Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-138-142
V. Hryn
Background. In recent years, there have emerged new directions in the study of the histological structure of the digestive tract in humans and mammals and, in particular, white rats, since non-inbred white rats are the main model for reproducing human pathology under experimental conditions as well as for preclinical testing of new drugs. Objective. A comparative study of the histological features of the cecum and appendix in rats and humans by means of bibliographic analysis. Material and methods. Bibliographic analysis is based on published peer-reviewed articles, books, textbooks, monographs, dissertation abstracts. For the purposes of a systematic review, the literature search (concerning the study of the histological structure of the cecum and appendix) was carried out on the Internet, in native literature sources, the scientific and electronic library of Poltava State Medical University using the following keywords: “histology”, “microscopic structure”, "digestive system", "cecum", "appendix", "white rats", "rat anatomy". Results. The mucous membrane of the gastrointestinal tract of white rats, in terms of its histological structure, is similar enough to that of humans to serve as an object in the experimental modeling of certain pathological conditions of the digestive system. Conclusions. There has been found an increased concentration of lymphoid nodules in cecal mucosa of white rats. In white rats and humans, the cecum and the appendix in humans are endowed with the same immune defense structures, which together represent the immune system of the digestive tract mucosa.
{"title":"HISTOLOGICAL FEATURES OF THE CECUM AND VERMIFORM APPENDIX IN RATS AND HUMANS: COMPARATIVE ASPECTS","authors":"V. Hryn","doi":"10.25298/2616-5546-2021-5-2-138-142","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-138-142","url":null,"abstract":"Background. In recent years, there have emerged new directions in the study of the histological structure of the digestive tract in humans and mammals and, in particular, white rats, since non-inbred white rats are the main model for reproducing human pathology under experimental conditions as well as for preclinical testing of new drugs. Objective. A comparative study of the histological features of the cecum and appendix in rats and humans by means of bibliographic analysis. Material and methods. Bibliographic analysis is based on published peer-reviewed articles, books, textbooks, monographs, dissertation abstracts. For the purposes of a systematic review, the literature search (concerning the study of the histological structure of the cecum and appendix) was carried out on the Internet, in native literature sources, the scientific and electronic library of Poltava State Medical University using the following keywords: “histology”, “microscopic structure”, \"digestive system\", \"cecum\", \"appendix\", \"white rats\", \"rat anatomy\". Results. The mucous membrane of the gastrointestinal tract of white rats, in terms of its histological structure, is similar enough to that of humans to serve as an object in the experimental modeling of certain pathological conditions of the digestive system. Conclusions. There has been found an increased concentration of lymphoid nodules in cecal mucosa of white rats. In white rats and humans, the cecum and the appendix in humans are endowed with the same immune defense structures, which together represent the immune system of the digestive tract mucosa.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48476234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-150-160
V. Andreev, V. Tsyrkunov, I. A. Kondratovich
Background. Though thioacetamide (TAA)-induced liver fibrosis (LF) is recognized as a classical model of toxic liver damage, there is no literature data on the description of its successive stages of histological and ultrastructural changes in various cell populations involved in fibrosis. Objective. To conduct morphological monitoring of fibrosis formation in the liver of rats using the TAA model of LF based on histological and ultrastructural changes in hepatocytes and perisinusoidal lipocytes (HSC). Material and methods. The experiment was carried out on 18 sexually mature male rats. LF was modeled by intraperitoneal injection of 2% TAA solution at a dose of 10 ml / kg every other day. Light microscopy of semi-thin sections of the liver was performed, as well as electron microscopy of ultrathin sections. Results. The study of semi-thin sections of rat liver tissue from the control group showed a normal architecture of the parenchyma, a large number of HSCs containing large lipid droplets ("resting" phenotype), a very small amount of cytoplasmic matrix poor in membrane organelles. In the animals that were receiving TAA for 4 weeks, a mesenchymalepithelial transition of HSCs from the "resting" type to a fibrogenic state (fibrogenic phenotype) was recorded, that was accompanied by a gradual decrease in the number of retinol-containing drops and the appearance of fibroblastlike cells (FLC) in HSCs. In the animals, that were receiving TAA for 12 weeks, the pool of fibrogenic cells in the liver increased, a mesothelial-mesenchymal transition occurred, characterized by the mesothelial cell migration deeper into the parenchyma and their acquisition of a mesenchymal phenotype. Lipid containing activated FLC were also found in fibrous tissue around the central vein. Foci of hepatic tissue destruction caused by necrosis and apoptosis of hepatocytes were much more common. Conclusions. Administration of TAA induces liver fibrosis while histological and ultrastructural monitoring of the state of hepatocytes and HSCs allows to monitor all stages of fibrosis, clarifying the mechanisms of damage to intracellular organelles and variants of hepatocyte death. This model of LF in rats can be used to test new antifibrotic drugs.
