Browsing by Author "Pilmane, Māra"

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    3D desekcijas galda loma anatomijas mācību procesā mūsdienās
    (Rīgas Pedagoģijas un izglītības vadības akadēmija, 2017) Pilmane, Māra; Kažoka, Dzintra; Institute of Anatomy and Anthropology
    Studiju kursa “Anatomija” apgūšana studentiem vienmēr ir bijusi saistīta ar īpašu specifiskumu, materiāla sarežģītību un nepieciešamību izprast dažādu struktūru telpiskās un topogrāfiskās attiecības. Interaktīvo mācību formu ieviešana ir viens no nozīmīgākajiem virzieniem mūsdienu augstskolas studentu sagatavošanas pilnveidošanā un ir papildu instruments mācību procesa optimizēšanā. Darba mērķis – noskaidrot 3D virtuālā desekcijas galda “Anatomage” iespējas un priekšrocības studiju kursa “Anatomija” īstenošanā un studentu zināšanu, prasmju līmeņa paaugstināšanā. Materiāli un metodes. Darbā tika analizēta studiju kursa “Anatomija” praktisko nodarbību norise Rīgas Stradiņa universitātes Morfoloģijas katedrā, izmantojot darbā ar studentiem 3D virtuālo desekcijas galdu “Anatomage”. Rezultāti. Desekcijas galds ļauj virtuāli atveidot cilvēka ķermeni dabīgā izmērā. To uz galda ekrāna var pārvietot, pagriezt ar pirkstiem un veikt griezumus jebkurā projekcijā. Izmantojot segmentācijas funkcijas, katras sistēmas tēma un anatomiskā struktūra var tikt apgūta atsevišķi. Struktūras tiek komentētas uz ekrāna ar nosaukumiem latīņu vai angļu valodā. Programmatūras nodrošinājums ļauj lejupielādēt cilvēka ķermeņu desekcijas bildes un griezumus, ļaujot vizualizēt audu un orgānu attiecības pa slāņiem, veikt dažādas virtuālas manipulācijas, izmantot dažādus bilžu formātus, dinamiskos un CT, MRI attēlus, pielietot un analizēt iekšējās bibliotēkas patoloģiskos gadījumus. Secinājumi: Desekcijas galda piedāvātās iespējas ir būtisks papildinājums praktiskajām nodarbībām, kas palīdz dziļāk apgūt studiju kursu, attīsta studentu iztēli, radošās spējas, veido plašu mācību materiālu klāstu, paaugstinot motivāciju mācīties un attīstot katra individuālās spējas un iemaņas. Balstoties uz iegūtajām zināšanām, studenti var pieņemt pārdomātus lēmumus, mācīties patstāvīgi un nepārtraukti papildināt savas zināšanas.
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    3D dissection tools in Anatomage supported interactive human anatomy teaching and learning
    (EDP Sciences, 2019) Pilmane, Māra; Kažoka, Dzintra; Berķis, U.; Vilka, L.; Department of Morphology
    The main aim of this study is to present the usage and importance of 3D dissection tools in the teaching and learning of Anatomy and to describe and explain our experience with Anatomage Table in Human Anatomy studies at Rīga Stradiņš University. In 2017–2018 two 3D dissection tools (scalpels) were used every week in work with Anatomage Table during the practical classes. As methods for collecting data were used discussions between students and teachers. Together 200 students of the Faculty of Medicine and Dentistry were involved in this study. It was possible to create incisions and cuts in order to remove and uncover different layers of organic tissues, to move deep inside step by step and find out which structures it was necessary to look for. Afterwards students showed that they were able to place the organs back and reattach the bones, muscles, blood vessels in the body and put the skin back on. Students enjoyed virtual tools in the practical classes and learned the material better. Virtual tools helped students and tutors to easily understand and memorize different anatomy structures. 3D scalpels were useful for different education activities, but the learning experience may be suitable further for the study of real materials.
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    3D printing technology in human anatomy modern teaching and learning
    (Rēzeknes Tehnoloģiju akadēmija, 2019) Kažoka, Dzintra; Pilmane, Māra; Lubkina, Velta; Indriksons, Alens; Usca, Svetlana; Rīga Stradiņš University
    There are various combinations of 3D printing technology and medical study process. The aim of this study was to summarize our first experience on 3D printing and outline how 3D printed models can be successfully used in Human Anatomy modern teaching and learning. In 2018 autumn semester, together with traditional methods, a three-dimensional (3D) printing has been introduced into Human Anatomy curriculum at Department of Morphology. In practical classes 39 groups of students from Faculty of Medicine 1st year together with 3 tutors used 3 different open source softwares to create anatomical models and prepared them for printing process. All anatomical models were produced using an FDM 3D printer, a Prusa i3 MK2 (Prusa Research). As methods for data collection were used our observational notes during teaching and learning, analysis of discussions between tutors and students, comments on the preparing and usability of the created and printed models. 3D printing technology offered students a powerful tool for their teaching, learning and creativity, provided possibility to show human body structures or variations. Presented data offered valuable information about current situation and these results were suitable for the further development of the Human Anatomy study course.
