New possibilities of complex ttreatment of cervical ectropion

Introduction. Ectropion of the cervix (EC) is a condition when there is a cicatricial deformity of the uterine cervix (as a result of traumatic injuries) with visualization of the ectopic columnar epithelium on the vaginal part of it. The ectopia is currently classified as a variant of the normal histophysiological state of the cervix. This article discusses the features of the course and methods of treatment of complicated EC.Objective of the study is: to develop and evaluate the effectiveness of a new method of complex treatment of CE.Material and methods. In an open prospective study, 133 patients with CE (groups 1 and 2) and 56 healthy women (group 3) has taken part. In group 1 (n = 83), we have used a method for treating CE developed by us, which included two stages: stage I – elimination of microbial and viral pathogen in combination with immunomodulatory therapy, II – electrosurgical treatment (Leep biopsy) and treatment of the cervix with Galavit (100 mg of dry matter) dissolved in 5 ml of Miramistin (Patent for invention RU 2568768 C1). In group 2 (n = 50), surgical treatment of CE has been preceded by vaginal sanitation, empirical antibacterial and antiviral therapy. Diagnostic measures, in addition to standards, have included: determination of interleukins IL-1β, IL-6, IL-8, IL-10 in the discharge of the cervical canal, ultrasound diagnostics with Doppler measurements in the vessels of the central zone of the cervix. Statistica 7.0, SPSS 17 packages have been used for statistical processing.Results and discussion. Before the start of treatment, patients in groups 1 and 2 have been found to have a combination of CE with cervicitis (100%), ASCUS cytological picture (more than 60%), abnormal colposcopic signs (100%), imbalance of the local immune system with a predominance of Th1 cytokines (the content of IL-8 increased 2.6 times; IL-1b – 13 times; IL-6 – 20 times, and IL-10 – in 1.7 times) against the background of increased vascularization and cervical perfusion. The reparative process after Leep biopsy in group 1 has ended by the end of 3 weeks in 65.6% of patients, in group 2 – in 25.5%, after 5 weeks – in 100% and 57.4%, respectively, after 8 – in group 2, 91.5%. The average period of epithelialization of a wound on the cervix in group 1 was 27.4 ± 4.3 days, in group 2 – 39.5 ± 5.6 days (p = 0.01). After 2 years, the recurrence of cervical pathology has been recorded only in group 2 (34.0%).Conclusion. The use of the developed method of two-stage complex therapy for CE increases the effectiveness of treatment, prevents complications after Leep biopsy, accelerates epithelialization by 30.6% and avoids recurrence of the disease.

Nasal Secretion Cytology of Children Attending a Primary School in Enugu Metropolis – A Preliminary Evaluation using the Blow-out Technique

Nasal smear is a valid method used to distinguish inflammatory and non-inflammatory conditions. The present study was conducted to evaluate the cytological picture and neutrophilic infiltration of nasal secretions of children from a primary school within Enugu metropolis in Enugu State, Nigeria. The study included 100 apparently normal pupils, 20 each from grade levels 1 to 5. The blow-out technique was used to obtain samples from the nasal cavity for smear preparation on slides. May-Grunwald-Giemsa was used to stain the smears for light microscopical examination. Smears were assessed for the presence of infiltrating inflammatory cells and a semi-quantitative grading of neutrophilic infiltration was conducted on each sample to indicate either absent, few, moderate or many. Mean age of participants is 6.25±0.44 years (range: 6–11 years). Results revealed that age and grade level of study had a strong association with the grade score of neutrophilic infiltration (p<0.05). Grade level 1 pupils, the youngest group (mean age: 6.25±0.44 years), had the highest abnormal cytological picture and neutrophilic infiltration while those in grade levels 3 to 5 who were older, were lower. There was no association between gender and neutrophilic infiltration. It can be concluded that significantly increased neutrophilic infiltration are obtained in the nasal secretions of younger schoolchildren below the age of 9 than the older pupils. This study also indicates that the blow-out method is a useful technique for obtaining nasal secretions for the assessment of infiltrating cells.