背景。虽然硫乙酰胺(TAA)诱导的肝纤维化(LF)被认为是中毒性肝损伤的经典模型，但目前尚无文献资料描述其在参与纤维化的各种细胞群中连续阶段的组织学和超微结构变化。目标。基于肝细胞和肝窦周围脂肪细胞(HSC)的组织学和超微结构变化，采用TAA模型对大鼠肝纤维化形成进行形态学监测。材料和方法。实验是在18只性成熟的雄性大鼠身上进行的。通过腹腔注射2% TAA溶液，剂量为10 ml / kg，每隔一天制造LF模型。对肝脏半薄切片进行光镜检查，超薄切片进行电镜检查。结果。对对照组大鼠肝组织半薄切片的研究显示，实质结构正常，大量含有大脂滴的造血干细胞(“静息”表型)，极少量的细胞质基质缺乏膜细胞器。在接受TAA治疗4周的动物中，记录了hsc从“静息”型向成纤维状态(成纤维表型)的间充质上皮转变，同时伴有含视黄醇滴滴数量的逐渐减少和hsc中成纤维细胞样细胞(FLC)的出现。在接受TAA 12周的动物中，肝脏中的纤维化细胞池增加，发生了间皮-间质转变，其特征是间皮细胞向实质迁移更深，并获得间质表型。在中心静脉周围的纤维组织中也发现了含有活化FLC的脂质。肝细胞坏死和凋亡引起的肝组织破坏灶更为常见。结论。TAA可诱导肝纤维化，同时对肝细胞和造血干细胞状态进行组织学和超微结构监测，从而监测纤维化的各个阶段，阐明细胞内细胞器损伤和肝细胞死亡变异的机制。该模型可用于新型抗纤维化药物的试验。
{"title":"MORPHOLOGICAL MONITORING OF EXPERIMENTAL LIVER FIBROSIS IN RATS","authors":"V. Andreev, V. Tsyrkunov, I. A. Kondratovich","doi":"10.25298/2616-5546-2021-5-2-150-160","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-150-160","url":null,"abstract":"Background. Though thioacetamide (TAA)-induced liver fibrosis (LF) is recognized as a classical model of toxic liver damage, there is no literature data on the description of its successive stages of histological and ultrastructural changes in various cell populations involved in fibrosis. Objective. To conduct morphological monitoring of fibrosis formation in the liver of rats using the TAA model of LF based on histological and ultrastructural changes in hepatocytes and perisinusoidal lipocytes (HSC). Material and methods. The experiment was carried out on 18 sexually mature male rats. LF was modeled by intraperitoneal injection of 2% TAA solution at a dose of 10 ml / kg every other day. Light microscopy of semi-thin sections of the liver was performed, as well as electron microscopy of ultrathin sections. Results. The study of semi-thin sections of rat liver tissue from the control group showed a normal architecture of the parenchyma, a large number of HSCs containing large lipid droplets (\"resting\" phenotype), a very small amount of cytoplasmic matrix poor in membrane organelles. In the animals that were receiving TAA for 4 weeks, a mesenchymalepithelial transition of HSCs from the \"resting\" type to a fibrogenic state (fibrogenic phenotype) was recorded, that was accompanied by a gradual decrease in the number of retinol-containing drops and the appearance of fibroblastlike cells (FLC) in HSCs. In the animals, that were receiving TAA for 12 weeks, the pool of fibrogenic cells in the liver increased, a mesothelial-mesenchymal transition occurred, characterized by the mesothelial cell migration deeper into the parenchyma and their acquisition of a mesenchymal phenotype. Lipid containing activated FLC were also found in fibrous tissue around the central vein. Foci of hepatic tissue destruction caused by necrosis and apoptosis of hepatocytes were much more common. Conclusions. Administration of TAA induces liver fibrosis while histological and ultrastructural monitoring of the state of hepatocytes and HSCs allows to monitor all stages of fibrosis, clarifying the mechanisms of damage to intracellular organelles and variants of hepatocyte death. This model of LF in rats can be used to test new antifibrotic drugs.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42771858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-174-183
K. S. Belyuk, K. N. Zhandarov, E. V. Mahiliavets, M. O. Radikevich, A. Zabolotnaya, R. Shyla, O. S. Soroka
