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Objective. Vocal fold polyps are the most common benign laryngeal lesions. Matrix metalloproteinases (MMP) play an important role in the physiological and pathological remodeling of tissues. The most important subgroup of MMP family consists of gelatinases A and B (MMP-2 and MMP-9). The objective of this study was investigation of the expression of MMP-2 and MMP-9 in vocal fold polyps and normal tissue of vocal folds. Material and methods. The immunohistochemical expression of MMP-2 and MMP-9 was investigated in specimens taken by endolaryngeal microsurgery from vocal fold polyps (n=30) and normal tissue of vocal fold (n=13, control group). Expression of MMP-2 and MMP-9, both in epithelium and stroma cells, was graded on a semiquantitative scale, ranging from 0 (no expression) to 6 points (high expression). Results. A statistically significant increase was observed in the expression of MMP-2 in stroma cells (P=0.0176) of vocal fold polyps compared to control vocal fold group, whereas no significant difference in the expression of MMP-2 was found in epithelium cells (P=0.1487). Comparison of expression of MMP-2 and MMP-9 in epithelium cells revealed a statistically significant increase in MMP-9 expression (P

The article deals with the activity stages and forms of Society of Lithuanian Pathologists (in 1954–1991 – Republic Scientific Society of Pathologoanatomists, in 1991–1996 – Society of Lithuanian Pathologoanatomists). Founder of the Society and the first President (in 1954–1976) was prof. Janina Mackevičaitė-Lašienė, in 1976–1996 – prof. Elena Stalioraitytė and since 1996 up till now – prof. Dalia Pangonytė. Taking into account the needs of medical research and practice, its activities varied. According to the tasks there are 4 stages of Society activity. The first – establishment of pathological practice, introduction into clinic and pathological practice of pathogenetic and nosologic diagnosis; the second – consolidation and development of pathological practice, conveyance of pathology knowledge, optimization of pathology teaching and training of specialists; the third – reforming of Society and pathological practice, widening of international relations; the fourth – introduction of recent methods and information technologies in pathological practice and teaching. The Society has organized ten republic conference and two congresses, four school-seminars, its members published 19 monographs and collections of articles, 6 textbooks, 28 learning books, 26 methodical recommendations, more than fifty members acquired academic degree.

Objective. The goal of the investigation was to evaluate the accuracy of medical diagnostics of death causes. Material and methods. In the framework of population-based postmortem examination program the latest premortem and postmortem diagnoses of the underlying (principal disease), direct (lethal complication) and contributory (contributory pathology) causes of death of 1030 deceased and autopsied people of local randomized unit (Jonava district) autopsy study were compared. Results. The discrepancy between premortem and postmortem diagnoses was 35.3% in the category “circulatory system diseases”, 26.5% in the category “malignant neoplasms”, 41.1% in the category “lethal complications”, and more than 50% in the category “contributory pathology”. Conclusions. The accuracy of data on underlying death cause is significantly limited due to overstating of circulatory system diseases, especially ischemic heart disease and understating of malignancies. Among mismatches in lethal complication cases more significant for outcome of disease were pneumonia and embolism of lung arteries, in contributory pathology – chronic bronchitis and ischemic heart disease.

The trends of development of atherosclerosis were evaluated by comparing the epidemiological morphological data from the seventh decade (first study, 1962–1965) and the tenth decade (second study, 1991–1993) of the 20th century. The first study included arteries from 818 patients (422 men and 396 women); whereas the second study included arteries from 1252 patients (958 men and 294 women). We have observed an age-independent increase in frequency and extent of the raised atherosclerotic lesions in aortas and coronary arteries of Kaunas men in the second study. Thus, the atherosclerosis has become more severe. The trends of development of atherosclerosis in aortas of Kaunas women were similar to those of men, but the atherosclerosis of coronary arteries did not progress until the fifth decade of life (the frequency of fibrous plaques in the left anterior descending artery was even lower, p

Purpose: To identify the changes of left ventricle mast cells expression in different functional classes of ischemic heart failure. Objectives: 1. To evaluate the number of chymase-positive cells in group without heart failure (HFstage A); 2) To evaluate the number of chymase-positive cells in group with heart failure (stage B); 3) To evaluate the number of chymase-positive cells in group with heart failure (stage C-D); 4) To evaluate the connection between the expression of mast cell chymase and total stenotic injury of coronary arteries (stenosis index). Methods: There were examined 60 myocardial samples of males who had ischemic heart disease. The subjects were classified into 3 groups. First group – ischemic heart disease without HF symptoms (n=25), second – ischemic heart disease with HF (stage B) (n=24), third – ischemic heart disease with HF (stage C-D) (n=11). There also was a control group. This group contained of 21 subjects who died from outside factors and acute diseases (no relation with heart pathology). Special morphological (microscopic and macroscopic) examination of the heart, coronary arteries and myocardium was performed based on methodics modified by WHO. A quantitative evaluation of left ventricular mast cells was performed by immunohistochemical myocardium examination with monoclonal antibodies against mast cell chymase (clone CC1 Novocastra, 1:200) using visual imaging system DAKO Real Envision. Statistics analysis. For comparison of hystomorphometric parameters between two or more groups there was used two way ANOVA method. The relationship between analysed parameters were determined by the regression analysis method. Results: There was no statistically significant differences between quantity of myocardial mast cells positive to chymase in subjects with ishemic heart disease but without HF and with HF (stage B) (p>0,05), but in both of these groups quantity of myocardial mast cells positive to chymase was bigger than in control group (p

