Кафедра акушерства і гінекології № 1

Постійне посилання на фонд

https://repository.pdmu.edu.ua/handle/123456789/6

Переглянути

Зараз показуємо 1 - 20 з 220

Aseptic inflammation as the essential link in the pathogenesis of endometrioid disease
(2023-10) Orlova, Yu. A.; Hromova, A. M.; Ketova, O. M.; Liakhovska, T. Yu.; Martynenko, V. B.; Krutikova, E. I.; Орлова, Юлія Андріївна; Громова, Антоніна Макарівна; Кетова, Олена Миколаївна; Ляховська, Тетяна Юріївна; Мартиненко, Віталій Борисович; Крутікова, Елла Іванівна
Abstract. Aseptic inflammation as the essential link in the pathogenesis of endometrioid disease. Orlova Yu.A., Hromova A.M., Ketova O.M., Liakhovska T.Yu., Martynenko V.B., Krutikova E.I. The paper was aimed at deter mination of the quantitative activity of iNOS and Arg1, as well as M1 and M2 phenotype macrophages in women with endometrioid disease to establish their role in the pathogenesis of endometriosis. A prospective study was performed in gynecological units of the medical facilities of Poltava city. 140 women of reproductive age who made up the main group (110 women with endometrioid disease) and the control group (30 women without endometrioid disease) voluntarily participated in the study. All women underwent planned surgical treatment for existing gynecological pathology. Before surgical treatment, women were examined in accordance with the current Orders of the Ministry of Health of Ukraine. The spectrophotometric method was used to determine the enzymatic markers of macrophages (in the endometrium and peritoneal fluid) polarized into M1(iNOS) and M2 (Arg1) phenotypes. The type of macrophages was determined individually in each patient according to the ratios: in iNOS>Arg1, the M1 macrophage type prevailed; in Arg1>iNOS, the M2 macrophage type prevailed. When examining endometrial samplings in women from the main group, the iNOS indicator was by 1.4 times higher compared to women from the control group. The obtained results at the stage of entry into the abdominal cavity showed that mostly women from the main group suffered from the pelvic adhesion, especially stage 3 and stage 4. Among the obtained results, the increased quantitative activity in the peritoneal fluid of both iNOS and Arg1 in women of the main group was significant compared to the control group. When comparing the stages of endometrioid disease to the rates of quantitative activity of macrophage enzyme markers (in peritoneal fluid), it was found that the increase in the stage of the disease (from stage 3 to stage 4) caused an increase in the quantitative activity of Arg1 by 1.9 times and a decrease in the quantitative activity of iNOS by 2.9 times. Therefore, the planning of surgical intervention for women with endometrioid disease should consider a significant percentage of the pelvic adhesive disease, especially at the severe stages. Initiation of the chronic aseptic inflammatory process in endometrioid disease is caused by an increased quantitative activity of iNOS in the endometrium. In the pathogenesis of endometrioid disease, the presence of M2 phenotype macrophages in the peritoneal fluid is important, while the switching of macrophage phenotypes from a pro-inflammatory subpopulation to an anti-inflammatory one is crucial. Реферат.
Assessment of endothelial dysfunction in pregnant women with obesity and preeclampsia
(Wiadomości Lekarskie, 2021-08) Zelinka-Khobzey, Marta; Tarasenko, Kostiantyn; Mamontova, Tetiana; Зелінка-Хобзей, Марта Миколаївна; Тарасенко, Костянтин Володимирович; Мамонтова, Тетяна Василівна
The aim: To assess the values of endothelial vascular growth factor (VEGF) in blood serum and circulating endothelial microparticles CD32+CD40+ in the peripheral blood of pregnant women depending on the severity of obesity and presence of preeclampsia. Materials and methods: the study included 122 pregnant women divided into groups in accordance with their height and weight parameters and presence of preeclampsia. We studied the serum VEGF concentration by enzyme-linked immunosorbent assay, carried out the count of CD32+CD40+ circulating endothelial microparticles in the peripheral blood by using flow cytometry. Results: It has been found out the serum VEGF concentration in pregnant women with obesity decreases with rising level of obesity and the preeclampsia manifestation. In contrast to the decrease in this marker, there is an increase in the number of circulating endothelial microparticles CD32+CD40+ in the peripheral blood of pregnant women with obesity and preeclampsia. This pattern of these indicators points out the presence of endothelial dysfunction, which may contribute to occurrence of preeclampsia in pregnant women with concomitant obesity. Conclusions: The indicators of VEGF concentration and the count of circulating endothelial microparticles CD32+CD40+ in the blood serum can serve as reliable markers for evaluating the severity of endothelial dysfunction in pregnant women with concomitant obesity and preeclampsia.