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    Acute retinal pigment epitheliitis and dosimetric follow-up : a case report
    (2024-05-01) Babenko, Tetiana; Fedirko, Pavlo; Saksonov, Stanislav; Shevchenko, Iryna; Pilmane, Māra; Vasylenko, Valentyna; Korobova, Oleksandra; Garkava, Natalia; Mykola, Kuriata; Institute of Anatomy and Anthropology
    Acute retinal pigment epitheliitis (ARPE; also known as Krill disease), a disease first described in the nineteen seventies, is characterized by fine pigment stippling in the macular area, surrounded by hypopigmented halo. The etiology of the disease is not yet known. The patient reported that he used to eat berries picked from the forest in the radioactive contaminated area in late June to early July, 2023. He complained of transient metamorphopsia and reduced vision in the left eye, and received eye examination including optical coherence tomography, general check-up, blood cell counts and whole body radionuclide content study. He was diagnosed with bilateral APRE. On the basis of measurements with the expert whole-body counter, the wholebody burden of Сs-137 for the patient was 505 Bq, and the estimated annual effective dose from internal radiation was 0.011 mSv/y. The estimated dose value was substantially lower than the basic dose limit for the population of 1 mSv/y as per requirement of the Law of Ukraine. Because APRE is a rare disease with an unknown etiology, careful attention deserves to be given to the finding of the disease in a patient who has sustained short-term exposure to ionizing radiation due to the incorporation of Сs-137 into his body tissues. For the first time it has become possible to assess adequately doses from internal radiation in a patient with APRE, which will allow to optimize efforts for further research on the etiology of this rare disorder.
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    Analysis of Inflammatory and Regulatory Cytokines in the Milk of Dairy Cows with Mastitis : A Comparative Study with Healthy Animals
    (2024) Lohova, Elizabete; Pilmane, Māra; Šerstņova, Ksenija; Melderis, Ivars; Gontar, Lukasz; Kochanski, Maksymilian; Drutowska, Andzelika; Gergely, Maroti; Prieto Simón, Beatriz; Institute of Anatomy and Anthropology
    Bovine mastitis remains a major problem in the global dairy cattle industry. The acute invasion of udder by pathogens induces innate immune response as the first defence mechanism in subclinical and clinical mastitis. The aim of the study was to determine inflammatory and regulatory cytokines IL-2, IL-4, TGF-β1, IL-17A, beta-defensin 3 and IL-10 and their potential changes in milk of dairy cows with subclinical and clinical mastitis, and to compare the findings with healthy animals. Milk samples from 15 holstein Friesian breed cows were used in the study. Cows were divided into three groups based on their health status (5 healthy, 5 subclinical and 5 clinical animals). All samples were tested using immunohistochemistry to evaluate IL-2, IL-4, IL-10, IL17A, TGF-β1 and β-Def 3 proteins. Expression of all proteins was detected in all milk samples. High expression of IL-2, IL-4, IL17A, TGF-β1 was detected in healthy cows’ milk and in milk of cows with subclinical and clinical mastitis. However, expression of IL-10 and β-Def 3 in milk samples of healthy cows was significantly higher compared to the milk of cows with subclinical and clinical mastitis (p <.001). IL-10 and β-Def 3 can be considered as informative biomarkers in diagnosis of subclinical and clinical mastitis.
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    Anatomical variations in position of mandibular foramen : An East European morphometric study in dry adult human mandibles for achieving a successful inferior alveolar nerve block
    (2019) Jain, Nityanand; Kažoka, Dzintra; Jain, Shivani; Pilmane, Māra; Rīga Stradiņš University; Department of Morphology; Institute of Anatomy and Anthropology
    In today’s era of modern dentistry, the race towards developing painless and trauma-less procedures remain an important goal of all major companies and dental researchers. One such technique of focus is the Inferior Alveolar Nerve Block (IANB) which remains by far the most common anesthetic technique followed worldwide prior to any submaxillary treatment procedure. Despite of it being so popular, the failure rates remain significantly high with estimates at 15-60% among dental practitioners and dental students alike. Major reasons for failure include inaccurate determination of Mandibular foramen, variations in location of foramen, presence of accessory foramen, etc. to name a few. The present article aims to present the morpho-anatomical variations in the position of Mandibular Foramen in East European population. For this reason, the distance of the foramen was measured from 5 different bony landmarks using digital Vernier caliper on dry human adult mandibles. Analyzing the results, the foramen was found to be positioned at a mean distance of 16.88 ± 2.43 mm on the right side and 17.33 ± 2.24 mm on the left side from the anterior border of the ramus. Similarly, it was found to be 12.31 ± 2.49 mm and 11.75 ± 2.47 mm on right and left sides respectively from posterior border of ramus. It was found to be 17.41 ± 3.22 mm and 18.01 ± 3.44 mm and 19.80 ± 3.86 mm and 20.11 ± 4.08 mm on right and left sides from mandibular notch and angle of mandible respectively.