Background. The frequency of chronic pancreatitis and its complications is steadily increasing, which makes the problem of treating this pathology one of the most urgent and significant. Objective. Improvement of the results of surgical treatment of patients with hypertension-ductal type of chronic pancreatitis with extended stricture of the intrapancreatic part of the common bile duct. Material and methods. During the period 2006–2021, 328 operations were performed in the Grodno University Clinic due to chronic pancreatitis with pathology of the ductal system in combination with pancreatic cysts. The total number of complications was 5,1%. 18 patients with chronic recurrent pancreatitis, ductal hypertension in combination with a cyst of the head pancreas, also with extended stricture of the terminal part common bile duct and mechanical jaundice were operated on according to the methods developed in the clinic: 12 patients underwent choledochopancreatoejunostomy, 5 patients underwent choledochocystopancreatoejunostomy, choledochocystoduodenostomy was performed in 1 case. Results. The developed methods make it possible to perform adequate internal drainage of the ductal system of the pancreas and bile ducts, as well as cystic formations. Conclusions. The application of the developed methods improves the results of surgical treatment complicated chronic pancreatitis.
{"title":"SURGICAL TREATMENT OF HYPERTENSION-DUCTAL TYPE OF CHRONIC PANCREATITIS, IN COMBINATION WITH BILIARY OBSTRUCTION SYNDROME","authors":"K. S. Belyuk, K. N. Zhandarov, E. V. Mahiliavets, M. O. Radikevich, A. Zabolotnaya, R. Shyla, O. S. Soroka","doi":"10.25298/2616-5546-2021-5-2-174-183","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-174-183","url":null,"abstract":"Background. The frequency of chronic pancreatitis and its complications is steadily increasing, which makes the problem of treating this pathology one of the most urgent and significant. Objective. Improvement of the results of surgical treatment of patients with hypertension-ductal type of chronic pancreatitis with extended stricture of the intrapancreatic part of the common bile duct. Material and methods. During the period 2006–2021, 328 operations were performed in the Grodno University Clinic due to chronic pancreatitis with pathology of the ductal system in combination with pancreatic cysts. The total number of complications was 5,1%. 18 patients with chronic recurrent pancreatitis, ductal hypertension in combination with a cyst of the head pancreas, also with extended stricture of the terminal part common bile duct and mechanical jaundice were operated on according to the methods developed in the clinic: 12 patients underwent choledochopancreatoejunostomy, 5 patients underwent choledochocystopancreatoejunostomy, choledochocystoduodenostomy was performed in 1 case. Results. The developed methods make it possible to perform adequate internal drainage of the ductal system of the pancreas and bile ducts, as well as cystic formations. Conclusions. The application of the developed methods improves the results of surgical treatment complicated chronic pancreatitis.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41722204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-118-123
N. Silivontchik, M. Shtonda
Non-alcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver in the absence of secondary causes. The review presents data on the role of fructose in the accumulation of fat in the liver and the mechanisms of NAFLD development. A number of data have been obtained on the effects of fructose, in the form of sugar-containing and fructose-containing drinks, related to NAFLD development.