CD68+ M1 Macrophages is associated with placental insufficiency under fetal growth restriction
(Aluna Publishing, 2021-02) Berezhna, V. A.; Mamontova, T. V.; Gromova, A. M.; Бережна, Варвара Анатоліївна; Мамонтова, Тетяна Василівна; Громова, Антоніна Макарівна
The aim of the current study was to elucidate the possible involvement of M1 and M2 macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction (FGR) and resulted in term births after 37 weeks of gestation and preterm births up to 37 weeks of gestation. Materials and methods: CD68+ and CD163+ macrophages were studied by immunohistochemical method, placental morphology in the placentas of 16 women whose pregnancies were complicated by FGR and resulted in term births at a gestational age after 37 weeks (1-st group, n = 7) or resulted in preterm births at a gestational age up to 37 weeks (2-nd group, n = 9). The control group consisted of 10 placentas of women with physiological pregnancies and births. Results: Women 2-nd group showed significantly low weight of the placenta, a short gestation period at the time of delivery, and a prolonged labor period than women of the control group (p <0.001; p <0.001; p <0.05, respectively). The level of CD68+ and CD163+ macrophages in the placentas of women 2-nd group was significantly higher than in woman 1-st group (p <0.001, p <0.001, respectively). A significant correlation was found between the expression level of CD68+ monocytes in the intervillous space and the weight of a newborn (r = - 0.765; p = 0.016) in women 2-nd group. Conclusions: These studies suggest that in the placentas of women whose pregnancies were complicated by FGR and resulted in preterm births, the increased activation of CD68+ macrophages of the pro-inflammatory pool may be associated with disorders of the vascular and stromal component of the villous chorion with the development of involutive and dystrophic changes. In general, this fact probably determines the progress of chronic placental insufficiency and aggravates the development of fetal growth restriction.
Cervical cancer: triggering factors
(Українська медична стоматологічна академія, 2018) Крутікова, Елла Іванівна; Крутикова, Элла Ивановна; Krutikova, E. I.
The relevance of the study of cervical carcinogenesis is due to the high incidence of the papillomavirus infection among young women (up to 95%), which oncogeneicity has been proven to date. The purpose of the present study was the analysis of the findings of recent studies on the triggers of cervical cancerogenesis. The author emphasizes the findings of immunocytochemical study of cervical cells for the detection of toll-like receptors (TLR 3,4,7,8), nitric oxide synthase (iNOS), the NF-kB p 65 transcription factor, which are the controllers of the cellular cycle. The dysfunction of these enzymes leads to carcinogenesis. The analyzed publications indicated that the TLR 3, 4, 7, 8, iNOS and NF-kB p 65 expressions in the epithelial cells of cervical cancer significantly exceeded the one in the benign HPV-cells and disease-free specimens (р<0,005). Thus, the TLR/NO signal path is involved in the pathogenesis of cervical cancer and is subject to study. Another point of the presented review is the effect of the folates on DNA-methylation and the expression of tumor suppressor of the FHIT (Frigile Histidine Triad) protein, which inhibits the cervical neoplasia. The studies were conducted on the CaSki (16 HPV-positive) and С33А (16 HPV-negative) cellular lines in women with CIN and carcinoma. It has been established that the higher the grade of the cervical lesions the more elevated the level of FHIT-methylation was, whilst the level of the RBC folate was decreasing. Thus, the deficiency of folates is one of the links of cervical carcinogenesis that should be considered by clinicians. The publications also reported on the HPV–L1capsid protein as a marker of the tension of the local cervical immunity, induced by the HPV infection. The capsid test in combination with and quantitative HPV-test of cervical specimens can be used as a criterion for the effectiveness of conservative therapy in CIN.; Актуальність вивчення пускових механізмів цервікального канцерогенезу зумовлена високою частотою папіломавірусної інфекції серед молодих жінок (до 95%), онкогенність якої доведена на сьогодняшній день. Проаналізовані джерела вказували на експресію TLR 3, 4, 7, 8, iNOS и NF-kB p 65 в епітеліоцитах раку шийки матки, яка значно перевищувала аналогічну в доброякісних клітинах-носіях папіломавирусу і здорових зразках (р<0,005). Сигнальный шлях TLR/NO залучений у патогенез цервікального раку і підлягає вивченню. Наступний аспект даного огляду присвячений впливу фолатів на ДНК-метилювання і експресії пухлинного супресору білка FHIT (Frigile histidine triad), який пригнічує неоплазию шийки матки. Дослідження проводились на клітинних лініях CaSki (HPV 16 позитивних) та С33А (HPV 16 негативних) жінок з CIN та карциномою. З'ясовано, що при підвищенні тяжкості ураження шийки матки відповідно підвищувався рівень метилювання FHIT, тоді як рівень фолату ерітроцитів (RBC) знижувався. Тобто, дефіцит фолатів являєтся одним із ланчюгів цервікального канцерогенезу, що необхідно враховувати клініцистам. Наведені також дані про капсидний білок HPV–L1, як про маркер напруження локального цервікального імунітету на фоні папіломавірусної інфекції. Капсидний тест у купі з кількісним HPV-навантаженням цервікальних зразків може бути використаний як крітерій ефективності консервативної терапії CIN; Актуальность изучения пусковых механизмов цервикального канцерогенеза обусловлена высокой частотой папилломавирусной инфекции среди молодых женщин (до 95%), онкогенность которой доказана на сегодняшний день. Проанализированные источники указывали, что экспрессия TLR 3, 4, 7, 8, iNOS и NF-kB p 65 в эпителиоцитах рака шейки матки значительно превышала таковую в доброкачественных клетках-носителях папилломавируса и здоровых образцах (р<0,005). Сигнальный путь TLR/NO вовлечён в патогенез цервикального рака и подлежит изучению. Другой аспект данного обзора посвящён влиянию фолатов на ДНКметилирование и экспрессию опухолевого супрессора белка FHIT (Frigile histidine triad), который подавляет неоплазию шейки матки. Исследования проводились на клеточных линиях CaSki (HPV 16 позитивных) и С33А (HPV 16 негативных) у женщин с CIN и карциномой. Выяснено, что по мере повышения тяжести поражения шейки матки повышался уровень метилирования FHIT, тогда как уровень фолата эритроцитов (RBC) снижался. Таким образом, дефицит фолатов является одним из звеньев цервикального канцерогенеза, что необходимо учитывать клиницистам. Приведены также данные о капсидном белке HPV–L1, как о маркере напряжения локального цервикального иммунитета на фоне папилломавирусной инфекции. Капсидный тест в совокупности с количественной HPV-нагрузкой цервикальных образцов может использоваться как критерий эффективности консервативной терапии CIN.