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    Anthropometric Evaluation of Mandibular Characteristics in the Medieval Kurdish Population of Girê Kortikê : Sex-Based Variations and Comparative Analysis
    (2023-09) Kavak, Vatan; Pilmane, Māra; Kažoka, Dzintra; Edelmers, Edgars; Satici, Omer; Institute of Anatomy and Anthropology
    Introduction: This research seeks to develop population-specific standards for skeletal sex determination, focusing on the medieval Kurdish population of Girê Kortikê and the mandible, a skull component presenting the highest degree of sexual dimorphism. This is the first study of its kind for this population. The research's primary objectives were to conduct anthropometric evaluations of several mandibular characteristics within this population, assess sex-based variations, determine relationships between various mandibular sizes, and contrast these findings with other existing studies. Materials and methods: A total of 121 mandibles (55 women, 66 men) were measured using 14 distinct anthropometric techniques, applying Pearson correlation coefficients, student's t-test, and principal component analysis (PCA) for comparison. Results: The study examined and discussed disparities between some chosen mandibular measurements and data from other populations. Statistically significant sex differences (p < 0.05) and correlations were identified in 12 of the anthropological measurements. The research found that the greater the height of the symphysis (GNI), the higher the foramen mentale height (FBB). Average measurements significantly deviated from the medieval Kurdish population when compared to populations in Santa Maria Xigui, Mexico (XIG), and Mexico City (MEX). Conclusion: No correlation was found between the height of the mandibular body (HML) and the mandible length (MLT). The study suggested distinct mandibular angle (MAN) sizes between sexes, indicating unique characteristics within the Girê Kortikê population, warranting further research for a more comprehensive evaluation. In conclusion, these findings emphasize the mandible's anatomical, historical, and cultural relevance in sex determination within the Girê Kortikê population.
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    Antimicrobial and Defense Proteins in Chronic Rhinosinusitis with Nasal Polyps
    (2023-07-06) Vīksne, Rūdolfs Jānis; Sumeraga, Gunta; Pilmane, Māra; Department of Otorhinolaryngology; Institute of Anatomy and Anthropology
    Background and Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) presently remains a difficult disease to manage. Antimicrobial and defense proteins are important factors that could help characterize the role of microorganisms in CRSwNP pathogenesis, as the concept of microbial dysbiosis in CRS is still being considered. Our aim is to investigate the complex appearance, relative distribution and interlinks of human β defensin 2 (HBD-2), human β defensin 3 (HBD-3), human β defensin 4 (HBD-4), and cathelicidin LL 37 (LL 37) in chronic rhinosinusitis with nasal polyps (CRSwNP)-affected human nasal mucosa. Materials and Methods: The study group consisted of 48 samples from patients with CRSwNP. Samples were collected during functional endoscopic sinus surgery. The control group consisted of 17 normal healthy nasal mucosa samples gathered during routine septoplasty. β-defensin-2, β-defensin-3, β-defensin-4 and cathelicidin LL 37 in tissue were detected via immunohistochemical analysis. Results: HBD-2, HBD-3 and LL 37 were significantly decreased in epithelial cells in both primary and recurrent nasal polyp samples ( p < 0.001) in comparison to control samples. HBD-2 was decreased in the subepithelial connective tissue of primary nasal polyp samples when compared to both recurrent polyp ( p = 0.050) and control ( p = 0.033) samples. In subepithelial connective tissue, significantly more HBD-3-positive structures were observed in primary nasal polyp samples ( p = 0.049) than in control samples. In primary polyp samples, moderate correlations between connective tissue HBD-3 and connective (R = 0.584, p = 0.001) and epithelial tissue LL 37 (R = 0.556, p = 0.002) were observed. Conclusions: Decreased HBD-2, HBD-3 and LL 37 concentrations in the epithelium suggest a dysfunction of the epithelial barrier in patients with nasal polyps. Decreased subepithelial connective tissue HBD-2 suggests different responses to nasal microbiota in patients with primary nasal polyps compared to recurrent nasal polyps. Increased HBD-3 in subepithelial connective tissue suggests a possible role of this antimicrobial peptide in the pathogenesis of primary nasal polyps.
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    Antimicrobial peptides and interleukins in cleft soft palate
    (2023-07-02) Deņisova, Arina; Pilmane, Māra; Kažoka, Dzintra; Institute of Anatomy and Anthropology
    Cleft palate is one of the most common and well-studied congenital anomalies; however, the role of protective tissue factors in its pathophysiology is still debated. The aim of our study was to evaluate interleukin and antimicrobial peptide appearance and distribution in cleft palate. Eight soft palate samples were obtained during veloplasty procedures. Immunohistochemical staining was applied to detect HBD-2-, HBD-3-, HBD-4-, LL-37-, IL-10-, and CD-163-positive cells via light microscopy. For statistical evaluation, the Mann–Whitney U test and Spearman’s rank correlation coefficient were used. A significant difference between study groups was observed for HBD-2 and IL-10 in epithelial and connective tissue as well as HBD-4 in connective tissue. The number of HBD-3- positive cells was moderate in the patients, and few were observed in the controls. The number of LL-37-positive cells varied from a moderate amount to a numerous amount in both study groups, whilst CD-163 marked a moderate number of positive cells in patients, and a few-to-moderate amount was observed in the controls. Numerous correlations between studied factors were revealed in cleft tissues. The increase in antimicrobial peptides HBD-2 and HBD-4 and anti-inflammatory cytokine IL-10 suggested a wide compensatory elevation of the local immune system against cleft-raised tissue changes. The correlations between the studied factors (HBD-2, HBD-3, HBD-4, LL-37, and IL-10) proved the synergistic involvement of common local defense factors in postnatal cleft palate morphopathogenesis.
