Pub Date : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.34
Olesya Redko, A. Dovhalyuk
Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition often associated with extrapulmonary complications. Hepatic injury is one of the common sequelae of ARDS. Mesenchymal stem cells (MSCs) have recently emerged as a promising therapeutic option for various diseases, including liver injuries. Their regenerative and immunomodulatory properties make them an attractive candidate for research in the context of liver injury associated with ARDS.Purpose: To investigate the ultrastuctural changes in the liver of rats with induced ARDS and the eff ects of subsequent MSC intervention during the initial stages of the experiment.Material and Methods. A total of 32 mature male Wistar rats were randomly allocated to one of four experimental groups: 1) control; 2) 24h ARDS; 3) 3d ARDS and 4) 24h ARDS + 2d MSC.Results. In groups 24h ARDS and 3d ARDS, we observed the development of early- stage acute liver injury characterized by vascular congestion and blood stasis, neutrophil infi ltration of the parenchyma, macrophage activation, and damage to hepatocyte ultrastructure. In contrast, the group 24h ARDS + 2d MSC showed a signifi cant reduction in infl ammation and edema. Most notably, hepatocytes displayed preserved ultrastructure.Conclusion. The administration of MSCs has a protective eff ect on the submicroscopic structure of hepatocytes, reducing infl ammation and parenchymal edema. These results indicate the regenerative and anti-infl ammatory mechanisms of MSCs, suggesting their potential in the treatment of liver injuries associated with ARDS.
{"title":"ULTRASTRUCTURAL CHANGES OF LIVER IN RATS WITH INDUCED ACUTE RESPIRATORY DISTRESS SYNDROME AND SUBSEQUENT MESENCHYMAL STEM CELL INTERVENTION DURING THE INITIAL STAGES OF THE EXPERIMENT","authors":"Olesya Redko, A. Dovhalyuk","doi":"10.24061/1727-0847.22.3.2023.34","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.34","url":null,"abstract":"Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition often associated with extrapulmonary complications. Hepatic injury is one of the common sequelae of ARDS. Mesenchymal stem cells (MSCs) have recently emerged as a promising therapeutic option for various diseases, including liver injuries. Their regenerative and immunomodulatory properties make them an attractive candidate for research in the context of liver injury associated with ARDS.Purpose: To investigate the ultrastuctural changes in the liver of rats with induced ARDS and the eff ects of subsequent MSC intervention during the initial stages of the experiment.Material and Methods. A total of 32 mature male Wistar rats were randomly allocated to one of four experimental groups: 1) control; 2) 24h ARDS; 3) 3d ARDS and 4) 24h ARDS + 2d MSC.Results. In groups 24h ARDS and 3d ARDS, we observed the development of early- stage acute liver injury characterized by vascular congestion and blood stasis, neutrophil infi ltration of the parenchyma, macrophage activation, and damage to hepatocyte ultrastructure. In contrast, the group 24h ARDS + 2d MSC showed a signifi cant reduction in infl ammation and edema. Most notably, hepatocytes displayed preserved ultrastructure.Conclusion. The administration of MSCs has a protective eff ect on the submicroscopic structure of hepatocytes, reducing infl ammation and parenchymal edema. These results indicate the regenerative and anti-infl ammatory mechanisms of MSCs, suggesting their potential in the treatment of liver injuries associated with ARDS.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334805","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.28
Yevgeniy Paltov, Z. Masna, Ilona Chelpanova, Kostyantyn Voytsenko
Over the past twenty years, the experimental direction of research has been the most relevant in morphology to study the dynamics of the course of nosologies. In terms of the dynamics of the occurrence of pathomorphological manifestations at the cellular, tissue, organ, and organism levels, it off ers a larger variety of pathology investigations. The study of the retina in the norm and the processes of modifying its structural reorganisation under the eff ect of various nosologies are accorded high importance in the scientifi c literature written by both domestic and international professionals. Despite these eff orts, the problem of opioid retinopathy on prolonged experimental opioid exposure remains essential. It is still unknown, in particular, if the correction of the chronic period of experimental opioid exposure may stabilise pathomorphological symptoms in the retinal layers and linkages of its hemomycrocirculatory bed. The purpose of the research is to fi nd out the features of structural reorganization in the retinal layers and links of its hemomicrocirculatory bed in the chronic period of experimental opioid exposure and the correction of these changes with pentoxifylline.Material and methods. The research used 34 male, sexually mature, non-breeding rats that ranged in weight from 160 to 270 g and were 4.5 to 7.5 months old as its subject matter. The correction dose of pentoxifylline was 2.857 mg/kg. At the end of the 10th week, the material was taken for ultrastructural examination of the retina. Before the sampling of the experimental site material, the animal was withdrawn from the experiment using diethyl ether. The eyeballs of rats were used as a material for ultrastructural examination. Ultrastructural preparations were prepared according to the generally accepted method. As a result of our research of the retina at the end of the tenth week in rats, which were injected with an opioid for six weeks, and subsequently discontinued for four weeks, the phenomena of degeneration of the pigment epithelium, destruction of the membrane discs of the outer segments of the photoreceptors, degenerative changes in the inner segments of the photoreceptors, degenerative and necrotic changes of individual photoreceptors developed. Degeneration and necrosis processes were detected in bipolar and amacrine neurons. Rats were injected with the opioid for six weeks, with its cancellation and subsequent four-week correction with pentoxifylline. After ten weeks of the experiment, degenerative changes in the apical microvilli of the pigment epithelium, destruction of the membrane discs of the outer segments of the photoreceptors, degeneration of bipolar and amacrine neurons, moderately pronounced discirculatory changes, and reactive processes of glial elements were detected. In rats given an opioid for six weeks, followed by four weeks of an opioid with pentoxifylline administration, fl ushing, stasis, and perivascular oedema in the choroidal arteries were esta