Characteristics of CD68+ and CD163+ expression in placenta of women with preeclampsia and obesity
(Aluna Publishing, 2021-08) Zelinka-Khobzey, Marta M.; Tarasenko, Kostiantyn V.; Mamontova, Tetiana V.; Зелінка-Хобзей, Марта Миколаївна; Тарасенко, Костянтин Володимирович; Мамонтова, Тетяна Василівна
The aim: to study the peculiarities of CD68+ and CD163+ macrophage expression in the placentas of women with obesity who developed preeclampsia by applying immunohistochemical method. Materials and methods: The study included 20 placentas taken from women who delivered full-term live-birth babies. The women were divided into 4 groups of 5 individuals each: women with physiological body weight (1st group); women with class II obesity (2nd group); women with physiological body weight and preeclampsia (3rd group); women with class II obesity, who developed preeclampsia (4th group). Results: The analysis of the expression level of CD68+ and CD163+ decidual macrophages shows the predominance of CD68+ pro-inflammatory profile over CD163+ anti-inflammatory profile in women of all groups. Evaluation of CD68+ and CD163+ expression levels of Kashchenko-Hofbauer cells in the stroma of the terminal villi of the placenta shows that the expression level of CD68+ macrophages is significantly higher in women with obesity and preeclampsia than in the control, or in women with obesity or preeclampsia. There was a reverse tendency to the polarization shift in Kashchenko-Hoffbauer cells in the stroma of the terminal villi towards the predominance of CD163+ macrophages over CD68+ macrophages in all groups of women. Conclusions: The imbalance in anti-inflammatory and pro-inflammatory profile of placental macrophages with a predominance of the latter can lead to the development of preeclampsia.
Comparison of the impact of antiseptic agents on gardnerella vaginalis and atopobium vaginae detected in the oral cavity of women with bacterial vaginosis
(Georgian Med News, 2023) Krutikova, A. D.; Krutikova, E. I.; Petrushanko, T. O.; Boichenko, O. M.; Moshel, T. M.; Ivanytskyi, I. O.; Крутікова, Анна Дмитрівна; Крутікова, Елла Іванівна; Петрушанко, Тетяна Олексіївна; Бойченко, Ольга Миколаївна; Мошель, Тетяна Миколаївна; Іваницький, Ігор Олексійович
Abstract. When women with comorbid bacterial vaginosis visit periodontologist, it is essential to understand the presence of cross-infection processes between the oral cavity and vagina in this particular category of subjects. Conducting detection of Gardnerella vaginalis and Atopobium vaginae, which are provocative microbial factors for bacterial vaginosis, is a mandatory step in the laboratory examination of subjects. When choosing an antiseptic for oral cavity disinfection, the use of 0.25% dequalinium chloride is more advisable. Both subjective and objective examination methods thoroughly demonstrate the higher clinical effectiveness of 0.25% dequalinium chloride: patients report a 20% more frequent improvement in subjective indicators, the index assessment of periodontal status improves by 1.2-1.6 times, and the detection rate of Gardnerella vaginalis and Atopobium vaginae is by 20% lower compared to 0.2% chlorhexidine. The specific composition of oral microbiota in this group of subjects necessitates adjustments to treatment protocols and consideration of the specific impact on Gardnerella vaginalis and Atopobium vaginae.
Complex histological and immunohistochemical study of monocytopoiesis in rats with determination of proliferative activity by expression Ki67 and CD68+ in the experiment
(Полтавський державний медичний університет, 2021) Martynenko, R. V.; Shepitko, V. I.; Stetsuk, Ye. V.; Boruta, N. V.; Yakushko, O. S.; Martynenko, V. B.; Мартиненко, Роман Віталійович; Шепітько, Володимир Іванович; Стецук, Євген Валерійович; Борута, Наталія Володимирівна; Якушко, Олена Святославівна; Мартиненко, Віталій Борисович
Ki67 is not only one of the markers of proliferation, but also an indirect determinant of the rate of cell division. CD68 is exploited as a valuable cytochemical marker to immunostain monocyte/macrophages in the histochemical analysis of inflamed tissues, tumor tissues, and other immunohistopathological applications. The purpose of the study was to determine the cell proliferation index of the monocytic line of red bone marrow using antibodies to CD68+ and Ki-67 in the control and intact groups of animals. There were established an equivalent degree of proliferative activity by progenitor cells with Ki-67 expression in the control and intact groups.