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    Apoptosis, ANUP, Chromogranin A, PGP 9.5, Endothelins and VEGF in Acquired Heart Diseases : Review of Literature
    (2015-05-14) Kulmane, Edīte; Pilmane, Māra; Lācis, Romāns; Institute of Anatomy and Anthropology
    According to the Centre for Disease Prevention and Control of Latvia data, in 2014 16076 latvians died from cardiovascular diseases and it is 57,03% of all deaths. Changes in myocardium of the diseased hearts are complex and pathogenesis is still not fully clear. Morphopathogenesis of cardiovascular diseases are complex molecular cell changes which include apoptosis, homeostasis regulating factors, and innervation and ischemia markers. In this article we wanted to provide an overview about apoptosis, atrial natriuretic peptide, chromogranin A, neuropeptide-containing innervation, endothelins and vascular endothelial growth factor in pathomorphology of acquired heart diseases and their clinical implications.
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    Appearance and distribution of tissue remodellation factors in the hard tissue of patients affected by cleft lip palate
    (2020-06-01) Buile, Dace; Pilmane, Māra; Akota, Ilze; Institute of Anatomy and Anthropology; Rīga Stradiņš University
    Bone repair after surgical intervention on cleft lip palate (CLP) depends on the coordinated action of multiple tissue regeneration factors. We determined the relative number and appearance of tissue factors: matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2), bone morphogenetic protein 2/4 (BMP 2/4), transforming growth factor beta (TGF-ß), Wnt3a protein (Wnt3a), Runt-related transcription factor 2 (Runx2), basic fibroblast growth factor (bFGF) and osteoprotegerin in hard tissue of CLP patients during first time surgical intervention. Fourtythree CLP patients with 24 bone and 36 cartilage samples were involved. Immunohistochemistry was used to assess the levels of tissue factors and the semi-quantitative census method was used for quantification of immunological structures. The increased amount of MMP-2 and bFGF positive cells was detected in the CLP group in cartilage and bone (p < 0.05), compared to the controls. A statistically significant (p = 0.012) increased amount of BMP 2/4 positive cells was found in cartilage of CLP patients, in comparison to the control group. Increased appearance of MMP-2, bFGF in hard tissue of the CLP patients indicates the predominance of tissue degradation. Increased number of BMP2/4 positive chondrocytes suggests improved cartilage growth and better regeneration in CLP patients.
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    Appearance of Growth Factors, Genes and Their Products in Cases of Human Embryo Tubal and Intrauterine Implantation. Summary of the Doctoral Thesis
    (Rīga Stradiņš University, 2012) Miskova, Anna; Pilmane, Māra; Rezeberga, Dace
    This promotion work deals with the basic points of pregnancy existence, such as embryo implantation, further trophoblast invasion and formation of placenta. It could be possible that fertilized oocyte implantation depends on relation between embryo and endometrial or fallopian tube cells. Molecular signalling at the time of blastocyst nidation could probably be the key to explain normal and abnormal implantation. Growth factors are important for regulation of a variety of cellular processes and typically act as signalling molecules between the cells. The role of growth factors in aetiology of ectopic pregnancy has not been yet clearly established. The aim of this study was to analyze the role of growth factors, their receptors and some genes in human embryo, endometrial and oviduct tissues in a case of uterine or tubal pregnancy. We used biotin–streptavidin method for determination of growth factors and their receptors, Barx1, Msx2 and TUNEL for evaluation of apoptotic cells. The distribution of these factors was detected semi quantitatively. The data was analyzed by nonparametric rank analysis with SPSS Statistic 17 software. A Mann-Whitney U test was used as appropriate for evaluation of significant differences. A p value <0.05 was considered as statistically significant. The Promotion work has been elaborated with ESF project support “Support for doctoral and post-doctoral investigations Riga Stradins University”.