{"title":"CHANGES IN THE STRUCTURAL ORGANIZATION OF CELLULAR COMPONENTS IN THE RETINAL LAYERS AND LINKS OF ITS HEMOMICOCIRCULATORY BED DURING THE CHRONIC PERIOD OF EXPERIMENTAL OPIOID EXPOSURE AND THE CORRECTION OF THESE CHANGES AT THE ULTRASTRUCTURAL LEVEL","authors":"Yevgeniy Paltov, Z. Masna, Ilona Chelpanova, Kostyantyn Voytsenko","doi":"10.24061/1727-0847.22.3.2023.28","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.28","url":null,"abstract":"Over the past twenty years, the experimental direction of research has been the most relevant in morphology to study the dynamics of the course of nosologies. In terms of the dynamics of the occurrence of pathomorphological manifestations at the cellular, tissue, organ, and organism levels, it off ers a larger variety of pathology investigations. The study of the retina in the norm and the processes of modifying its structural reorganisation under the eff ect of various nosologies are accorded high importance in the scientifi c literature written by both domestic and international professionals. Despite these eff orts, the problem of opioid retinopathy on prolonged experimental opioid exposure remains essential. It is still unknown, in particular, if the correction of the chronic period of experimental opioid exposure may stabilise pathomorphological symptoms in the retinal layers and linkages of its hemomycrocirculatory bed. The purpose of the research is to fi nd out the features of structural reorganization in the retinal layers and links of its hemomicrocirculatory bed in the chronic period of experimental opioid exposure and the correction of these changes with pentoxifylline.Material and methods. The research used 34 male, sexually mature, non-breeding rats that ranged in weight from 160 to 270 g and were 4.5 to 7.5 months old as its subject matter. The correction dose of pentoxifylline was 2.857 mg/kg. At the end of the 10th week, the material was taken for ultrastructural examination of the retina. Before the sampling of the experimental site material, the animal was withdrawn from the experiment using diethyl ether. The eyeballs of rats were used as a material for ultrastructural examination. Ultrastructural preparations were prepared according to the generally accepted method. As a result of our research of the retina at the end of the tenth week in rats, which were injected with an opioid for six weeks, and subsequently discontinued for four weeks, the phenomena of degeneration of the pigment epithelium, destruction of the membrane discs of the outer segments of the photoreceptors, degenerative changes in the inner segments of the photoreceptors, degenerative and necrotic changes of individual photoreceptors developed. Degeneration and necrosis processes were detected in bipolar and amacrine neurons. Rats were injected with the opioid for six weeks, with its cancellation and subsequent four-week correction with pentoxifylline. After ten weeks of the experiment, degenerative changes in the apical microvilli of the pigment epithelium, destruction of the membrane discs of the outer segments of the photoreceptors, degeneration of bipolar and amacrine neurons, moderately pronounced discirculatory changes, and reactive processes of glial elements were detected. In rats given an opioid for six weeks, followed by four weeks of an opioid with pentoxifylline administration, fl ushing, stasis, and perivascular oedema in the choroidal arteries were esta","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334845","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}
Abstract. Road tra ffi c injury, like other types of traumatic injuries, has a rather complex clinical characteristic and is multicomponent. The purpose of the study: To verify and form the clinical characteristics of injuries in victims of tra ffi c accidents in the conditions of a regional city. Material and methods. A retrospective analysis of 242 cases of victims who were injured as a result of a traffi c accident and were treated in the emergency medical hospital of Chernivtsi from 2019 to 2020 was conducted. The research array was formed by the method of irreversible randomization using the methodology of random numbers. The results. As a result of the study, it was found that in the conditions of the regional city, 66.11 % of the victims of road accidents receive an injury with a severity of damage of more than 16 points according to the standardized scoring system NISS, i. e. polytrauma. In the general array of the study, the highest mortality rate was recorded in victims with an injury severity of 45-75 points and 34-45 points (33.34 % and 30.30 %, respectively). Among drivers, damage with a severity of up to 24 points according to the standardized scoring system NISS (light injury) is 76.13 %, among passengers – 67.04 %, and among pedestrians – 51.51 %. Severe (35-44 points) and extremely severe injury (45-75 points) together have the same weight: for drivers – 10.23 %, for passengers – 13.64 %, for pedestrians – 31.82 %, i. e. pedestrians receive more serious injuries, and the sign of participation in traffi c has a probable infl uence on the severity of injuries in victims of tra ffi c accidents. Pedestrian survivors have the highest number of injuries with NISS severity of 16-24 points – 39.62 %, drivers and passengers – up to 16 points (46.83 % and 42.85 %, respectively). In the array of dead pedestrians and passengers, the highest specifi c weight is given to victims with a severity of 45-75 points (38.46 % and 36.37 %, respectively), and drivers with a severity of damage of 35-44 points – 33.34 %, that is, a sign of participation in traffi c and the severity of damage have a probable infl uence on the occurrence of a negative result of the course of the traumatic process. Conclusions. For the victims of road accidents in the conditions of the regional city, in general, a relatively mild injury is characteristic – up to 34 points, 82.65 %, and an injury up to 16 points is 33.89 %. It was established that the severity of damage depends on the sign of participation in tra ffi c: the most severe injuries are sustained by pedestrians (specifi c weight of severe and extremely severe injuries – 31.82 %), the least severe – drivers, 10.23 %. It was established that the severity of damage in victims of traffi c accidents in the conditions of a regional city obviously depends on participation in traffi c and is a signifi cant factor in the occurrence of mortality.
