Наукові праці. Кафедра загальної та клінічної патофізіології імені Д.О. Альперна

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A case report of a hemorrhagic stroke with atrial fibrillation in combination with hypertension
(2024) Samoilova, Hanna; Markovska, Olena; Tovazhnyanska, Olena; Myroshnychenko, Mykhailo; Bibichenko, Viktoria; Sakal, Hanna
Background. Stroke is a heterogeneous syndrome, and identification of risk factors and treatment dependson the specific pathogenesis of the disease. Cardiovascular diseases are risk factors for the development of acute disorders of cerebral circulation. According to recent studies, one third of all ischemic strokes are cardioembolic. The main pathoetiology of a hemorrhagic stroke in the form of intracerebral hemorrhages is chronic hypertension and cerebral amyloid angiopathy. The occurrence of a hemorrhagic stroke against the background of atrial fibrillation in combination with hypertension is a rather rare phenomenon and poses a problem in the choice of treatment for such patients. The aim was to determine the optimal treatment for a complex case of a hemorrhagic stroke with atrial fibrillation in combination with hypertension. Materials and methods. We present the clinical case of an 84-year-old woman who developed a hemorrhagic stroke on the background of atrial fibrillation in combination with hypertension. The main issue the cardio-neurological team faced was the administration of oral anticoagulants. On the one hand, the patient had indications for their administration according to current clinical guidelines (CHA2 DS2-VASc score of 6 points); on the other hand, the presence of a hemorrhagic stroke is a contraindication. Results. This case demonstrates the solution to the difficult issue of choosing treatment for a hemorrhagic stroke and prevention of secondary complications of atrial fibrillation in combination with hypertension. After medical cardioversion, using clinical recommendations for the treatment of a hemorrhagic stroke, as well as given the positive dynamics of the neurological status, the patient was prescribed apixaban at a dose of 2.5 mg twice a day under the control of a coagulogram from the 7th day of the disease onset. Conclusions. We believe it is necessary to perform a thorough neurological examination and assessment of cognitive functions in all patients with atrial fibrillation, as well as to consider neuroimaging prior to the prescription of anticoagulant therapy. We recommend considering the administration of oral anticoagulants to patients with a low risk of recurrence and a high risk of thromboembolic complications after intracerebral hemorrhage.
Morphological and functional features of the colonic mucus barrier in patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis
(2024) Dorohavtseva, Hanna; Dorofieiev, Andrey; Dyadyk, Olena; Myroshnychenko, Mykhailo
Aim: The purpose was to identify the morphological and functional features of the colonic mucus barrier in patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis. Materials and Methods: In the research, three groups were formed. Group 1 included fragments of the mucous membrane of the large intestine, which were collected from 12 people during autopsies. The results of autopsies and histological examination of the material did not reveal any gastrointestinal pathology. Group 2 included biopsies of the mucous membrane of the large intestine from the area of the diverticulum of 34 patients with symptomatic uncomplicated diverticular disease. Group 3 included biopsies of the mucous membrane of the large intestine of 26 patients with acute uncomplicated diverticulitis. Histological (hematoxylin and eosin staining), histochemical (PAS reaction) and immunohistochemical (mouse monoclonal antibodies to Mucin 2 (MUC2) and Mucin 4 (MUC4)) staining methods were used. A morphometric study was also carried out. Results: In patients with diverticular disease, the authors identified disturbances in the morphofunctional state of the mucus barrier of the colon, the structure and function of goblet cells contained in its mucous membrane, characterized by a decrease in the thickness of the mucus layer covering the surface of the mucous membrane; a decrease in the size and number of goblet cells with a decrease in their mucus-producing ability; a change in the mucin profile, characterized by a violation of the content of MUC2 and MUC4. These changes were greatest in patients with acute uncomplicated diverticulitis compared with patients with symptomatic uncomplicated diverticular disease. Conclusions: The identified disturbances in the morphofunctional state of the mucus barrier of the colon, structural and functional changes in goblet cells may be one of the mechanisms for the development of acute uncomplicated diverticulitis and symptomatic uncomplicated diverticular disease.