Author: Ugnė Bingelytė Name of the research: suicide methods, dynamics, prevention in the county of Kaunas in years 2015–2017. Objective of the research– to find out which suicide methods are the most common in years 2015– 2017 in the county of Kaunas, analyze it by different factors, such as: gender, age, residence (city, country) and talk about the dynamics of it as well as prevention. Tasks of the research: 1) Evaluate methods of the suicides and their dynamics in the county of Kaunas in years 2015– 2017; 2) Analyze the distribution of the methods by gender, age, residence and its dynamics; 3) Find out the proportion of suicides in which alcohol was involved, analyze how it differs according to a residence, gender and age group. See how it changes throughout the years. The data for Kaunas county of State Forensic Medicine Service was used for the research. There were 347 suicides in the county of Kaunas in years 2015– 2017. The average age of women suicides is 61 years, men– 51 years. Suicide by hanging was the most common method in the county of Kaunas in years 2015– 2017. The rate of suicides by this method did not have significant change throughout the years. This method of suicides is the most common in all age groups, it is also equally spreaded through men and women. Residence does not have any influence on the method of suicide. The second most common method of suicide among men is using a firearm. Men are more often affected by alcohol than women. The residence does not correlate with alcohol use or number of suicides. There is a significant difference in alcohol use among different age groups. The alcohol use is most common in the age groups of 40– 54 years and 55– 69 years. The least common age group for alcohol use is 10– 24 years. In 2017, the correlation between method of suicide and use of alcohol was noticed. The firearms were used only by those who used alcohol (men). An effective awareness and prevention of alcohol could possibly cut the suicide rate, especially among men (age group of 40– 69 years).

Gastrointestinės stromos tumorai (GIST) – dažniausi mezenchiminės kilmės virškinamojo trakto navikai, kurie pradėti identifikuoti ir diagnozuoti tik per pastaruosius 25 m. GIST, pagal ligos progresavimo reliatyvią riziką, klasifikuojami į rizikos kategorijas, kurių nustatymas 2002 m. Nacionalinių sveikatos institutų sutarimu (NSI) paremtas dviem kintamaisiais: naviko dydžiu ir navikinių ląstelių mitozių skaičiumi 50 DPRL, kurių apimamas plotas įvairių studijų ir rekomendacijų duomenimis varijuoja nuo 5 mm² iki 11,9 mm². Neaišku, kaip netikslus mitozių skaičius įtakoja rizikos kategorijos nustatymą bei jų sąsajas su ligos progresavimu. Nors atliktose didžiausiose GIST studijose teigiama, kad, esant identiškiems morfologiniams požymiams, skrandžio GIST prognozė geresnė, kiti tyrėjai nustatė morfologinius požymius lemiančius geresnę šių navikų prognozę. Esant prieštaringoms nuomonėms, tyrimo metu nustatėme ir palyginome skirtingų lokalizacijų GIST morfologinius požymius ir prognozę. NSI klasifikacijoje buvo pastebėta, kad ligos prognozę įtakoja ir GIST histologinis fenotipas, tačiau tuomet nebuvo pakankamai atliktų studijų, paneigiančių ar patvirtinančių šiuos teiginius, todėl detaliai nagrinėjome skirtingų histologinių fenotipų GIST morfologinius požymius ir jų įtaką ligos prognozei bei kitų morfologinių požymių: naviko dydžio, mitozių skaičiaus, ląstelingumo, branduolių polimorfizmo ir nekrozės sąsajas su ligos prognoze. Gastrointestinal stromal tumours (GIST) – the most common mesenchymal tumours of the gastrointestinal tract which have been identified and diagnosed in the past 25 years. GIST, according to relative risk of disease progression, are classified in risk categories which under the agreement of the National Institutes of Health (2002) were based on two variables: tumour size and mitotic count in 50 HPF, which total area varies from 5 mm² to 11.9 mm². There is no consensus what area is sufficient for the counting of mitoses. Thus, we compare number of GIST tumor cell mitoses in different sized areas and evaluated the impact of mitotic rate changes in determination of risk categories and their relation to the progression of the disease. According to the data of largest GIST study, disease prognosis is also influenced by tumour localization, other researchers found morphological features of these tumours leading to a better prognosis. Thus, we identified and compared the different localizations of GIST morphological features and prognosis. It was observed that disease prognosis is also determined by the tumour histological phenotype, but up till now the controversial results of histological phenotypes relationship to disease prognosis are published. We set morphological features of different GIST histological phenotypes and evaluate their relation to disease progression, evaluate the impact of GIST morphological features to disease prognosis.

Gastrointestinal stromal tumours (GIST) – the most common mesenchymal tumours of the gastrointestinal tract which have been identified and diagnosed in the past 25 years. GIST, according to relative risk of disease progression, are classified in risk categories which under the agreement of the National Institutes of Health (2002) were based on two variables: tumour size and mitotic count in 50 HPF, which total area varies from 5 mm² to 11.9 mm². There is no consensus what area is sufficient for the counting of mitoses. Thus, we compare number of GIST tumor cell mitoses in different sized areas and evaluated the impact of mitotic rate changes in determination of risk categories and their relation to the progression of the disease. According to the data of largest GIST study, disease prognosis is also influenced by tumour localization, other researchers found morphological features of these tumours leading to a better prognosis. Thus, we identified and compared the different localizations of GIST morphological features and prognosis. It was observed that disease prognosis is also determined by the tumour histological phenotype, but up till now the controversial results of histological phenotypes relationship to disease prognosis are published. We set morphological features of different GIST histological phenotypes and evaluate their relation to disease progression, evaluate the impact of GIST morphological features to disease prognosis