{"title":"ANALYSIS OF CLINICAL AND ANATOMICAL CHARACTERISTICS OF TRAFFIC INJURIES IN THE CONDITIONS OF THE REGIONAL CITY. REPORT THREE: SEVERITY OF DAMAGE","authors":"Serhiy Guryev, Vitaly Kushnir, Volodymyr Hrebenyuk","doi":"10.24061/1727-0847.22.3.2023.25","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.25","url":null,"abstract":"Abstract. Road tra ffi c injury, like other types of traumatic injuries, has a rather complex clinical characteristic and is multicomponent. The purpose of the study: To verify and form the clinical characteristics of injuries in victims of tra ffi c accidents in the conditions of a regional city. Material and methods. A retrospective analysis of 242 cases of victims who were injured as a result of a traffi c accident and were treated in the emergency medical hospital of Chernivtsi from 2019 to 2020 was conducted. The research array was formed by the method of irreversible randomization using the methodology of random numbers. The results. As a result of the study, it was found that in the conditions of the regional city, 66.11 % of the victims of road accidents receive an injury with a severity of damage of more than 16 points according to the standardized scoring system NISS, i. e. polytrauma. In the general array of the study, the highest mortality rate was recorded in victims with an injury severity of 45-75 points and 34-45 points (33.34 % and 30.30 %, respectively). Among drivers, damage with a severity of up to 24 points according to the standardized scoring system NISS (light injury) is 76.13 %, among passengers – 67.04 %, and among pedestrians – 51.51 %. Severe (35-44 points) and extremely severe injury (45-75 points) together have the same weight: for drivers – 10.23 %, for passengers – 13.64 %, for pedestrians – 31.82 %, i. e. pedestrians receive more serious injuries, and the sign of participation in traffi c has a probable infl uence on the severity of injuries in victims of tra ffi c accidents. Pedestrian survivors have the highest number of injuries with NISS severity of 16-24 points – 39.62 %, drivers and passengers – up to 16 points (46.83 % and 42.85 %, respectively). In the array of dead pedestrians and passengers, the highest specifi c weight is given to victims with a severity of 45-75 points (38.46 % and 36.37 %, respectively), and drivers with a severity of damage of 35-44 points – 33.34 %, that is, a sign of participation in traffi c and the severity of damage have a probable infl uence on the occurrence of a negative result of the course of the traumatic process. Conclusions. For the victims of road accidents in the conditions of the regional city, in general, a relatively mild injury is characteristic – up to 34 points, 82.65 %, and an injury up to 16 points is 33.89 %. It was established that the severity of damage depends on the sign of participation in tra ffi c: the most severe injuries are sustained by pedestrians (specifi c weight of severe and extremely severe injuries – 31.82 %), the least severe – drivers, 10.23 %. It was established that the severity of damage in victims of traffi c accidents in the conditions of a regional city obviously depends on participation in traffi c and is a signifi cant factor in the occurrence of mortality.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334927","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.37
Zoia Nebesna, Iryna Hetmaniuk, Olexandra Andriyishyn, Oleh Hrymalyuk
The article presents the experience of creation and introduction into the educational process the selective discipline «Current issues of medical embryology», which is taught at the Department of Histology and Embryology of TNMU named after I. Gorbachevskii. The selective discipline is designed for applicants of the second level of higher education, qualifi cation «Doctor», fi eld of knowledge 22 «Health care», specialty 222 «Medicine». The working program and syllabus of this discipline are developed in accordance with the standards of higher education and the working curriculum of the training of masters of medicine in the second year of study. The structure of the discipline includes 3 credits (90 hours): 20 hours of practical classes and 70 hours of independent work. Type of control – credit.The teaching of the elective discipline «Current issues of medical embryology» is aimed at forming higher education students’ systemic knowledge and understanding of the conceptual foundations and principles of human embryogenesis, which can be used for diagnosis, treatment and prevention of developmental defects, which remain the main cause of child mortality and disability.
