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Vokhidov Ulugbek Nuridinovich, Tashkent Medical Academy Akhundjanov Nozim Obidovich, Tashkent Medical Academy Department of ENT diseases with course of dentistry E-mail: dr_ulugbek@list.ru
Features of mesenchymal formations of chronic polypoid rhinosinusitis
Abstract: The aim of the study was to investigate the mesenchymal formations in the stroma of polyps of different forms of chronic polypoid rhinosinusitis. We carried out morphological and immunohistochemical study of paraffin blocks prepared from nasal polyps, which remote by endoscopic operation in 45 patients with chronic polypoid rhinosinusitis in 2013. The study showed that the observation of mesenchymal formations in nasal polyps, which could be regarded as a growth zone of polyps.
Keywords: chronic polypoid rhinosinusitis, morphological study, immunohistochemical study, mesenchymal formations.
Bibliography: 8 sources.
Chronic polypoid rhinosinusitis (CPRS) is o ne of the most important forms of chronic rhinosinusitis (CRS), which proceeds with the rapid growth of polyps and frequent relapses [1]. CPRS represent a common benign disease affecting 4% of the general population [3].
CPRS is a disease with unknown etiology, characterized by a persistent symptomatic inflammation of the nasal and sinonasal mucosa [2; 5]. In patients with CPRS, the epithelium is damaged (partial shedding, complete denudation, or loss of cilia) and shows an abnormal remodeling (goblet cell hyperplasia, basal cell hyperplasia, or metaplasia) [6, 8]. As a consequence, the identification of molecular mechanisms of the upper airway epithelial cells involved in repair, proliferation, and mucociliary differentiation under normal and pathological conditions, offers some potential for the development of new strategies for CPRS treatment [4; 5; 7].
With this in mind, the study of morphological and immunohys-tochemical characteristics of the various forms of CPRS is relevant and timely. Based on the above, the aim of this study was to investigate the mesenchymal formations in the stroma of polyps in different forms of chronic polypoid rhinosinusitis.
Material and methods. The material of this study were paraffin sections of surgical specimens, remote during endoscopic nasal surgery of 45 patients with diagnosed CPRS aged 18-77 years who were hospitalized in the third clinic of the Tashkent Medical Academy in 2013. The morphological study was conducted with paint on hematoxylin-eosin. Immunohistochemical studies were performed by immunoperoxidase. The primary antibodies used murine monoclonal antibodies — to Vimentin (1: 100 dilution, "Termo", Germany), mouse monoclonal antibody to CD138+ (dilution 1:50, "DAKO", Germany), because these markers help to determine the condition of immunological status in the nasal polyps. The results of the survey were evaluated on the light microscope. Statistical analysis of research conducted on the Microsoft Excel 2010.
Results and discussion. The morphological symmetry of postoperative material have been stated the prevalence of eosino-
philic infiltration in 33 speciments (73.3%), while in 12 (26.7%) noted the predominance of neutrophil infiltration. This was the basis for the division into 2 groups: patients with chronic "eosinophilic" polypoid rhinosinusitis and patients with chronic "neutrophil" polypoid rhinosinusitis.
As indicated above, we have carried out an immunohistochemical study using monoclonal markers of Vimentin and CD138. Selection of these markers is specific because Vimentin stains mes-enchymal cells, which may be located in the stroma of the nasal mucosa, in its side, may describe the picture growth of nasal polyps. CD138 stains a mature epithelial cell, that's why immunohistochem-ical picture can determine their presence, expression, as well as some characteristics.
Mesenchymal cells are undifferentiated (immature) cells available in many species of multicellular organisms. Stem cells are able to self-renew, to form a new stem cells divide by mitosis and differentiate into specialized cells, i. e. converted into the cells of various organs and tissues.
From the pictures presented in Figures 1 and 2 can be determined that Expression of Vimentin marker notes in both forms of nasal polyps, but high expression characteristic for "neutrophil" polyps. These figures show the formation of epithelial cells (stained blue) in a cluster of mesenchymal cells (stained brown). On im-munohistochemical Figure 1 is determined by the dynamics of mesenchymal cells, it is abundantly towards the epithelium. Also, there is a high expression in the epithelium of macropreparation. This may affect the rapid growth of polyps that often occurs when "eosinophilic" forms polyps.
Fig. 2 noted that the presence of high expression ofVimentin in the stroma shows a great activity of mesenchymal cells, which confirms our assumption that these mesenchymal clusters are a place of growth units. In terms ofprognostic data of these changes appear to be indicative of future relapses or may indicate the formation of fibrous tissue, which is often present in neutrophilic polyps.
In Fig. 3 and 4 there is high expression of CD138 in the mature epithelial cells, as evidenced by the lack of expression of this mark-
Features of mesenchymal formations of chronic polypoid rhinosinusitis
er in clusters mesenchymal structures and the average expression in the cells located in the stroma. In the maturation stage epithelial cells gradually directed by mesenchymal cells in the epithelial side. It is
Fig. 1. «Eosinophilic» polyp. Immunohistochemical study (X200). There is a high expression ofVimentin in the stroma.
