Fibromuscular dysplasia of aortic aneurysm vasa vasorum (a rare case report)

Aim. To describe a rare occurrence of fibromuscular vasa vasorum dysplasia of the aortic aneurysm wall.Materials and methods. Surgical material from the ascending aortic aneurysm wall was examined. Longitudinal strips of the aortic wall were excised for histological examination with subsequent 24-h fixation in 10% buffered formalin. A histological isopropanol assay was performed with an automated Logos microwave tissue processor (Milestone, Italy) with subsequent sample embedding into paraffin. Sections were obtained with a rotary microtome (Leica, Germany). Staining was performed with haematoxylin-eosin, van Gieson’s picrofuchsin, orcein for elastic fibres, Hotchkiss’ PAS reaction with alcian blue for glycosaminoglycans. Histological and histochemical properties of the aortic wall were studied and imaged with a Leica DM 1000 microscope (Germany) equipped with a camera ICC50 E at magnifications 40x, 100x, 200x, 400x.Results. The conducted histological examination of the aortic aneurysm wall revealed most pronounced changes in media and adventitia layers. Elastic fibres in media were swollen, homogeneous, crimped, with pronounced dystrophic and necrobiotic changes in smooth myocytes. Regions of compromised cells and elastic fibres in media contained pockets of alcian-positive glycosaminoglycans. Specific changes were revealed in adventitia vasa vasorum in the form of a pronounced wall thickening and lumen narrowing due to dysplastic fibromuscular tissues.Conclusion. A rare form of fibromuscular dysplasia of the vasa vasorum of the ascending aortic aneurysm wall observed in a 43 years-old woman demonstrated the morbid morphology of smooth myocytes, as well as fibrous collagenous and elastic structures. The described features were likely associated with the aortic wall trophic structure and aneurysm morphogenesis.

Substantiation of the Results of Morphological Examination of the Urinary Bladder Wall in Experimental Diabetic Cystopathy

Measurement of consumed water and daily diuresis proved the pathomorphological manifestations of streptozotocin-induced -induced cystopathy in the experiment on rats according to the results of biochemical studies of blood and urine. It is argued that the desquamation of cells in the transitional epithelium, its atrophy, stratification violation, and baring of the basal membrane are caused by a large volume of urine, which excessively stretches the urinary bladder, destroying the intercellular contacts of the urothelial layer. It is proved that primary hyperglycemia leads to widening of the lumen of the arterioles and moderate thickening of the basal membrane of the micro-hemovessels, and high chronic hyperglycemia – directly triggers the whole cascade of pathomorphological changes: on the 42nd day of the experiment it causes vasoconstriction of the arterioles, and at the later terms – the secondary expansion of the arterioles and venules of the microcirculatory bed of UB (urinary bladder); is the cause of dystrophic changes of endothelial cells, further thickening and lamellar transformation of the basal membrane and plasma permeation of the perivascular connective tissue; causes the appearance of dark involutional myocytes with few organelles and sarcoplasm sequestration. Hydropic dystrophy of smooth myocytes has been found to be associated with the hydration of blood plasma as a result of excessive polydipsia in diabetic animals, and vacuole dystrophy of urothelial cells, enlargement of their size and interstitial edema – with low specific urinary density due to the multiple fast increase of diuresis. It has been established that prolonged high glucosuria and decreased diuresis lead to a decrease in urothelial cell size, compaction of their cytoplasm and ultrastructural readjustment. The increase of the content of glycosylated hemoglobin during the experiment justified the appearance and increase of the sludge-syndrome.