XII tarptautinėje St Gallen krūties vėžio konferencijoje (2011) Ekspertų komisijos priimta nauja pacientų klasifikacija sisteminei terapijai atlikti, paremta biologiniais krūties vėžio subtipais, kurie apibrėžiami imunohistocheminiu tyrimu (IHC). Tačiau ši nauja navikų klasifikacija iš esmės pagrįsta pusiau kiekybiniu biožymenų raiškos vertinimu, todėl išlieka aktuali ribinių verčių nustatymo problematika. Esminiai pokyčiai IHC tyrimų srityje galimi atsiradus skaitmeninio vaizdinimo technologijoms, leidžiančiomis IHC tyrimų rezultatus analizuoti kiekybiniais parametrais. Darbe naudojant skaitmeninį vaizdo analizės metodą atliktas išsamus biologinių žymenų tyrimas leido palyginti svarbių, tačiau nepakankamai ištirtų (p53, AR, p16, BCL2, SATB1, HIF1) IHC žymenų informatyvumą su esamų prognozinių žymenų (ER, PR, HER2, Ki67) rodikliais. Ištirtas platus genetinių ir epigenetinių krūties vėžio žymenų spektras. Pirmą kartą 10 IHC žymenų rinkinio, įvertinto skaitmeninės analizės būdu, duomenys panaudoti faktorinės analizės metodu nustatyti jų variacijų vidinius veiksnius, atskleidžiančius biologinius dėsningumus ir IHC žymenų bei jų derinių informatyvumą. Šios analizės rezultatai leido naujai įvertinti publikuotų krūties vėžio IHC žymenų bei jų derinių (p16, SATB1, HIF1, Ki67/BCL2 ir kt.) informatyvumą. The 12th International St Gallen conference on breast cancer (2011) proposed patient categorization for systemic therapy, based on intrinsic breast cancer subtypes, defined by imunohistochemistry (IHC) test results. Since this classification is based on semi-quantitative expression of IHC biomarker expression, an issue of defining and applying cutoff values remains. Essential improvement in the IHC testing has become possible with digital image analysis tools enabling quantitative evaluation of the IHC data. This study explores data obtained by digital image analysis methods applied to evaluate a comprehensive biomarker dataset (p53, AR, p16, BCL2, SATB1, HIF1) along with well established (ER, PR, HER2, Ki67) biomarkers. Also, an extensive set of genetic and epigenetic biomarkers has been tested. For the first time, the dataset of 10 IHC biomarkers, evaluated by digital analysis was explored by the means of factor analysis to establish the intrinsic factors of biological variation and informative value of IHC biomarkers and their combinatiions. The results also provided insights into the significance and combinatorial effects of the established and relatively new biomarkers (p16, SATB1, HIF1, Ki67/BCL2, etc.).

The theme covered in the dissertation is about investigation of the morphological differences of the conduction system of the human heart and those of other heart tissues, applying spectroscopic, histochemical and proteomic methods. The described spectroscopical and proteomic investigations of the human heart conduction system and other heart tissues in the dissertation indicate clear structural differences between these tissues. Electrophoresis shows protein groups which may be detected only in a conduction system tissue. The dissertation concludes that estimated fluorescence and proteomic differences between His bundle and myocardium tissues may allow us to suggest that distinction of the bioelectrical impulse velocity in these tissues is determined by the specific morphological odds. According to these differences it is possible to create the visualization method of the conduction system. Disertacijos objektas yra žmogaus širdies laidžiosios sistemos ir kitų širdies audinių morfologinių skirtumų tyrimas spektroskopiniais, histocheminiais ir proteominiais metodais. Disertacijoje pateikti žmogaus širdies laidžiosios sistemos ir kitų širdies audinių palyginamieji spektroskopiniai ir proteominiai tyrimai parodė aiškius struktūrinius šių audinių skirtumus. Baltymų elektroforezės metodu rasta baltymų grupė aptinkama tik širdies laidžiosios sistemos audinyje. Darbe konstatuojama, kad rasti fluorescenciniai ir baltyminės sudėties skirtumai tarp žmogaus širdies laidžiosios sistemos ir miokardo audinių leidžia manyti, kad bioelektrinio impulso sklidimo greičių skirtumus sąlygoja ne tik ląstelių išsidėstymas, skersmuo, bet ir specifiniai morfologiniai skirtumai. Pasinaudojus nustatytais morfologiniais skirtumais galima sukurti žmogaus širdies laidžiosios sistemos vaizdinimo metodiką, kuri leistų nustatyti širdies laidžiosios sistemos anatomines ypatybes.

Disertacijos tema: Odos kraujagyslių ir jungiamojo audinio pažeidimai sergant sistemine skleroze. Disertacijos tikslas buvo nustatyti kraujagyslių pažeidimo ir fibrozės vystymosi eiliškumą, ištiriant kraujagyslių pakitimus odoje ir jungiamajame audinyje sergantiems sistemine skleroze , su šiai patologijai būdinga kraujagyslių atrezija, bei palyginant su kitomis būklėmis, kurių metu kraujagyslių atrezijos nėra (sistemine raudonaja vilklige), bei su būklėmis, kurioms būdingas kraujagyslių funkcinis nestabilumas (Reino sindromas). Tai retrospektyvus tyrimas. Analizuota po 20 kiekvienos iš minėtų ligų sergančių ligonių ir kontrolinės grupės odos biopsijų. Be rutininių histocheminių dažymų, naudata eilė imunohistocheminių žymenų ir elektroninis mikroskopinis tyrimas. Nustatyta, kad sergantiems sistemine skleroze odoje ankščiau, negu išreikšta fibrozė pasireiškia kraujagyslių endotelio pažeidimai ir padidėjęs kraujagyslių sienelės pralaidumas. Nustatyta, kad kraujagyslių endotelio augimo veiksnio VEGF-A ir jo receptoriaus FLT-1, ir ypač HSP-47 (terminio šoko baltymo, kolagenams specifinio šaperono skatinančio fibrozę), bei eNOS (endotelio azoto sintazės) gausi ekspresija yra ankstyvos sisteminės sklerozės stadijos endotelio pakenkimo imunohistocheminiai žymenys. Taip pat nustatyta, kad ankstyvosios sisteminės sklerozės stadijos patogenezėje odoje vyrauja smulkių kraujagyslių pažeidimai. Rekomenduota naudoti odos biopsiją kaip pagalbinį diagnostinį metodą diferencijuojant tarp... [toliau žr. visą tekstą] Dissertation topic: the damage to dermal blood vessels and connective tissue during systemic sclerosis. The aim of this dissertation was to determine the sequence in the development of vascular damage and fibrosis by studying vascular changes in the skin and connective tissue of systemic sclerosis patients with vascular atresia characteristic of this pathology and by comparing it with other conditions, where there is no vascular atresia (systemic lupus erythematosus), and with conditions, which are characterised by vascular function instability (Raynaud’s phenomenon). This was a retrospective study, which analysed 60 patients with the aforementioned diseases, 20 with each disease, and a control group of 20 skin biopsies. In addition to routine histochemical stains, a series of immunohistochemical signs and electron microscopic examination were used. It was determined that damage to the vascular endothelium and increased permeability of the vascular walls appear earlier than expressed fibrosis in the skin of systemic sclerosis patients and that the abundant expression of vascular endothelial growth factor (VEGF)-A and its receptor FLT-1 and especially HSP-47 (heat shock protein, a collagen-specific chaperone that induces fibrosis) and eNOS endothelial (nitric oxide synthase) are immunohistochemical signs of endothelial injury in the early stage of systemic sclerosis. It was determined that in the pathogenesis of the early stage of systemic sclerosis, damage to the small blood... [to full text]

