{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:06:01Z","timestamp":1777921561696,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Chronic appendicitis (CA) is a diagnosis characterized by long-standing right lower quadrant pain. We analyzed clinical, morphological, and immunohistochemical studies of the appendix to confirm the adequacy of surgery for CA in children\n                      <jats:italic toggle=\"yes\">with chronic right lower quadrant pain<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>We carried out comparative studies of clinical presentations and results of morphological and immunohistochemical studies of remote appendicitis in 55 children with chronic recurrent lower quadrant pain (CRLQP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Morphological and immunohistochemical studies revealed three types of changes in the appendix. Type 1 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200921)\u2014chronic inflammation. Inflammatory leukocyte infiltration was localized within the mucous membrane of the appendix. An immunohistochemical study revealed a significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01) increase in the expression of CD106 (vascular cell adhesion molecule 1) and in the number of matrix metalloproteinase 9 (MMP-9) positive cells. Type 2 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200920)\u2014lymphoid hyperplasia. Morphological changes were characterized by lymphoid infiltration of the mucosa and submucosa of the appendix. Immunological changes were characterized by an increase (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01) in the expression and number of MMP-9, expression of CD106 positive cells, an increase in the expression of collagen III\u03b1 in combination with a decrease in the expression and number of positive vascular endothelial growth factor (VEGF) and vasoactive intestinal peptide cells. Type 3 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200912)\u2014catarrhal inflammation. Morphological changes were characterized by impaired blood circulation only in the mucous membrane, without destructive or inflammatory changes. Immunological changes were characterized by an increase (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01) in the expression and number of VEGF-positive cells, which may indicate a response to local hypoxia of the appendix and explain neovascularization in a chronic condition. The abdominal syndrome after appendectomy was noted to disappear in 89% of patients. The established changes in remote appendicitis, other than acute inflammation, make it possible to consider reasonable appendectomy a way of treating CRLQP in children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We have identified immunohistochemical and morphological changes pointing to autoimmune and vascular mechanisms of appendix damage in children with CRLQP. Laparoscopic appendectomy helps to eliminate abdominal pain in most CA patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2021.0348","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T16:11:15Z","timestamp":1637165475000},"page":"1397-1401","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical, Morphological, and Immunohistochemical Justification of Surgery for Chronic Appendicitis in Children"],"prefix":"10.1177","volume":"31","author":[{"given":"Igor","family":"Khvorostov","sequence":"first","affiliation":[{"name":"Federal State Government-Financed Educational Institution of Higher Education \u201cVolgograd State Medical University\u201d of the MH RF, Volgograd, Russia."},{"name":"Department of Surgery, Federal State Autonomous Institution \u201cNational Medical Research Center of Children's Health\u201d of the Ministry of Health of the Russian Federation, Moscow, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexey","family":"Sinitsyn","sequence":"additional","affiliation":[{"name":"Federal State Government-Financed Educational Institution of Higher Education \u201cVolgograd State Medical University\u201d of the MH RF, Volgograd, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Snigur","sequence":"additional","affiliation":[{"name":"Federal State Government-Financed Educational Institution of Higher Education \u201cVolgograd State Medical University\u201d of the MH RF, Volgograd, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2029-7820","authenticated-orcid":false,"given":"Alexey","family":"Gusev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal State Autonomous Institution \u201cNational Medical Research Center of Children's Health\u201d of the Ministry of Health of the Russian Federation, Moscow, Russia."},{"name":"RUDN University (Peoples' Friendship University of Russia), Moscow, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Dyakonova","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal State Autonomous Institution \u201cNational Medical Research Center of Children's Health\u201d of the Ministry of Health of the Russian Federation, Moscow, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Yatsyk","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal State Autonomous Institution \u201cNational Medical Research Center of Children's Health\u201d of the Ministry of Health of the Russian Federation, Moscow, Russia."},{"name":"Federal State Educational Institution of Additional Professional Education of Russian Medical Academy of Continuing Professional Education, Moscow, Russia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-013-1677-x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-016-3990-2"},{"key":"e_1_3_4_4_2","first-page":"153","article-title":"Chronic appendicitis in children","volume":"18","author":"Crymble PT","year":"1949","unstructured":"Crymble PT, , Forsythe I. Chronic appendicitis in children. Ulster Med J, 1949; 18:153\u2013172.","journal-title":"Ulster Med J"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6026"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-003-1103-5"},{"key":"e_1_3_4_7_2","first-page":"273","article-title":"Diagnostic scores for acute appendicitis. Abdominal Pain Study Group","volume":"161","author":"Ohmann C","year":"1995","unstructured":"Ohmann C, , Yang Q, , Franke C. Diagnostic scores for acute appendicitis. Abdominal Pain Study Group. Eur J Surg, 1995; 161:273\u2013281.","journal-title":"Eur J Surg"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.32893"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpedi.2017.01.006"},{"key":"e_1_3_4_10_2","unstructured":"Dabbs DJ. Diagnostic Immunohistochemistry: Theranostic and Genomic Applications 5th ed. Elsevier 2018. 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