Recommendations for Cerebrospinal Fluid Cytology. A Review Article

The description of cytological findings in cerebrospinal fluid (CSF) is very inconsistent in the literature since no generally recognized uniform classification of these findings has been proposed to date. The need for developing such a classification system becomes quite obvious against the background of renaissance CSF cytology is currently experiencing in our country. A precondition sine qua non for developing a uniform classification system is its general applicability and recognition as well as a capacity to establish, using precisely formulated conclusions, the aetiological diagnosis, something quite impossible with today's terminology. Our draft classification is that used by a team of physicians working previously in the CSF Laboratory of the Department of Neurology of Charles University School of Medicine I in Prague. The classification employed there is based on monitoring pathology in the cytological picture both according to the presence of the prevailing cellular population in CSF and to the presence of activation in elements of lymphocyte and monocyte lines. We were able to combine both criteria into a single viable system expressing the current status of cellular response in CSF. The presence of a pathological cytological finding provides the basis for defining individual cytological CSF syndromes closely related to the etiological diagnosis of the patient, which in the great majority of cases make it possible to formulate the diagnostic conclusion. The classification employed allows to establish the diagnosis in diseases manifesting themselves by at least a mild alteration of the cytological picture. In general, it is useful for classifying inflammatory, neoplastic diseases, inter-meningeal haemorrhage and morphological manifestations of CNS tissue destruction. A distinct advantage is the plausible classification of cytological findings in oligo-cellular CSF specimens which to date has been difficult to make due to the low numbers of cellular elements detected in samples. In cytological examination of CSF, the parameters evaluated include, in addition to the number of elements, qualitative representation of individual cellular lines. (1-Monografie). When evaluating the monocyte-macrophage system and/or the reticuloendothelial system, attention is focused on the proportions of activated monocytes and, particularly, on the presence of macrophages showing a specific substrate of phagocytosis. It is according to this substrate that macrophages are further divided into erythron-phages, sidero-phages, lipo-phages, lympho-phages, leuko-phages or myco-phages, etc. To visualize a substrate, it is often necessary to use additional staining e.g., staining by Oil Red for lipids, Berlin Blue for iron, etc. If inter-meningeal haemorrhage is suspected, monitoring of the phagocytosis of red blood cells and haematogenic pigments allows us to determine the approximate age and course of the bleeding. Monitoring of lipo-phagocytosis visualizing the scavenging response on CNS parenchymal damage also has a number of potential applications. As the number of CSF examinations increases, proportionately increasing numbers of cells are being detected. This is true especially of diseases involving the presence of primary or secondary neoplastic processes right in the CNS or in the vicinity of CSF pathways. The currently employed cytological methods of CSF examination, whenever malignant elements were detected, have made it possible to establish the presence of a tumor disease in general only. For instance, monitoring of the functional status of nucleoli, PAS positivity, or the presence of adipose droplets in the cytoplasm suggest only indirectly an increased metabolic activity of the cells monitored. Other morphological markers of atypical cells (polymorphism of cells, nuclei, polynuclear elements, cytoplasm basophilia, atypical mitoses, etc.,) may only raise suspicion of the presence of a tumorous process, but not identify the cellular system the belong to. Another problem which by no means is negligible is the low number of cells detected. As a result, we started to study the mode of reaction of atypical elements with certain monoclonal antibody binding to individual antigens, tumor markers specific for the respective cellular populations. Moreover, the method can be used to determine the degree of their maturity, presence of individual receptors, state of activation in the course of their cellular cycle.

Diagnostic parallels in the cytological diagnosis of squamous breast cancer. Clinical case

Introduction. Squamous cell carcinoma is a rare form of breast cancer, makes up no more than 2% of invasive breast cancer, usually found in old age. The effectiveness of the cytological research method in the preoperative diagnosis of breast cancer directly depends on the sample preparation of the obtained material. Description of the clinical case. The possibilities of cytological diagnostics are presented using modern methods of sample preparation such as liquid cytology, cell blocks. Conclusion. Features of the cytological picture in combination with clinical and radiological data should become the basis for reliable diagnosis of squamous breast cancer at the preoperative stage.

Study of clinical and morphological features of postoperative nasal septum perforations

The literature provides many ways to close perforations of the nasal septum (NS), there is no differential approach to the choice of technique depending on the etiological factor. Objective: to study the clinical and morphological features of tissues at the edges of postoperative nasal septum perforations (PNSP) to substantiate the choice of the optimal surgical technique. Materials and methods. 52 patients are divided into 3 groups in accordance with the area (S) of PNSP: 1st S < 1 cm2 (10%); 2nd S 1–2 cm2 (75%), 3rd S > 2 cm2 (15%). In group 2, the subgroups are: 2A – PNSP without curvature of the NS (CNS) (52%); 2B – PNSP with CNS (48%). The state of the mucous membrane (MM) and supporting tissues at the edges of the PNSP, the results of a cytological study from the edges of the PNSP, and specific complaints of the patients were evaluated. Results: In group 1 and 2 at the edges of the PNSP, there was a significant decrease in tissue elasticity compared with group 3, indicating a deficit in supporting tissues (p < 0.05). The ratio of the area of the defect of supporting tissues and PNSP in group 1 was 1 to 3.5, in group 2 – 1 to 1.5, in group 3 – 1 to 1.1. A high degree of elasticity of the posterior edge of PNSP is accompanied by pronounced clinical manifestations, regardless of the size of PNSP, and is confirmed by the cytological picture of inflammation (p <0.01). The presence of CNS enhances the clinical manifestations of PNSPI (p < 0.05). Conclusion: the structure of the edges of PNSP forms the clinical picture of the disease. When choosing a closure method for PNSP, the surgeon must solve the following problems: the size of the NS defect required for replacement is determined not so much by the dimensions of the PNSP as the area of the defect in the supporting tissues of the NS; with a deficit of local tissues, it is advisable to additionally use grafts; MM in the area of the posterior and lower edges has pronounced signs of inflammation, these tissues should be removed during the operation.

