Background and aimsOne of the most severe manifestation displays of tuberculosis (TB) generalization is meningitis/meningoencephalitis. The purpose of this work was to improve the diagnostic efficiency of TB central nervous system (CNS) affection in human immunodeficiency virus (HIV)-infected persons.Materials and methodsMeninges and cerebral tissues, taken from died patients, who were HIV-infected and dead from TB of CNS affection, were investigated histologically.Results and discussionOur examination showed that clinical course of the pathologic process loses the peculiarity of TB-undulating character, and changes in tissues have monomorphism that appears in the presence of the same type of granulomas with a few Pirogov–Langhans cells. Alterative reactions with formation of the large fields of caseous necrosis, necrotic focuses, areas of infiltration with polymorphic cellular elements went out on the first plan in the disorder of cerebrum in patients with the terminal stage of HIV infection. The tendency to decrease in inflammatory–proliferative processes was observed, which is confirmed by the presence of the poorly expressed cellular reaction on the peripheries of focuses of caseous necrosis.ConclusionMorphologic features of tuberculous meningoencephalitis in HIV-infected patients are the presence of edema, gliosis, trombovasculitis, small focal hemorrhage, tuberculous granuloma formation with a small number of Pirogov–Langhans cells, and the prevalence of alterative–exudative reactions.
Харьковский национальный медицинский университет, г. Харьков, Украина Цель. Определение анатомической изменчивости верхнечелюстной пазухи и компонентов остиомеатального комплекса, а также подбор на основании полученных данных оптимального доступа к зоне гайморовой пазухи для выбора метода лечения гайморита, позволяющего минимизировать интра-и постоперационные осложнения.Материал и методы. Изучены результаты исследований околоносовых пазух 30 пациентов, проведенных на спиральном компьютерном томографе. Среди них 10 пациентов с субтотальным снижением пневматизации верхнечелюстного синуса и 10 пациентов с гиперплазией слизистой оболочки. Контрольная группа -10 СКТ здоровых лиц. Определены средний объем, плотность костной стенки верхнечелюстного синуса, средние размеры нижней носовой раковины, размеры, плотность крючковидного отростка в физиологических и патологических условиях, корреляция между этими показателями.Результаты. Значительная корреляция (r=0,96, 0,96, 0,95 и 0,9 в физиологическом состоянии и r=0,95, 0,94, 0,97 и 0,91 при гайморите) была отмечена между объемом, толщиной и плотностью стенок верхнечелюстного синуса. Умеренная корреляция -между объемом синуса, толщиной и плотностью крючковидного отростка, объемом синуса и продольным размером нижней носовой раковины в неизмененной пазухе (r=0,65, 0,68 и 0,66). Очень сильная корреляция -между толщиной верхней стенки и объемом синуса (r=0,96). Сильная положительная линейная зависимость (r=0,72) отмечена между объемом и толщиной медиальной стенки (р<0,05). Достоверная (р=0,01) сильная (r=0,75) взаимосвязь -между толщиной крючковидного отростка и средним объемом синуса. Очень сильная линейная корреляция -между плотностью средней и верхней стенки гайморовой пазухи в физиологических и патологических условиях (r=0,9 и 0,84).Заключение. Спиральная компьютерная томография -диагностически значимый метод исследования верхнечелюстных синусов. Определены параметры околоносовых пазух, необходимые для успешной эндоскопической ринохирургии. Полученные данные помогают выбрать доступ во время эндоскопических операций, предотвратить интра-, послеоперационные осложнения, спрогнозировать вероятность внутричерепного или внутриглазничного распространения патологического процесса.Ключевые слова: околоносовые пазухи, верхнечелюстной синус, спиральноя компьютерная томография, плотность, крючковидный отросток, нижняя носовая раковина Objective. Determining the anatomical variability of the upper maxillary sinus and ostiomeatal complex components as well as on the basis of the obtained data the selection of the optimal access to the zones of the maxillary sinus to choose sinusitis treatment method, which allows minimizing intra-and postoperative complications.Methods. The results of studies of the paranasal sinuses of 30 patients conducted on the spiral computed tomography were studied: 10 with the subtotal reduction of pneumatization of the maxillary sinus and 10 patients with hyperplasia of the mucous membrane. The control group included 10 SCTs of healthy individuals. The average vol...
Precancerous processes of the female reproductive system continue to be an issue that is being actively studied, despite the successes of recent years. One of the key prognostic factors is the characterization of the receptor set, primarily the mammary gland and endometrium, namely estrogen (ER), progesterone (PR), epidermal growth factor-2 (HER2) receptors. Purpose – to identify the features of the distribution of estrogen, progesterone and epidermal growth factor receptors in the tissues of the endometrium, cervix and mammary gland with a combination of HIV infection and alcohol abuse. Fifty women of reproductive age from 20 to 40 years were studied. After routine conduction and immunohistochemical staining, ER and PR expression were determined by a modified D.Allred scale. HER2 expression was determined by a semi-quantitative method. The obtained digital data were statistically processed. A morphometric study indicates that the combination of HIV infection and alcohol abuse significantly affects the distribution of receptors in the female reproductive system. To a greater extent, the overall score is reduced by reducing the number of cellular elements with the expression of ER and PR. HER2 receptor expression is significantly reduced in the endometrium and mammary gland. These changes may be facilitated by atrophic changes in these organs, which occurs in immunodeficiency. According to the D.Allred scale, the mean score decreases from 5.45±0.63 to 3.10±0.88 in the endometrium, from 4.68±0.65 to 2.47±0.58 in the cervix, from 6.57±0.67 to 3.57±0.77 in the mammary gland (p<0.05). HER2 expression decreased from 3.24±0.47 to 2.21±0.23 in the endometrium, from 3.43±0.66 to 2.36±0.32 in the mammary gland (p<0.05). The development of immunodeficiency is characterized by the restructuring of female reproductive organs with a change in the receptor set of the endometrium, cervix and mammary gland and a decrease in both the qualitative and quantitative composition of the receptors, which may serve as a prerequisite for the development of a triple-negative phenomenon in tumors of these organs.
The share of chronic odontogenic rhinosinusitis is 40% among all chronic rhinosinusitis. Using automated information systems for differential diagnosis will improve the efficiency of decision-making by doctors in diagnosing chronic odontogenic rhinosinusitis. Therefore, this study aimed to develop an intelligent decision support system for the differential diagnosis of chronic odontogenic rhinosinusitis based on computer vision methods. A dataset was collected and processed, including 162 MSCT images. A deep learning model for image segmentation was developed. A 23 convolutional layer U-Net network architecture has been used for the segmentation of multi-spiral computed tomography (MSCT) data with odontogenic maxillary sinusitis. The proposed model is implemented in such a way that each pair of repeated 3 × 3 convolutions layers is followed by an Exponential Linear Unit instead of a Rectified Linear Unit as an activation function. The model showed an accuracy of 90.09%. To develop a decision support system, an intelligent chatbot allows the user to conduct an automated patient survey and collect patient examination data from several doctors of various profiles. The intelligent information system proposed in this study made it possible to combine an image processing model with a patient interview and examination data, improving physician decision-making efficiency in the differential diagnosis of Chronic Odontogenic Rhinosinusitis. The proposed solution is the first comprehensive solution in this area.
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