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fistula and application of straight esophageal anastomosis with one-row uninterrupted stitches through all layers of the esophageal wall with atraumatic needle, vicryl 6/0 and vascular acceptance. The latter was performed as follows: after the promotion ofventricle probing, one-row uninterrupted stitch leaving both ends of the thread as traction suture, then, with the help of traction sutures, turn the esophagus 180° along own axis to apply one-row uninterrupted stich on the posterior wall of the esophagus. After the removal of traction sutures, the esophagus returns to normal anatomic position turning 180° along its axis. Also, when applying uninterrupted stitch, the needle should enter at the distance of 0.2 cm. from the edge of distal end of the esophagus, herewith, the esophagus partially enters the lumen of the oral end of the esophagus.
It is known that in EA, gastroesophageal reflux is often observed due to the disruption of angle of His. This may contribute to the penetration of gastric juice in the zone of anastomosis during early post-operation period and can lead to anastomotic leakage and/or other early post-operation complications. Hence, to prevent the penetration of gastric content in the zone of anastomosis, catheter Foley-6 Fr/Ch was used as gastric probing, which is placed into ventricle during operation, blown up and tightened. As a result, gastric cardia is sealed with a blown-up part of the catheter thus protecting the zone of anastomosis from the penetration of gastric content during early post-operation period. Consequently, it prevents the development of anastomotic leakage.
Results and discussion
During post-operation period, contrast X-ray of the esophagus was performed on 2-3 day to detect gastroesophageal reflux. Also, the control of the condition of anastomosis was conducted, if there was a suspicion of anastomotic leakage (in case of appearance of mucus-foam discharge in drainage) with water soluble X-ray contrast substance. The feeding of children with EA started on 4-5 day at small diastasis, and, at big diastasis, not earlier than on 7-8 day of the post-operation period. In case of absence of signs of leakage, the drainage was removed from posterior mediastinum on 6-7 day post operation. In case of anastomotic leakage, drainage from mediastinum and gastric probing were not removed until full healing of fistula. The period of healing of fistula was 32 ± 7.5 days.
The indicators of early post-operation period in the patients of primary and control groups are presented in Table 1.
Table 1. - Indicators of the early post-operation period in patients with EA
Indicators Primary group (n = 127) Control group (n = 65)
Gastro-esophageal reflux - 60 (92 %)
Leaking of anastomosis - 34 (52 %)
Anastomotic leakage and mediastinitis 4 (3 %) 15 (23 %)
As the table shows, among the patient in the primary group operated by the improved method, in the early post-operation period, gastro-esophageal reflux during contrast X-ray research was not revealed in a single case, and among children of the control group, gastro-esophageal reflux was detected in 60 (92 %) cases. This certifies about the fact that esophageal probing with the catheter Foley-6 Fr/Ch effectively prevents the penetration of gastric content in the zone of anastomosis.
Moreover, among the patients of the primary group, anastomotic leakage was observed only in 4 (3 %) children, which is almost 8 times less than in the application of anastomosis by traditional method. «Leaking» of mucus was not detected in this group, because uninterrupted stitches on the esophagus secured the tightness of anastomosis.
In the control group (n = 65), «leaking» of anastomosis in the early post-operation period was noted in 34 (52 %) patients, and anastomotic leakage — in 15 (23 %) patients. Although, most of these children showed for a long period of time own closing of the leakage, 6 (40 %) of them developed severe purulent-septic complications, which were one of the leading reasons of postoperation deaths.
The results of our observations allow concluding that the improved method of surgical correction significantly reduces the risk of post-operation anastomotic leakage and improves the results of operative treatment of esophageal atresia. This method is patented under № IAP 05092 and registered in the state register of inventions of the Republic of Uzbekistan.
References:
1. Erbolatov N. K. Esophageal atresia. Modern views on the problem//Pediatrics and children surgery. - 2008. - № 3. - P. 38-40.
2. Krasovskaya T. V., Kucherov Yu. I. and others. Complications of the operative treatment of esophageal atresia//Children surgery. -2001. - № 3. - P. 44-46.
3. Golovanov E. S., Malyshev M. G. Esophageal atresia in newborns in Arkhangelsk region//Ecology of the man. - 2003 - № 4. - P. 26-28.