Features of the functional morphology of the placenta in case of premature amniotic fluid discharge
(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Liakhovska, T. Y.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Ляховська, Тетяна Юріївна
Premature discharge of amniotic fluid creates conditions for ascending infection of the placenta, fetus and newborn, disruption of uteroplacental blood circulation with the subsequent development of fetal distress. The placenta is one of the first barriers that help limit exposure to harmful substances. Dysfunction of the placenta can contribute to complications that increase the morbidity and mortality of both the fetus and the newborn. The study aimed to determine the morphological features of the placenta in case of premature discharge of amniotic fluid. Ninety placentas of women with the premature and timely discharge of amniotic fluid were examined using a standardized method of organo- and morphometry. In 42% of cases, there was a central attachment of the umbilical cord, in 35% (24/69) – lateral and in 1% – membrane. The length of the umbilical cord was 61.6±8.3 cm, and the distance from the place of the membranes to the edge of the placenta was 14.36±3.8 cm. In 41% (28/69) placentas, the course of the vessels was main, in 40% (27/69), it was mixed and in 20% (14/69) dispersed. The intervillous space with the premature discharge of amniotic fluid was empty in only three observation cases (4%). In other cases (96%), it is uneven, in some places sharply narrowed, up to its complete disappearance (the focus of acute infarction). In 10 observations (15%), the intervillous space was centrally expanded with the accumulation of blood and the formation of haemorrhages. In others, it is filled with single erythrocytes and exfoliated syncytial elements. In 8 observations (12%) in the intervillous space, single and concentrated accumulations of segmented nuclear leukocytes were found - focal intervillitis. Early signs of "ageing" of the placenta with the premature discharge of amniotic fluid and disruption of uteroplacental blood flow were revealed. The presence of "infarctions" of the placenta, partial thrombosis, and uneven blood vessels contributed to a synchronous increase in fetal distress.
Features of ultrasound imaging in fetal intrauterine growth retardation
(Полтавський державний медичний університет, 2021-04) Berezhna, V. A.; Бережна, Варвара Анатоліївна
Fetal growth retardation complicates an average of 10% of all pregnancies. Today, ultrasound examination is used in obstetrics for diagnosis. Therefore, early detection of this complication is the key to adequate treatment and reduction of perinatal consequences. A deeper understanding of the early accompanying ultrasound parameters will allow timely detection or prevention of intrauterine fetal development. Purpose: to conduct an antenatal ultrasound examination of women with intrauterine growth retardation. Materials and methods: Ultrasound fetometry and placentometry were performed in women of the main group with intrauterine growth retardation (n-41) and women in the comparison group with the physiological course of pregnancy (n-12). Results: at the initial ultrasound examination, among women in the main group, fetuses below the 10th percentile were probably more common and had a decrease in biparietal head size and abdominal circumference (p = 0.001, p = 0.08). With repeated ultrasound examination, the frequency of detecting decreased indicators of biparietal head size, head circumference, abdominal circumference, femoral shaft length below the 10th percentile among women in the main group increases by 1.5 times, and significantly differs from the indicators of the comparison group. (p = 0.0002, p = 0.001). A decrease in the biophysical profile of the fetus to 6-7 points accompanies 63.4% of pregnancies with intrauterine growth retardation. The amniotic fluid index below the 5th percentile in relation to the gestational age in women at the initial examination was 2.4%, and at the second examination - 7.3%. The placental ultrasound marker of premature maturation by gestational age 21.4%, the presence of petrification in 58.5%. Conclusions: In case of timely detection of fetometric and placentometric changes, it is possible, from the standpoint of modern obstetrics, to start etiopathogenetic therapy and prevention of this complication of pregnancy.
Improving the quality of education at the Department of Obstetrics and Gynaecology through practical approaches to student assessment
(International Science Group, 2023) Mitiunina, Nina; Hromova, Antonina; Talash, Valentin; Prylutska, Neonila; Gromova, Oleksandra; Мітюніна, Ніна Іванівна; Громова, Антоніна Макарівна; Талаш, Валентин Васильович; Прилуцька, Неоніла Олексіївна; Громова, Олександра Леонідівна
This article addresses the topical issue of improving the quality of medical education on the example of the Department of Obstetrics and Gynaecology. The authors propose practical approaches to student assessment aimed at developing practical skills and critical thinking. Among the methods considered are the use of standardised clinical simulations, the creation of a student portfolio and the involvement of students in the assessment process. The practical examples and recommendations highlighted contribute to improving the quality of medical education and the training of future doctors. This article may be useful for teachers and administrators of medical faculties who want to improve the process of teaching and assessment of students. Such practical approaches to student assessment at the Department of Obstetrics and Gynaecology are important not only for improving the level of learning, but also for harmonising medical education with modern requirements and standards. The use of standardised clinical simulations helps students gain experience and confidence in performing medical procedures, which is critical for future doctors. The student portfolio allows students to track and demonstrate their own professional development and achievements, which contributes to a more objective assessment of their learning. In addition, involving students in the assessment process gives them a greater voice in shaping the curriculum and ensures greater ownership and responsibility in their learning. This article provides specific examples and recommendations for implementing the above assessment methods at the Department of Obstetrics and Gynaecology. They can serve as an important source of information and insights for educators and administrators who are interested in improving the quality of medical education and training of future doctors.