{"title":"NON-ALCOHOLIC FATTY LIVER DISEASE: WITH A FOCUS ON FRUCTOSE","authors":"N. Silivontchik, M. Shtonda","doi":"10.25298/2616-5546-2021-5-2-118-123","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-118-123","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver in the absence of secondary causes. The review presents data on the role of fructose in the accumulation of fat in the liver and the mechanisms of NAFLD development. A number of data have been obtained on the effects of fructose, in the form of sugar-containing and fructose-containing drinks, related to NAFLD development.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43044768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-143-149
V. Sheibak, A. Pauliukavets
Background. Tryptophan is an essential amino acid found mainly in protein foods and its availability is highly dependent on a diet. A significant part of tryptophan is metabolized in the gastrointestinal tract by the intestinal microbiota, producing a number of biologically active molecules, including aryl hydrocarbon receptor ligands, kynurenines, and serotonin (5-hydroxytryptamine). Objective. To analyze scientific studies confirming the key role of tryptophan microbial catabolites on the function of a macroorganism. Material and methods. The analysis of 47 English-language literature sources containing information on the effects of tryptophan metabolites on the mammalian organism was carried out. Results. It has been established that tryptophan metabolism plays a central role both in a normal macroorganism and in pathological conditions, it being directly or indirectly controlled by the intestinal microbiota. Conclusions. Thus, tryptophan metabolism is an important therapeutic target, underutilized in the treatment of a number of chronic neurological pathologies and immunocompetent conditions. An important factor is the use of nutraceuticals and probiotics by microorganisms that modulate the metabolism of tryptophan in the intestine and stimulate the synthesis of specific metabolites.
{"title":"TRYPTOPHAN: A KEY METABOLITE OF HOMEOSTASIS AND A REGULATOR OF BODY FUNCTIONS","authors":"V. Sheibak, A. Pauliukavets","doi":"10.25298/2616-5546-2021-5-2-143-149","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-143-149","url":null,"abstract":"Background. Tryptophan is an essential amino acid found mainly in protein foods and its availability is highly dependent on a diet. A significant part of tryptophan is metabolized in the gastrointestinal tract by the intestinal microbiota, producing a number of biologically active molecules, including aryl hydrocarbon receptor ligands, kynurenines, and serotonin (5-hydroxytryptamine). Objective. To analyze scientific studies confirming the key role of tryptophan microbial catabolites on the function of a macroorganism. Material and methods. The analysis of 47 English-language literature sources containing information on the effects of tryptophan metabolites on the mammalian organism was carried out. Results. It has been established that tryptophan metabolism plays a central role both in a normal macroorganism and in pathological conditions, it being directly or indirectly controlled by the intestinal microbiota. Conclusions. Thus, tryptophan metabolism is an important therapeutic target, underutilized in the treatment of a number of chronic neurological pathologies and immunocompetent conditions. An important factor is the use of nutraceuticals and probiotics by microorganisms that modulate the metabolism of tryptophan in the intestine and stimulate the synthesis of specific metabolites.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-161-167
O. A. Zhigaltsova-Kuchinskaya, N. Silivontchik, S. Likhachev, I. Pleshko, A. Klyuchareva, G. D. Sitnik
Bacground. The optimization of Wilson’s disease (WD) diagnosis is one of the most disputable problem. Objective. The retrospective study of initial assessment findings under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Material and methods. The results of laboratory tests and Kaiser-Fleischer rings (KF rings) identification under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Results. At stage I, 17 patients (16.7%; 95% CI 10.7–25.1) were defined as having clinically definitive WD based on the combination of low serum ceruloplasmin and KF rings, 4 patients (3.9%; 95% CI 1.5–9.7) – based on the drop of ceruloplasmin level. After stage II, involving 24-hour urinary copper excretion evaluation, the rate of definitive diagnosis of WD reached 24,5% (95% CI 17.2 33.7). After stage III (genotyping for carriage of ATP7B gene mutations) – 56.9% (95% CI 47.2–66.0). Serum free copper increase was found in 54.9% (95% CI 41.4 67.7) of cases. Conclusions. Under clinical suspicion for WD, initial structured ophthalmological, laboratory and molecular-genetic assessment ensured the diagnosis of WD only in 56.9% (95% CI 56.9; 47.2–66.1). Frequent detection of serum free copper increase (54.9%, 95% CI 41.4 67.7) allows to use this test due to its greater availability as compared with 24-hour urinary copper excretion evaluation in WD diagnostics.