4. Mokrushina O. G. Restoration of functions of esophagus after the application of esophageal anastomosis in newborns. Dissertation of the candidate of medical sciences. - Moscow, 2003. - P. 13.
5. Chittmittrapap S., Spitz L., Kielt E. M.//J. Pediatr. Surg. - 1990. - Vol. 25. - P. 508-511.
Yuldashev Sanjar Keldiyarovich, Republican specialized scientific-practice medical centre of obstetrics and gynecology, Uzbekistan, junior scientific employee
E-mail: yuldashev_s@inbox.ru
Minimum closure of myomatous nodule floor as the sparing method, reducing surgical traumas at conservative myomectomy
Abstract: In purpose on to studying of infuence of operative techniques of conservative method of myomectomy at women of reproductive age on a cytokine state of blood profile in aspect of reduction of intraoperation surgical trauma of the tissue there have been made conservative myomectomy (CME) by laparatomy at 46 women with a uterine myoma on developed by
us technique. Efciency of a technique on the 3rd and 5th days of the postoperative period estimated with definition in dynamics of Interleukin 1, 6 and TNF-a level in blood. For 3rd days after the operational period in group ofwomen with which it has been made conservative myomectomy by a traditional method marked authentically sharp increases in level of maintenance of IL-1; IL -6 and TNF. Results showed high efficiency of new technique CME in comparison with a traditional method in preservation of reproductive to function of women.
Keywords: uterus myoma, conservative myomectomia, cytokine, interleukin, surgical trauma.
Introduction
Studying of results of surgical treatment shows, that the current of the postoperative period is in many respects connected as with volume of surgical intervention in a abdominal cavity, and with localisation and the sizes of an operational wound [3; 4]. In reply to any damage, whether it be the trauma, surgical operation, an infection, etc., in an organism develops a complex of the physiological reactions directed on localisation of the centre of damage and restoration of disturbed functions [1; 2; 3; 5].
This difficult process, directed on preservation of a homeostasis, is known as an infammation, and a complex local and system changes, originating after damage, makes concept of an acute phase of an inflammation. Cytokines play basic role in realization of the inflammatory answer to the surgical trauma. Cytokine production reflects a traumatizing of surgical intervention. Te strengthened synthesis of cytokines begins in reply to penetration into organism a microorganisms or damage of fabrics. After extensive surgical interventions a cytokine concentration reaches a maximum by 24 o'clock and remains increased throughout 48-72 hours of the postoperative period.
Last years, because of development of methods of quantitative definition of levels of cytokines production, it has been reached considerable progress on understanding of the role of some cytokines in norm and in pathology [2; 4]. Te high level of studied cytokines testifies to development of a local and general inflammation. So, IL-1 in consequence of the ability to increase of body temperature it is established as endogen pirogene. Te tumor necrosis factor-a (TNF-a) stimulates a local inflammation, and in system — causes a syndrome of a septic shock, activates and damages cells, operating on cells of hypothalamus, causes a fever, secretion of IL-1, IL-6, fibers of acute phase [2; 3; 5]. At studying of results of operative interventions it is necessary to note the traumatizing factor or "surgical stress".
It is known, that blood cytokine level reflect a current condition of work of immune system and development of protective reactions, gravity of inflammatory process and its transition to system level. Cytokine production reflects on traumatizing of surgical intervention [1; 2; 4].
Research objective
An estimation influence minimum closuring of myomatous nodule floor at performance conservative myomectomy at women of active reproductive age on a condition a blood cytokine profile in aspect of reduction of a surgical trauma of the tissue.
Material and methods
Research and treatment was conducted in department of operative gynecology of the Republican specialised scientific-practical medical centre of obstetrics and gynecology (RSSPMC O&G), Tashkent. In total there have operated 66 women at the reproductive age, suffering with uterine myoma ofvarious localisation and the sizes. All patients have been divided on two groups depending on a technique of performed CME method. The group I was made by 46 patients, whom it has been performed CME by the technique which developed by us; and group II (comparision group) included 20 women at whom CME was made by a traditional method. The age of patients varied from 20 up to 42 years (in average 33.51 ± 2.4 years) in both groups.
Estimation of efficacy of developed ME technique was spent followingly.