Reparative osteogenesis in mandible in cases of filling a bone defect with hydroxyapapatite-containing osteotropic material and injecting the surrounding soft tissues with thymalin: experimental and morphological study
(2024) Boiko, Andrii; Malanchuk, Vladislav; Myroshnychenko, Mykhailo
Treatment of patients with mandible bone tissue defects and reparative osteogenesis stimulation in it is an urgent issue today, despite the large number of invasive and non-invasive treatment approaches and scientific research on this topic. The purpose of the study was to identify the morphological features of reparative osteogenesis in the lower jaw bone of rats in cases of filling a bone defect with hydroxyapatite-containing osteotropic material (bone graft «Biomin GT») and injecting the surrounding soft tissues with thymalin. Materials and methods. An experiment was conducted on 48 mature rats of the WAG population weighing 160-180 grams which were divided into four groups. Group 1 included 12 rats with a simulated holey defect in the lower jaw. Group 2 included 12 rats with a simulated holey defect in the lower jaw followed by its closure with hydroxyapatite-containing osteotropic material (bone graft «Biomin GT»). Group 3 included 12 rats with a simulated holey defect in the lower jaw with injecting the surrounding soft tissues with thymalin. Group 4 included 12 rats with a simulated holey defect in the lower jaw followed by its closure with hydroxyapatite-containing osteotropic material (bone graft «Biomin GT») and injecting the surrounding soft tissues with thymalin. The material for the morphological study was a fragment of the lower jaw from the area of the simulated holey defect. Histological, morphometric and statistical research methods were used. Results. In this study, it was shown by the authors an activation of reparative osteogenesis in the lower jaw under conditions of simultaneous filling the bone defect with hydroxyapatite-containing osteotropic material (bone graft «Biomin GT») and injection the surrounding bone defect soft tissue with thymalin. Stimulation of reparative osteogenesis in the lower jaw of rats occurred due to rapid cleaning of the bone defect cavity from necrotic tissues and hematoma fragments; a decrease in the number of neutrophil leukocytes, an increase in the number and morphofunctional state of monocytes, macrophages, lymphocytes, cells of fibroblastic differon; balanced change (increase or decrease) in the number and morphofunctional state of bone forming osteoblasts and bone resorbing osteoclasts depending on the stage of reparative osteogenesis; activation of hematopoietic processes in lamellar bone tissue from the regenerate; activation of bone tissue mineralization processes. Conclusions. Thymalin injection in the soft tissues surrounding the bone defect in the lower jaw, filled with hydroxyapatite-containing osteotropic material (bone graft «Biomin GT»), significantly stimulates the process of reparative osteogenesis, which makes it possible to recommend this technique in dentistry for treatment the patients with mandible bone tissue defects.
Eryptosis in rats with polycystic ovary syndrome under intermittent cold exposure conditions
(2024) Zhulikova, Maryna; Zhulikov, Oleh; Myroshnychenko, Mykhailo; Nakonechna, Oksana; Kapustnyk, Nataliia
Mine-explosive trauma of the maxillofacial region: current state of the problem and description of a case from practise
(2024) Huseynov, Agil; Malanchuk, Vladislav; Maistrenko, Vyacheslav; Myroshnychenko, Mykhailo; Markovska, Olena; Hryniuk, Oleksii; Boiko, Andrii
Military conflicts, terrorist attacks and wars around the world pose a wide range of questions to the medical community about providing medical care to military personnel and civilians with mine-explosive trauma, which is characterized by simultaneous damage of various anatomical areas, including the maxillofacial region. The purpose of this work was to describe a case from practice of treating a patient with a mine-explosive trauma, which manifested by a fracture of the right zygomatic-orbital complex and the upper jaw on the right. Using own case from practice, the authors showed that the treatment of patients with mine-explosive trauma of the maxillofacial region is long-term, multi-stage and should take place in a specialized hospital with the involvement of a team of multidisciplinary specialists
Expression features of T-lymphocytes, B-lymphocytes and macrophages in the post-traumatic regenerate of the mandible rats under conditions of filling a bone defect with hydroxyapatite-containing osteotropic material and thymalin injecting the surrounding soft tissues
(2024) Boiko, Andrii; Malanchuk, Vladislav; Myroshnychenko, Mykhailo; Markovska, Olena; Shapkin, Anton; Marakushyn, Dmytro