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    Assessment of apoptosis and appearance of hepatocyte growth factor in placenta at different gestational ages : A cross-sectional study
    (2021-06) Kreicberga, Ilze; Junga, Anna; Pilmane, Māra; Institute of Anatomy and Anthropology
    Background: Fetal growth is determined by the interaction between mother and fetus using the placental interface throughout the pregnancy. Objective: To research apoptosis and appearance of hepatocyte growth factor (HGF) in placentas of different gestational ages and to describe the anthropometrical and clinical indices of mothers and newborns. Materials and Methods: The study material was obtained from 53 human immunodeficiency virus negative pregnant women of legal age without systemic diseases. The staining of placental apoptotic cells was processed by a standard in situ cell death detection kit. The detection of HGF was provided by the ImmunoCruz goat ABC Staining System protocol sc-2023. Relative distribution of positive structures was evaluated using the semiquantitative counting method. Results: The mean rank value of the amount of HGF-containing cells (cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, Höfbauer cells, and cells of extraembryonic mesoderm) was 1.61 ± 0.94. Apoptotic cells (cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, and cells of extraembryonic mesoderm) were found in all placental samples of various gestational ages (term 13.00 ± 13.05 and preterm 27.00 ± 18.25); in general, their amount decreased with advancing gestational age of the placenta (p < 0.01). Conclusion: Weight of a placenta directly depends on the gestational age and correlates with the main fetal anthropometrical parameters (weight, length, and head and chest circumferences). The decrease in HGF-containing and apoptotic cells with advancing gestation depends on the adaptation potential of the placenta, proving the other ways of cellular disposition.
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    The Assessment of CDX1, IHH, SHH, GATA4, FOXA2, FOXF1 in Congenital Intra-Abdominal Adhesions
    (2024) Freijere-Pope, Helēna; Pilmane, Māra; Junga, Anna; Pētersons, Aigars; Institute of Anatomy and Anthropology; Rīga Stradiņš University
    Congenital abdominal adhesions are a rare condition that can result in a small bowel obstruction at any age, more frequently in pediatric populations. The cause remains unknown, and the importance of aberrant congenital bands is related to the difficulty of diagnosis, and cases of death with late detection have been documented. This research examines the expression of Caudal Type Homeobox 1 (CDX1), Indian Hedgehog (IHH), Sonic Hedgehog (SHH), GATA Binding Protein 4 (GATA4), Forkhead Box A2 (FOXA2) and Forkhead Box F1 (FOXF1) gene expression in human abdominal congenital adhesion fibroblast and endothelium cells by chromogenic in situ hybridization, with the aim of elucidating their potential association with the etiology of congenital intra-abdominal adhesion band development. The potential genes’ signals were examined using a semi-quantitative approach. Significant correlations were observed between the expression of CDX1 (p <.001) and SHH (p=0.032) genes in fibroblasts from congenital intra-abdominal adhesions compared to fibroblasts from control peritoneal tissue. Statistically significant very strong correlations were found between the CDX1 and IHH comparing endothelium and fibroblast cells in congenital abdominal adhesion bands. There was no statistically significant difference found in the distribution of IHH, FOXA2, GATA4, and FOXF1 between the fibroblasts and endothelium of the patients compared to the control group. The presence of notable distinctions and diverse associations suggests the potential involvement of numerous morpho-pathogenetic processes in the development of intraabdominal adhesions.
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    Assessment of Professional Singers using Laryngeal, Respiratory, and Airflow Measurements
    (2024-12) Sumerags, Dins; Jain, Nityanand; Pilmane, Māra; Sumeraga, Gunta; Institute of Anatomy and Anthropology; Department of Morphology; Department of Otorhinolaryngology
    Purpose: In the pedagogy of classical vocal singing, it can be difficult to determine the human voice fach, especially for the voice of aspiring vocalists. Hence, an objective metric-based system for the determination of the human voice is needed. In the present study, we investigated the anthropological and aerodynamic parameters for 60 professional singers with a professionally confirmed singing range. Methods: Amongst the 60 included professional singers, there were ten participants each for sopranos, mezzo-sopranos, altos (female vocal fach), and tenors, baritones, basses (male vocal fach). Airflow measurements were recorded using spirometry whilst anthropological measurements were taken using CT scans. Appropriate statistical analyses were done using the Mann-Whitney U test and Kruskal Wallis H test with post-hoc tests and Bonferroni correction. p < 0.05 was considered statistically significant. Results: Soprano singers, who have the highest pitch, were found to be the shortest and least heavy, whilst basses, who have the lowest pitch, were found to be tallest and heaviest amongst the study participants. Furthermore, sopranos had the smallest lung volumes while the basses had the largest lung volumes (raw spirometry measures). However, when normalized ratios were considered, no differences were observed. Finally, laryngeal size showed sexual dimorphism due to developmental changes. Conclusions: A mix of anthropological and aerodynamic measurements may be useful to assist singers and vocal pedagogues to assess and determine voice types before the beginning of their vocal studies.