Lipoleiomyoma of the uterus in a woman of reproductive age (clinical case)
(2024) Talash, V. V.; Palyokha, Ya. V.; Gromova, A. M.; Talash, V. V.; Martynenko, V. B.; Prylutska, N. O.; Mitunina, N. I.; Талаш, Валентин Васильович; Пальоха, Я. В.; Громова, Антоніна Макарівна; Талаш, Вікторія Володимирівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Мітюніна, Ніна Іванівна
Uterine lipoleiomyoma is one of the variants of uterine leiomyoma, which is histologically represented by the presence of mature fat and smooth muscle cells. The relevance of the coverage of this clinical case is determined by the extreme rarity of the development of uterine lipoleiomyoma in women of reproductive age. The purpose of this work was to record this clinical case in the world statistics of lipoleiomyoma, to evaluate methods of diagnosis and differential diagnosis, to determine the role of early diagnosis of uterine lipoleioma in the subsequent tactics and scope of surgical treatment. Data from the medical records of a 41-year-old inpatient were analyzed. In addition to the generally accepted clinical and biochemical methods of blood and urine examination, electrocardiogram, ultrasound examination of the pelvic organs, the level of ovarian tumor markers in the blood (CA 125, HE4 and the ROMA index) was determined. The diagnosis of the disease was based on the data of pathohistological and immunohistochemical studies. Based on the results of a review of the medical literature, analysis of articles obtained as a result of a search of PubMed, SCOPUS, Web of Science, MedScape databases, the current state of the problem is highlighted, literary data related to the incidence, features of the clinical course, diagnosis and treatment of uterine lipoleiomyoma are summarized. The clinical case presented in the article demonstrates an incidental finding of a uterine lipoleiomyoma in a woman of reproductive age, measuring 30x25x20 cm, originated subserously from the body and cervix of the uterus, in the area of its isthmus. Under this condition, it occupied the entire Douglas space, the area of the sacro-uterine ligaments and the parietal peritoneum, intimately adjacent to the sigmoid and rectum, to the ureters and iliac vessels. The peculiarity of this clinical case is that sonographically uterine lipoleiomyoma was hidden under the "mask" of a dermoid cyst of the right ovary. Macroscopically, it differed from a typical lipoleiomyoma by the purple-bluish color of its outer surface and soot-colored, fine-lobed spongy structure on the section. The diagnosis of uterine lipoleiomyoma was verified only on the basis of pathohistological and immuno histochemical research. Microscopically, the lipoleiomyoma had a mesenchymal structure with a pronounced vascular component and consisted of mitotically inactive bundles of smooth muscle cells and mature adipocytes. Im munohistochemically, a positive reaction for caldesmon, desmin, smooth muscle actin alpha of tumor cells and for S.100 (DAKO, polyclonal) fatty cells was detected, which confirmed the hypothesis of direct transformation of smooth muscle cells existing in the leiomyoma of the uterus into fatty cells. This clinical case should complement the global statistical indicators of diagnosis of uterine lipoleiomyoma in women of reproductive age. Lipoleiomyoma should be considered as the primary diagnosis in case of detection of a large uterine tumor in women with excess body weight and be removed immediately after diagnosis, otherwise it is impossible to exclude its malignancy. For the planned diagnosis of neoplasms of the female genital organs, preference should be given to non-invasive research methods: magnetic resonance or computer tomography with contrast enhancement. The problem of these tumors lies in their unpredictable histogenesis, the unexpected presence of fat in the microscopic structure, and in the visual similarity to sarcomas. Verification of the diagnosis is carried out on the basis of pathohistological and immunohistochemical studies of the tumor preparation.Uterine lipoleioma can have a purplie-bluish color and develop by a broad base from the body and cervix of the uterus, as a result of "lipomatous" metaplasia of the uterine leiomyoma existing in a woman. Regular preventive examinations of women of all ages are crucial for timely detection of this rare neoplasm. Ліполейоміома матки – один з варіантів лейоміоми матки, яка гістологічно представлена наявністю зрілих жирових і гладком’язових клітин. Актуальність висвітлення цього клінічного випадку визначається надзвичайною рідкісністю розвитку ліполейоміоми матки в жінок репродуктивного віку. Метою цієї роботи було зафіксувати такий клінічний випадок у світовій статистиці ліполейоміоми, оцінити методи діагностики, диференціальної діагностики, визначити роль ранньої діагностики ліполейоми матки в подальшій тактиці та у визначенні об’єму оперативного лікування. Проаналізовано дані медичної документації стаціонарної хворої 41-річного віку. Окрім загальноприйнятих клінічних та біохімічних методів дослідження крові та сечі, електрокардіограми, ультразвукового обстеження органів малого тазу, визначали рівень онкомаркерів яєчників у крові (СА 125, НЕ4 та індекс ROMA). Діагноззахворювання базувався на даних патогістологічного та імуногістохімічного досліджень. За результатами огляду медичної літератури, аналізу статей, отриманих у результаті пошуку баз даних PubMed, SCOPUS, Web of Science, MedScape, висвітлено сучасний стан проблеми, узагальнено літературні дані, що стосуються захворюваності, особливостей клінічного перебігу, діагностики та лікування ліполейоміоми матки. Наведений у статті клінічний випадок демонструє випадкову знахідку ліполейоміоми матки в жінки репродуктивного віку, розмірами 30х25х20 см, яка розпочинала свій ріст субсерозно з тіла та шийки матки, у ділянці її перешийку. За цієї умови вона займала весь дугласів простір, зону крижово-маткових зв’язок і парієтальної очеревини, інтимно прилягаючи до сигмоподібної та прямої кишки, до сечоводів і здухвинних судин. Особливістю цього клінічного випадку