A comparative evaluation of bone marrow biopsy and bone marrow aspiration in different haematological condition with special reference to leukaemia and lymphoma

Background: For diagnosis of haematological disorders there are three modalities to examine bone marrow, bone marrow aspiration cytology (BMA), bone marrow imprint (BMI) and bone marrow biopsy (BMB). BMA gives cytological picture; BMI also gives cytological picture but cells are less in number and BMB gives cytological as well as architectural picture. BMA alone may not be sufficient to reach diagnosis therefore the present study was undertaken to compare the above modalities. The study was conducted with the aim to perform cytomorphological evaluation of bone marrow in various haematological disorders with special reference to leukaemia and lymphoma and to compare bone marrow aspiration smears with bone marrow trephine biopsy.Methods: The present study was conducted in department of pathology, LLRM Medical College, Meerut inpatients attending the outpatient department and in-patient department of pediatrics and medicine of SVBP Hospital attached to LLRM Medical College, Meerut, over a period of one year i.e. from March 2018 to May 2019. A detailed clinical history, physical examination and laboratory examination of all the cases was done.Results: Out of 50 cases, maximum number of cases were of anemia 26/50 (52%) followed by leukemia 17/50 (34%), lymphoma 5/50 (10%), multiple myeloma 1/50 (2%), myelofibrosis 1/50 (2%), leishmaniasis 1/50 (2%) and idiopathic thrombocytopenic purpura 1/50(2%). BMA smears were compared with biopsy and concordance and discordance was established. The overall diagnostic accuracy of aspiration was 94%.Conclusions: Bone marrow examination is a safe, quick easy and cost-effective procedure with very less patient discomfort. BMA shows better cellular details when compared to BMI and BMB. BMB is diagnostic investigation in dry tap cases like aplastic anemia, myelofibrosis, myelodysplastic syndrome and metastatic tumors. In present study, concordance between BMA and BMB was seen in majority of the cases and diagnostic accuracy was 94% study concludes that bone marrow aspiration cytology and trephine biopsy complement each other and should be performed simultaneously for complete bone marrow work up and evaluation.

Development of a Neurocomputer Modular Information System for Cancerous Diseases Diagnostics in Animals

Information system was developed in the form of a web application that makes it possible to identify microscopic images of cytological samples, to establish an initial diagnosis and to provide recommendations for its further confirmation based on additional data. Approaches, assumptions and prerequisites adopted in the information system development are described. It is proposed to use neural networks as the information system element in sample identification and making the initial diagnosis. Patient data, affected area images and microscopic images of cytological samples are planned to be collected in the information system database under creation. Cytological sample images serve as the input data for neural networks operation. Cytological picture assessment is based on the use of the following characteristic features: preparation background, number and location of cells, size and shape of cells, nucleus, presence of multinucleated cells and fission entities (atypical mitoses), etc.

PSVI-26 Cytological picture of the lymphoid tissue in the inguinal node with calval leptospirose

In this regard, the cytological picture of the lymphoid tissue in calves’ inguinal lymph node with spontaneous leptospirosis was studied. The study material was taken from the inguinal lymph node of the 11 calves who died of leptospirosis during the enzootic period in Azerbaijan. The study material samples were fixed in 10% neutral formalin solution, followed by pouring in paraffin, coloring azur sections with 2-eosin and counting 13 cell types (lymphoblast, prolymphocyte, lymphocyte, free reticular cell, process sinus reticular cell, endothelium, fibroblast, histiocyte, macrophage, polyblast, plasmablast, protoplasmocyte, plasmacyte) using MOV-15. It was established that the number of lymphoblasts in the inguinal lymph node with subacute leptospirosis decreased 2.2 times, the number of prolymphocytes decreased 1.4 times, the number of lymphocytes decreased 4.4 times. The number of free reticular cells from the cells of the reticuloendothelium decreased 3.7 times. However, the number of grown sinus reticular cells and the endothelium of the sinuses fluctuated within the normal range. The number of fibroblasts increased 1.7 times, histiocytes - 6.6 times, macrophages - 11.8 times, and polyblasts - 11 times (Table 1). At the same time, there was a sharp increase in the number of cells in the plasma row. Of those, the number of plasmablasts increased 8.5 times, protoplasmocytes - 30.4 times, plasma cells - 17 times. Overall, the cytological picture in the inguinal lymph node during spontaneous leptospirosis in calves was characterized by an increase in the number of plasma cells, fibroblasts, histiocytes, macrophages, polyblasts and a decrease in the number of lymphoblasts, prolymphocytes, lymphocytes and free reticular cells.