{"title":"INITIAL ASSESSMENT FINDINGS IN PATIENTS WITH CONFIRMED WILSON’S DISEASE","authors":"O. A. Zhigaltsova-Kuchinskaya, N. Silivontchik, S. Likhachev, I. Pleshko, A. Klyuchareva, G. D. Sitnik","doi":"10.25298/2616-5546-2021-5-2-161-167","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-161-167","url":null,"abstract":"Bacground. The optimization of Wilson’s disease (WD) diagnosis is one of the most disputable problem. Objective. The retrospective study of initial assessment findings under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Material and methods. The results of laboratory tests and Kaiser-Fleischer rings (KF rings) identification under clinical suspicion for WD in 102 patients with the confirmed diagnosis. Results. At stage I, 17 patients (16.7%; 95% CI 10.7–25.1) were defined as having clinically definitive WD based on the combination of low serum ceruloplasmin and KF rings, 4 patients (3.9%; 95% CI 1.5–9.7) – based on the drop of ceruloplasmin level. After stage II, involving 24-hour urinary copper excretion evaluation, the rate of definitive diagnosis of WD reached 24,5% (95% CI 17.2 33.7). After stage III (genotyping for carriage of ATP7B gene mutations) – 56.9% (95% CI 47.2–66.0). Serum free copper increase was found in 54.9% (95% CI 41.4 67.7) of cases. Conclusions. Under clinical suspicion for WD, initial structured ophthalmological, laboratory and molecular-genetic assessment ensured the diagnosis of WD only in 56.9% (95% CI 56.9; 47.2–66.1). Frequent detection of serum free copper increase (54.9%, 95% CI 41.4 67.7) allows to use this test due to its greater availability as compared with 24-hour urinary copper excretion evaluation in WD diagnostics.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45869678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-124-131
V. V. Yurkouski, A. M. Schestuk, A. S. Karpicki, R. P. Lavrinuk
The increase in the number of patients requiring liver transplantation raises the question of expanding and clarifying the criteria of hepatic grafts suitability for transplantation, and also shows the need to develop new, fast and noninvasive methods for assessing the functional state of the liver at the stage of donor examination and treatment. Hepatic grafts with severe steatosis, previously considered unsuitable for transplantation due to the higher risk of primary graft failure, are now referred to as potential for transplantation. There are several ways to diagnose and determine the stage of steatosis, but, unfortunately, today none of them can give an accurate and rapid assessment of its grade in a hepatic graft. Currently, the "gold standard" for determining liver steatosis is a biopsy with subsequent examination of samples by a pathomorphologist. There are also prognostic models, non-invasive tests and instrumental methods, the effectiveness of which has been proven - these are ultrasound elastography, contrast computed tomography and contrast computed tomography with liver density measurement. The decision on the suitability of a hepatic graft for transplantation depends on many factors, both on the part of the donor and on the part of the recipient, and it would be correct to assume that these data should be taken into account in aggregate. The review covers all the approaches currently used to quantify and qualitatively assess steatosis in liver transplants from a brain-dead donor.