{"title":"THE EXPERIENCE OF CREATING AND TEACHING THE ELECTIVE COURSE «CURRENT ISSUES OF MEDICAL EMBRYOLOGY» FOR THE TRAINING OF SECOND-LEVEL HIGHER EDUCATION APPLICANTS WITH THE SPECIALTY 222 «MEDICINE» AT TERNOPIL NATIONAL MEDICAL UNIVERSITY NAMED AFTER I. YA. HORBACHEVSKIY","authors":"Zoia Nebesna, Iryna Hetmaniuk, Olexandra Andriyishyn, Oleh Hrymalyuk","doi":"10.24061/1727-0847.22.3.2023.37","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.37","url":null,"abstract":"The article presents the experience of creation and introduction into the educational process the selective discipline «Current issues of medical embryology», which is taught at the Department of Histology and Embryology of TNMU named after I. Gorbachevskii. The selective discipline is designed for applicants of the second level of higher education, qualifi cation «Doctor», fi eld of knowledge 22 «Health care», specialty 222 «Medicine». The working program and syllabus of this discipline are developed in accordance with the standards of higher education and the working curriculum of the training of masters of medicine in the second year of study. The structure of the discipline includes 3 credits (90 hours): 20 hours of practical classes and 70 hours of independent work. Type of control – credit.The teaching of the elective discipline «Current issues of medical embryology» is aimed at forming higher education students’ systemic knowledge and understanding of the conceptual foundations and principles of human embryogenesis, which can be used for diagnosis, treatment and prevention of developmental defects, which remain the main cause of child mortality and disability.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334933","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.32
Viktor Polyovyy, Mykola Stets, Andrii Bocharov, Oleksandr Ivan’ko, Oleg Sydorchuk, Vasyl Stepan, Ruslan Sydorchuk
The frequency of complications of malignant neoplasms (MN) of the stomach remains high (10-40 %) and does not show a constant tendency to decrease, despite the introduction of new methodological approaches.The aim of the study. To analyze the factors of successful surgical treatment of gastric lesions, which in turn can be a prerequisite for optimizing surgical tactics in such patients.Material and methods. The research design included a statistical analysis of the medical records of 6,885 oncological patients with abdominal localization of gastric MN and an assessment of the results of treatment of 56 patients with a complicated course of gastric MN. All patients involved in the study signed the appropriate informed consent. The average age of the patients was 56.3±8.61 years, men signifi cantly predominated in the cohort of patients with gastric lesions – 76.79 % against 23.21 % women. Patients were managed according to the ESMO 2022 Gastric cancer Clinical Practice Guideline for diagnosis, treatment and follow-up.Research results. A special feature of gastric MN is its diagnosis in the late stages – the number of patients in the IV stage doubled the number of III stage patients and tripled the number of I-II stages patients. Among the gastric MN complications perforation was observed in 51.79 %, gastrointestinal bleeding in 26.79 %, andgastric stenosis in 21.43 %.Conclusions. The choice of the nature, scope and stages of surgical intervention in patients with gastric MN should take into account the prevalence of the oncological process, the nature and severity of complications, the presence of comorbidities and the characteristics of the patient’s condition. Water-electrolyte and metabolic disorders in complicated gastric MN require a longer period of correction with consideration of options for endoscopic recanalization and enteral therapy, which creates conditions for radical removal of the process during emergency surgical interventions. The contingent of patients with complicated forms of gastric MN requires a complex individual approach and optimized surgical treatment to ensure quality of life in the immediate and long-term postoperative periods.
{"title":"PROBLEMS OF SURGICAL TREATMENT OF GASTRIC MALIGNANT NEOPLASMS COMPLICATIONS","authors":"Viktor Polyovyy, Mykola Stets, Andrii Bocharov, Oleksandr Ivan’ko, Oleg Sydorchuk, Vasyl Stepan, Ruslan Sydorchuk","doi":"10.24061/1727-0847.22.3.2023.32","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.32","url":null,"abstract":"The frequency of complications of malignant neoplasms (MN) of the stomach remains high (10-40 %) and does not show a constant tendency to decrease, despite the introduction of new methodological approaches.The aim of the study. To analyze the factors of successful surgical treatment of gastric lesions, which in turn can be a prerequisite for optimizing surgical tactics in such patients.Material and methods. The research design included a statistical analysis of the medical records of 6,885 oncological patients with abdominal localization of gastric MN and an assessment of the results of treatment of 56 patients with a complicated course of gastric MN. All patients involved in the study signed the appropriate informed consent. The average age of the patients was 56.3±8.61 years, men signifi cantly predominated in the cohort of patients with gastric lesions – 76.79 % against 23.21 % women. Patients were managed according to the ESMO 2022 Gastric cancer Clinical Practice Guideline for diagnosis, treatment and follow-up.Research results. A special feature of gastric MN is its diagnosis in the late stages – the number of patients in the IV stage doubled the number of III stage patients and tripled the number of I-II stages patients. Among the gastric MN complications perforation was observed in 51.79 %, gastrointestinal bleeding in 26.79 %, andgastric stenosis in 21.43 %.Conclusions. The choice of the nature, scope and stages of surgical intervention in patients with gastric MN should take into account the prevalence of the oncological process, the nature and severity of complications, the presence of comorbidities and the characteristics of the patient’s condition. Water-electrolyte and metabolic disorders in complicated gastric MN require a longer period of correction with consideration of options for endoscopic recanalization and enteral therapy, which creates conditions for radical removal of the process during emergency surgical interventions. The contingent of patients with complicated forms of gastric MN requires a complex individual approach and optimized surgical treatment to ensure quality of life in the immediate and long-term postoperative periods.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334864","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.38
Oleksandr Rodynskyi, Olga Seleznyova
The review examines the peculiarities of mediator systems under the conditions of metabolic syndrome. The processes of oxidative stress that occur in adipose tissue are described and can be caused not only by an increase in ROS production, but also by a decrease in the antioxidant protection of adipocytes. Features of the eff ects of antioxidant enzymes are shown, which creates prerequisites for further study of their activity in various tissues against the background of metabolic disorders characteristic of metabolic syndrome. Convincing evidence is provided that functional changes in the expression, activity, and regulatory properties of neuronal NO synthase play a key role among the molecular causes of MS. Understanding the molecular basis of the functioning of the signifi cant components of the NO cycle, the patterns of their changes, the relationship between this cycle and oxidative and nitrosative stress will allow in the future to develop methods of more eff ective diagnosis, treatment and prevention of metabolic syndrome.
