No abstract

No abstract

e21067 Background: The purpose of the study was to analyze the expression of angiogenesis-controlling markers (CD31, VEGF) in tissues of melanocytic skin lesions. Methods: The study included 20 patients with benign pigmented lesions and 15 patients with superficial spreading and nodular melanoma. Immunohistochemical study was performed on sections of paraffin blocks for standard morphological studies using murine monoclonal CD31 and VEGF antibodies. UltraVision Quanto Detection System HRP DAB was used for visualization. Angiogenesis in tumors was assessed by intratumoral microvessel density (iMVD) index. Microvessels were stained with anti-CD31 antibody. The number of vessels was determined in each area of sight using objective lens with 40x magnification and AxioVs40 v-4.8.1.0 program. The tumor was considered VEGF-positive if more than 25% of tumor cells showed positive staining, and percentages of these tumor cells were calculated in each case (in %). Results: Quantitative evaluation of iMVD showed that the median number of microvessels in an area of sight in melanoma and nevi was 10.0±0.9 and 4.1±0.4, respectively, results of CD31 expression were statistically significant (р˂0.05). The numbers of CD31-stained vessels in melanoma ranged from 4 to 18 in one area of sight. 14 nevus cases (70%) showed 4 and less vessels, and only giant-cell nevi (6-30%) demonstrated up to 15 vessels in one area of sight. VEGF expression was found in the cytoplasm of melanoma cells in 100% of cases (15), in nevi – in 65% (13). The expression was not found in nevi cells in 35% (7). The number of VEGF-positive cells varied greatly in both melanomas and in nevi – from less than 5% to 50%. The maximal VEGF expression was observed in melanomas – 32.5±2.9%, while in nevi 23.8±2.1% (р˂0.05). Conclusions: The immunohistochemical study demonstrated a high angiogenic potential of melanoma that can be used as an additional criterion for tumor progression and malignant transformation of melanocytic skin neoplasms and thus contribute to the development of novel approaches to the diagnosis of the disease.

No abstract

Introduction. For the prevention of recurrent ischemic stroke (IS) in patients with atrial fibrillation (AF), oral anticoagulants (OAC) are considered a priority. The comorbidity of AF patients raises a discussion about the non-alternative feasibility and exceptional clinical efficacy of OAC. The validity of the choice of a specific antithrombotic agent can be assessed using a dynamic assessment of the causes of the first and recurrent stroke in patients with AF.Aim. To assess the frequency recurrent IS and quality of medicament prevention therapy in patients with AF depend on heterogeneity of stroke leading pathogenetic mechanism.Materials and methods. The data from the register of 200 patients with IS and AF were analyzed. 55 (27.5%) patients suffered recurrent IS (24 (43,6%) men, 31 (56,4%) women, mean age 72,3 ± 10,2 years). The pathogenetic subtype of recurrent IS was determined, including a retrospective assessment of the pathogenetic subtype of a previous IS. We studied the presence and nature of antithrombotic therapy (ATT) preceding a second stroke.Results. The first IS was due to cardiogenic embolism in 36.4% of patients, the atherothrombotic subtype occurred in 18.2%, and the lacunar subtype in 34.5% of patients. Embolic stroke from an undetermined source (ESUS) - in 10.9% of patients. OACs were prescribed only to 31.7% of patients, antiplatelet agents - to 14.6% of patients, 53.7% of patients did not receive ATT. The leading pathogenetic subtype of recurrent stroke was cardiogenic embolism (70.7%), the frequency of lacunar stroke decreased (4.9%), and the frequency of atherothrombotic stroke remained unchanged. In 14 patients with recurrent stroke, AF was first detected, including all patients with ESUS.Conclusion. The proportion of recurrent stroke in patients with AF is 27.5%. Compared with the first stroke, recurrent stroke in patients with AF is characterized by an increase in the proportion of cardiogenic embolism up to 70.7%, which is due to the insufficient prescription of OAC, which must be recommended, including for patients with non-cardioembolic subtypes of stroke.