{"title":"NON-INVASIVE METHODS FOR ASSESSING HEPATIC GRAFT STEATOSIS IN A DECEASED DONOR WHO IS DECLARED BRAIN-DEAD","authors":"V. V. Yurkouski, A. M. Schestuk, A. S. Karpicki, R. P. Lavrinuk","doi":"10.25298/2616-5546-2021-5-2-124-131","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-124-131","url":null,"abstract":"The increase in the number of patients requiring liver transplantation raises the question of expanding and clarifying the criteria of hepatic grafts suitability for transplantation, and also shows the need to develop new, fast and noninvasive methods for assessing the functional state of the liver at the stage of donor examination and treatment. Hepatic grafts with severe steatosis, previously considered unsuitable for transplantation due to the higher risk of primary graft failure, are now referred to as potential for transplantation. There are several ways to diagnose and determine the stage of steatosis, but, unfortunately, today none of them can give an accurate and rapid assessment of its grade in a hepatic graft. Currently, the \"gold standard\" for determining liver steatosis is a biopsy with subsequent examination of samples by a pathomorphologist. There are also prognostic models, non-invasive tests and instrumental methods, the effectiveness of which has been proven - these are ultrasound elastography, contrast computed tomography and contrast computed tomography with liver density measurement. The decision on the suitability of a hepatic graft for transplantation depends on many factors, both on the part of the donor and on the part of the recipient, and it would be correct to assume that these data should be taken into account in aggregate. The review covers all the approaches currently used to quantify and qualitatively assess steatosis in liver transplants from a brain-dead donor.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48496642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-168-173
T. Amvrosieva, N. Paklonskaya, Y. Kaltunova, I. Belskaya, E. Kishkurno
Background. Individual cases of viral hepatitis E are recorded in the Republic of Belarus annually indicating the need for the pathogen monitoring at both the population and reservoir levels. Objective. To consolidate the monitoring data on hepatitis E virus over the period of 2018 - 2021, as well as to work out an effective algorithm for its laboratory screening. Material and methods. As part of the study, 345 samples were analyzed, including 227 human biological samples, 37 samples of biological materials of domestic pigs, 22 samples of food and 59 samples of waste water. Results. According to the results of serum diagnostics, in the group of kidney recipients (n = 29), the detection rate of IgM and IgG to hepatitis E virus was 6.9% [0.85%; 23.03%] and 17.2% [7.13%; 35, 02%] respectively; in the group of patients with pregnancy pathology (n = 44) - 6.8% [1.68%; 18.89%] and 11.4% [4.5%; 24.43%] respectively. In patients with acute hepatitis of unknown etiology (n = 26), antiviral IgM was not detected, while the frequency of antiviral IgG detection reached 7.7% [1.02%; 25.26]. In control group (blood donors, n = 53) IgM and IgG were detected in 1.9% [0.6%; 10.88%] and 5.7% [1.35%; 15.97] of those examined respectively. Hepatitis E virus RNA was detected in 8 human biological samples (3.8%) from kidney recipients. The identified hepatitis E viruses were represented by genotype GIII and belonged to a previously unidentified subgenotype (GIIIa - GIIIi). In the studied samples of biological material from pigs, as well as in samples of food and waste water, hepatitis E virus RNA was not detected. Conclusions. An algorithm for hepatitis E virus laboratory screening has been developed and tested. Its section concerning the diagnosis of viral hepatitis E is set out in the Instructions for use "Algorithm for laboratory diagnosis of viral hepatitis E" (No. 148-1220 from January 28, 2021).
