The dynamics of the focal changes in the gastric mucosa of patients with chronic gastritis based on the data from a multiyear endoscopic observation in a polyclinic

Out of 1700 patients suffering from chronic gastritis, a group of 221 patients followed up for 6 to 14 years at an outpatient clinic was distinguished. Endoscopy and biopsy of gastric mucosa areas with focal lesions were carried out annually. 140 patients were discovered to have atrophic hyperplastic gastritis, 81 "complete" erosions". The lesions were of solitary or multiple character and were coupled with the other manifestations of chronic gastritis. Histology revealed different manifestations of chronic atrophic gastritis. 7.2% of the patients showed moderate dysplasia of the epithelium. The follow-up of focal hyperplasias established invariability of those formations or occurrence of the new ones in 89% of cases. In patients with "complete" erosions, such a course was recorded in 47% of cases whereas in the remainder, there was a decrease or complete disappearance of the sign. Dynamics of the histological appearance available in 28% of the patients, lay in atrophy enhancement and in the appearance of foci of intestinal metaplasia. In an equal number of cases, dysplasia of the epithelium was invariable; in some cases, it disappeared or else its intensity changed (within the framework of mild and medium degree).     

Assessment of the Capacity of the ProGraf-7000 X-Ray Apparatus for Tomosynthesis

Slices of density of an object reconstructed using tomosynthesis from a limited-angle projection are attractive as a medical diagnostic tool due to high resolution of such slices and much smaller, compared to full-angle CT, required radiation dose and cost of instrument manufacture. However, the incompleteness of the projection sets leads to reconstruction artifacts that look like smeared (or repeated) and faded images of actual objects lying in other slices and requires reconstruction methods tolerant to such incompleteness and convenient for possible use of additional information about the object for the suppression of artifacts. The reconstruction method of folded projections, which is advantageous for limited-angle projection sets, is suggested. Examples of reconstructed slices are given for scanning angles 40, 60, and 90 degrees. A specially designed plastic phantom containing metallic inclusions producing strong artifacts was used. The study of these and other reconstruction results in various geometric and noise conditions indicates that the tomosynthesis option producing images of acceptable quality can be implemented in the standard ProGraph-7000 X-ray apparatus and may have considerable area of application.     

Labial Adhesion with Acute Urinary Retention Secondary to Bartholin's Abscess

Labial adhesions are usually seen in early childhood or in the postmenopausal years, but this clinical entity is rarely seen in the reproductive years. We report a case of labial adhesion with acute urinary retention secondary to Bartholin's abscess in a reproductive‐aged woman with normal menstrual periods. We emphasize the possible occurrence of labial adhesion following Bartholin's abscess in the reproductive years with normal estrogen levels.     

Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia is characterized by moderate thrombocytopenia and thrombotic complications, whereas quinine/quinidine-induced thrombocytopenia usually presents with severe thrombocytopenia and bleeding. Using flow cytometry and assays of procoagulant activity, we investigated whether sera from patients with these immune drug reactions could stimulate normal platelets to generate platelet-derived microparticles with procoagulant activity. Sera or purified IgG from patients with heparin-induced thrombocytopenia stimulated the formation of platelet-derived microparticles in a heparin-dependent fashion. Further studies showed that heparin-induced thrombocytopenia sera also produced a marked increase in procoagulant activity. In contrast, sera from patients with quinine- or quinidine-induced thrombocytopenia did not generate platelet-derived microparticles nor generate increased procoagulant activity. However, quinine/quinidine-induced thrombocytopenia sera produced a significant increase in the binding of IgG to platelets in a drug-dependent fashion, whereas sera from patients with heparin-induced thrombocytopenia demonstrated no drug-dependent binding of IgG to platelets. We also observed increased levels of circulating microparticles in patients with acute heparin-induced thrombocytopenia compared with control patients. Our observations indicate that the generation of procoagulant platelet-derived microparticles in vivo is a plausible explanation for the thrombotic complications observed in some patients with heparin-induced thrombocytopenia.     

Insights into Severe 5,10‐Methylenetetrahydrofolate Reductase Deficiency: Molecular Genetic and Enzymatic Characterization of 76 Patients

5,10‐Methylenetetrahydrofolate reductase (MTHFR) deficiency is the most common inherited disorder of folate metabolism and causes severe hyperhomocysteinaemia. To better understand the relationship between mutation and function, we performed molecular genetic analysis of 76 MTHFR deficient patients, followed by extensive enzymatic characterization of fibroblasts from 72 of these. A deleterious mutation was detected on each of the 152 patient alleles, with one allele harboring two mutations. Sixty five different mutations (42 novel) were detected, including a common splicing mutation (c.1542G>A) found in 21 alleles. Using an enzyme assay in the physiological direction, we found residual activity (1.7%–42% of control) in 42 cell lines, of which 28 showed reduced affinity for nicotinamide adenine dinucleotide phosphate (NADPH), one reduced affinity for methylenetetrahydrofolate, five flavin adenine dinucleotide‐responsiveness, and 24 abnormal kinetics of S‐adenosylmethionine inhibition. Missense mutations causing virtually absent activity were found exclusively in the N‐terminal catalytic domain, whereas missense mutations in the C‐terminal regulatory domain caused decreased NADPH binding and disturbed inhibition by S‐adenosylmethionine. Characterization of patients in this way provides a basis for improved diagnosis using expanded enzymatic criteria, increases understanding of the molecular basis of MTHFR dysfunction, and points to the possible role of cofactor or substrate in the treatment of patients with specific mutations.     

A humanised tissue‐engineered bone model allows species‐specific breast cancer‐related bone metastasis in vivo

Bone metastases frequently occur in the advanced stages of breast cancer. At this stage, the disease is deemed incurable. To date, the mechanisms of breast cancer‐related metastasis to bone are poorly understood. This may be attributed to the lack of appropriate animal models to investigate the complex cancer cell–bone interactions. In this study, two established tissue‐engineered bone constructs (TEBCs) were applied to a breast cancer‐related metastasis model. A cylindrical medical‐grade polycaprolactone‐tricalcium phosphate scaffold produced by fused deposition modelling (scaffold 1) was compared with a tubular calcium phosphate‐coated polycaprolactone scaffold fabricated by solution electrospinning (scaffold 2) for their potential to generate ectopic humanised bone in NOD/SCID mice. While scaffold 1 was found not suitable to generate a sufficient amount of ectopic bone tissue due to poor ectopic integration, scaffold 2 showed excellent integration into the host tissue, leading to bone formation. To mimic breast cancer cell colonisation to the bone, MDA‐MB‐231, SUM1315, and MDA‐MB‐231BO breast cancer cells were cultured in polyethylene glycol‐based hydrogels and implanted adjacent to the TEBCs. Histological analysis indicated that the breast cancer cells induced an osteoclastic reaction in the TEBCs, demonstrating analogies to breast cancer‐related bone metastasis seen in patients.