这篇综述探讨了代谢综合征条件下介质系统的特殊性。文章描述了发生在脂肪组织中的氧化应激过程，其原因不仅包括 ROS 生成的增加，还包括脂肪细胞抗氧化保护能力的下降。研究显示了抗氧化酶的作用特点，这为在代谢综合征所特有的代谢紊乱背景下进一步研究抗氧化酶在各种组织中的活性创造了先决条件。有令人信服的证据表明，神经元 NO 合酶的表达、活性和调节特性的功能性变化在多发性硬化症的分子病因中起着关键作用。了解氮氧化物循环重要组成部分的功能的分子基础、其变化的模式、该循环与氧化和亚硝酸应激之间的关系，将有助于未来开发出更有效的诊断、治疗和预防代谢综合征的方法。
{"title":"MODIFICATION OF NEURAL INTERACTIONS AND FUNCTIONAL ACTIVITY OF MEDIATOR SYSTEMS UNDER CONDITIONS OF METABOLIC SYNDROME","authors":"Oleksandr Rodynskyi, Olga Seleznyova","doi":"10.24061/1727-0847.22.3.2023.38","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.38","url":null,"abstract":"The review examines the peculiarities of mediator systems under the conditions of metabolic syndrome. The processes of oxidative stress that occur in adipose tissue are described and can be caused not only by an increase in ROS production, but also by a decrease in the antioxidant protection of adipocytes. Features of the eff ects of antioxidant enzymes are shown, which creates prerequisites for further study of their activity in various tissues against the background of metabolic disorders characteristic of metabolic syndrome. Convincing evidence is provided that functional changes in the expression, activity, and regulatory properties of neuronal NO synthase play a key role among the molecular causes of MS. Understanding the molecular basis of the functioning of the signifi cant components of the NO cycle, the patterns of their changes, the relationship between this cycle and oxidative and nitrosative stress will allow in the future to develop methods of more eff ective diagnosis, treatment and prevention of metabolic syndrome.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335051","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.26
Olena Voynytska
Abstract. The constant development of modern neurosurgery and the increase in requirements for the performance of surgical approaches carried out through the bones of the skull vault lead to the formation of new requests to morphologists regarding the detailing and clarifi cation of the craniometric characteristics of any structure of the bony base of the head, including the parietal bones, as one of the largest and form-forming elements of the entire skull. The purpose of our study is to establish the craniometric features of the parietal bones of the skull of an adult human, taking into account gender and certain types of craniotype. The study was performed on 82 bone preparations, including isolated parietal bones, as well as 48 tomograms obtained during the examination of patients. The basic principle of establishing a craniotype is the calculation of the cranial index, which allows classifying anatomical objects according to the shape of the head structure. For statistical analysis, we used Statistica 13.5.0.17 (trial version) and Microsoft Excel of the MS 365 corporate package. In order to identify the existing craniometric features of the structure of the parietal bones, data on the length and width of the bone were obtained, a statistical analysis of these parameters was carried out, the craniotype of each object was established, existing patterns were established and inherent ranges were described.