{"title":"HEPATITIS E VIRUS MONITORING RESULTS AND ITS LABORATORY SCREENING ALGORITHM","authors":"T. Amvrosieva, N. Paklonskaya, Y. Kaltunova, I. Belskaya, E. Kishkurno","doi":"10.25298/2616-5546-2021-5-2-168-173","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-168-173","url":null,"abstract":"Background. Individual cases of viral hepatitis E are recorded in the Republic of Belarus annually indicating the need for the pathogen monitoring at both the population and reservoir levels. Objective. To consolidate the monitoring data on hepatitis E virus over the period of 2018 - 2021, as well as to work out an effective algorithm for its laboratory screening. Material and methods. As part of the study, 345 samples were analyzed, including 227 human biological samples, 37 samples of biological materials of domestic pigs, 22 samples of food and 59 samples of waste water. Results. According to the results of serum diagnostics, in the group of kidney recipients (n = 29), the detection rate of IgM and IgG to hepatitis E virus was 6.9% [0.85%; 23.03%] and 17.2% [7.13%; 35, 02%] respectively; in the group of patients with pregnancy pathology (n = 44) - 6.8% [1.68%; 18.89%] and 11.4% [4.5%; 24.43%] respectively. In patients with acute hepatitis of unknown etiology (n = 26), antiviral IgM was not detected, while the frequency of antiviral IgG detection reached 7.7% [1.02%; 25.26]. In control group (blood donors, n = 53) IgM and IgG were detected in 1.9% [0.6%; 10.88%] and 5.7% [1.35%; 15.97] of those examined respectively. Hepatitis E virus RNA was detected in 8 human biological samples (3.8%) from kidney recipients. The identified hepatitis E viruses were represented by genotype GIII and belonged to a previously unidentified subgenotype (GIIIa - GIIIi). In the studied samples of biological material from pigs, as well as in samples of food and waste water, hepatitis E virus RNA was not detected. Conclusions. An algorithm for hepatitis E virus laboratory screening has been developed and tested. Its section concerning the diagnosis of viral hepatitis E is set out in the Instructions for use \"Algorithm for laboratory diagnosis of viral hepatitis E\" (No. 148-1220 from January 28, 2021).","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49403613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.25298/2616-5546-2021-5-1-44-49
L. Pinsky, N. Ovcharenko, M. Khaitovych, G. Solovyova, A. V. Koveshnikov, Soumavo Mukherjee
Background. One of the significant factors in the progression of fibrotic changes in the liver is hepatocyte steatosis, that persists in drug addicted patients even after the elimination of the hepatitis C virus and cessation of drug use. Analysis of the pathomorphogenesis of hepatic steatosis in opioid dependence (OZ) will make it possible to assess the factors that affect ultrastructural changes in hepatocytes and the processes of lipid granule (LH) degradation. Objective. Assessment of ultrastructural changes in LH in the liver tissue of patients with OZ. Material and methods. Histological preparations of liver tissue from 20 patients with OZ aged 21 to 40 years (18 men and 2 women) with different duration of OZ and opioid tolerance. Results. There was established the following dependence of ultrastructural changes in the liver in patients with different duration of OZ and opioid tolerance. The most pronounced changes were noted in the group of patients with prolonged (more than 6 years) opioid intoxication and high tolerance to opioids in the liver tissue, in whom, along with severe steatosis, there were more significant violations of the mechanisms of LH degradation, destruction of cristae in mitochondria, a decrease in the number of lipophagosomes and PH with signs of superficial degradation than in the group of patients with OZ duration up to 6 years, as well as with moderate and high opioid tolerance. Conclusions. Ultrastructural changes in hepatocytes in the form of progression of steatosis in the centrilobular and periportal zones, a decrease in the activity of LH degradation, gross morphological changes in mitochondria, a decrease in the activity of surface LH degradation depend on the activity and duration of opioid dependence and are more pronounced with long-term (more than 6 years) highly progressive opioid dependence.
