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Indiaminov Sayit, Samarkand state medical institute, doctor degree in medicine, department of forensic medicine
E-mail: davolash@mail.ru
Damages to hypothalamus vessels in various types of blood loss on the background of acute alcohol intoxication
Abstract: Hypothalamus of people died of acute, massive blood loss and hemorrhagic shock on the background of alcohol intoxication (47 cases) and without it (50 cases) has been studied by histological methods. In acute blood loss on the background of acute alcohol intoxication spasm of hypothalamus arteries is less marked but anemic vessels of microcirculatory bed occurred more often than without alcoholemia.
Keywords: alcohol intoxication, hypothalamus vessels, massive blood loss.
Blood loss on the background of acute alcohol intoxication is a wide-spread variant of traumatizing effects [9, 10]. In damage to the heart and large vessels resulting in massive blood loss thanato-genesis most probably is associated with anemia of microcirculatory bed vessels (MCB) in the brain. Dystonia ofvessels and impairment of rheological features of the blood in the brain are most significant in multiple damages to peripheral vessels [2]. Ethanol intoxication produces impairment of vascular wall permeability and its metabolic disturbances which result in marked edema of the brain, dura mater and pia mater [1; 6]. Simultaneously with disturbance of the brain vascular system following acute intoxication caused by ethyl alcohol (ethanol content in the blood and urine makes 4.1-8.9%) high degree of damage to neurons in the brain trunk is noted [4; 5]. Morphofunctional insolvency of the brain vessels and strengthening of thanatogenetic vascular — coagulopathic component are observed in the brain in blood loss on the background of AAI. Detailed study of arteries and MCB vessels condition in hypothalamus in various types of blood loss on the background of alcohol intoxication will make it possible to reveal additional aspects of thanatogenesis.
Aim: to evaluate thanatogenesis in various types of blood loss and hemorrhagic shock (HSh) on the background of alcohol intoxication by studying morphological condition of hypothalamus vascular system.
Material and methods. The wall of ventricle III with hypothalamus area has been studied in 47 corpses ofpersons who underwent forensic medical expert examination for death caused by acute (ABL) (3 cases), massive (MBL) blood loss due to impairment of the heart and magistral vessels (14), MBL caused by impairment of peripheral vessels (22) and in persons who died at the in-patient department in clinically made diagnosis of HSh caused by MBL following the impairment of peripheral vessels (8cases). Blood loss and hemorrhagic shock were caused by impairments of vessels, organs and tissues by sharp (cut-stab) instruments. In all observations in forensic chemical study presence of ethyl alcohol in amount to 3% was determined in the blood of died people. Hypothalamus of the people died of similar types of blood loss and HSh has also been studied without presence of alcohol in their blood (50 cases). The pieces of the brain were fixed in 10% of neutral formalin, carried through alcohol battery, poured over with paraffin and colored by hematoxilin and eosin, resorcin- fuxin according to Veigert' method, with Shiff-reactive, Mallory and Nissle's method. In all types of blood loss and HSh functional condition of arteries is determined by quantity. With this arterial tonus is estimated in conditional units: spasm- 0,0, normotony — 0,5, atony — 1,0. Average indexes on the whole material give quantitative characteristics which expresses
functional condition of muscular type arteries of a certain caliber [7]. In addition the content of blood filled MCB vessels was determined on hypothalamus sections with application of a large quadrate of measuring net of G. G. Avtandilov (25points) in all types of blood loss and HSh The study was carried out on two levels of hypothalamus — inner (the 1st level) and outer (the2d level) layers. For mathematic processing of the data the Student's method with determination of arithmetic mean M, average error of relative values m and coefficient of difference reliability t was employed; applied subprograms of Microsoft Excel 97 program product were used in the part of descriptive statistics, determination of standard deviations and comparison of extracts.
