Modern aspects of the etiology and pathogenesis of hyperplastic endometrial processes

The article presents modern approaches to the etiology, classification and pathogenesis of endometrial hyperplastic processes. Hyperplastic processes of the endometrium, representing an urgent medical and social problem, which is due to the peculiarities of the clinical manifestation of the disease (uterine bleeding), reduced reproductive potential, high recurrence rate, limited conservative treatment of this pathology in pre- and postmenopausal women, due to concomitant extragenital diseases and a high risk of malignancy.On the basis of new criteria of pathomorphological diagnostics, drawing parallels with the accumulated experience and clinical data, the immunohistochemical profile for each histotype of hyperplastic process of endometrium is created, certain diagnostic determinants are defined. Namely, simple and complex endometrial hyperplasia without atypia are characterized by imbalance between proliferation and apoptosis, manifested in moderate activation of the intratissue APUD system, lack of activation of proapoptotic protein p53, increased levels of antiapoptotic protein 2. Atypical forms of endometrial hyperplasia (simple and complex) are characterized by expression in the epithelial component of the proapoptotic protein p53, an increase in the level of antiapoptotic protein Bcl-2 in 2-2.5 times, expressed by activation of the intratissue APUD system.

Theoretical justification of mineral water inhalations in the complex therapy of common diseases under the adverse effects of natural factors of the Arctic zone of the Russian Federation

Unfavorable natural factors in the Arctic can be the reason for the formation of various somatic diseases or their exacerbations. Respiratory organs are one of the primary systems that perceive the pathogenic potential of these factors. Since the cells of the APUD system, producing hormones and other biologically active substances, are concentrated in the upper respiratory tract, one can assume their participation in the negative effects of the natural conditions of the Arctic north. It was previously demonstrated that a change in the activity of the APUD-system of the digestive tract can also provoke various diseases and the therapeutic efficacy of drinking mineral waters is due to their stimulating effect on this functional system. It was found that the inhalation of mineral water, even with a single exposure, has a significant polymodal effect on the secretion of hormones and the regulation of metabolic reactions: first, the production of gastrin, glucagon, vasoactive intestinal polypeptide and the content of free fatty acids in the blood are activated. Then, there is an increase in insulin secretion and serotonin levels in the blood against the background of inhibition of aldosterone secretion. With the course use of mineral water inhalations, it was found that its therapeutic effect in patients with duodenal ulcer disease, as well as in patients with metabolic syndrome, is associated with changes in the hormonal regulation of carbohydrate and lipid metabolism, which justifies the possibility of using the method of mineral water inhalations for the treatment and prevention of the diseases caused by the negative impact of natural factors in the Arctic.

Results of treatment of patients with endometrial polyps using a differentiated approach

The problem of treatment of endometrial polyps remains relevant, because it has high risks of malignancy and a steady tendency to increase the frequency of relapses and is inherent from 26 to 78% in women of different age categories. The objective: is to reduce the frequency of relapses of endometrial polyps by introducing a differentiated treatment strategy for patients with endometrial polyps based on the study of new pathogenesis links. Materials and methods. Clinical and laboratory examinations and treatment of 66 women diagnosed with endometrial polyp at the age of 24–43 years were carried out, which were further divided into two statistically equivalent groups: A (n=34) and B (n=32). All women received treatment according to the 4-stage algorithm of the current order of the Ministry of health of Ukraine No. 676 dated 31.12.2004. The difference in the management of group A patients was that their treatment was supplemented by immunomodulate therapy. At the first stage of the study, additional hysteroresectoscopy was performed, endometrial samples were obtained to determine its type of pathology, develop an immunohistochemical profile of the endometrium with the establishment of a receptor phenotype, identify the inflammatory process, and determine the state of the apoptosis system and the APUD system of the endometrium. Results. Active histological screening of the endometrial condition showed that signs of chronic endometritis (positive reaction of CD-138 and CD-68 markers) in women with endometrial polyp with physiological background endometrium were observed in 26.5% of group A patients after 3 months of treatment, which required a repeat course of treatment based on the results of viral and bacteriological examination. In group B, this rate was 46.9%. All the examined women, against the background of the use of gestagens, showed changes in the endometrial receptor phenotype, which were manifested by a decrease in the number of progesterone receptors in the glandular epithelium by an average of 1.4 times. However, the expression levels of Bcl-2 protein and EC cells had no statistical differences, since there were no signs of proliferation in the background endometrium, including local ones. Viral-bacterial screening of the study showed a sharp decrease in the number of pathogens in the endometrium, but in studies of patients of both groups, viral-bacterial associations were determined. Bacterial screening revealed the presence of anaerobic microflora. The study of the level of tumor necrosis factor in flushes from the uterine cavity indicated a unidirectional trend with the dynamics of the CD-138 index. The results of treatment of patients with endometrial polyp with physiological endometrium showed that the full effect of treatment in group A (antibacterial therapy with gestagens + immunomodulatory therapy) was determined after a year in 85.2% of patients, 14.8% of women had a relapse of endometrial polyp, in the group where patients received only antibacterial therapy with gestagens – a relapse was diagnosed in 37.5% of patients. Conclusion. Determining the tactics of differentiated treatment of endometrial polyps, it is necessary to take into account the results of immunohistochemical research and viral-bacterial control of the endometrial condition, which allows improving the results of treatment of endometrial polyps from 62.5% to 85.2 %, and is a prevention of relapse of endometrial polyp. Key words: endometrial polyps, hysteroscopy, endometrial immunohistochemical examination, apoptosis system, endometrial APUD system, viral-bacterial screening.

Characteristic of Сells' Reaction of APUD-System of Guinea Pigs as Marker of Adaptive-Compensatory Processes under Aerogenic Immunization against Plague

Carried out was morphometric analysis of cells' reaction of APUD system (neuroendocrinal cells) of guinea pigs immunized with live plague vaccine by aerogenic method. The results of investigations were compared with characteristics of the state of biomodel's internal organs. Elucidated was that the changes of morphofunctional state of neuroendocrinal cells in lungs and organs of immunity were of phase character suggesting the involvement of APUD system elements in the inhalant method of antigenic material intake. Assessment of APUD-system cell's reaction enables to estimate indirectly the nature of adaptive and compensatory processes in biomodel in the course of anti-plague vaccination.

Neuroendocrinal Aspects of Analysis of Biomodel Lymphoid Organs Response to Administration of Live Tularemia Vaccine

Evaluated were alterations in thymus, regional and remote lymphatic glands, and spleen of biomodels as well as neuroendocrinal cells reaction in these organs in simulating anti-tularemia vaccinal process. Received are quantitative characteristics of neuroendocrinal environment state of biomodels' lymphoid organs on the 5 day after administration of anti-tularemia vaccine in different doses. Elucidated were certain principles in cells' reaction of APUD-system of biomodel's lymphoid organs and lungs, associated with nature of their alterations. Identified were the prospects of application of the APUD-system cells quantitative characteristics in view of improving and optimizing the evaluation methods as regards safety and efficiency of live vaccines.

The structurally functional organization of cells in respiratory waysto norm and at a pathology

The term the APUD-system represents an abbreviation of four English words: Amine Precursore Uptake and Decarboxylation, these cells designating the basic property: ability to absorb predecessors entered from the outside biogenic amine to subject them decarboxylation with the subsequent formation biogenic amine and hormones. Biologically active substances which are produced by cells APUD-systems, are responsible for formation of conditioned reflexes, stages of memory and a dream, for formation of painful and emotional sensations.