{"title":"PATHOMORPHOGENESIS OF LIVER STEATOSIS IN PATIENTS WITH OPIOID DEPENDENCE","authors":"L. Pinsky, N. Ovcharenko, M. Khaitovych, G. Solovyova, A. V. Koveshnikov, Soumavo Mukherjee","doi":"10.25298/2616-5546-2021-5-1-44-49","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-1-44-49","url":null,"abstract":"Background. One of the significant factors in the progression of fibrotic changes in the liver is hepatocyte steatosis, that persists in drug addicted patients even after the elimination of the hepatitis C virus and cessation of drug use. Analysis of the pathomorphogenesis of hepatic steatosis in opioid dependence (OZ) will make it possible to assess the factors that affect ultrastructural changes in hepatocytes and the processes of lipid granule (LH) degradation. Objective. Assessment of ultrastructural changes in LH in the liver tissue of patients with OZ. Material and methods. Histological preparations of liver tissue from 20 patients with OZ aged 21 to 40 years (18 men and 2 women) with different duration of OZ and opioid tolerance. Results. There was established the following dependence of ultrastructural changes in the liver in patients with different duration of OZ and opioid tolerance. The most pronounced changes were noted in the group of patients with prolonged (more than 6 years) opioid intoxication and high tolerance to opioids in the liver tissue, in whom, along with severe steatosis, there were more significant violations of the mechanisms of LH degradation, destruction of cristae in mitochondria, a decrease in the number of lipophagosomes and PH with signs of superficial degradation than in the group of patients with OZ duration up to 6 years, as well as with moderate and high opioid tolerance. Conclusions. Ultrastructural changes in hepatocytes in the form of progression of steatosis in the centrilobular and periportal zones, a decrease in the activity of LH degradation, gross morphological changes in mitochondria, a decrease in the activity of surface LH degradation depend on the activity and duration of opioid dependence and are more pronounced with long-term (more than 6 years) highly progressive opioid dependence.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44635292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.25298/2616-5546-2021-5-1-65-70
A. Krasnov, V. Anischenko, K. Krasnov, V. Pelts, O. A. Krasnov, V. Pavlenko
Background. An increase in the incidence of hepatic echinococcosis is noted annually, surgery remaining its main treatment option. Objective. To analyze the treatment structure and evaluate the treatment outcomes of the patients operated for hepatic echinococcosis in the Surgical department №2 of SAHI "KCEH named after M.A. Podgorbunsky" over the period of 2016 - 2020. Material and methods. The analyzed group included treatment outcomes of 58 patients (22 men (38%), 36 women (62%)), who underwent 76 surgical interventions for liver echinococcosis in the Surgical department №2 on the basis of SAHI "KCEH named after M.A. Podgorbunsky". The difference between the number of operations performed and that of actual patients is explained by the use of staged surgery in a number of cases. Results. The majority of the 76 operations performed over the period of 2016 - 2020 were open resections - 50 (65.8%) cases. Of these, extensive anatomic segmental hepatic resections were performed in 22 cases (44%). In 14 (24%) of all patients staged surgery was used, making it possible to exclude a number of patients from the category of "non-resectable" and to perform surgery with good outcomes. A fatal outcome was noted in one case. Conclusions. The use of various surgical techniques including staged minimally invasive and laparoscopic ones in a specialized surgical department allows achieving good treatment outcomes.
{"title":"THE STRUCTURE AND OUTCOMES OF SURGICAL TREATMENT OF LIVER ECHINOCOCCOSIS IN A SPECIALIZED CENTER","authors":"A. Krasnov, V. Anischenko, K. Krasnov, V. Pelts, O. A. Krasnov, V. Pavlenko","doi":"10.25298/2616-5546-2021-5-1-65-70","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-1-65-70","url":null,"abstract":"Background. An increase in the incidence of hepatic echinococcosis is noted annually, surgery remaining its main treatment option. Objective. To analyze the treatment structure and evaluate the treatment outcomes of the patients operated for hepatic echinococcosis in the Surgical department №2 of SAHI \"KCEH named after M.A. Podgorbunsky\" over the period of 2016 - 2020. Material and methods. The analyzed group included treatment outcomes of 58 patients (22 men (38%), 36 women (62%)), who underwent 76 surgical interventions for liver echinococcosis in the Surgical department №2 on the basis of SAHI \"KCEH named after M.A. Podgorbunsky\". The difference between the number of operations performed and that of actual patients is explained by the use of staged surgery in a number of cases. Results. The majority of the 76 operations performed over the period of 2016 - 2020 were open resections - 50 (65.8%) cases. Of these, extensive anatomic segmental hepatic resections were performed in 22 cases (44%). In 14 (24%) of all patients staged surgery was used, making it possible to exclude a number of patients from the category of \"non-resectable\" and to perform surgery with good outcomes. A fatal outcome was noted in one case. Conclusions. The use of various surgical techniques including staged minimally invasive and laparoscopic ones in a specialized surgical department allows achieving good treatment outcomes.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46355736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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