Histological features of the mitral valve in normal and opioid exposure in experiment

To date, pathology of the cardiovascular system is the most common, tends to increase, most often leads to disability and mortality of the population at a young working age and is an important medical and social problem. The purpose of the study was to establish the features of micro organization of the mitral valve in white rat in norm and after opioid action. The study material is presented by histological samples of a mitral valve of the white rat. The study was performed on 30 adult white reproductive age rats weighing 160-220 g. The experimental animals were injected intramuscularly 1 time per day for the same period of 42 days (6 weeks) with the opioid drug analgesic “Nalbuphine”. Using histological methods, 30 mitral valves of white rat were examined. Microscopy of histological preparations of the valves of the heart was performed sequentially, assessing the morphological changes in the norm and under the action of the opioid after 6 weeks of the experiment. Emphasis was placed on the presence or absence of endothelial layer, as well as the condition of endothelial cells in normal and at the action of the damaging factor, determining the signs of their dystrophy, desquamation and proliferation. It is established that the normal mitral valve is represented by endocardial folds. The rat endocardium consists of three layers: endothelial (endothelial cells rich layer, attached to the basement membrane), subendothelial (connective tissue rich in fibroblasts) and a muscular-elastic layer (represented by smooth myocytes, plaited collagen fibers). After 6 weeks of administration of Nalbuphine, the mitral valve is in a stage of decompensation, when the outer and inner endothelial layers are destroyed, the endothelial cells are deformed, the subendothelial layer is represented by single bundles of different directions. In the musculo-elastic layer, contact between smooth myocytes and fragmented and thinned, collagen and elastic fibers is lost. This study allows us to conclude on the destructive effect of opioid agents on the valvular apparatus of the heart.

The Role of Smooth Myocytes and Macrophages in Development of Complicated Forms of Arterial Atherosclerosis

Purpose:to conduct morphohistochemical and immunohistochemical study of arterial unstable atherosclerotic plaques for assessment of the state of smooth muscle cells (SMC) and macrophages.Materials and methods.The surgical material of the peripheral arteries (femoral, popliteal, external carotid) was obtained from 50 patients aged over 60 years, followed by morphohistochemical, immunohistochemical studies.Results.Hyperplasia of secretory smooth muscle cells (SMC), and new formation of thin-walled capillary vessels was noted in unstable atherosclerotic plaques. Macrophagic infiltration was detected in the intima of arteries, in places of accumulation of foam cells.Conclusion.Unstable atherosclerotic plaque is a cellular-intercellular process with the participation of lipids, macrophages, and with predominance of SMC and newly formed vessels.

Особливості процесів ліпопероксидаціїв порожній кишціпри резекції різних об’ємів паренхіми печінки

Introduction. Resections of large volumes of liver parenchyma are complicated by postresection portal hypertension, which leads to structural and functional changes in the organs of the basin portal hepatic vein. The features of the remodeling of the jejunum structures and the features of the processes of lipid peroxidation after resection of different volumes of liver parenchyma were not adequately investigated.The aim of the study – to learn the features of lipid peroxidation processes in the jejunum of experimental animals after resection of different volumes of liver parenchyma.Research Methods. The studies were performed on 36 white male rats, which were divided into 3 groups. The first group consisted of 12 intact experimental animals (control), 2nd – 12 animals, which removed the left side lobe of the liver, which was 31.5% of its parenchyma, 3rd – 12 rats after resection of the left and right lateral lobes, that is 58, 1% of liver parenchyma. One month after the beginning of the experiment, euthanasia of rats was performed by bloodletting under conditions of thiopental anesthesia. In quantitative evaluation of lipid peroxidation processes, the content of diene conjugates and active products of thiobarbituric acid in the wall jejunum homogenates were determined. Sections from the jejunum were fixed in a 10% neutral formalin solution, and after conducting, the ethyl alcohol of increasing concentration was placed in paraffin. Histologic sections 5–7 мm thick after deparaffinization were stained with hematoxylin-eosin, for van Gizon, Mallory, Weigert, and toluidine blue. Gistostereometrically there were determined the relative volumes of damaged endothelial cells, epithelial cells, smooth myocytes, relative volume of stroma in the muscle. A correlation analysis was carried out between biochemical and histostereometric indices with the definition of the coefficient (r) of correlation. Quantitative values were processedstatistically.Results and Discussion. It was established that in conditions of the simulated experiment one month after the resection of the liver the expressed processes of lipid peroxidation occurred in the intestine. Thus, after removal of 31.5% of the liver parenchyma, the content of diene conjugates increased in 1.9 times after resection of 58.1% of liver parenchyma – 3.4 times, the concentration of active products of tiobarbituric acid, respectively, in 2.1 and 6.7 times. The obtained and analyzed indicators testify that at removal of significant volumes of liver parenchyma processes of peroxide oxidation of lipids, which depend on the removed volume of a liver, are substantially increased. A relative volume of damaged epithelial cells of the mucous membrane of the jejunum in the 2nd group of observations increased in 2.6 times, endothelial cells – 2 times, smooth myocytes – 1.86 times, stroma in the muscle of the jejunum– 12.7%. After resection of 58.1% of liver parenchyma,the investigated morphometric parameters increased by 30.6; 19.0; 11.8 and 2.4 times. Correlation connections between the concentrationlipid peroxidation products and relative volumes of damaged endothelial cells, epithelial cells, smooth myocytes and stroma in the wall of the jejunum were positive and significant and intensified when 58.1% of liver parenchyma were removed and ranged from +0.53 to +0.84,Conclusions. Lipid peroxidation plays an important role in the adaptive-compensatory processes of the jejunumafter resection of different volumes of liver parenchyma. The degree of morphological changes in the jejunum correlates with the concentration oflipid peroxidation products and depends on the removed volume of liver parenchyma.

