PECULIARITIES OF MORPHOETIOPATHOGENESIS OF ACUTE APPENDICITIS AND CONSEQUENCES AFTER APPENDECTOMY.

OBJECTIVE: The aim: To study the features of morphoethiopathogenesis of acute appendicitis and the consequences after appendectomy. PATIENTS AND METHODS: Materials and methods: 10 preparations of human appendix were studied, from which 5 appendixes were normal in people who died in adulthood and old age and 5 processes were taken intraoperatively during appendectomy. Morphometric characteristics of the tissue structures of the preparations were compared with the systematic review data, the literature search by the following keywords: morphoethiopathy", "vermiform process", "lymphoepithelial formations", "digestive system", "lymphoid nodule", "Peyer's patches", "mucous membrane". RESULTS: Results: Pathogenesis of acute appendicitis - it is a consistent, staged process that is completely subject to the laws of exudative inflammation in response to microbial aggression. Removal of the appendicular process should be approached carefully and based on possible immunological consequences. Removal of the appendix as an immunocompetent organ Unreasonable removal of pathohistological unchanged appendix has medical consequences (can lead to consequences such as colon cancer) and not only. CONCLUSION: Conclusions: Our results suggest that the vermiform appendix retains its active function throughout human life. The study provides an overview with current knowledge about the etiology, pathogenesis and possible consequences of appendectomy as the main method of treatment of acute appendicitis. The search for ways to prevent appendicitis can be successful only by finding out the causes and factors that in some individuals cause the inability of the appendix to resist bacterial invasion. Appendix is necessary to fully support the immune responses of the digestive tract, but it belongs to the category of those organs, the loss of which during forced surgery does not cause significant damage to the body.

HEALTH DISORDER ASSOSIATED WITH PERMANENT DISABILITY AS THE SIGN OF BODILY HARM.

OBJECTIVE: The aim: The paper is aimed at creation of the procedure and criteria for determining a health disorder associated with permanent disability as a sign of serious bodily harm. PATIENTS AND METHODS: Materials and methods: To identify the problems faced by forensic medical and judicial practice in determining a health disorder associated with permanent disability, we studied more than 100 criminal proceedings from 2007 to the present time. RESULTS: Results: Ways to further improvement of the procedure for conducting expert studies on health disorders, associated with persistent loss of general ability to work as a characteristic feature of the bodily harm have been found to avoid errors in forensic medical and judicial practice. The issues of conducting forensic medical examinations to determine the degree of loss of general ability to work remain unresolved. The lack of joint research projects conducted by both medical and legal scientists leads to the polysemy and different approaches in the stating of certain concepts that are the subject of study of both medical and law sciences. Currently, the definition of the offence against health is debatable and the issues of criteria for determining such damage are not completely settled to date. CONCLUSION: Conclusions: We consider the development of the Procedure and Criteria for determining the degree (in percentage) of the permanent loss of general ability to work of victims of criminal offences, established by forensic medical experts, is crucial.

Microscopic structure of albino rats' small intestine.

OBJECTIVE: Introduction: The small intestine of albino rats is a transitive canal between the stomach and the cecum that is closely located from each other, reaches a length of one meter, which in comparison ratio to body weight significantly exceeds the corresponding segment in humans. The aim: The paper is aimed at thorough histological study of the wall and structure of albino rats' small intestine mucosa. PATIENTS AND METHODS: Materials and methods:30 mature albino male rats were involved into the study. The specimens of albino rats' small intestine, fixed in 10% neutral buffered formalin solution, have been studied. The study was carried out using conventional histological methods for obtaining serial paraffin sections stained with hematoxylin-eosin. Epoxy plastination of individual tissue samples of the small intestine was performed. Subsequently, polished thin sections were made, stained with 1% methylene blue and 1% borax solution. The obtained specimens were studied on the "Konus" light microscope equipped with Sigeta DCM-900 9.0MP digital microphoto attachment with the Biorex 3 software adapted for studies of such type. RESULTS: Results and conclusions: For the first time in the practice of histological study of the epithelial covering of the mucous membrane of the small intestine, attention is drawn to the specific pattern of its organization on the intestinal villi. It has been found that epithelial covering consists of alternating cluster epithelial aggregations separated by fissured depressions. Since no mentioning about them has been found in the publication, these cluster aggregations of enterocytes can be called epithelial buds of the intestinal villi. Consequently, it can be concluded that with the exception of some specific morphological features, the small intestine of albino rats is homologous to human one by its histological structure, which means that it can be used as a model for various experimental studies.

Features of angioarchitecture of the albino rats stomach and small intestine.

