertion and likewise in interdental embrasures located between two implants or implants and pontics. Moreover, the buccal margin growth was observed in almost 80% of crowns. Such findings seem to indicate that buccal margin and papilla around implant‐supported crowns presented a coronal growth over time, especially during its first year. The average papilla growth between two implants was no lower than that observed in papilla present between implants and natural teeth. Conclusions Recessed areas at collar of implant‐supported prostheses appear to positively influence papillae and buccal margin growth, especially in its first year. Papilla growth between two implants was similar to that observed between implants and natural teeth.

Vaccination has been recently attracted as one of the most successful medical treatments of the prevalence of many infectious diseases. Mucosal vaccination has been interested in many researchers because mucosal immune responses play part in the first line of defense against pathogens. However, mucosal vaccination should find out an efficient antigen delivery system because the antigen should be protected from degradation and clearance, it should be targeted to mucosal sites, and it should stimulate mucosal and systemic immunity. Accordingly, mucoadhesive polymeric particles among the polymeric particles have gained much attention because they can protect the antigen from degradation, prolong the residence time of the antigen at the target site, and control the release of the loaded vaccine, and results in induction of mucosal and systemic immune responses. In this review, we discuss advances in the development of several kinds of mucoadhesive polymeric particles for mucosal vaccine delivery.

Recent advances in endoscopic imaging of the esophagus have revolutionized the diagnostic capability for detecting premalignant changes and early esophageal malignancy. In this article, we review the practical application of narrow-band imaging focusing on diseases of the esophagus, including Barrett’s esophagus, adenocarcinoma, and squamous cell carcinoma. (Gut Liver 2021;15:492-499)

Dipeptidyl peptidase 4 inhibitors (DPP-4i) are associated with an increased risk of developing bullous pemphigoid (BP) in patients with diabetes. Autoantibodies targeting epitopes on the processed BP180, 120-kDa (LAD-1), and 97-kDa (LABD97) linear immunoglobulin (Ig)A dermatosis antigens are the major autoantibodies in DPP-4i-associated BP. However, no case of mucous membrane pemphigoid (MMP) developing during treatment with DPP-4i has been reported. We report a case of MMP associated with DPP-4i. A man in his late 70s presented with oral mucous membrane erosion and a few blisters on his upper chest and back. He had used linagliptin for diabetes for over 1 year when he presented. The immunological characteristics were similar to DPP4i-associated BP: higher reactivity to LAD-1 and LABD97 than to the full-length BP180. The aphthae achieved remission after oral linagliptin was replaced with sitagliptin. However, 6 months later, the aphthae relapsed and any DPP-4i was discontinued. The aphthae disappeared, and now he is completely free from lesions associated with MMP. This case suggests that the DPP-4i may have shared roles in the production of IgG antibodies to LAD-1 or to LABD97 in the pathogenesis of DPP-4i-associated BP and MMP. Our case highlights the possibility of overlooking the mild MMP in DPP-4i-treated diabetes patients with mucosal lesions.