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    Audu funkcionālā morfoloģija bērniem ar abpusēju caurejošu lūpas, alveolārā izauguma un aukslēju šķeltni ontoģenētiskā aspektā. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2016) Smane-Filipova, Liene; Pilmane, Māra
    Lūpu un aukslēju šķeltnes ir viena no izplatītākajām iedzimtajām anomālijām, kas bērnam izraisa estētiskus un funkcionālus traucējumus. Abpusēja caurejoša šķeltne ir smaga patoloģija, tās ārstēšanai tiek lietotas daudzetapu plastiskas ķirurģiskas korekcijas, brūces slēdzas un veidojas rētaudi, kas var negatīvi ietekmēt sejas un mutes dobuma audu augšanu. Mūsdienās morfopatoģenētiskai sejas šķeltņu skarto audu izpētei ir būtiska nozīme, lai izprastu šīs embrionāli determinētās patoloģijas etiomorfopatoģenēzi un pēcoperācijas audu remodelācijas potenciālu. Sejas un mutes dobuma attīstības pamatā ir vairāki precīzi koordinēti procesi – šūnu proliferācija, diferenciācija, migrācija, programmēta šūnu nāve, ekstracelulārās matrices sintēze un degradācija, vietējās audu aizsardzības faktoru bāzes veidošanās. Minētos procesus embrija audos koordinē dažādas signālmolekulas un augšanas faktori. Noteikti gēni, ārvides un teratogēnie faktori var izraisīt kādas noteiktas signālmolekulas un/vai augšanas faktoru trūkumu vai pārlieku lielu to esamību, kā rezultātā var attīstīties sejas šķeltnes. Pētījuma mērķis bija specifisku signālmolekulu un šūnu nāves noteikšana šķeltņu skartajos audos, kā arī to faktoru noteikšana, kuri visbūtiskāk raksturo abpusējas caurejošas šķeltnes morfopatoģenēzi ontoģenētiskajā aspektā. Pētījumā tika iekļauti 46 pacienti: 22 bērniem bija abpusēja caurejoša lūpas, alveolārā izauguma un aukslēju šķeltne, 24 bērniem – vienpusēja caurejoša lūpas, alveolārā izauguma un aukslēju šķeltne. Ar imūnhistoķīmisko metodi tika izpētīts un analizēts matrices metaloproteināzes-2 (MMP-2), matrices metaloproteināzes-8 (MMP-8), matrices metaloproteināzes-9 (MMP-9), matrices metaloproteināzes-2 audu inhibitora (TIMP-2), matrices metaloproteināzes-4 audu inhibitora (TIMP-4), gēnu proteīnu MSX1, IRF6, PAX9, RYK, vaskulārā endotēlija augšanas faktora (VEGF), transformējošā augšanas faktora beta-3 (TGFβ3), transmembranozā glikoproteīna CD34 (CD34), proteīngēnvielas 9.5 (PGP 9.5), nestīna, proliferācijas marķiera Ki-67 (Ki-67), osteokalcīna (OC), osteopontīna (OP), osteoprotegerīna (OPG) un kaula morfoģenētiskā proteīna 2/4 (BMP2/4) imūnreaktīvo šūnu un nervšķiedru relatīvais daudzums. Izmantojot TUNEL metodi, tika izpētīta apoptotisko šūnu klātbūtne un sadalījums. Kopumā smagākajam šķeltnes veidam – abpusējai caurejošai lūpas, alveolārā izauguma un aukslēju šķeltnei – tika konstatēta samazināta transkripcijas faktora IRF6, MSX1 un PAX9, augšanas faktora TGFβ3 un VEGF klātbūtne, kā arī samazināta šūnu proliferācija un apoptoze mīkstajos audos, bet balstaudos samazināta OPN, OPG, MMP-2, TIMP-2, BMP2/4 un TGFβ3 klātbūtne. Pārliecinoši identificējām, ka morfoloģiskās audu izmaiņas ir smagākas pacientiem ar abpusēju šķeltni. Atkārtotu operāciju laikā vieniem un tiem pašiem pacientiem darbā novērojām palielinātu MSX1, MMP-9, TIMP-4, TGFβ3, Ki-67 un samazinātu VEGF ekspresiju.