OBJECTIVE: Introduction: The stomach and small intestine are important organs of the digestive system and, to date, they are the subject of research by morphologists, endocrinologists, immunologists, gastroenterologists, and other researchers. The aim: The paper is aimed at the study and systematization of the features of angioarchitecture of the albino rats stomach and small intestine. PATIENTS AND METHODS: Materials and methods: The study based on the injection of the blood vasculature of abdominal organs of 20 albino male rats with 5% gelatin solution, colored with filtered black ink, was performed. The specimens were subject to photographing from different aspect angles in their original state, and then, after dehydration in alcohols with the transition to pure acetone, they were embedded in the epoxy. Photographing of the obtained specimens was made by a digital camera, as well as a binocular magnifier MBS-9, equipped with a digital photoattachment Sigeta DCM-900 9.0MP. RESULTS: Results and conclusions: The results of injecting of blood vasculature of albino rats' gastrointestinal tract with ink mass clearly demonstrate the specific difference in the intraorganic angioarchitecture of its different regions, which depends entirely on their functional purpose in the digestive process. In the stomach, the highest concentration of blood microvessels is in its glandular part, which is explained by the increased nutrient needs of the secretory process of the gastric glands, while the mucous membrane of its fundus (pre-stomach) contains a scattered network of exchange microvessels that only promote the process of regeneration of the stratified squamous (partially keratinized) covering epithelium. In the small intestine, the typical principle of the organization of the microvasculature of its mucous membrane is somewhat modified in the duodenum, which is associated with the presence of mucous (Brunner's) glands in it, as well as in those sites (starting from the duodenum) where the group lymph nodes (Peyer's patches) are localized.

Stereomorphology of the glandular parenchyma of the inferoposterolateral area of human prostate gland.

OBJECTIVE: Introduction: The human prostate gland contains numerous tubular masses of different calibers in its parenchyma. They form the tubuloalveolar prostate glandules, constituting from numerous prostatic excretory ductules as well as major excretory ducts. The aim: The study was aimed at 3D visualization of individual microelements of the tubuloalveolar aggregations, localized within the peripheral area. PATIENTS AND METHODS: Materials and methods: To meet the objectives of the study a series of paraffin plane-parallel 4 µm sections has been obtained in the peripheral prostate area. The serial sections were stained with hematoxylin and eosin. After the analysis of the series of sections, the graphical two-dimensional and plastic 3D reconstructions of the investigated microobjects have been made sequentially in depth. RESULTS: Results: Presence of the epithelial creases and invaginations of the wall in the luminal contour of tubuloalveolar aggregations of the prostate has been found. Creases can be solitary, multiple, or wavy; they can be localized both symmetrically and asymmetrically, with different heights and thicknesses. Intraluminal invaginations, along with the epithelial crease, contain a stromal muscle component with localized blood loop-shaped microvessel. The creases of the glandular epithelium and intraluminal invaginations can "overlap" the lumens of the tubuloalveolar aggregations up to 2/3 of the width, making the inner lumen sinuous that influences the laminar flow of the liquid. CONCLUSION: Conclusions: Alternation of the considerable enlargement and narrowing of the inner diameter is common for the tubuloalveolar aggregations which can affect the secreta deposition and movement.

Stereomorphology of the peripheral zone of the human prostate.

OBJECTIVE: Introduction: The human prostate gland is a complex organ that consists of two main components - glandular and non-glandular. The first of them represents a compound of components of different origin, structure, location, and complexity of spatial organization. Their stereomorphology and microanatomical interrelations remain understudied for a number of reasons. The aim: The objective of the research was to study the stereomorphological features of the glandular component of the peripheral zone of the prostate in view of its zonal structure concept. PATIENTS AND METHODS: Materials and methods: The material for the study was the glandular zone of the human prostate, which corresponds to the peripheral zone of the prostate according to the classification (Mc.Neal J.E., 1988). The following methods were used in the study: histological (4 mkm thick paraffin sections), microscopic (light microscopy using the Olympus BX-41 microscope), stereomorphological (obtaining waxed model reconstructions based on graphic ones). The study was conducted on 10 isolated prostate preparations (10 series of 50 preparations in each) taken from the deceased men without changes in the organ under investigation. The prostate gland was fixed in a 10% solution of buffered formalin, followed by obtaining serial plane-parallel sections and staining with hematoxylin and eosin according to the conventional technique. RESULTS: Results and conclusions: The ducts of the glands of the peripheral zone of the human prostate normally have recurrent luminal dilatations, which, like the multi-cavity terminal portions, can serve as a place for depositing a secret. The ducts of the peripheral zone glands, with the exception of the main duct, visually differ little in diameter. Their walls and walls of intra-acinar cavities are lined with homologous epithelial cells. Therefore, there is no clear morphological boundary between the transfer of the terminal portion to the duct and from one excretory duct to the other.