Results and discussion. The study of hypothalamus in various types of blood loss on the background of alcohol intoxication of slight and moderate severity made it possible to determine the changes of morphofunctional condition ofhypothalamus vessels in comparison with blood loss without alcoholemia. In ABL on the background of alcoholemia spasm of various caliber arteries is noted in hypothalamus. Tonus condition of large and small arteries on the 1st level of hypothalamus makes 0,2, average — 0,1 conditional units. On the 2d level of the organ tonus of large arteries makes 0,2 conditional units, average and small ones — 0,1. In ABL without alcoholemia spasm of arteries is marked in a greater degree and makes 0,1 for the most of hypothalamus vessels excluding average arteries on level 1 (0,2). In MBL caused by single impairment of the heart and magistral vessels on the background of alcoholemia, tonus of arteries oflarge, average and small caliber makes 0,3, 0,4, 0,5 conditional units. However in a deep hypothalamus layer the vessels appear to be sharply spasmodic, their tonus makes 0,2, 0,2, 0,1 in conditional units accordingly. These indexes in the given type of blood loss without alcoholemia after a single injury make 0,1, 0,2 and 0,3 on level 1 of hypothalamus for large, average and small arteries and 0,1, 0,3, 0,7 conditional units on level 2 that can be estimated as dystonia of the organ vascular system. Less marked spasm of intracerebral arteries is observed in multiple injuries of the heart and magistral vessels resulting in MBL on the ground of alcoholemia. On level 1 of hypothalamus tonus of arteries of large, average and small caliber makes 0,5, 0,5 and 0,4 conditional units and 0,5,0,4, 0,2 accordingly. In similar types of blood loss without AAI the indexes are 0,5, 0,5 and 0,3 on level 1 and 0,4, 0,2 and 0,3 conditional units. In MBL caused by single impairment of peripheral vessels on the background of AAI spasm of small arteries (0,2 conditional units) is observed. Large and average arteries are being in the condition of a slight spasm (0,4 and 0,4 cond. un.) on level 1 of hypothalamus, normotonia or spasm on level 2 (0,5 and 0,3 cond. un.). In multiple injuries of peripheral vessels on the background of alcoholemia
Damages to hypothalamus vessels in various types of blood loss on the background of acute alcohol intoxication
arterial spasm is more clearly marked, on level 1 arterial tonus of large, average and small caliber makes 0,2, 0,3 and 0,1 of cond. un., on level 2-0,2,0,2 and 0,1. For hypothalamus vessels after similar type of blood loss without AAI in single injury the signs of dystonia are typical, as the tonus of large, average and small arteries on level 1 makes 0,4,0,2 and 0,6 and on level 2-0,5,0,4 and 0,2 cond. un. In multiple injuries of peripheral vessels a similar picture is observed, as arterial tonus of different caliber makes 0,4, 0,3 and 0,2 on level 1 and 00,6,0,4 and 0,2 on level 2. In HSh caused by MBL after injury of peripheral vessels on the background ofAAI spasm of small arteries is more typical. Tonus of large, average and small arteries makes 0,4,0,4 and 0,2 cond. un. on level 1 and spasm of vessels is more clearly marked on level 2 making 0,2,0,2 and 0,1. In HSh caused by a single injury of peripheral vessels without alcoholemia spasm of different caliber arteries occurs rarer: 0,4, 0,2 and 0,6 cond. un. on level 1 and on level 2 their atonia is noted (0,7, 0,6 and 0,6 cond. un.). Probably in ABL, MBL and HSh on the background of AAI and without it dissociated spasm of arteries is often observed as it does not occur equally in the vessels of different caliber. However in blood loss without alcoholemia tendency ofvessels to atonia is often observed that is not marked in different types of blood loss on the background ofAAI. In hypothalamus (level 1) the number ofblood filled vessels in ABL on the background ofAAI and without it is not significantly different but on level 2 in alcoholemia their number is 3.8 times less than only in blood loss. In MBL due to single or multiple injuries of the heart and magistral vessels on the background of AAI marked blood filling of hypothalamus is marked and these indexes are much higher than the similar ones without alcoholemia. In a single injury of peripheral vessels resulting in MBL anemia of MCB vessels is determined in hypothalamus ofpersons' group with AAI and it is decreased in comparison with the group without alcoholemia 1.5 times on level 1 and almost 7 times on level 2. In multiple injuries in alcoholemia the number of blood filled MCB vessels is larger in hypothalamus on level 1 whereas on level 2 their number is reliably less than in comparative group without alcohol in blood. In comparison of two subgroups of persons with HSh caused by a single injury of peripheral vessels on the background of alcoholemia and without it we revealed that the number of blood filled vessels of MCB is also less particularly in a deep layer of hypothalamus (2.4 times). Thus, in ABL on the background of AAI spasm of hypothalamus arteries is less marked but anemic MCB vessels were more often observed than without alcoholemia. It can be caused by disturbance of redistribution of blood in the brain in alcoholemia. In ABL having the course of rapid loss of relatively small blood volume death is caused by heart failure [9]. In MBL caused by a single or multiple impairments of the heart and magistral vessels on the