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    Audu funkcionālā morfoloģija bērniem ar abpusēju caurejošu lūpas, alveolārā izauguma un aukslēju šķeltni ontoģenētiskā aspektā. Promocijas darbs
    (Rīgas Stradiņa universitāte, 2016) Smane-Filipova, Liene; Pilmane, Māra
    Lūpu un aukslēju šķeltnes ir viena no izplatītākajām iedzimtajām anomālijām, kas bērnam izraisa estētiskus un funkcionālus traucējumus. Abpusēja caurejoša šķeltne ir smaga patoloģija, tās ārstēšanai tiek lietotas daudzetapu plastiskas ķirurģiskas korekcijas, brūces slēdzas un veidojas rētaudi, kas var negatīvi ietekmēt sejas un mutes dobuma audu augšanu. Mūsdienās morfopatoģenētiskai sejas šķeltņu skarto audu izpētei ir būtiska nozīme, lai izprastu šīs embrionāli determinētās patoloģijas etiomorfopatoģenēzi un pēcoperācijas audu remodelācijas potenciālu. Sejas un mutes dobuma attīstības pamatā ir vairāki precīzi koordinēti procesi – šūnu proliferācija, diferenciācija, migrācija, programmēta šūnu nāve, ekstracelulārās matrices sintēze un degradācija, vietējās audu aizsardzības faktoru bāzes veidošanās. Minētos procesus embrija audos koordinē dažādas signālmolekulas un augšanas faktori. Noteikti gēni, ārvides un teratogēnie faktori var izraisīt kādas noteiktas signālmolekulas un/vai augšanas faktoru trūkumu vai pārlieku lielu to esamību, kā rezultātā var attīstīties sejas šķeltnes. Pētījuma mērķis bija specifisku signālmolekulu un šūnu nāves noteikšana šķeltņu skartajos audos, kā arī to faktoru noteikšana, kuri visbūtiskāk raksturo abpusējas caurejošas šķeltnes morfopatoģenēzi ontoģenētiskajā aspektā. Pētījumā tika iekļauti 46 pacienti: 22 bērniem bija abpusēja caurejoša lūpas, alveolārā izauguma un aukslēju šķeltne, 24 bērniem – vienpusēja caurejoša lūpas, alveolārā izauguma un aukslēju šķeltne. Ar imūnhistoķīmisko metodi tika izpētīts un analizēts matrices metaloproteināzes-2 (MMP-2), matrices metaloproteināzes-8 (MMP-8), matrices metaloproteināzes-9 (MMP-9), matrices metaloproteināzes-2 audu inhibitora (TIMP-2), matrices metaloproteināzes-4 audu inhibitora (TIMP-4), gēnu proteīnu MSX1, IRF6, PAX9, RYK, vaskulārā endotēlija augšanas faktora (VEGF), transformējošā augšanas faktora beta-3 (TGFβ3), transmembranozā glikoproteīna CD34 (CD34), proteīngēnvielas 9.5 (PGP 9.5), nestīna, proliferācijas marķiera Ki-67 (Ki-67), osteokalcīna (OC), osteopontīna (OP), osteoprotegerīna (OPG) un kaula morfoģenētiskā proteīna 2/4 (BMP2/4) imūnreaktīvo šūnu un nervšķiedru relatīvais daudzums. Izmantojot TUNEL metodi, tika izpētīta apoptotisko šūnu klātbūtne un sadalījums. Kopumā smagākajam šķeltnes veidam – abpusējai caurejošai lūpas, alveolārā izauguma un aukslēju šķeltnei – tika konstatēta samazināta transkripcijas faktora IRF6, MSX1 un PAX9, augšanas faktora TGFβ3 un VEGF klātbūtne, kā arī samazināta šūnu proliferācija un apoptoze mīkstajos audos, bet balstaudos samazināta OPN, OPG, MMP-2, TIMP-2, BMP2/4 un TGFβ3 klātbūtne. Pārliecinoši identificējām, ka morfoloģiskās audu izmaiņas ir smagākas pacientiem ar abpusēju šķeltni. Atkārtotu operāciju laikā vieniem un tiem pašiem pacientiem darbā novērojām palielinātu MSX1, MMP-9, TIMP-4, TGFβ3, Ki-67 un samazinātu VEGF ekspresiju.
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    Augšanas faktoru, gēnu un to produktu sadalījums I trimestrī cilvēka embriju implantācijas gadījumos olvadā un dzemdē. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2012) Miskova, Anna; Pilmane, Māra; Rezeberga, Dace
    Šajā promocijas darbā ir aplūkoti un analizēti ļoti nozīmīgi procesi, kas attiecas uz grūtniecības iestāšanās iespējamību un tās saglabāšanu pēc embrija implantācijas ar turpmāko trofoblasta invāziju un funkcionējošas placentas formēšanos. Iespējams, ka blastocistas implantācijas vieta ir atkarīga no izdalīto augšanas faktoru mijiedarbības ar mātes audiem, kas nosaka tiešu implantācijas lokalizāciju un turpmāko embrija attīstību. Augšanas faktori ir nozīmīgi šūnu proliferācijas, migrācijas un diferenciācijas procesos, bet pareiza noteiktu gēnu ekspresija vai „klusēšana” koordinē cilvēka embrija attīstību. Dažādas implantācijas gadījumos augšanas un transkripcijas faktoru sadale ir maz izpētīta, nav noteikta faktoru nozīme olvada grūtniecības morfopatoģenēzē. Dotā darba mērķis bija izpētīt dažādu augšanas faktoru, gēnu un to produktu ekspresijas sadalījumu cilvēka embrija, olvada un endometrija audos pirmajā trimestrī, kā arī augšanas faktoru un gēnu nozīmi nepareizas blastocistas implantācijas patoģenēzē. Darbā tika lietota biotīna – streptavidīna imūnhistoķīmijas metode augšanas faktoru, to receptoru, Msx2, BARX1 un cilvēka defensīna beta 2 sadalījuma noteikteikšanai audos. Apoptozes noteikšanai tika izmantota TUNEL metode. Imūnhistoķīmiski noteikto struktūru relatīvā biežuma apzīmēšanai tika lietota puskvantitatīvās skaitīšanas metode. Iegūto datu puskvantitatīvai izvērtēšanai tika izmantotas neparametriskās statistikas metodes (ar SPSS Statistic 17 datorprogrammas palīdzību): Manna-Vitnija (Mann-Whitney) tests. Rezultāti tika uzskatīti par ticamiem, ja p<0,05. Promocijas darbs veikts ar ESF nacionālās programmas „Atbalsts doktorantūras un pēc doktorantūras pētījumiem medicīnas zinātnēs” atbalstu.