Spatial organization of the excretory ducts and sections of microcirculatory blood flow of the labial salivary glands in older adults.

OBJECTIVE: Introduction: Salivary glands have a significant impact on the state of the homeostasis of the human body, oral cavity in particular, sensitively responding to pathological processes. The reactivity of the salivary glands in response to pathological processes that are organically linked to morphology and functions of the organ's structures, and particularly the excretory ducts of the glands and their microcirculatory blood flow, is one of the problems which have not been solved to date. The aim of the paper was to elucidate the features of the stereomicroscopic structure of the excretory ducts and sectors of the microcirculatory blood flow in labial glands of older adults. PATIENTS AND METHODS: Materials and methods: The object of the study was the labial mucosa of the older adults, which was cut into 3х3 mm pieces and fixed in the buffered 4% glutaraldehyde solution with subsequent 2-hour fixation in osmium. Once the pieces were washed and dehydrated they were embedded into the Epon-812. The series of the semi-thin sections, made from the obtained epoxy blocks, were stained in phosphate buffered 0,1% toluidine blue solution. The serial semi-thin sections were subjected to histological and cytological studies and multilayered plastic reconstruction. RESULTS: Results and conclusions: The series of histological epoxy semi-thin sections, as well as graphic and plastic reconstruction of the sectors of microcirculatory blood flow and excretory ducts of the human labial glands have demonstrated a range of morphological facts that can be used to clarify the intertissue stereological relationships. They also determined the syntopic proximity of the capacitive sectors of microcirculatory blood flow to the excretory ducts of the gland. Such pattern is especially notable in the collecting venules and intralobular ducts. It has been shown that the biggest venule is the collecting venous vessel. Anastomoses between the intralobular arterioles and collecting venules have been found in the microcirculatory blood flow of the labial glands.

General comparative anatomy of human and white rat digestive systems: a bibliographic analysis.

OBJECTIVE: Introduction: The gastrointestinal tract of humans has much in common with most species of laboratory animals, particularly at the level of microscopic study. White rats are widely used in the experiments to determine the influence of the environmental factors on the human. The aim: Study the general comparative anatomy of the digestive system of the human and the white rat through the bibliographic analysis of the publications. PATIENTS AND METHODS: Materials and methods: Current scientific publications on the study of the human and the white rat gastrointestinal tract morphology were used as the material for the research by analyzing, synthesizing and generalizing the information obtained. RESULTS: Review and conclusions: Generally, the anatomical structure of the white rat digestive system is similar to the human one. Phylogenetically, the digestive systems of humans and rats are the homologous functional system that are much in common regarding the structure and functions of the organs, the significance of which is in the perception, mechanical and chemical (enzymatic) digestion and absorption of the nutrients into the body.

Evaluation of the effectiveness of surgical management in local purulent-septic complications of acute pancreatitis.

OBJECTIVE: Introduction: In the past decades, mortality in acute pancreatitis ranges from 3% to 15 % and depends mainly on the severity of the diseases, which is characterized by the development of necrotic processes in the pancreas and systemic complications. Notwithstanding the numerous studies on severe forms of acute pancreatitis, no significant improvement of treatment outcomes of this category of patients is observed. The integrated diagnosis and treatment of this pathology, prognosis and prevention of purulentseptic complications are relevant to date. The aim: To evaluate the effectiveness of surgical management depending on the nature and incidence of local purulent-septic complications of acute pancreatitis. PATIENTS AND METHODS: Materials and methods: We have analyzed the treatment outcomes of 422 patients with acute pancreatitis who were treated in the Surgical Unit at Poltava Regional Clinical Hospital in the period from 2010 to 2015. All patients were admitted to hospital following 1-7 days after infection. 315 (74.6 %) of them were diagnosed with mild acute pancreatitis; patients received conservative treatment and were discharged from the hospital within 7-10 days. Moderate and severe pancreatitis with the development of local parapancreatic complications were diagnosed in 107 patients (25, 4%) (men=67 (62.6%); women=40 (37, 4%)). Age of patients ranged from 22 to 81 years (47, 9±1.5 years). The severity of the disease was determined according to BISAP score, the presence of multiple organ failure was confirmed by the Modified Marshall Score (2012 modification) Patients were examined in compliance with the requirements of the Order of the Ministry of Health of Ukraine No 297 as of 02 April, 2010. RESULTS: Review and conclusions: Moderate acute pancreatitis is characterized by localization of purulent-septic complications in 1-2 anatomical areas with fluid component mainly. Severe acute pancreatitis is characterized by the localization of purulent-septic complications in 2 or more anatomical areas with tissue component mainly. The efficacy of aspiration-and-drainage interventions depended on the proliferation of fluid accumulations in 1-2 anatomical areas and presence of fluid component mainly. Primarily, open necrsequestrotomy is the most appropriate surgery to be performed in patients with mainly tissue component in the fluid aggregations and the prevalence of local parapancreatic complications in more than two anatomic areas.