Aim: The purpose of the study was to determine the features of the expression of T-lymphocytes, B-lymphocytes, macrophages in the post-traumatic regenerate of the mandible rats under conditions of filling a bone defect with hydroxyapatite-containing osteotropic material and thymalin injecting the surrounding soft tissues. Materials and Methods: An experiment was conducted on 48 mature rats of the WAG population weighing 160-180 grams. Four groups were formed. Group 1 included 12 rats with a simulated holey defect in the lower jaw. Group 2 included 12 rats with a simulated holey defect in the lower jaw followed by its closure with hydroxyapatite-containing osteotropic material (bone graft “Biomin GT”). Group 3 included 12 rats with a simulated holey defect in the lower jaw with injecting the surrounding soft tissues with thymalin. Group 4 included 12 rats with a simulated holey defect in the lower jaw followed by its closure with hydroxyapatite-containing osteotropic material (bone graft “Biomin GT”) and injecting the surrounding soft tissues with thymalin. The material for the morphological study was a fragment of the lower jaw from the area of the simulated holey defect. An immunohistochemical study was performed using monoclonal antibodies to CD68, CD20, CD163, CD86, CD3. Results: A comprehensive experimental and morphological study conducted by the authors revealed that thymalin injection of the soft tissues surrounding the bone defect of the lower jaw, filled with hydroxyapatite-containing osteotropic material “Biomin GT”, stimulates local immune reactions in the post-traumatic regenerate, which is manifested, firstly, by an increase in the number T-lymphocytes on the 3rd day of the experiment and their increase up to the 28th day; secondly, by increasing the number of B-lymphocytes on the 14th day of the experiment with their further increase up to the 28th day; thirdly, by increasing the number of macrophages on the 3rd day of the experiment and their growth up to the 28th day; fourth, changes in macrophages phenotypes (decrease in the number of M1-macrophages and increase in the number of M2-macrophages). Conclusions: Stimulation of local immune reactions in the post-traumatic regenerate can be one of the mechanisms that activate reparative osteogenesis in the lower jaw of rats under the conditions of filling bone defects with hydroxyapatite-containing osteotropic material “Biomin GT” and thymalin injecting the surrounding soft tissues.
Features of apoptotic and proliferative processes in experimental infected radiation-induced skin ulcer under conditions of photodynamic therapy and the use of platelet-rich plasma
(2024) Pushkar, Olena; Myroshnychenko, Mykhailo; Koliada, Oleh
Aim: The purpose of the study was to identify the features of apoptotic and proliferative processes in experimental Staphylococcus aureus-infected radiation skin ulcer under conditions of photodynamic therapy and the use of platelet-rich plasma. Materials and Methods: An experimental study was conducted on 95 six-month-old male rats of the WAG population, which were divided into three groups. Group 1 included 25 animals that were simulated a radiation ulcer of the skin in the thigh area with subsequent application to its surface on the 7th day after irradiation with 0.2 ml of a suspension of the Staphylococcus aureus (ATCC 25923) reference strain (0.5 million microbial cells/cm2 ). Group 2 included 25 animals with Staphylococcus aureus-infected radiation skin ulcer, which were subjected to photodynamic therapy a day after infection. Group 3 included 45 animals with Staphylococcus aureus-infected radiation skin ulcers, which, 1 day after infection, received photodynamic therapy in the first half of the day, and in the second half of the day the periphery of the wound defect was injected with platelet-rich plasma. The material for the study was skin with underlying soft tissues from the area of radiation exposure. Histological, immunohistochemical, morphometric and statistical methods were used. Results: In cases of simultaneous use of photodynamic therapy and platelet-rich plasma, compared with photodynamic therapy alone, the processes of apoptosis and proliferation were more balanced, active, with a shift in the proliferative-apoptotic ratio towards proliferation processes and met the needs of the regenerative process. From the 10th to the 22nd day of the experiment these processes increased, which indicated active healing processes, that, during survey microscopy on the 22nd day, were manifested by the complete filling of the wound cavity with granulation and connective tissues with the presence of an epithelial layer on the surface of the regenerate. From the 22nd to the 45th day of the experiment, a decrease in the rate of regeneration was recorded, as evidenced by a decrease in the intensity of apoptotic and proliferative processes. The intensity of the latter was sufficient, which led to the healing of Staphylococcus aureus-infected radiation skin ulcer on the 45th day with complete restoration of the original structure of the skin. Conclusions: Photodynamic therapy in combination with the use of platelet-rich plasma balancedly activates apoptotic and proliferative processes with a predominance of the latter in granulation and connective tissues filling the lumen of Staphylococcus aureus-infected radiation skin ulcer, which on the 45th day of the experiment leads to wound healing with complete restoration of the original structure of the skin.