Darbo tikslas: nustatyti reumatoidinio artrito (RA), seronegatyvių spondiloartropatijų (SpA) bei sisteminės raudonosios vilkligės (SRV) paplitimą Vilniaus mieste. Darbo metodika: Buvo atlikti 3 tyrimai: 1. RA ir SRV paplitimo Vilniaus mieste apskaičiavimas, remiantis Vilniaus miesto RA ir SRV sergančių asmenų duomenų baze; 2. RA ir SRV paplitimo Vilniaus mieste populiacinis tyrimas, apklausiant Vilniaus miesto gyventojus paštu; 3. RA ir SpA paplitimo Vilniaus mieste populiacinis tyrimas, apklausiant Vilniaus miesto gyventojus telefonu. Rezultatai: remiantis Vilniaus miesto RA ir SRV sergančiųjų duomenų baze, RA paplitimas Vilniaus mieste 2004m. pabaigoje buvo 0,14% (95% PI 0,13-0,15). Apskaičiuotas SRV paplitimas Vilniuje 2004m. pabaigoje buvo 0,0174% arba 17,4/100 000 gyventojų (95% PI 0,0137-0,0218). Atlikus RA ir SRV paplitimo tyrimą (apklausą paštu), nustatyta, kad RA paplitimas Vilniuje yra 0,37% (95% PI 0,21-0,62), o SRV paplitimas – 0,0498% (95% PI 0,006-0,180). RA paplitimas buvo standartizuotas pagal amžių ir lytį, remiantis 2004m. pradžios Vilniaus miesto populiacija, apskaičiuotas standartizuotas RA paplitimas yra 0,32% (95% PI 0,18-0,57). Atlikus RA ir SpA paplitimo tyrimą (apklausą telefonu), apskaičiuotas RA paplitimas buvo 0,76% (95% PI 0,44-1,24), o SpA paplitimas - 0,62% (95% PI 0,33-1,06). RA ir SpA paplitimas buvo standartizuotas pagal amžių ir lytį, remiantis 2004m. pradžios Lietuvos populiacija, apskaičiuotas standartizuotas RA paplitimas yra 0,51% (95%... [toliau žr. visą tekstą] Objective: to assess the prevalence of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and spondyloarthropathy (SpA) in Vilnius, Lithuania. Methods: 3 prevalence studies were conducted: 1. Registry-based study of the prevalence of RA and SLE; 2. Population-based study of the prevalence of RA and SLE (interview conducted by mail); 3. Poulation-based study of the prevalence of RA and SpA (interview conducted by telephone). Results: according to the Vilnius RA and SLE registry, the prevalence of RA in Vilnius at the end of year 2004 was 0,14% (95% CI 0,13-0,15), and the prevalence of SLE was 0,0174% or 17,4/100 000 (95% CI 0,0137-0,0218). The population-based study, conducted by mail, revealed 15 RA and 2 SLE cases, accounting for a prevalence rate of RA of 0,37% (95% CI 0,21-0,62), and a prevalence of SLE rate of 0,0498% (95% CI 0,006-0,180). The standardized prevalence rate according to age and sex in the Vilnius population showed an RA prevalence of 0,32% (95% CI 0,18-0,57). The population-based study, conducted be telephone, detected 16 RA and 13 SpA cases, resulting in a crude prevalence of 0,76% (95% CI 0,44-1,24) for RA and 0,62% (95% CI 0,33-1,06) for SpA. The standardized prevalence rate according to age and sex in the Vilnius population showed an RA prevalence of 0,51% (95% CI 0,29-0,96) and a SpA prevalence of – 0,75% (95% CI 0,38-1,40).

Local tumour progression remains the main problem after radiofrequency ablation of liver tumours and it is usually the only measure of treatment efficacy. The aim of our study was to investigate and evaluate the prognostic value of computed tomography and ultrasonography as well as the histological result of core biopsy material from ablated tumour on assessment of radiofrequency ablation effectiveness. Materials and methods: We have studied 68 malignant primary and metastatic hepatic tumours treated by radiofrequency ablation. Ablation was performed using perfusion electrodes. Evaluation of tumours before ablation and follow up was performed by means of contrast enhanced computed tomography and ultrasonography. Ablation zone was biopsied for histological examination. Results and conclusions: 58 successfully treated hepatic tumours were suitable for the final analysis. The local progression of nine (15.5 %) tumours was detected on follow up. Mean follow up time for analysed tumours was 16.3 months with a range from 1.7 to 38.7 months. It was showed, that: 1. The result of histological examination of ablation zone biopsy material taken one month after radiofrequency ablation of malignant liver tumour does not predict local tumour progression. 2. Tumour size 30 mm and larger and tumour proximity closer than 5 mm to hepatic vessels larger than 3 mm are significant risk factors for local tumour progression after radiofrequency ablation of malignant liver tumours 3. Tumour type... [to full text] Nors vietinis naviko progresavimas yra esminė problema, atliekant piktybinių navikų kepenyse radijo dažnio abliaciją, dažniausiai tai yra vienintelis rodiklis, apibrėžiantis šio gydymo metodo veiksmingumą. Mūsų tyrimo tikslas buvo nustatyti kompiuterinės tomografijos ir ultragarso tyrimų bei histologinio stulpelinės biopsijos medžiagos, paimtos iš abliuoto naviko, histologinio tyrimo rezultato reikšmę anksti vertinant radijo dažnio abliacijos veiksmingumą. Tyrimo medžiaga ir metodai: Į tyrimą buvo įtraukti 68 pirminiai ir metastaziniai kepenyse esantys navikai. Radijo dažnio abliacija buvo atliekama naudojant perfuzijos elektrodus. Navikai prieš abliaciją ir po jos atliekant kontrolinius tyrimus buvo vertinami kompiuterinės tomografijos ir ultragarsinio tyrimo metodais. Po abliacijos praėjus vienam mėnesiui buvo atliekama abliacijos zonos punkcinė stulpelinė biopsija, audiniai tiriami histologiškai. Rezultatai ir išvados: Galutinei analizei buvo tinkami 58 sėkmingai gydyti navikai. Radiologinio stebėjimo metu buvo nustatyti devyni (15,5 %) vietinio naviko progresavimo atvejai. Vidutinis analizuotų navikų stebėjimo laikas buvo 16,3 mėnesiai (nuo 1,7 iki 38,7 mėnesių). Nustatyta, kad: 1. Biopsijos medžiagos, paimtos iš abliacijos zonos praėjus vienam mėnesiui po naviko, esančio kepenyse, radijo dažnio abliacijos, histologinio tyrimo rezultatas neleidžia prognozuoti vietinio naviko progresavimo 2. Naviko dydis 30 mm ir naviko lokalizacija arčiau kaip per 5 mm nuo didesnio nei 3... [toliau žr. visą tekstą]