摘要现代神经外科的不断发展以及对通过颅顶骨进行手术的要求的不断提高，对形态学家提出了新的要求，即对头部骨性基底的任何结构，包括顶骨，作为整个颅骨中最大的和形成形状的元素之一，进行详细描述和头颅测量特征的确定。我们研究的目的是确定成年人类头骨顶骨的颅测量特征，同时考虑到性别和某些类型的开颅类型。研究对象是 82 块骨骼制备物，包括孤立的顶骨，以及在对患者进行检查时获得的 48 张断层扫描图。确定开颅类型的基本原则是计算颅骨指数，该指数可根据头部结构的形状对解剖对象进行分类。为了进行统计分析，我们使用了 Statistica 13.5.0.17（试用版）和 MS 365 公司软件包中的 Microsoft Excel。为了确定顶骨结构的现有头颅测量特征，我们获得了骨骼长度和宽度的数据，对这些参数进行了统计分析，确定了每个物体的头颅类型，确定了现有模式并描述了固有范围。
{"title":"CRANIOMETRICAL CHARACTERISTICS OF THE PARITAL BONES OF THE HUMAN SKULL VAULT WITH DIFFERENT GENDER AND CRANIOTYPE","authors":"Olena Voynytska","doi":"10.24061/1727-0847.22.3.2023.26","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.26","url":null,"abstract":"Abstract. The constant development of modern neurosurgery and the increase in requirements for the performance of surgical approaches carried out through the bones of the skull vault lead to the formation of new requests to morphologists regarding the detailing and clarifi cation of the craniometric characteristics of any structure of the bony base of the head, including the parietal bones, as one of the largest and form-forming elements of the entire skull. The purpose of our study is to establish the craniometric features of the parietal bones of the skull of an adult human, taking into account gender and certain types of craniotype. The study was performed on 82 bone preparations, including isolated parietal bones, as well as 48 tomograms obtained during the examination of patients. The basic principle of establishing a craniotype is the calculation of the cranial index, which allows classifying anatomical objects according to the shape of the head structure. For statistical analysis, we used Statistica 13.5.0.17 (trial version) and Microsoft Excel of the MS 365 corporate package. In order to identify the existing craniometric features of the structure of the parietal bones, data on the length and width of the bone were obtained, a statistical analysis of these parameters was carried out, the craniotype of each object was established, existing patterns were established and inherent ranges were described.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335239","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.30
V. Kosharnyi, Larisa Abdul-Ogly, Evgeny Boyko, Serhii Tkachenko, Kateryna Kushnaryova
In the conditions of wartime, the frequency of damage to the nerves of the lower extremity increased sharply. Open injuries make up the vast majority of peripheral nerve injuries. Understanding variations in the topography and the condition of the surrounding soft tissue structures allows for a detailed assessment of the condition of the peripheral nerves of the lower limb, to diagnose the exact site of damage, the type of neuropathy, and to choose treatment and rehabilitation tactics. The purpose of the study will be to establish variants of the fetal topography of the long branches of the sacral plexus. The material for the study of topographical and anatomical features of the long branches of the sacral plexus was 26 human fetuses of 5-7 months. The sciatic nerve is the largest nerve in humans, originating from the ventral division of spinal nerves L4 to S3 and containing fi bers from both the posterior and anterior lumbosacral plexuses. The sciatic nerve runs along the entire back surface of the lower limb up to the foot. The sciatic nerve innervates a signifi cant part of the skin and muscles of the thigh, lower leg, and foot. It was established that the long branches of the sacral plexus can be subjected to compression or damage in diff erent parts of its anatomical course. Among the variants of the anatomical variability of the long branches of the sacral plexus, the topography of the sciatic nerve is the most common. In the three studied fetuses of 180.0 mm, 215.0 mm, 255 mm TKD, a high branching variant of the sciatic nerve was detected, and the features of the long branches of the sacral plexus in the specifi ed fetuses were unilateral. In this case, when assessing clinical symptoms, practicing doctors should take into account options for bilateral asymmetry. Prospects for further research. Deepening the study of the variant anatomy of the long branches of the sacral plexus in human fetuses of diff erent ages.
在战时条件下，下肢神经受损的频率急剧增加。开放性损伤占周围神经损伤的绝大多数。了解地形的变化和周围软组织结构的状况，可以详细评估下肢周围神经的状况，诊断确切的损伤部位和神经病变类型，并选择治疗和康复策略。这项研究的目的是确定胎儿骶丛长支地形图的变体。研究骶丛神经长支地形和解剖特征的材料是 26 个 5-7 个月的人类胎儿。坐骨神经是人类最大的神经，起源于脊神经 L4 至 S3 的腹侧分部，包含腰骶后丛和腰骶前丛的分支。坐骨神经沿着整个下肢后表面一直延伸到足部。坐骨神经支配着大腿、小腿和足部的大部分皮肤和肌肉。已经证实，骶神经丛的长支在其解剖路线的不同部位可能会受到压迫或损伤。在骶丛长支的解剖变异中，坐骨神经的地形是最常见的。在所研究的三个 TKD 分别为 180.0 mm、215.0 mm 和 255 mm 的胎儿中，均检测到坐骨神经的高分支变异，且特定胎儿的骶丛长分支特征均为单侧。在这种情况下，医生在评估临床症状时，应考虑双侧不对称的选择。进一步研究的前景。深入研究不同年龄胎儿骶丛长枝的变异解剖。
{"title":"SOME OPTIONS OF FETAL TOPOGRAPHY OF THE LONG BRANCHES OF THE CROSS PLEXUS","authors":"V. Kosharnyi, Larisa Abdul-Ogly, Evgeny Boyko, Serhii Tkachenko, Kateryna Kushnaryova","doi":"10.24061/1727-0847.22.3.2023.30","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.30","url":null,"abstract":"In the conditions of wartime, the frequency of damage to the nerves of the lower extremity increased sharply. Open injuries make up the vast majority of peripheral nerve injuries. Understanding variations in the topography and the condition of the surrounding soft tissue structures allows for a detailed assessment of the condition of the peripheral nerves of the lower limb, to diagnose the exact site of damage, the type of neuropathy, and to choose treatment and rehabilitation tactics. The purpose of the study will be to establish variants of the fetal topography of the long branches of the sacral plexus. The material