є те, що сонографічно ліполейоміома матки ховалась під «маскою» дермоїдної кісти правого яєчника. Макроскопічно вона відрізнялась від типової ліполейоміоми багряноціанотичним кольором її зовнішньої поверхні та брудно-бурим кольором і дрібночасточковою губчастою структурою на розрізі. Діагноз ліполейоміоми матки був верифікований лише на підставі патогістологічного та імуногістохімічного дослідження. Мікроскопічно ліполейоміома мала будову мезенхімоми з вираженим судинним компонентом і складалась з мітотично неактивних пучків гладком’язових клітин і зрілих адипоцитів. Імуногістохімічно виявлялась позитивна реакція на кальдесмон, десмін, гладком’язовий актин альфа пухлинних клітин і на S.100 (DAKO, поліклональні) жирових клітин, що підтверджувало гіпотезу про пряме перетворення гладком’язових клітин наявної у хворої лейоміоми матки в жирові клітини. Цей клінічний випадок має доповнити світові статистичні показники діагностики ліполейоміоми матки в жінок репродуктивного віку. Ліполейоміому слід розглядати як первинний діагноз у разі виявлення великої пухлини матки в жінок з надмірною масою тіла та видаляти її відразу після встановлення діагнозу, оскільки інакше неможливо виключити її злоякісність. Для планової діагностики новоутворень жіночих статевих органів перевага повинна надаватись неінвазивним методам дослідження: магнітно-резонансній або комп’ютерній томографії з контрастним підсиленням. Проблема, пов’язана з цими пухлинами, полягає в їхньому непередбачуваному гістогенезі, неочікуваній наявності жиру в мікроскопічній будові та у візуальній схожості з саркомами. Верифікація діагнозу проводиться на підставі патогістологічного та імуногістохімічного досліджень препарату пухлини. Ліполейома матки може мати багряно-ціанотичний колір та розвиватись широкою основою з тіла та шийки матки внаслідок ліпоматозної метаплазії наявної в жінки лейоміоми матки. Регулярні профілактичні огляди жінок усіх вікових періодів мають вирішальне значення для своєчасного виявлення цього рідкісного новоутворення.
Morphometric analysis of placental and M1/M2 macrophages polarization in the detection of fetal growth restriction
(Українська медична стоматологічна академія, 2021) Berezhna, V. A.; Gromova, A. M.; Mamontova, T. V.; Udovytska, N. O.; Starchenko, I. I.; Vesnina, L. E.; Бережна, Варвара Анатоліївна; Громова, Антоніна Макарівна; Мамонтова, Тетяна Василівна; Удовицька, Наталія Олегівна; Старченко, Іван Іванович; Весніна, Людмила Едуардівна
The purpose of the present study was to analyzed the morphometric characteristics and CD68 and CD163 expression of macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction. The study revealed low indices of the mass and area of the placentas, but high indices of the fetoplacental weight ratio. The level of CD68+ macrophages in fibrously altered terminal villi of the placenta was significantly higher in both groups women whose pregnancies were complicated by fetal growth restriction. There was significant increased CD163+ macrophages in fibrously altered terminal villi. Thus, in the placentas of women whose pregnancy was complicated by fetal growthrestriction and resulted preterm birth, there were disruptions of the vascular and stromal component of the chorionic villus with the changes to macrophage polarization from M1 to M2 types in fibrously altered terminal villi of the placenta.
Obstetric outcomes of pregnancies after fertility treatment
(2020) Steshenko, Alexander; Ketova, Olena; Liakhovska, Tetiana; Hanna, Leila; Стешенко, Олександр; Кетова, Олена Миколаївна; Ляховська, Тетяна Юріївна; Ханна, Лейла
Pathogenetic role of macrophage colony-stimulating factor (csf-1) in predicting endometrioid disease
(Aluna Publishing, 2021-09) Orlova, Y. A.; Hromova, A. M.; Kaidashev, I. P.; Shlykova, O. A.; Izmailova, O. V.; Martynenko, V. B.; Орлова, Юлія Андріївна; Громова, Антоніна Макарівна; Кайдашев, Ігор Петрович; Шликова, Оксана Анатоліївна; Ізмайлова, Ольга Віталіївна; Мартиненко, Віталій Борисович
The aim: To assess the CSF – 1 level in peritoneal fluid and menstrual blood of women with endometrioid disease and to investigate its diagnostic and prognostic specificity. Materials and methods: The study included 80 women of child-bearing age (mean age 30.95 ± 6.49 years) with benign gynaecological pathology of the ovaries and / or fallopian tubes. The women included in the study were divided into two groups: study group (n = 50, mean age 31.04 ± 6.3 years), consisting of patients with confirmed endometrioid disease, and control group (n = 30, mean age 30.8 ± 6.8 years), involving individuals without signs of endometriosis (p> 0.05). Results: We have found significantly higher level of CSF-1 content in the peritoneal fluid in the subjects of the study group (2027.05 ± 732.64 pg / ml) compared with those in the control group (1725.62 ± 466.06 pg / ml) (p = 0.029). There is a tendency towards an increase in CSF-1 level in women with endometriosis in its more severe stages and more severe and extended adhesions. The investigation of CSF-1 content in menstrual blood has demonstrated significant increase in its values in the women of the study group (9431.6 ± 2866.22 pg / ml) compared with the values in the control group (6637.12 ± 954.05 pg / ml), (p = 0.00004). Thus, there is a tendency towards the growth in CSF-1 level in peritoneal fluid and menstrual blood in women with endometriosis and concurrent increase in severity of the disease. Conclusions: There has been found significant increase in CSF-1 content in women with endometrioid disease in both peritoneal fluid and menstrual blood (1.2 and 1.4 times, respectively). Thus, macrophage growth factor (CSF-1) can be used as a diagnostic and prognostic criterion in evaluating the progression of endomertioid disease
Prevention of preeclampsia in pregnant women with obesity
(Journal of Education, Health and Sport, 2021-03) Zelinka-Khobzey, Marta; Tarasenko, Kostiantyn; Mamontova, Tetiana; Shlykova, Oksana; Зелінка-Хобзей, Марта Миколаївна; Тарасенко, Костянтин Володимирович; Мамонтова, Тетяна Василівна; Шликова, Оксана Анатоліївна