Nors vietinis naviko progresavimas yra esminė problema, atliekant piktybinių navikų kepenyse radijo dažnio abliaciją, dažniausiai tai yra vienintelis rodiklis, apibrėžiantis šio gydymo metodo veiksmingumą. Mūsų tyrimo tikslas buvo nustatyti kompiuterinės tomografijos ir ultragarso tyrimų bei histologinio stulpelinės biopsijos medžiagos, paimtos iš abliuoto naviko, histologinio tyrimo rezultato reikšmę anksti vertinant radijo dažnio abliacijos veiksmingumą. Tyrimo medžiaga ir metodai: Į tyrimą buvo įtraukti 68 pirminiai ir metastaziniai kepenyse esantys navikai. Radijo dažnio abliacija buvo atliekama naudojant perfuzijos elektrodus. Navikai prieš abliaciją ir po jos atliekant kontrolinius tyrimus buvo vertinami kompiuterinės tomografijos ir ultragarsinio tyrimo metodais. Po abliacijos praėjus vienam mėnesiui buvo atliekama abliacijos zonos punkcinė stulpelinė biopsija, audiniai tiriami histologiškai. Rezultatai ir išvados: Galutinei analizei buvo tinkami 58 sėkmingai gydyti navikai. Radiologinio stebėjimo metu buvo nustatyti devyni (15,5 %) vietinio naviko progresavimo atvejai. Vidutinis analizuotų navikų stebėjimo laikas buvo 16,3 mėnesiai (nuo 1,7 iki 38,7 mėnesių). Nustatyta, kad: 1. Biopsijos medžiagos, paimtos iš abliacijos zonos praėjus vienam mėnesiui po naviko, esančio kepenyse, radijo dažnio abliacijos, histologinio tyrimo rezultatas neleidžia prognozuoti vietinio naviko progresavimo 2. Naviko dydis 30 mm ir naviko lokalizacija arčiau kaip per 5 mm nuo didesnio nei 3... [toliau žr. visą tekstą] Local tumour progression remains the main problem after radiofrequency ablation of liver tumours and it is usually the only measure of treatment efficacy. The aim of our study was to investigate and evaluate the prognostic value of computed tomography and ultrasonography as well as the histological result of core biopsy material from ablated tumour on assessment of radiofrequency ablation effectiveness. Materials and methods: We have studied 68 malignant primary and metastatic hepatic tumours treated by radiofrequency ablation. Ablation was performed using perfusion electrodes. Evaluation of tumours before ablation and follow up was performed by means of contrast enhanced computed tomography and ultrasonography. Ablation zone was biopsied for histological examination. Results and conclusions: 58 successfully treated hepatic tumours were suitable for the final analysis. The local progression of nine (15.5 %) tumours was detected on follow up. Mean follow up time for analysed tumours was 16.3 months with a range from 1.7 to 38.7 months. It was showed, that: 1. The result of histological examination of ablation zone biopsy material taken one month after radiofrequency ablation of malignant liver tumour does not predict local tumour progression. 2. Tumour size 30 mm and larger and tumour proximity closer than 5 mm to hepatic vessels larger than 3 mm are significant risk factors for local tumour progression after radiofrequency ablation of malignant liver tumours 3. Tumour type... [to full text]