for the study of topographical and anatomical features of the long branches of the sacral plexus was 26 human fetuses of 5-7 months. The sciatic nerve is the largest nerve in humans, originating from the ventral division of spinal nerves L4 to S3 and containing fi bers from both the posterior and anterior lumbosacral plexuses. The sciatic nerve runs along the entire back surface of the lower limb up to the foot. The sciatic nerve innervates a signifi cant part of the skin and muscles of the thigh, lower leg, and foot. It was established that the long branches of the sacral plexus can be subjected to compression or damage in diff erent parts of its anatomical course. Among the variants of the anatomical variability of the long branches of the sacral plexus, the topography of the sciatic nerve is the most common. In the three studied fetuses of 180.0 mm, 215.0 mm, 255 mm TKD, a high branching variant of the sciatic nerve was detected, and the features of the long branches of the sacral plexus in the specifi ed fetuses were unilateral. In this case, when assessing clinical symptoms, practicing doctors should take into account options for bilateral asymmetry. Prospects for further research. Deepening the study of the variant anatomy of the long branches of the sacral plexus in human fetuses of diff erent ages.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334828","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.33
M.V. Svirhun, Andrii Semenenko
The article analyzes the dynamics of cognitive dysfunction and the dependence of the occurrence of postoperative cognitive dysfunction (POCD) in obese patients after hip arthroplasty under spinal anesthesia. The Mini Mental State Examination (MMSE) scale was used as one of the main evaluation scales of POCD. On the day of admission, the patient’s BMI was calculated. Neuropsychological testing was performed in dynamics: 1) the day before surgery; 2) 3 days after the operation – as of the 4th day; 3) after 6 days – as of the 7th day and 4) the day before discharge from the hospital. The number of patients included in the study is 120 patients. Depending on the level of the average MMSE score in the postoperative period in relation to the level in the admission period, retrospectively divided into groups: «Without negative dynamics of cognitive functions» (n=85) and «With negative dynamics of cognitive functions» (n=35). The analysis of the average value of the body mass index and the character of the physique of patients depending on the dynamics of cognitive function the day before discharge indicated only the presence of a tendency to increase the average value of the body mass index (27.6 vs. 25.8 kg/m2, p=0.14 for T -test for Independent Samples) and cases with severe alimentary- constitutional obesity (7.7 % vs. 0.9 %, p=0.07 according to the χ2 test) in the group of patients with negative dynamics of cognitive function compared to the group without it. Thus, the results of the analysis suggest a certain dependence of severe obesity with the development of cognitive disorders.
文章分析了椎管内麻醉下髋关节置换术后肥胖患者认知功能障碍的动态变化以及发生术后认知功能障碍（POCD）的依赖性。迷你精神状态检查（MMSE）量表被用作 POCD 的主要评估量表之一。入院当天，计算患者的体重指数（BMI）。神经心理测试是动态进行的：1）手术前一天；2）手术后 3 天--第 4 天；3）6 天后--第 7 天；4）出院前一天。参与研究的患者人数为 120 人。根据术后平均 MMSE 评分与入院时的评分水平，回顾性地将患者分为以下几组："无认知功能负动态 "组（85 人）和 "有认知功能负动态 "组（35 人）。根据患者出院前一天的认知功能动态，对其体重指数平均值和体质特征进行分析，结果显示体重指数平均值仅有上升趋势（27.6 千克/米对 25.8 千克/米）。6 vs. 25.8 kg/m2, p=0.14 for T -test for Independent Samples），以及认知功能动态为负的患者组与无认知功能动态为负的患者组相比，存在严重的营养性肥胖（7.7 % vs. 0.9 %, χ2 检验 p=0.07）。因此，分析结果表明，严重肥胖与认知障碍的发展有一定的依赖性。
{"title":"ANALYSIS OF THE OCCURRENCE OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN OBESE PATIENTS AFTER HIP ARTHROPLASTY UNDER SPINAL ANESTHESIA","authors":"M.V. Svirhun, Andrii Semenenko","doi":"10.24061/1727-0847.22.3.2023.33","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.33","url":null,"abstract":"The article analyzes the dynamics of cognitive dysfunction and the dependence of the occurrence of postoperative cognitive dysfunction (POCD) in obese patients after hip arthroplasty under spinal anesthesia. The Mini Mental State Examination (MMSE) scale was used as one of the main evaluation scales of POCD. On the day of admission, the patient’s BMI was calculated. Neuropsychological testing was performed in dynamics: 1) the day before surgery; 2) 3 days after the operation – as of the 4th day; 3) after 6 days – as of the 7th day and 4) the day before discharge from the hospital. The number of patients included in the study is 120 patients. Depending on the level of the average MMSE score in the postoperative period in relation to the level in the admission period, retrospectively divided into groups: «Without negative dynamics of cognitive functions» (n=85) and «With negative dynamics of cognitive functions» (n=35). The analysis of the average value of the body mass index and the character of the physique of patients depending on the dynamics of cognitive function the day before discharge indicated only the presence of a tendency to increase the average value of the body mass index (27.6 vs. 25.8 kg/m2, p=0.14 for T -test for Independent Samples) and cases with severe alimentary- constitutional obesity (7.7 % vs. 0.9 %, p=0.07 according to the χ2 test) in the group of patients with negative dynamics of cognitive function compared to the group without it. Thus, the results of the analysis suggest a certain dependence of severe obesity with the development of cognitive disorders.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335011","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 : 2023-09-28DOI: 10.24061/1727-0847.22.3.2023.31