background of alcohol intoxication of mild or moderate severity less marked arterial spasm is marked in hypothalamus in comparison with similar blood loss but without alcoholemia. In these terminal conditions in alcoholemia blood filling of MCB vessels is better marked. In MBL caused both by single and multiple injuries of peripheral vessels in presence of alcohol in the blood spastic conditions of arteries and anemia of MCB vessels is marked more often. The same phenomenon is noted in HSH. According to some authors opinion in alcohol intoxication of a mild degree impairment of the brain is less in blood loss that can be associated with pain- killing effect of alcohol [14]. In our observations arterial dystonia in hypothalamus in blood loss on the background of preceding AAI was not observed. Vascular dystonia is considered as manifestation ofvascu-lar decompensation, that is confirmed by frequent diapedetic blood loss [12; 13]. However in blood loss on the background of AAI there is no circulation improvement in hypothalamus as difference of arterial tonus of large, average and small caliber persists. There is a complex, multi-link regulation in the vascular system of the brain which determines interaction of different histological structures in arteries, capillaries and veins joining them on blood flow realization, providing metabolism and neurons function [11]. Probably in blood loss both without alcoholemia and on the background ofAAI disturbance of coordinated activity of hypothalamus vessels takes place, i. e. dystonia of vascular system on the whole. In HSh there is also no tonus improvement of intracerebral vessels on AAI background. In MBL taking place on AAI background tonus condition correlate with blood filling condition of MCB vessels. In MBL caused by injury of the heart and magistral vessels in less arterial spasm blood filled MCB vessels occur more often. Constant anemia ofMCB vessels is observed in MBL caused by injuries of peripheral vessels and also in HSh. In these blood loss types arterial spastic condition is observed more often. The revealed features of tonus condition of different caliber arteries and blood filling of MCB vessels in hypothalamus in different blood loss types and HSh serve as additional criteria for evaluation of thanatogenesis.
Conclusions: 1. In acute blood loss on the background of alcohol intoxication spasm of hypothalamus arteries is less marked but anemic MCB vessels occurred more often than without aco-holemia. 2. In massive blood loss caused by single or multiple impairments of the heart and magistral vessels on the background of alcohol intoxication of mild and average severity less marked arterial spasm, better blood filling of MCB vessels are noted in comparison with a similar blood loss but without alcoholemia. 3. In massive blood loss caused by both single and multiple injuries of peripheral vessels and also in hemorrhagic shock spastic arterial condition and MCB vessels anemia are noted more often.
References:
1. Babahanyan R. V., Petrov L. V. Principles of postmortal diagnostics of acute poisonings: Manual for physicians/Edited by prof. G. B. Kovalevsky. - Saint-Petersburg, 2002. - Pub. 47. P. 48.
2. Bogomolov D. V. et al. Pathology and clinical features of poisonings by alcohol substitutes//Narcology. - M., 2006. - N.3 (51). -P. 42-46.
3. Bogomolov D. V. et al. Thanatological evaluation of morphological brain changes in alcohol disease.//Norcology. - M., 2006. N. 11 (N.59). - P. 45-47.
4. Indiaminov S. I. Medicolegal characteristic of the cerebrum in casw of hemorragic shock//ByKOBHHCbKHH MegrnHKH BicHHK. - 2013. - C. 70.
5. Indiaminov S. I. Forensic medical evaluation ofvascular and neuronal damages to the brain in acute blood loss and anemia//Forensic medical expert examination. - Moscow, 2010. - N. 1 (53) P. 5-7.
6. Indiaminov S. I. Morphological features of the human brain in different variants of fatal blood loss on the background of alcohol intoxication/Herald of Russian State Medical University. - Moscow. 2011. N.5. - P. 63-66.
7. Kalayev A. A. et al. Microcirculatory bed of dura mater encephali in conditions of alcohol intoxication//Morphology. 2006. - V. 129, N. 4. - P. 57.
8. Klevno V. A. et al. Actual and perspective scientific studies of forensic medicine.//Forensic med. expert exam. - 2007. - V.50, N.1 -P. 3-8.
9. Kryukov V. N., Sarkisyan B. A. et al. Diagnosticum of death causes in mechanic impairments. - Novosibirsk: Science, 2003. - V. 7. - P. 131.