The aim of the investigation was to examine and evaluate age-related structural changes in media of human basilar artery The main objectives of the thesis were as follows: 1. To examine the quantitative changes in the collagen fibres in media of basilar artery; 2. To evaluate the quantitative changes in muscular cells in the media of basilar artery; 3. To evaluate the quantitative changes in the elastic fibres in the media of basilar artery; 4. To evaluate the changes in the thickness of the tunica media; 5. To examine the structural changes in the human basilar artery intima and internal elastic membrane; 6. To assess the relation of different quantitative histological changes and to determine their correlation with age. Academic novelity of the investigation Cerebrovascular diseases cause huge mortality and disablement. Epidemiologic research has revealed that the morbidity and mortality rates due to cerebrovascular diseases tend to increase. We evaluated basilar artery wall structural changes occuring while ageing. Histomorphometrically analysed material enabled to evaluate general cerebral artery wall peculiarities related to age. We evaluated histomorphometrically quantitative changes of elastic and collagen fibres, muscular cells in ageing in different age groups. We also made analysis not only of elastic and collagen fibres area, but also of perimeter and number of fibres. We analyzed the changes in the thickness of the tunica media. We examined the structural changes in the human basilar artery intima and internal elastic membrane. Quantitative results enabled to evaluate the type of basilar artery. The obtained results we compared in male and female groups, and were compared with results published in literature while analyzing structural changes in ageing arteries. Histomorphometrical findings advert attention to the changes of arteries structure in ageing, peculiarities of ageing, differences of their occurance from extracranial arteries. An analysis of histophysiologic aspects of age-related changes in the basilar artery will provide a basis for differentiating them from pathomorphologic changes that are caused by the atherosclerotic pathology of cerebral arteries. A study of the dynamics of age-related changes in the arteries obtained from victims who died of violent death will help us understand better the morphologic substrate of the development of encephalic infarction. Morphometric analysis of intracranial cerebral arteries, namely, the basilar artery, in different gender and age groups will reveal some peculiarities of the development of this artery. An evaluation of age-related histophysiologic changes in the basilar artery can be important in the attempts to explain general age-related processes of brain blood flow and different artery pathologies. ANALYZED MATERIAL AND METHODS The results of post mortem histological studies of the basilar artery from 102 individuals, whose age varied from 20 to 86 years are reported. We analyzed histological samples of basilar artery from 52 male and 50 female. Three age groups were settled. CONCLUSIONS 1.The area of collagen bundles in the basilar artery increases with age, while the number and perimeter of collagen bundles decreases in both gender groups. The increasing collagen area and the simultaneously decreasing number and perimeter of collagen bundles allow us to assume that the collagen network becomes less branchy with age. It can be argued that collagen fibres intertwine and the area of their cross-section increases. Correlation between collagen network area and age was strong in both gender groups: in male (r=0,56; p< 0,05) and in female (r=0,6; p< 0,05). Correlation between basilar artery collagen bundles perimeter and age in male and female was statistically significant in both groups: in male group (r=-0,436; p< 0,05) and in female (r=-0,478; p< 0,05). Correlation between collagen bundles number and age was also statistically significant in male (r=-0,41; p< 0,05) and female (r=-0,45; p< 0,05) groups. 2.The number of smooth muscle cells can decrease twice after the age of 20 years until the old age independently from gender. Their decrease has a strong correlation with age. Rather similar differences in the decrease of SMC between male and female of the same age show that in both gender groups SMC tend to decrease in the basilar artery in a similar way. Statistical data have revealed that the decrease in SMC had a strong statistically significant negative correlation with age (p0,05 in female).A decrease can also be observed in the number of elastic fibre bundles and their perimeter in both gender groups. With age, elastic fibres grow thinner and fragment, which influences the properties of the basilar artery. The artery becomes more rigid and loses its elasticity. 4.The media thickness increases with age in both male’s and female’s basilar arteries. The correlation with age was of medium strength both in the male (r=0.36) and female (r=0.4) group. In all the cases this correlation was statistically significant (p0.05). Media thickening in this artery is influenced more by the age-related increase of the collagen content rather than the fragmentation of elastic fibres. We assume that the decrease in the SMC number does not have a direct influence on the media thickness. Female’s media thickness changes more considerably than that of male younger than 40 years. 5.The internal elastic membrane in the basilar artery of young individuals is homogeneous and not fragmented. More distinct cases of the internal elastic membrane duplication can be observed in the individuals aged 30 to 40 years. It strengthens the protective function of the internal elastic membrane. Initial stages of intima thickening, not followed by the internal elastic membrane fragmentation or the cell penetration through the internal elastic membrane. 6.With age collagen content increases in the tunica media, while the SMC number decreases. In the male’s group a medium correlation was observed (r = -0.5, p0.05). The increase of the collagen area is faster than the decrease of elastic fibres, the collagen tissue replaces the decreasing elastic fibre bundles. Correlation between the smooth muscle cells number and the area of elastic fibres was strong and positive (male’s r= 0.6, female’s r= 0.6; p

Su amžiumi susiję struktūriniai simpatinės nervų sistemos pokyčiai sukelia įvairių organų funkcijos sutrikimus. Simpatinio kamieno viršutiniai kakliniai mazgai, pagrindiniai galvos smegenų kraujagyslių simpatinės inervacijos šaltiniai, yra svarbūs galvos smegenų kraujotakos autonominės reguliacijos centrai. Tačiau žmogaus simpatinių mazgų morfofunkciniai tyrimai yra pavieniai. Todėl šio darbo tikslas buvo ištirti trijų amžiaus grupių žmonių ir mirusiųjų dėl išeminio galvos smegenų infarkto simpatinio kamieno viršutinio kaklinio mazgo morfologinius bei neurocheminius ypatumus, ir nustatyti jų sąsajas su amžiumi ir išeminiu galvos smegenų infarktu. Tyrimo rezultatai rodo, kad amžiaus eigoje vystosi žmogaus simpatinio kamieno viršutinio kaklinio mazgo neuronų morfologinių parametrų, neurofilamentų baltymo, nervų augimo faktoriaus receptorių p75 imunoreaktyvumo pokyčiai. Skirtingose amžiaus grupėse aptinkami neuronų ir satelitinių ląstelių apoptoz����s požymiai. Pagyvenusio amžiaus žmonių, mirusių dėl išeminio galvos smegenų infarkto, simpatiniuose mazguose vystosi neuropatologinės alteracijos požymiai: padidėja neuronų afinitetas baziniams dažams, atsiranda neuronų su degeneraciniais ir hipertrofijos požymiais židiniai, satelitinių ląstelių proliferacija, limfocitų židininė infiltracija, sumažėja neuronų kūno, branduolio, citoplazmos plotai, aptinkamas didesnis neurofilamentams ir nervų augimo faktoriaus receptoriams p75 imunoreaktyvių neuronų skaičius, didesnis apoptozinis... [toliau žr. visą tekstą] Age-related structural changes of the sympathetic nervous system cause the disturbance of the involuntary functions of various organs. The superior cervical ganglia are the main source of sympathetic innervation of the cerebral arteries and important center of autonomic regulation of the cerebral circulation. However, only single morphofunctional studies of the human sympathetic ganglia are performed. Therefore, the aim of the study was to investigate morphological and neurochemical peculiarities of the human superior cervical ganglion in three age groups and in the subjects dead of ischemic cerebral infarction and establish their relation to age and ischemic cerebral infarction. The results of the present study show that changes of neurons morphologic parameters and immunoreactivity to neurofilament and nerve growth factor receptor p75 in the human superior cervical ganglion are developed in the course of aging. Morphological features of apoptosis in the sympathetic neurons and satellite cells in different age groups are detected. The signs of neuropathological alteration of the sympathetic ganglion of subjects with ischemic cerebral infarction were the following: increased tinctorial affinity of neurons, foci of neurons with features of neuron death and hypertrophy, proliferation of satellite cells, focal lymphocyte infiltration, decrease of neuron body, nucleus, cytoplasm area, increase of neurofilament and nerve growth factor receptor p75 immunoreactive neurons... [to full text]

