[Morphological predictors of water-electrolyte disorders in patients with preventive ileostomy after rectal resection for cancer]. / Issledovanie morfologicheskikh prediktorov vodno-elektrolitnykh narushenii u patsientov so sformirovannoi preventivnoi ileostomoi pri rezektsii pryamoi kishki po povodu raka.

OBJECTIVE: To analyze morphological changes in wall of functioning and non-functioning small intestine in patients with preventive ileostomy and to determine histological predictors of water-electrolyte disorders. MATERIAL AND METHODS: We prospectively analyzed 57 patients >18 years old who underwent rectal resection with preventive ileostomy between January 2022 and November 2023. Anthropometric data included gender, age, body mass index, ECOG and ASA classes. Complications associated with large losses through ileostomy were water-electrolyte disorders, dehydration and acute renal failure with repeated hospitalization. Morphological analysis implied intraoperative full-layer biopsy of small intestine on anterior abdominal wall (ileostomy). Intraoperative biopsy of efferent and afferent loops was also carried out. Tissue samples were examined by light microscopy. We analyzed mean height of mucous membrane villi and depth of crypts, as well as their ratio. Fibrosis and swelling of submucosa were evaluated too. The results were analyzed in the SPSS Statistics 20 software. RESULTS: Mean height of intestinal villi <465 microns (p=0.028), ratio of their height to crypt depth <4.38 (p=0.034) and submucosal fibrosis (p=0.031) significantly affected malabsorption and readmission of patients. The risk of readmission was 11.5 and 5.5 times higher in univariate analysis. Multivariate analysis revealed in-hospital dehydration with resumption of infusion therapy as a predictor of readmission (p=0.046). CONCLUSION: Ileostomy is a certain stress for the patient's body. Not every patient is able for adaptation. One of the adaptation mechanisms is hypertrophy of mucous membrane villi involved in digestion. This mechanism is less pronounced in patients with repeated hospitalizations. Preoperative morphological examination of ileum mucosa may be an additional objective predictor of possible complications of preventive ileostomy.

[Morphological and functional aspects of recurrent postoperative ventral hernias]. / Morfofunktsional'nye aspekty retsidiva posleoperatsionnykh ventral'nykh gryzh.

AIM: To define the optimal treatment of postoperative ventral hernias. MATERIAL AND METHODS: It was performed microscopic examination of intraoperative specimens which were obtained from 40 patients with medium, large and giant hernia. The aim was to reveal ultrastructural changes and morphological features which are associated with abdominal wall weakness in case of postoperative ventral hernia. There were 28 (70%) cases of primary postoperative hernia and 12 (30%) cases of recurrent and multiple-recurrent hernia. In 4 patients polypropylene mesh implants were implanted prior to recurrence. Tissue specimens were obtained from the top of herniation, hernial ring and in 6 cm from the hernial ring. RESULTS AND DISCUSSION: Electron microscopy showed that postoperative ventral hernias are accompanied by ultrastructural destructive changes in cells of the skin, aponeurosis and muscles that indicates on morphofunctional failure of abdominal wall tissues. Swelling and degradation of collagen, fibroblasts vacuolization, capillary sludge of erythrocytes, development of vacuum zones with the fragments of altered collagen fibrils, red blood cells and mast cells are morphological signs of micronecrosis followed by abdominal wall weakness and postoperative ventral hernias. CONCLUSION: Postoperative ventral hernias are associated with morphological and functional failure of abdominal wall due to tissue destructive changes. Therefore, this obviously defective tissue can not be used per se and especially with tension. Mesh implants should be applied.

[Hepatoid adenocarcinoma of the lung with multiple metastases to the small bowel].

The authors describe a case of hepatoid adenocarcinoma of the lung with multiple metastases to the small bowel. An immunohistochemical study has been conducted.

[The comparative characteristics of pulmonary and renal ultrastructural changes in burn sepsis].

The results of histological and electron microscopic studies of the lung and kidney from the patients who died from burn sepsis are presented. The lung and kidney showed blood circulatory disorders, reversible and irreversible damages, and cell necrosis. The most pronounced changes of lung cells were revealed near coccal bacteria.

[Comparative morphometric analysis of rat embryonic and fetal pulmonary structures after general hypothermia].

The applied model of morphological assessment of the lung at strictly dated stages of embryonic (gestational day 14) and fetal (gestational day 20) development permitted to specify major planimetric parameters of organ parenchyma, the magnitudes of form-factors of the objects studied. On the basis of morphometric criteria, two main phenotypical variants of rat lung development were established. The factor of hypothermia, by modifying the limits of normal development, "typifies" its variants already in embryonic and perinatal periods with the participation of preacinar regions. This phenomenon is a manifestation of an individual intrauterine preadaptation by the formation of individual variants of "effect of readiness" to the challenge by a similar factor after birth with the object of probable minimal expenditures for the organism.