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    Augšanas faktoru, gēnu un to produktu sadalījums I trimestrī cilvēka embriju implantācijas gadījumos olvadā un dzemdē. Promocijas darbs
    (Rīgas Stradiņa universitāte, 2012) Miskova, Anna; Pilmane, Māra; Rezeberga, Dace
    Šajā promocijas darbā ir aplūkoti un analizēti ļoti nozīmīgi procesi, kas attiecas uz grūtniecības iestāšanās iespējamību un tās saglabāšanu pēc embrija implantācijas ar turpmāko trofoblasta invāziju un funkcionējošas placentas formēšanos. Iespējams, ka blastocistas implantācijas vieta ir atkarīga no izdalīto augšanas faktoru mijiedarbības ar mātes audiem, kas nosaka tiešu implantācijas lokalizāciju un turpmāko embrija attīstību. Augšanas faktori ir nozīmīgi šūnu proliferācijas, migrācijas un diferenciācijas procesos, bet pareiza noteiktu gēnu ekspresija vai „klusēšana” koordinē cilvēka embrija attīstību. Dažādas implantācijas gadījumos augšanas un transkripcijas faktoru sadale ir maz izpētīta, nav noteikta faktoru nozīme olvada grūtniecības morfopatoģenēzē. Dotā darba mērķis bija izpētīt dažādu augšanas faktoru, gēnu un to produktu ekspresijas sadalījumu cilvēka embrija, olvada un endometrija audos pirmajā trimestrī, kā arī augšanas faktoru un gēnu nozīmi nepareizas blastocistas implantācijas patoģenēzē. Darbā tika lietota biotīna – streptavidīna imūnhistoķīmijas metode augšanas faktoru, to receptoru, Msx2, BARX1 un cilvēka defensīna beta 2 sadalījuma noteikšanai audos. Apoptozes noteikšanai tika izmantota TUNEL metode. Imūnhistoķīmiski noteikto struktūru relatīvā biežuma apzīmēšanai tika lietota puskvantitatīvās skaitīšanas metode. Iegūto datu puskvantitatīvai izvērtēšanai tika izmantotas neparametriskās statistikas metodes (ar SPSS Statistic 17 datorprogrammas palīdzību): Manna-Vitnija (Mann-Whitney) tests. Rezultāti tika uzskatīti par ticamiem, ja p<0,05. Promocijas darbs veikts ar ESF nacionālās programmas „Atbalsts doktorantūras un pēc doktorantūras pētījumiem medicīnas zinātnēs” atbalstu.
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    Basic Fibroblast Growth Factor (bFGF), Fibroblast Growth Factor Receptor 1 (FGFR1), Transforming Growth Factor Beta (TGF-β) and Chromogranin A (CgA) Appearance in Congenital Intra-abdominal Adhesions in Children under One Year of Age
    (2015-09-09) Augule, Anna; Pilmane, Māra; Ābola, Zane; Volrāts, Olafs; Institute of Anatomy and Anthropology; Department of Paediatric Surgery
    Aim: Of this work was to determine dispersion of TGF-b, fibrosis modulating factor (bFGF and FGR1) and granule marker chromogranin A in case of intra-abdominal adhesion which could be essential factors in disease pathogenesis. Thus than could be used as possible biomarker. Study Design: Observational study. Place of Study: Institute of Anatomy and Anthropology and Department of Children Surgery, Rīga Stradiņš University. Materials and Methods: The specimens used for research were obtained from 50 patients aged 1 to 292 days. They underwent abdominal surgery due to obstructive gut malrotation and several additional pathologies. Tissues were processed for bFGF, FGFR1, TGF-β and CgA by means of biotin-streptavidin immunohistochemistry. Results: In adhesion tissue bFGF positive connective tissue cells varied from a few to an abundant amount, but in 15 specimens no positive structure was observed. Few connective tissue fibers and moderate to numerous fibroblasts and macrophages contained FGFR1. A moderate number of TGF-β positive connective tissue fibers were observed. Some specimens also contained positive fibroblasts, macrophages and endotheliocytes. Few connective tissue cells contained CgA. A moderate correlation was observed between bFGF and FGFR1 (Spearman’s rank correlation coefficient = .500, P < .001) as well as between bFGF and CgA (Spearman’s rank correlation coefficient = .311, P = .03). Conclusions: The connection between the less distinct bFGF and more prominent FGFR1 proves the compensatory stimulation of receptors as a response on the lack of the same factor in case of adhesion disease. Persisting appearance of TGF-β positive structures in congenital adhesions indicates the continuing growth/regeneration potential of loose connective tissue. Positive CgA structures indicate the involvement of the neuroendocrine system in case of adhesion disease.