Reducing the occurrence of preeclampsia is one of the key tasks in modern obstetrics, especially in pregnant women with concomitant obesity, who are at high risk for preeclampsia, the leading pathogenetic segment of which is endothelial dysfunction. The purpose of this work is to evaluate the effectiveness of the integrated therapeutic and preventive complex (TPC) in order to prevent preeclampsia in pregnant women. These parameters were evaluated using such markers as the concentration of vascular endothelial growth factor (VEGF) in blood serum and the content of circulating endothelial microparticles (CEM) CD32+CD40+ in peripheral blood in pregnant women with obesity of varying severity over the course of treatment we proposed. 110 pregnant women were included in the study: women with physiological body weight (n=26); women with class I obesity (n=42), and women with class II-III obesity. The groups of pregnant women with concomitant obesity were divided into two equal subgroups; one of the subgroups received the TPC (acetylsalicylic acid, calcium supplements, L-arginine, diosmin). The findings obtained demonstrate a significant improvement of endothelial status over the course of the therapy that is manifested with an increase in the serum VEGF concentration and a decrease in the content of CD32+CD40+ CEM in the peripheral blood. Our clinical assessment of pregnancy course, childbirth and the postpartum period in women with obesity and physiological body weight has shown a decrease in the occurrence of complications due to taking the integrated TPC. We have registered a decrease in the incidence of preeclampsia, placental dysfunction, occurrence of miscarriage, operative delivery and postpartum complications.
Quantitative and qualitative changes in red bone marrow monocyte dipherone and microenvironmental cells during long-term triptorelin acetate administration in the experiment
(Полтавський державний медичний університет, 2023) Martynenko, R. V.; Shepitko, V. I.; Pelypenko, L. B.; Boruta, N. V.; Martynenko, V. B.; Vilhova, O. V.; Stetsuk, Y. V.; Мартиненко, Роман Віталійович; Шепітько, Володимир Іванович; Пелипенко, Лариса Борисівна; Борута, Наталія Володимирівна; Мартиненко, Віталій Борисович; Вільхова, Олена Вікторівна; Стецук, Євген Валерійович
States. Huggins and Hodges demonstrated the therapeutic effect of testosterone deficiency in the gonads in the 1940s and thus confirmed the concept that prostate cancer is an androgen-dependent disease. Androgen deprivation therapy (ADT) is the main palliative treatment for men with locally advanced and metastatic prostate cancer, with the goal of reducing testosterone levels to the level obtained by surgical castration. The long-term chemical castration with triptorelin acetate leads to quantitative and qualitative changes in monocytic sprout cells at all levels of differentiation and proliferation with a complementary reaction of microenvironmental cells. The maximum quantitative changes in monocyte cells were observed at the 3rd month of the study, followed by a gradual recovery to the control group. Changes in the microenvironment cells: macrophages and reticular cells, were characterized by a stable reaction in the early stages of the study in the form of a decrease in the number and ratio of NSCs, with subsequent recovery of quantitative and qualitative changes to the level of the control group of animals. The adipocyte reacts at all stages of the study with a steady increase in quantitative and qualitative characteristics.
Severity of endothelial dysfunction manifestations in response to therapeutic and prophylactic complex aimed at preventing preeclampsia in women with concomitant obesity
(Дніпровський державний медичний університет, 2022) Zelinka-Khobzey, M. M.; Tarasenko, K. V.; Зелінка-Хобзей, Марта Миколаївна; Тарасенко, Костянтин Володимирович
Abstract. Severity of endothelial dysfunction manifestations in response tо thеrареutіс аnd рrорhylасtіс соmрlеx аіmеd аt рrеvеntіng рrеесlаmрsіа іn wоmеn wіth соnсоmіtаnt оbеsіty. Zelinka-Khobzey М.М., Tarasenko К.V. Reducing the incidence of preeclampsia (PE) is one of the main tasks of modern obstetrics, since PE has been known as one of the most serious hyреrtеnsіvе dіsоrdеrs оf prеgnаncy due to its impact on maternal and child health. This issue is especially revenant for managing prеgnаnt wоmеn wіth соnсоmіtаnt оbеsіty as they are at high risk for PE. Endothelial dysfunction is known as a leading pathogenetic chain in the pathogenesis of PE. Сіrсulаtіng еndоthеlіаl mісrораrtісlеs (СЕM) have been proved to act as markers of endothelial damage. The aim of this study is to evaluate the effectiveness оf thе thеrареutіс аnd рrорhylасtіс соmрlеx (ТРС) developed to prevent the occurrence of preeclampsia іn рrеgnаnt wоmеn wіth оbеsіty оf vаryіng sеvеrіty by аssеssіng thе sеvеrіty оf mаnіfеstаtіоns аssоcіated wіth thе sеvеrіty оf еndоthеlіаl dysfunctіоn. Thе study іnсludеd 48 pregnant women in the third trimester wіth physіоlоgical bоdy wеіght, clаss І оbеsіty аnd clаss II–III оbеsіty wіthоut prеесlаmpsіа, similar groups with PE, and groups of pregnant women with class I obesity and class II-III obesity who had preeclampsia during the course of receiving the thеrаpеutіc аnd prоphylасtіс соmplеx. We counted сіrсulаtіng еndоthеlіаl mісrораrtісlеs СD32+СD40+ in the peripheral blood by flоw сytоfluоrоmеtry. According to the level of expression of сіrсulаtіng еndоthеlіаl mісrораrtісlеs СD32+СD40+ іn thе blооd рlаsmа оf prеgnаnt wоmеn wіth оbеsіty оf vаryіng sеvеrіty, who developed preeclampsia during the thеrаpеutіс аnd рrоphylасtіс соursе іnсludіng аcetylsalicylic acіd, L-arginine, calcium supplements and calcium supplements in order to prevent preeclampsia, there was a decrease in the severity of endothelial dysfunction. We also observed the reduction in the incidence of obstetric and prenatal complications associated with еndоthеlіаl dysfunctіоn іn prеgnаnt wоmеn wіth cоnсоmіtant оbеsіty whо recеived thіs cоursе thаt рrоvеs its effесtіvеnеss аnd аррrорrіаteness in obstetric practice.