Discussion. This study supports the hypothesis that nasal polyp tissue located zones, which are responsible for the growth of polyps. In our study, we have given considerable attention to the mesenchymal formations arranged in a ring. In the study using markers found that the basic structures developing in the mesenchymal formations and maturing then sent into the stroma, some in the epithelium. In studies Rezato R. et al. [4], the focus was on metaplasia epithelium and stromal edema. However, I consider the fact that polyps are divided by the infiltration of cellular elements in the two forms, neutrophil and eosinophil, a rich edema in the stroma ofpolyps noted in "eosinophilic" polyps. In neutrophil polyps, they are, in most cases, the dense
Fig. 3. «Eosinophilic» polyp. Immunohistochemical study (X200). There is a high expression of the marker CD138 in the epithelium of the polyp. Thus, based on the survey data, it could be concluded that: 1. Identification of forms of chronic polypoid rhinosinusitis is appropriate to determine the clinical features of polypoid process and followed selection of treatment.
possible that the origin of the latter is connected with the activity of mesenchymal cells. The last layer epithelial cells not painted CD138, therefore, this marker are missing.
Fig. 2. «Neutrophilic» polyp. Immunohistochemical study (x100). There is a high expression of Vimentin in the stroma and
mesenchymal formations. and fibrous. In the study by Professor Shin S. H. [5] in Korea shows that chronic rhinosinusitis with polyps are divided into neutrophils and eosinophils, they also note different forms such as seromucinous gland hyperplasia, and stromal atypia types. In our study, those forms were not detected, and it can be a feature of the occurrence in different countries. The main attention should be paid to "growth areas", since they may be the main reasons for relapse polypoid process. Unfortunately, in the literature we reviewed we found quite a demanding attention data "growth zones", in this context, we believe that the information which is reflected in our study is interesting and can open up a new perspective on the pathogenesis of nasal polyps.
Fig. 4. «Neutrophilic» polyp. Immunohistochemical study (x100). There is a high expression of the marker CD138 in the epithelium and stroma of the polyp.
2. Defined in polyps mesenchymal formations, appear to be the growth zone, the presence of which may determine the growth and recurrence of the disease.
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Eshnazarov Kamolhuja Eshnazarovich, MD - Department of Orthopaedic Surgery Shinchon Yonsei Hospital. Seoul, Korea E-mail; kamolhuja77@mail.ru Jae Han Ko,
MD - Department of Orthopedic Surgery, Yonsei University, College of Medicine, Seoul, Korea E-mail; kojaehan@yuhs.ac Asilova Saodat Ubaevna, MD, Professor - Department of Traumatology, Orthopaedics with neurosurgery, Tashkent Medical Academy. Uzbekistan.
E-mail; asilova_saodat@mail.ru. Khaydarov Azizjon Qosimovich, MD - Department of Traumatology, Orthopaedics with neurosurgery, Tashkent Medical Academy. Uzbekistan.
E-mail; haydarov.azizjon@mail.ru Hyoung-Sik Kim,
' MD. PhD, - Department of Orthopaedic Surgery Yonsei University Yongin Severance Hospital. Seoul, Korea E-mail: ysos111@yuhs.ac Corresponding author: Hyoung-Sik Kim4" MD. PhD
How changed publication of hip and knee arthroplasty between 2005-2014 years. What we missed?
Abstract: The PubMed, EBSCO Health MedLine and ScienceDirect database was utilized with the similar advanced search to retrieve the corresponding result. Numbers of publication of hip and knee arthroplasty were searched separately on each database with advanced search using the following search terms: (Knee arthroplasty) or (Knee replacement) and (Hip arthroplasty) or (Hip replacement) included publication dates for 10 year from 2005.01.01 to 2014.12.31. Within a formula for the arithmetic mean definition we determined the average measurement of publication of hip and knee arthroplasty. All obtained data were analyzed and formed on the tables and graphs figures using Microsoft Excel for Windows 2013. The cases with hip arthroplasty or hip replacement in PubMed over the 10 years period were 17.939, which increased from 1354 to 2772 between 2005-2014 years. EBSCO Health Medline publications were 17,783, which similarly increased from 1342 to 2235 between 2005-2014 years. And ScienceDirect publications were 29,970 and grew from 1857 to 3600 in period 2005-2014. The hip arthroplasty publication arithmetic mean was increased from 1518 to 2702 between the 2005-2014 years, when the knee arthroplasty publication arithmetic mean was growing from 1136 to 2771. Percent ratio shows that the growth rate of publications knee arthroplasty 10% was faster than hip arthroplasty 7% during the 10 years. Publication of materials knee arthroplasty have been sharply increased during the last years, it shows that the interest in study about problems knee arthroplasty have been increased in conjunction.
Keywords: Hip arthroplasty; knee arthroplasty; language of publication.
Introduction of publication trends hip and knee arthroplasty in last years [13;
In length of time the number of hip and knee arthroplasty sur- 25; 26; 31]. gery has been increased. [1; 2; 3; 4] in parallel the number of re- Most ofpublished studies show that many authors were pointed
search related to this issue has been enlarged [5; 6; 7; 8]. The study to studying various peculiar properties such as analysis publication and research of scientific publications in a specific sphere, in inter- trends in one field, different publication rates between countries national bibliographic databases, is one of the frequently used meth- and journals [14; 15]. Despite the importance publication trends of ods of evaluation the scrutiny of this topic [9; 10; 11; 12]. While the hip and knee arthroplasty were insufficiently studied and pub-reviewing published orthopedic researches and articles in scientific lished in scientific journals [16; 17]. We know that many research-journals, we convinced that only a few articles were published about ers and scholars even clinician doctors commonly use the PubMed