Comparative histological structure of the gastrointestinal mucosa in human and white rat: a bibliographic analysis.

OBJECTIVE: Introduction: According to numerous domestic and foreign researchers, morphofunctional structure of the digestive system of humans and rats have much in common, therefore, rats are used as the laboratory animals during the experiments. The aim of the paper was the comparative study of the histological structure of the gastrointestinal mucosa in human and white rat through the bibliographic analysis of the publications. PATIENTS AND METHODS: Materials and methods: The material for the investigation was current publications on the study of the histological structure of the intestine mucosa in human and white rat by analyzing, synthesizing and generalizing the resulting data. RESULTS: Review and discussion: Histologically, the gastrointestinal mucosa in white rat is similar to the human one. The gastrointestinal mucosa in white rats (with the exception of the generic difference in the structure of the stomach and the caecum), in its histological structure, is quite similar to the human one, to be studied in the experimental simulation of the specific lesions of the digestive system.

The use of morphological study technique for investigation of labial and palatine glands.

INTRODUCTION: Due to the deterioration of environmental conditions that promotes the onset of inflammatory and autoimmune diseases, and the progress in the diagnosis, the frequency of registration of intercurrent pathology of salivary glands has markedly risen in recent years, demonstrating the increased scientific interest in the research of the common and distinctive features of their structure. THE AIM: The paper was aimed at the development of the method of morphological study of human minor salivary (labial and palatine) glands by the use of plastic wax reconstruction to obtain the plastic model of the acini and ducts of human minor salivary glands. MATERIALS AND METHODS: Specimens of the glandular area of the hard palate mucosa and labial mucosa in its middle third have been studied. To gain the objective of the investigation the technique for morphological study of the human minor salivary (labial and palatine) glands is to be developed, encompassing the analysis of the spatial organization of the glandular epithelium of the labial and palatine glands together with blood microcirculatory flow by fixing the obtained specimens of the minor salivary glands in 4% glutaraldehyde solution and osmium tetroxide with subsequent embedding into the Epon-812, staining the serial semi-thin sections with phosphate buffered 0,1% toluidine blue solution, photomacrography of the distinguished boundaries of the investigated structures and obtaining of photoreconstructions. RESULTS AND CONCLUSIONS: Thus, the use of suggested technique enables to obtain the megascopic reconstruction of the acini and ducts of the labial and palatine glands, which can be studied from different sides, getting the full visualization of the shape and size, as well as to explore the glands' inner configuration, the geometry of the lumen of the epithelial excretory ducts, to determine changes in the thickness of the wall, to get a visual representation of the microtopographic interactions between the different parts of blood microcirculatory flow and excretory ducts of the minor salivary glands.

Report on the study of spatial organization of the human prostate glands.

OBJECTIVE: Introduction: In terms of the spatial organization human prostate is the complex organ due to the fact that it consists of several types of glands, localized in several histotopographic areas, characterized by the heterogeneous structure. On the other hand, most of the prostate glands are characterized by the high degree of adjacency to each other and quite complicated architectonics of both the external and internal contours of their acini and terminal ducts. The aim: The paper was aimed at the study of steromorphological features of the tubuloalveolar secretory elements in the peripheral area of the human prostate. PATIENTS AND METHODS: Material and Methods: 10 isolated postmortem specimens of the prostate gland, urinary bladder, seminal vesicles, fragments of the seminal ducts and urinary tracts which were taken from adult patients, died for the reasons not associated with the pathology of the urogenital system, have been analyzed to study the features of spatial organization of the human prostate glands in its peripheral area. To analyze the secretory components of the prostate stereological and decomposition methods have been used, which allow visualization of its structural and functional elements in all three inter-perpendicular planes. RESULTS: Results and Conclusions: The use of the suggested method enables to get the megascopic reconstruction of the acini and terminal ducts of the prostate gland which can be studied from all sides, getting a comprehensive idea about the shape and size, as well as allows to explore the inner topography of the organ's structure, the geometry of the lumen of the epithelial excretory ducts, to determine the changes in the thickness of the wall, to get a visual representation of microtopographic correlation between the different parts of blood microcirculatory flow with the acini and terminal ducts of the prostate gland.