Radiofrequency catheter ablation (RFA) is a rapidly developing, minimally invasive method of treatment for heart arrhythmias. Its employment is however limited due to complications, including thromboembolic ones. The basic of seven objectives of this dissertation were to: 1. by using different agonists of aggregation, to evaluate alteration of platelet aggregation in the venous blood and platelet-rich plasma, fibrinogen and D-dimer levels before RFA, immediately after, 24 hours and 72 hours after RFA under the influence of RFA in patients suffering from heart arrhythmia; 2. to establish the influence of the total RFA energy, structural heart disease, antithrombotic medicines know in the alteration of platelet aggregation induced by different agonists and in the alteration before RFA, immediately after and 24 hours after RFA. The obtained data show that changes in PA after RFA depended on whether PA proceeded in the venous blood or plasma and on the agonist used to induce aggregation. According to the results, PA is suppressed immediately after RFA and increases in 24 hours. The level of the applied total energy had an effect on changes in platelet aggregation after RFA. The dynamics of PA in patients with and without a structural heart disease were similar. The obtained pre-RFA values of PA were lower in blood and even lower in plasma in the group of patients who used aspirin, as compared to those who used low molecular mass heparin or no antithrombotic medicines. Despite the... [to full text]

The display of Lithuanian mare’s endometritis and endometrosis was investigated. The prevalence of myofibroblasts and tenascin was determined during endometritis and endometrosis. An acute phase protein serum amyloid A studies in mares’ endometrium were carried out. The changes of the vessels walls thickness and the amount of elastic fibers, due to mares’ age and endometrial pathology, were evaluated using morfometric analysis.

THE ASSESSMENT OF INFLUENCE OF ZINC IONS AND ECHINACEA PURPUREA (L.) MOENCH FOR MICE INTOXICATED BY CADMIUM IONS Abstract Background. Cadmium (Cd), a well-known environmental hazard, exerts a number of toxic effects in organism. It disturbs the activity of biochemical systems of cells. Accumulation of cadmium depends on the amount of essential trace elements, including zinc. Echinacea purpurea (L.) Moench (EP) can modify its influence. The aim of the study was to assess the influence of ions of cadmium, zinc, and EP on organism in experimental model of mice. The objectives of the scientific work were as follows: 1. To evaluate the accumulation of cadmium in the internal organs of experimental mice after acute and chronic intraperitoneal and per oral intoxication. 2. To assess morphological changes in liver tissue, mitotic and apoptotic activity of liver cells after the intoxication by cadmium ions of different duration and dose. 3. To assess the effect of zinc ions to the accumulation of cadmium in the internal organs and to the mitotic and apoptotic activity of liver cells in the organism of mice intoxicated by cadmium. 4. To evaluate the effect of EP to accumulation of cadmium in internal organs, mitotic and apoptotic activity of liver cells after the chronic intraperitoneal and per oral intoxication by cadmium ions. The scientific novelty of the study. This work makes our knowledge about mechanisms and outcomes of acute and chronic exposure to cadmium deeper. The... [to full text]

1. INTRODUCTION The incidence of diseases whose pathogenesis chain includes changes in the functioning of the immune system is currently on the increase. The increasing prevalence of primary and secondary immunodeficiencies is a relevant issue in immunopathology. Secondary immunodeficiencies, caused by such factors as bacteria, viruses, helminths, chemical substances, medications, radiation, stress, etc., result in higher morbidity. Immunosuppression occurs in cases of oncological or allergic diseases, bronchial asthma, etc. immunosuppression is relevant in cases of malignant tumors whose incidence in Lithuania has been increasing with every year during the recent period. Oncological treatment involves the application of radiotherapy and chemotherapy with cytostatics that are strong immunosuppressants, and thus the restoration of the immune system with immunostimulants is becoming a relevant issue. Insufficient nutrition, disturbed nutrient resorption, negative nitrogen balance, chronic alcoholism, and drug abuse – all these factors result in the deceleration of cell proliferation and decreased T-lymphocyte counts and function. Immunodeficiency increases morbidity with infectious diseases, since the organism becomes incapable of the rapid destruction of the causative agents. Such conditions increase the probability of the spreading of the infection, and condition the increased activity of the opportunistic infections caused by adenoviruses, cytomegaloviruses, etc... [to full text]

1. INTRODUCTION Most complications after elective or urgent reconstructive operations on abdominal aorta are predictable and it is possible to prevent them. The development of the operating techniques, a good preoperative preparation of patients and post-operative nursing of patients enables to achieve good results of treatment when the post-operative death-rate is from 0 to 12 percent [Hallin A., 2001]. The better results depend on the prevention of especially dangerous complications, such as colon ischemia, apropos diagnostics and adequate treatment. The selection of patients of high risk becomes extra important. The proper evaluation of preoperative aortography while being aware of the fact that the reconstruction of IMA is needed, and following the specific requirements for the operating techniques strictly, enables to avoid ischemia of the gut completely or to reduce its frequency to a minimum [Belov I.V., 2002]. Post-operative GIC can be especially serious. Due to them the hospitalization period can prolong and the post-operative mortality generally increases [Chan K.H., 1989; Huddy S.P., 1991; Christenson J.T., 1994; Mercado P.D., 1994; Lubetkin E.I., 1996]. Less seldom but very difficult GIC occur to those patients for whom have been made none abdominal high coverage operations. The given frequency of the spread of GIC is about 2 percent after open heart operations [Huddy S.P., 1991; Christenson J.T., 1994; Mercado P.D., 1994], 7 percent after neurosurgical operations... [to full text]

In the present study clinical performance of new highly cardiospecific biochemical markers of myocardial injury was investigated and these markers were compared with conventional enzymes. The multimarker risk assessment score index, including biochemical markers of myocardial injury, inflammation and haemostasis, was developed for the prognosis of patients after ACS. The prognostic value of BNP concentration changes in predicting LV remodeling and dysfunction after MI was evaluated along with other biochemical markers of myocardial injury.