Clinical and morphological features of eccrine acrospiroma: analysis of literature data and case from practice
(2024) Myroshnychenko, Mykhailo; Sakal, Hanna; Pasiyeshvili, Nana; Kapustnyk, Nataliia; Kucheriavchenko, Maryna; Kotenko, Oleksandr; Maistrenko, Ihor; Sirenko, Victor
Eccrine acrospiroma is a rare benign tumor of the skin arising from the epithelial cells of eccrine sweat ducts. The clinical picture is characterized by its variability, so a detailed morphological study of the operative material is necessary to establish a diagnosis. Differential diagnosis must be carried out with hemangioma, melanoma, infected sebaceous cyst, metastatic skin lesion, and other tumors from elements of the sweat gland. In the article the authors presented the clinical and morphological analysis of own case from practice of large eccrine acrospiroma on the back surface of the left thigh which was diagnosed in a 56-year-old man.
Special at-rich sequence-binding protein 2 and its role in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact
(2024) Huseynov, Agil; Malanchuk, Vladislav; Myroshnychenko, Mykhailo; Kapustnyk, Nataliia; Sukharieva, Liliia; Selivanova, Larisa
Aim: The purpose of the study was to identify the role of SATB2 in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact. Materials and Methods: An experiment was carried out on 48 mature male rats of the WAG population, which were divided into 4 groups. Each group included 12 experimental animals. Group 1 included rats that were modeled with a perforated defect of the lower jaw body. Group 2 included animals that were modeled with a perforated defect similar to group 1. In animals, a microdevice for electrical action was implanted subcutaneously in the neck area on the side of the simulated bone defect. The negative electrode connected to the negative pole of the battery was in contact with the bone defect. The battery and electrode were insulated with plastic heat shrink material. Group 3 included rats that were modeled with a perforated defect similar to previous groups, the cavity of which was filled with synthetic bone graft “Biomin GT” (RAPID, Ukraine). Group 4 included animals that were modeled with a perforated defect similar to groups 1-3, the cavity of which was filled with synthetic bone graft “Biomin GT” (RAPID, Ukraine). The simulation of electrical stimulation was the same as in group 2. The material for the morphological study was a fragment of the body of the lower jaw from the zone of the perforated defect. Immunohistochemical study was performed using rabbit anti-human SATB2 monoclonal antibody. Results: In the regenerate filling the defect in the bone tissue of the lower jaw of rats, there was an increase in SATB2 expression under conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation. The most pronounced expression of SATB2 was observed under conditions of simultaneous filling the defect with a synthetic bone graft material and electrical stimulation; minimally expressed – in conditions of filling the defect with a synthetic bone graft material; moderately expressed – under conditions of electrical stimulation. In the regenerate, in cases of all treatment methods, SATB2 was expressed by immune cells, fibroblastic differon cells, osteoblasts, and in case of electrical stimulation, also by adipocytes, vascular pericytes and endothelial cells, epidermis. Conclusions: The activation of SATB2 expression identified by the authors is one of the mechanisms for stimulating reparative osteogenesis under the conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation. Мета: Мета дослідження – визначити роль SATB2 у загоєнні експериментального дефекту кісткової тканини нижньої щелепи, заповненому синтетичним кістковим трансплантатом та електростимуляційним впливом. Матеріали і методи: Експеримент проведено на 48 статевозрілих щурах-самцях популяції WAG, які були поділені на 4 групи. Кожна група включала 12 піддослідних тварин. До 1 групи увійшли щури, яким моделювався перфорований дефект тіла нижньої щелепи. До групи 2 увійшли тварини, яким моделювали перфораційний дефект, подібний до групи 1. Тваринам імплантували мікропристрій для електричної дії підшкірно в ділянку шиї з боку імітованого дефекту кістки. Негативний електрод, підключений до негативного полюса батареї, контактував з дефектом кістки. Акумулятор і електрод були ізольовані пластиковим термоусадковим матеріалом. 