I. Dzyubanovsky, Andriy Kovalchuk, Oleh Dzyubanovsky
One of the urgent problems in urgent abdominal surgery remains acute disseminated peritonitis (AP), the mortality rate of which remains high due to the development of multiple organ failure syndrome, despite the use of modern methods of diagnosis and treatment.The purpose of the study. To substantiate the possibility of using laparoscopic methods of treatment depending on the severity and stage of morphological changes of the target organs and the duration of peritonitis simulated in the experiment.Material and methods. The experiment used 150 sexually mature non-linear female rats, weighing 180.0-220.0 grams, which were kept on the standard ration of the vivarium of the Central Research Laboratory with maintenance of food and drinking regimes recommended by the norms of keeping laboratory animals. The animals were divided into 5 groups – a control group (30 rats) and 4 experimental groups (120 rats), which underwent HP simulation by intraperitoneal injection of 1 ml of 30 % autocal. The animals of the research group were removed from the experiment under sodium thiopental anesthesia by bloodletting on the 1st, 3rd, 5th, and 7th days. Results of the study. Morphohistochemical study of the target organs on the 1st day of the experiment: singleorgan changes were observed (examination of the peritoneum revealed its pronounced swelling). A slight vascular reaction of the basal membrane of the mucous membrane was established in the small intestine. On the 3rd day, the changes remained monooraneous with increases in infl ammatory phenomena. On the 5th day, the spread of the systemic infl ammatory response to the lungs and kidneys was confi rmed. Areas with foci of dystrophic- necrotic changes in the epithelium of the tubules were visualized in individual excretory tubules in the kidneys.In the lungs: the number of erythrocytes and fi brin increased in the cellular component. On the 7th day of the experiment, the heart and liver were involved in the process. In the heart, dystonia and paresis of microcirculatory vessels, erythrocyte stasis, and the formation of cell aggregates in the lumen of vessels were observed. In the liver, it is observed: congestion of the central veins, manifestations of venous stasis.Conclusion. Based on the stages of morphological changes of the studied organs at diff erent times, the simulation of acute peritonitis allowed us to theoretically justify a diff erentiated approach to the selection of the type of surgical interventions.
{"title":"STAGES OF MORPHOLOGICAL CHANGES OF TARGET ORGANS IN EXPERIMENTALLY SIMULATED ACUTE PERITONITIS","authors":"I. Dzyubanovsky, Andriy Kovalchuk, Oleh Dzyubanovsky","doi":"10.24061/1727-0847.22.3.2023.31","DOIUrl":"https://doi.org/10.24061/1727-0847.22.3.2023.31","url":null,"abstract":"One of the urgent problems in urgent abdominal surgery remains acute disseminated peritonitis (AP), the mortality rate of which remains high due to the development of multiple organ failure syndrome, despite the use of modern methods of diagnosis and treatment.The purpose of the study. To substantiate the possibility of using laparoscopic methods of treatment depending on the severity and stage of morphological changes of the target organs and the duration of peritonitis simulated in the experiment.Material and methods. The experiment used 150 sexually mature non-linear female rats, weighing 180.0-220.0 grams, which were kept on the standard ration of the vivarium of the Central Research Laboratory with maintenance of food and drinking regimes recommended by the norms of keeping laboratory animals. The animals were divided into 5 groups – a control group (30 rats) and 4 experimental groups (120 rats), which underwent HP simulation by intraperitoneal injection of 1 ml of 30 % autocal. The animals of the research group were removed from the experiment under sodium thiopental anesthesia by bloodletting on the 1st, 3rd, 5th, and 7th days. Results of the study. Morphohistochemical study of the target organs on the 1st day of the experiment: singleorgan changes were observed (examination of the peritoneum revealed its pronounced swelling). A slight vascular reaction of the basal membrane of the mucous membrane was established in the small intestine. On the 3rd day, the changes remained monooraneous with increases in infl ammatory phenomena. On the 5th day, the spread of the systemic infl ammatory response to the lungs and kidneys was confi rmed. Areas with foci of dystrophic- necrotic changes in the epithelium of the tubules were visualized in individual excretory tubules in the kidneys.In the lungs: the number of erythrocytes and fi brin increased in the cellular component. On the 7th day of the experiment, the heart and liver were involved in the process. In the heart, dystonia and paresis of microcirculatory vessels, erythrocyte stasis, and the formation of cell aggregates in the lumen of vessels were observed. In the liver, it is observed: congestion of the central veins, manifestations of venous stasis.Conclusion. Based on the stages of morphological changes of the studied organs at diff erent times, the simulation of acute peritonitis allowed us to theoretically justify a diff erentiated approach to the selection of the type of surgical interventions.","PeriodicalId":411391,"journal":{"name":"Clinical anatomy and operative surgery","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334883","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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