Summary of the Doctoral Dissertation Biomedical Science, Medicine (07 B) The doctoral dissertation has been prepared at Kaunas University of Medicine during the period of 2000-2004. Scientific Supervisor: Prof. Dr. Romualdas Gailys (Kaunas University of Medicine, Biomedical Sciences, Medicine – 07 B) The dissertation will be defended at the Medical Research Council of Kaunas University of Medicine. Chair: Prof. Habil. Dr. Dalia Pangonytė (Kaunas University of Medicine, Biomedical Sciences, Medicine – 07 B) Members: Prof. Habil. Dr. Vaiva Lesauskaitė (Kaunas University of Medicine, Biomedical Sciences, Medicine – 07 B) Prof. Habil. Dr. Laima Griciūtė (Vilnius University, Biomedical Sciences, Medicine – 07 B) Assoc. Prof. Dr. Antanas Sederevičius (Lithuanian Veterinary Academy, Biomedical Sciences, Veterinary Medicine – 12 B) Dr. Rimantas Žalinkevičius (Kaunas University of Medicine, Biomedical Sciences, Medicine – 07 B) Official opponents: Dr. Birutė Žilaitienė (Kaunas University of Medicine, Biomedical Sciences, Medicine – 07B) Assoc. Prof. Dr. Arvydas Laurinavičius (Vilnius University, Biomedical Sciences, Medicine – 07B) The dissertation will be defended at the open session of the Medical Research Council on the July 1st, 2005 in the auditorium of the Clinic of Pathology at Kaunas University of Medicine. Address: Eivenių str. 2, LT- 50009 Kaunas, Lithuania. The summary of the Doctoral Dissertation was sent out on May 31st, 2005. The Dissertation is available in the... [to full text]

The scientific novelty of the study A large number of reports have demonstrated that depressed heart rate variability after myocardial infarction (MI), left ventricular dysfunction and arrhythmias are powerful predictors of mortality. Nevertheless there is a lack of detailed assessment of heart rate variability in the acute period of MI, especially during the first 24 hours, from long-term (24-h) recordings, and the value of different parameters of heart rate variability in predicting dangerous complications of MI was not fully evaluated. The indications of complex and constant monitoring of heart rate variability, left ventricular function, arrhythmias in acute MI are not based on scientific studies as well as their value in predicting the effect of different methods of management, course and outcomes of critical cardiac conditions. Thus, the current study differs from all the earlier studies in that we assessed heart rate variability in the very early period of myocardial infarction (the first and the third day) using long time recordings (24 h), both – time-domain and frequency-domain –methods, and evaluated its changes in relation to arrhythmias and left ventricular function, using not only conventional 2D-echocardiography but also left ventricular long axis function assessment by M-mode and tissue Doppler imaging. The aim of the study The aim of the study was to determine the association between heart rate variability, cardiac arrhythmias and left ventricular... [to full text]

INTRODUCTION Autonomic control of cardiac function is fundamental for the maintenance of circulatory homeostasis under changing environmental and behavioral conditions (Pardini et al., 1987). The intrinsic cardiac nervous system is principal in the maintenance of the adequate cardiac output, the power, the rate of contraction, and the volume of blood delivered to cardiac muscle thorough the coronary vasculatures (Armour and Ardell, 1994). For many years it has been thought that cardiac ganglia possess only cholinergic parasympathetic postganglionic neurons and serve as simple stations of transmission of inhibitory impulse to the heart (Mawe et al., 1996). However, recent morphological and physiological evidence indicates that the mammalian intrinsic cardiac nervous system contains afferent sensory (Ardell et al., 1991; Armour and Hopkins, 1990; Cheng et al., 1997), efferent sympathetic and parasympathetic postganglionic neurons (Horackova et al., 1996; Mawe et al., 1996; Randall et al., 1987), and a population of local circuit neurons that function to interconnect neurons within and between the separate aggregates of ganglia that form the various intrinsic cardiac ganglionated plexuses (Butler et al., 1990). These neurons might be unipolar, bipolar or multipolar in shape (Armour et al., 1997; Baptista and Kirby, 1997; Edwards et al., 1995; Xi et al., 1991) and possesses varied immunohistochemical properties (Singh et al., 1999). Functionally diverse cardiac ganglion neurons... [to full text]

Abbreviations ALT – alanine aminotransferase AST – aspartate aminotransferase BMI – body mass index CHC – chronic hepatitis C EBR – early biochemical response EHR – early histological response EIA – enzyme immunoassay EVR – early virological response HAI – hepatitis activity index HCV – hepatitis C virus HCV RNA - hepatitis C virus ribonucleic acid Helicobacter spp. – Helicobacter species H. pylory – Helicobacter pylori IFN – interferon α-2b PCR – polymerase chain reaction PEG IFN – peginterferon RBV – ribavirin SVR – sustained virological response SBR – Sustained biochemical response INTRODUCTION Chronic hepatitis due to hepatitis C virus (HCV) infection is a worldwide disease representing a serious public health problem. Chronic hepatitis C (CHC) infection affects nearly 170-200 million people worldwide. The prevalence of anti-HCV at this time in the general adult population of Lithuania is nearly 50 thousand (0.9%). Without effective treatment strategies, hepatitis C - related morbidity and mortality is expected to increase nearly 3-fold by the year 2015. Current hepatitis C therapies are aimed at achieving eradication of HCV infection as a means of delaying progression to end-stage liver disease and preventing the development of hepatocellular carcinoma. The treatment options include interferon (IFN), ribavirin (RBV) and peg interferon’s a-2a and a-2b (PEG IFN). IFN-based regiments for the treatment of CHC have become increasingly effective and are to eradicate virus... [to full text]