Стан антиоксидантної системи експериментальних тварин при пошкодженні дванадцятипалої кишки за умов пострезекційної портальної гіпертензії

Introduction. The resections of large volumes of the liver leads to postresection portal hypertension that results in structural-functional changes in the organs of portal vena system. The features of remodeling structures of duodenum and state of the antioxidant system of organism in the conditions of postresection portal hypertension are not studied yet. The aim of the study – to learn the state of the antioxidant system for experimental animals at the structural-functional changes of duodenum in the conditions of postresection portal hypertension. Research Methods. The studies were performed on 39 white male rats, which were divided into 3 groups. The first group consisted of 15 intact experimental animals (control), 2nd – 12 animals, which eliminated 42 % of liver parenchyma, 3rd – 12 rats after resection of 58.1 % of liver parenchyma. One month after the beginning of the experiment, euthanasia of rats was performed by bloodletting under conditions of thiopental anesthesia. In the blood of experimental animals, indicators characterizing the state of oxidative protection were determined – the activity of superoxidedismutase, catalase and ceruloplasmin. Sections of the duodenum were fixed in a 10 % neutral formalin solution and, after passing through the ethyl alcohol of increasing concentration, were placed in paraffin. Histologic sections 5–7 мm thick after deparaffinization were stained with hematoxylin-eosin, for van Gizon, Mallory, Weigert, and toluidine blue. Gistostereometrically determined the relative volumes of damaged endothelial cells, epithelial cells, smooth myocytes. A correlation analysis was carried out between biochemical and histogeometric indices with the definition of the coefficient (r) of correlation. Quantitative values were processed statistically. Results and Discussion. It is set that in the conditions of the modelled experiment activity of superoxidedismutase at the resection of 42 % parenchyma of liver statistically for certain (р<0.001) diminished on 15.5 % and at removal of 58.1 % parenchima of liver – on 25 %; activity of catalase – accordingly on 22.2 and 38.8 % and activity of ceruloplasmin – on 15.3 and 21.3 %. Received and the analyzed indexes testify that at resection of considerable volumes (42; 58.1 %) parenchyma of liver antioxidant defence of organism gets worse substantially and depends on removal at volumes of liver. A relative volume of the damaged endotheliocytes is in 2 to the group of supervisions with high authenticity (р<0.001) grew in 8.4 times, epithelial cells – in 18.9 times, and smooth myocytes – in 12 times. After the resection of 58.1 % parenchyma of liver the investigated morphometric parameters increased accordingly in 15.8; 31.4 and 18.1 times. Correlation connections between the indexes of antioxidant defence and relative at volumes of the damaged endotheliocytes, epithelial cells and smooth myocytes in duodenum at resection 42 % parenchima of liver were opposite moderate and significance (r=–0.48ч–0.56) at resection 58.1 % of liver – significance (r=–0.72÷-0.83). Conclusions. The obtained results indicate that antioxidant protection of the organism plays an important role in the adaptive-compensatory processes of the duodenum after resection of different volumes of liver parenchyma. The degree of antioxidant defense of the organism depends on the removed volume of liver parenchyma and the number of damaged structures of the duodenum.