10. Molina P. E. et al. Alcohol's Burden on Immunity Following Burn, Hemorrhagic Shock, or Traumatic Brain Injury//Alcohol research: current reviews. - 2015. - T. 37. - №. 2. - C. 263.
11. Moreno M. C. et al. Alcohol Intake and Apoptosis: A Review and Examination of Molecular Mechanisms in the Central Nervous System. - 2016.
12. Popov V. L. Solved and unsolved problems of forensic medicine.//Forensic med. expert exam. - M, 2011. N.1 - P. 4-9.
13. Tonisson M. Clinical picture and biochemical changes in blood in children with acute alcohol intoxication: ahc. - 2015.
14. Yang J. Y. et al. Role of microglia in ethanol-induced neurodegenerative disease: Pathological and behavioral dysfunction at different developmental stages//Pharmacology & therapeutics. - 2014. - T. 144. - №. 3. - C. 321-337
Isakova Lola Isakovna, Research Institute of Sanitation, Hygiene and Occupational Diseases of the Ministry of Health
of the Republic of Uzbekistan, senior scientific-applicant of the hygiene laboratory of children and teenagers E-mail: lola.isakova.86@mail.ru
Characteristic of physical activity of young athletes of the Syrdarya region of Uzbekistan
Abstract: 746 young athletes, 538 (72,1%) from them boys and 208 (27,9%) girls, in aged from 7 to 17 years were examined, living in the Syrdarya region of Uzbekistan Republic. It was defined that girls playing sports were 2,6 times less, than their peers athletes. More than 50% of boys-athletes were engaged in team sports, 32% — different types of single combats; about 9% — complicity coordinated types of sports, 3,5% — acyclic high-speed and strength oriented and about 3% of boys-athletes were engaged in chess. Among girls-athletes, distribution about classification of sports, had been presented by following groups: 76,4% were complicity coordinated types of sports, 12,9% — team sports, 4,8% — different types of single combats, 3,4% — acyclic high-speed and strength orientation and 2,4% of girls-athletes were engaged in chess. Examined pupils of the Syrdarya region who are regularly attend systematic sports activities within 4 years; an average duration of one training occupation was 2 hours, from 3 to 5-6 times a week.
Keywords: young athletes, sports educational institutions, different types of sport, systematic sports activities, physical activity, motive mode.
Physical activity are primary communication facility and interaction with environment, household, labor, sports and other types of activity having important social issues. Systematic physical training and going for sport are trained and enhanced physiological functions regulation mechanisms, increased the level of capacity to be act of an organism and its nonspecific resistance. There is a big and irreplaceable role of physical activity for growing organism as natural stimulator of its growth and development. Standard sizes of physical activity for various age periods and different social national groups cannot be same that should be changed with age, as in quantitative, and in a qualitative terms [1, 19-29].
"Upbringing of the healthy and harmoniously developed generation means formation of state base with a great future, achievement of high authority in the world" is a priority task. Government of the republic has been set for itself the task of consecutive children's sport development in close connection with process of education and upbringing, realization of a large-scale work in this direction.
Creation according to Presidential Decree of Uzbekistan Republic in 2002 the Children's sport development Fund has been served as an important step on the way of children's sport development. The fund acts as an effective mechanism of realization ofthe purposes and tasks in children's sport field. The main objectives of the Fund — to promote of realization the state policy in the physical activity and
sport development field among children, awakening of interest in sport at younger generation, protection of youth against various adverse effects, upbringing them in the spirit of a patriotism.
Government of Uzbekistan Republic has been developed and adopted the state social programs which are directed to strengthening of children health state of and diseases prevention, by general promotion of healthy lifestyle, instilling of interest in physical activity and sport. In evidence of this are realized Resolutions of the President of RUz №PP-2221 from 8/1/2014. "About the State program on further strengthening of population reproductive health, mothers health protection, children and teenagers in Uzbekistan for 2014-2018" and №PP-2487 from 2/9/2016 "About the State program "The year of healthy mother and child".
To realize the tasks for further strengthening of youth interest in sport, approval of healthy lifestyle principles in society, system organizations of the sports competitions directed to continuous involvement of pupils and students to sports activity according to national model and the education program, and also ensuring effective functioning of this system the three-stage sports competitions "Umid Nikhollary", "Barkamol Avlod" and "Universiada" among pupils of comprehensive schools, academic lyceums and professional colleges, and also students of higher educational institutions are held in republic.