3 група включала щурів, яким моделювали перфорований дефект, подібний до попередніх груп, порожнину якого заповнювали синтетичним кістковим трансплантатом «Біомін ГТ» (РАПІД, Україна). До 4 групи увійшли тварини, яким моделювався перфорований дефект, подібний до груп 1-3, порожнину якого заповнювали синтетичним кістковим трансплантатом «Біомін ГТ» (РАПІД, Україна). Моделювання електростимуляції проводилося так само, як і в 2 групі. Матеріалом для морфологічного дослідження був фрагмент тіла нижньої щелепи із зони дірчастого дефекту. Імуногістохімічне дослідження проводили з використанням кролячих моноклональних антитіл проти людини SATB2. Результати: При заповненні регенератом дефекту кісткової тканини нижньої щелепи щурів спостерігалося підвищення експресії SATB2 в умовах електростимуляції; заповнення дефекту синтетичним кістково-трансплантаційним матеріалом; одночасне заповнення дефекту синтетичним кістковим трансплантатом і електростимуляція. Найбільш виражена експресія SATB2 спостерігалась за умов одночасного заповнення дефекту синтетичним кістковим трансплантатом та електростимуляції; мінімально виражені – в умовах заповнення дефекту синтетичним кістково-трансплантаційним матеріалом; помірно виражені – в умовах електростимуляції. У регенераті при всіх методах лікування SATB2 експресувався імунними клітинами, фібробластичними дифероновими клітинами, остеобластами, а при електричній стимуляції також адипоцитами, судинними перицитами та ендотеліальними клітинами епідермісу. Висновки: Виявлена авторами активація експресії SATB2 є одним із механізмів стимуляції репаративного остеогенезу в умовах електростимуляції; заповнення дефекту синтетичним кістково-трансплантаційним матеріалом; одночасне заповнення дефекту синтетичним кістковим трансплантатом і електростимуляція.
Features of local immune reactions in skin with underlying soft tissues in patients with multiple sclerosis
(2020) Markovska, Olena; Tovazhnyanska, Olena; Myroshnychenko, Mykhailo; Shapkin, Anton; Nekrasova, Nataliya; Samoilova, Hanna; Lapshyna, Iryna
The aim of the study is to identify the peculiarities of local immune reactions in the skin with underlying soft tissues in patients with different variants of the multiple sclerosis’ course. Material and methods: The study included 35 patients, hospitalized in the neurological department of the Communal Nonprofit Enterprise of Kharkiv Regional Council «Regional Clinical Hospital» with the established diagnosis of multiple sclerosis. The patients were divided into three study groups, based on different variants of this pathology’s course. Group 1 included 16 patients with relapsing-remitting type of multiple sclerosis. Group 2 included 11 patients with a secondary-progressive type of multiple sclerosis course. Group 3 included 8 patients with a primary progressive type of multiple sclerosis. Patients of all groups underwent a biopsy of the skin with underlying soft tissues in the lower third of the inner surface of the right lower leg. The comparison group (group 4) was represented by 10 autopsy cases (7 women and 3 men) conducted on the basis of the pathological anatomy department of the Communal Nonprofit Enterprise of Kharkiv Regional Council «Regional Clinical Hospital». There were no signs of the nervous system’s pathology during life in all cases of this group. The cause of death was a dislocation of the brain stem or hematocephaly and the main disease was arteriovenous malformation or congenital aneurysm of the cerebral vessels. The material for the morphological study was skin with underlying soft tissues. Microspecimens stained with histological and immunohistochemical methods were studied, using an Olympus BX-41 microscope. The obtained data were statistically processed, using Statistica 6.0 and Microsoft Excel 2003 programs. Results: Survey microscopy showed that in groups 1-3 in comparison with group 4 immune cell infiltrations were more pronounced in the skin with underlying hypodermis. Significantly larger mean values of the absolute number of CD 3-, CD 20- and CD 68-positive cells were revealed immunohistochemically in groups 1-3 compared with group 4. Thus, it was found in patients with multiple sclerosis the activation of T-cell immunity, B-cell immunity and macrophage system with the development of an immune imbalance between them. Our results allow us to think about the participation of all the above immune cells in the pathogenesis of multiple sclerosis development. The revealed disorders of local immune reactions in the skin with underlying hypodermis in patients with multiple sclerosis are less pronounced in the remitting-recurrent variant of the course of the disease, more pronounced in the secondary-progressing and, especially, primary-progressing variants. Conclusions: In patients with multiple sclerosis in the skin with underlying hypodermis activation of T-cell immunity, B-cell immunity and the macrophage system is observed with the development of an immune imbalance between them, characterized by the prevalence of the absolute number of macrophages among all immune cells. Less pronounced violations of local immune reactions in the skin with underlying hypodermis are noted in remitting-relapsing variant of multiple sclerosis course, more pronounced in a secondary-progressing and, especially, primary-progressing variants.