Simultaneous laparoscopic operations in combination with gynecological and surgical pathology
(Полтавський державний медичний університет, 2023) Martynenko, V. B.; Hromova, A. M.; Sheiko, V. D.; Nesterenko, L. A.; Zezekalo, V. M.; Orlova, Yu. A.; Talash, V. V.; Kachailo, I. A.; Мартиненко, Віталій Борисович; Громова, Антоніна Макарівна; Шейко, Володимир Дмитрович; Нестеренко, Леонід Анатолійович; Зезекало, Варвара Максимівна; Орлова, Юлія Андріївна; Талаш, Валентин Васильович; Качайло, І. А.
Laparoscopic gynecology has been used worldwide over the last few decades. Many surgical interventions previously performed laparotomically use minimally invasive laparoscopic techniques. Gynecological diseases often occur with other pathologies of internal organs that require surgical treatment. Simultaneous interventions have numerical advantages compared to traditional methods of surgical treatment. As a result of the analyzed clinical data of the conducted research, it can be stated that the simultaneous operations performed to solve gynecological and general surgical pathologies had a course similar to traditional surgical interventions. No cases of development of complications or adverse events were recorded. All patients received the maximum possible amount of treatment with the elimination of more pathological processes, which significantly improved their quality of life.
Soluble endoglin as an early prediction marker of intrauterine growth retardation
(2021) Gromova, A. M.; Berezhna, V. A.; Gromova, O. L.; Lyakhovska, T. Yu.; Ketova, O. M.; Громова, Антоніна Макарівна; Бережна, Варвара Анатоліївна; Громова, Олександра Леонідівна; Ляховська, Тетяна Юріївна; Кетова, Олена Миколаївна
High levels of circulating endoglin contribute to the development of endothelial dysfunction, which underlies the pathogenesis of intrauterine growth retardation and can be used as a prognostic marker for the development of this pathology. We collected serum from pregnant women with intrauterine growth retardation (n-41) initially at diagnosis and before delivery, and pregnant women with physiological pregnancy (n-8), using enzyme-linked immunosorbent assay to test soluble endoglin levels. It was found that the level of soluble endoglin concentration was 7.2±0.2 at the initial examination and 9.5±0.1 at the repeated examination in women who gave birth to low birth weight children with fetal developmental delay and constitutionally small children, while the level of this factor in women in the comparison group was 3.7±0.3. It was found that the level of soluble endoglin concentration was significantly higher in women who gave birth to children with intrauterine growth retardation than the level of this factor in women in the comparison group, which is highly informative to use its prognostic value.
The role of paraplacental tissues in fetal homeostasis
(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Ketova, O. M.; Krutikova, E. I.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Кетова, Олена Миколаївна; Крутікова, Елла Іванівна
The amniotic sac and amniotic membranes are of great importance in the release of childbirth activity, the biomechanism of childbirth, as a factor that contributes to the physiological processes of smoothing and opening of the cervix. We studied the changes in the morphological structure of 30 amniotic membranes during premature rupture and 10 during timely rupture. A clinical-morphological study with premature rupture of the amniotic membranes was carried out taking into account changes in the vaginal discharge depending on the duration of the waterless interval. In contrast to membranes with premature spillage of amniotic fluid, with premature rupture of the amniotic membranes near their edge, pronounced swelling of all elements of the membranes is noted. With premature discharge of amniotic fluid and a minimal waterless interval, degenerative changes in the membranes in women with premature rupture occur much earlier. Destruction of epithelial cells and their degenerative changes were observed in the amnion. There is no clear border between the amnion and the smooth chorion. With a waterless interval of 8 or more hours, parietal deciduitis develops first, then chorioamnionitis. Placental basal and septal deciduitis and less often intervillosis join. When the water-free period increased for more than 10 hours, dystrophic changes of the epithelium were noted, marked transformation into a continuous cuticular formation. The detected changes in the amnion and chorion, with a minimal waterless interval, are characterized by the destruction of epithelial cells, degenerative changes, the absence of a clear border between the amnion and the chorion, changes in the intercellular space, swelling and thickening of the walls of blood vessels, which suggests that with their premature rupture, the most characteristic degenerative-dystrophic changes. Inflammatory reaction is joined when the waterless interval is lengthened.

Переглянути

Перегляд Кафедра акушерства і гінекології № 1 за Назва

Результатів на сторінці

Налаштування сортування