Effect of magnesium orotate on histostructure and dynamics of changes in matrix metalloproteinase-9 in the wall of internal carotid arteries

Цель исследования состояла в изучении структурных особенностей и механизмов формирования патологической извитости внутренних сонных артерий с оценкой влияния терапии магния оротатом. Материал и методы. С помощью световой микроскопии и иммуногистохимичекого анализа исследовали фрагменты артерий, полученные при последовательно выполненной билатеральной резекции внутренних сонных артерий (ВСА) у пациентов с двусторонней патологической извитостью до и после лечения магния оротатом. Результаты. До лечения в средней оболочке артерий наблюдалась слабо выраженная гистохимическая реакция гладких миоцитов на эластин, фрагментация внутренней эластической мембраны и визуальное уменьшение численности эластических волокон. Наружная оболочка во всех исследованных образцах выглядела в разной степени «разрыхленной». После лечения магния оротатом структура средней оболочки ВСА выглядела более компактной с тесным расположением пучков гладких миоцитов во всех образцах. Коллагеновые волокна наружной оболочки располагались более компактно лишь на периферии, где наружная оболочка ВСА практически сливается с тканями рядом расположенных органов. При этом наблюдались признаки разобщения и сетчатая архитектура волокон. Выраженная иммуногистохимическая реакция клеток средней и наружной оболочек на металлопротеиназу-9 (МПП-9) до лечения магния оротатом позволяет рассматривать активацию синтеза этого фермента в качестве одного из механизмов, вызывающих разобщение (а, возможно, - и деградацию) пучков гладких миоцитов, волокон коллагена и эластина при формировании патологической извитости. Лечение магнием оротатом достоверно оптимизирует гистологическую структуру стенки артерий. Заключение. В основе формирования патологической извитости ВСА может быть нарушение соотношения продукции коллагена и эластина гладкими миоцитами, фибробластами средней и наружной оболочек, и/или активация синтеза этими же клетками матриксной МПП-9. Магния оротат способствует восстановлению гистологической архитектоники стенки ВСА, возможно, вследствие ингибирования образования ММП-9 клетками артериальных оболочек, и восстановлению компактной архитектурной конструкции последних. The aim is to identify the structural features and mechanisms of formation of pathological tortuosity of the internal carotid arteries (ICA) with evaluation of the effect of therapy with magnesium orotate. Material and methods. With the help of light microscopy, immunohistochemical analysis, fragments of arteries obtained with successively performed bilateral rezection of the ICA in patients with their bilateral pathological tortuosity before and after treatment with magnesium orotate were studied. Results. Before the treatment in the middle shell arteries revealed weakly expressed in histochemical reaction of smooth muscle cells on elastin, the fragmentation of the internal elastic membrane and visual decrease in the number of elastic fibers. The outer shell in all the investigated samples looked different degrees of «loosened». After treatment with magnesium orotate structure of the middle shell of the ICA look more compact close bundles of smooth myocytes in all samples. Collagen fibers of the outer shell was located in a more compact, only on the periphery, where the outer sheath of the ICA almost merges with the tissues of adjacent organs was present signs of separation and mesh architecture of the fibers. Pronounced immunohistochemical reaction of cells of middle and outer shells on metalloproteinase-9 to the treatment of magnesium orotate allows us to consider the activation of the synthesis of this enzyme as one of the mechanisms that lead to dissociation (and, perhaps, - and degradation) bundles of smooth myocytes, collagen fibers and elastin in the formation of pathological tortuosity. Treatment with magnesium orotate significantly optimizes histological structure of the walls of the arteries. Conclusion. At the basis of the formation of pathological tortuosity of the ICA, there may be a disruption in the ratio of production of collagen and elastin to smooth myocytes, fibroblasts of the middle and outer membranes, and / or activation of the synthesis by these cells of matrix metalloproteinase-9. Magnesium orotate contributes to the restoration of the histological architectonics of the wall of the ICA due to a decrease in the activity of MMP-9 formation by cells of the arterial membranes and restoration of the compact architectural structure of the latter.

Cellular/intercellular interrelations in various parts of aorta after reconstructive treatment of aortic stenosis in infants

<p><strong>Aim.</strong> The article focuses on the evaluation of cellular/intercellular relationships in various parts of the aorta after reconstructive treatment of aortic stenosis in infants.<br /><strong>Methods.</strong> Medical histories and protocols of autopsies of three newborns were studied after surgical treatment of aortic coarctation. The operations were performed in children at 8th, 10th and 15th day after birth. In two cases, resection of the aortic lumen narrowing, botulinum duct ligation and formation of a direct aortic anastomosis were performed. In one observation, a closed balloon dilatation of the aorta in the area of constriction was used. When performing autopsy, the size of the heart, the perimeter of the aorta at the surgical sites and various parts of the aorta were examined. The fragments of the wall of the aortic sections were cut out and fixed in 10% neutral formalin. Histologic sections were prepared in a conventional way followed by staining them with hematoxylin-eosin or picrofuxin by Van Gieson, while elastic fibers were stained with rezorcin-fuchsin by Hotchkiss and Periodic acid–Schiff (PAS) in order to detect mucopolysaccharides.<br /><strong>Results.</strong> Cellular/intercellular relationships in various parts of the aorta following aortic coarctation in infants have some morphological features. Morphometric examination of the heart and aorta showed a significant increase in the volume and mass of the heart compared with the normal values due to myocardial hypertrophy of the right and left ventricles of the heart. An uneven narrowing of the aortic lumens was most pronounced in the arch and isthmus as compared to the ascending and thoracic parts of aorta. Morphological examination of the aortic wall in the constriction zones demonstrated the presence of coagulation necrosis, lysis of elastic, collagen fibers with surrounding hyperplasia of smooth myocytes, newly formed thin-walled capillary vessels. Outside the coarctation zone, the most significant changes characterized by the development of hypoelastosis, non-uniform accumulation of acid mucopolysaccharides were observed in the walls of the arch and the ascending aorta. <br /><strong>Conclusion.</strong> In infants with coarctation of the aorta, dilatation of the ascending aorta with compensatory hypertrophy of the heart is observed, and a muscle-fibrous tissue, rich in smooth myocytes and newly formed thin-walled vessels, tends to develop in stenotic zones. The risk of restenosis development is believed to depend on the prevalence and severity of proliferative processes of the cellular elements of the aorta, which allows us to consider early surgical interventions to prevent irreversible destructive changes as justifiable.</p><p>Received 2 February 2017. Accepted 27 May 2017.</p><p><strong>Funding:</strong> The study required no additional funding and sponsorship.<br /><strong>Conflict of interest:</strong> The author declares no conflict of interest.<br /><strong>Acknowledgements</strong><br />The author expresses his gratitude towards Professor S.V. Shlyk, Dr. Sci. (Medicine), Rector of Rostov State Medical University, Professor N.I. Volkova, Dr. Sci. (Medicine), Pro-Rector for Research of Rostov State Medical University and the researchers of the Molecular/Biological &amp; Optical Research Methods Department.</p>