Prior to and after operation in dynamics: estimated blood pro inflammatory cytokine levels. Research the maintenance of in-terleykin-1 (IL-1), interleykin-6 (IL-6), The tumor necrosis factor (TNF-a) in blood plasma of women determined by immune enzyme analyzing on commercial test systems of firm "Vector-best" by means ofIFA analyzer "Anthos-2010" (Austria) in dynamics before operation and on the 3rd, 5th days of the postoperative period.
On the early postoperative period: in dynamics observed of a body temperature, visually estimated healing of a postoperative wound, and also by dopplerometry on the 5th day after operation estimated a postoperative hem condition on a uterus.
In 3 months after operation estimated a psychosomatic condition and also character менструальной functions of women by the conducting a questioning.
Results and discussion
All women from clinical group during performing a CME were applied the surgical technique developed by us which consisted in the following. Laparotomy was carried out by the method John Koel, after, we have tied up a 3 pair of uterine arteries, and myomatous uterine was carried out into the wound are by hands defined the location and the size of intramural myomatous nodule. Depending on localization of nodules the cut of a serous cover and its capsule was made slit, transverse or oblique. Enucleating of myomatous nodule were performed preferentially by blunt way. Then have imposed a suture on a nodule floor bottom, using synthetic resolving suture material — vicril, legate, the short end of ligature deduced in the middle outside, and with another longer end made concentric closure of lateral walls of the nodule floor by legating after each tour. And amount of tours depended on size of nodule and its depth of penetration. Last tour closure was made subserous without an exit into abdominal cavity. The ends of ligature were knuckling and immersed in a nodule floor cavity. Thus, there will achieved a maximum tightening of walls of nodule floor, both in horizontal, and in a vertical direction which allows in further to formation of valuable hem. It promotes more high-grade preservation of reproductive function. Absence of legate on the surface of uterine will reduces probability of development of adhesive process in the abdominal cavity.
As a result of the carried out researches it is established some features of change of cytokine status in blood plasma in women with uterine myoma, depending on a performed method of CME. Preoperative initial levels of IL-1 in both groups essentially did not differ among themselves and have made 1.84 pg/ml in the basic group and 1.48 pg/ml in comparison group (p > 0.05). On the 3ld days after operation there has been noted sharp increase of maintenance of IL-1 up to 135.74 pg/ml in comparison group, that on 90 times exceeded its initial level. In the main group a maintenance of IL-1 essentially has not changed and has made 1.98 pg/ml. On the 5th day of postoperative period a level of IL-1 in main group has decreased nearer to its initial level though in group of comparison with its initial level did not reach initial sizes. Although, IL-1 is endogen piro-gen, owing to the ability to increase of body temperature, we can
explain temperature reaction at 16 patients in group II. In the group I subfebrile temperature was registered only in 3 patients.
Results of research of IL-6 levels at women in compared groups were given by following data. In patients from comparison group the level of IL-6 has made — 6.15 pg/ml, in main group patients — 4.88 pg/ml, and significant distinctions between them is not revealed. However, on the 3rd day at the postoperative period in women who have being performed CME by traditional method the level of IL — 6 has made the maximum value — 585.11 pg/ml against 5.46 pg/ml in main group. And in comparison with its preoperative level (p < 0.001), on the 5th day we observed decreasing in level of IL-6 to 7.94 pg/ml in comparison group, that came nearer to data before operation on 2 times exceeded similar indicators of the main group which by the end of 5th day have made — 3.82 pg/ml in comparison with its initial data.
As a received result from the analysis of the condition of TNF-a observed a similar pattern of change of its maintenance in dynamics on the postoperative period (table 1). So, on the 3rd day after performing of CME by a traditional method the level of TNF-a has made 27.59 pg/ml, that on 11 times has exceeded than its initial level (before operation) — 2.3 pg/ml and (P < 0.005), on the 5th days it has made — 2.99 pg/ml, coming nearer to its initial data. In the main group at all investigation phases the level of TNF-a was stable and made: 2.05 pg/ml before operation, 2.29 pg/ml — on the 3 days and 1.93 pg/ml on the 5th day accordingly.
Analyzing the received data as a result of our research, we marked authentically sharp increases in level of maintenance of IL-1, IL-6 and TNF-a on the 3rd day after operation period in group of women which has been made CME by traditional method.
It is known, that IL-1, IL-6 and TFN-a are proinflammatory cytokines, so any damages or the microbic agent are named as «mediators» of local inflammatory reaction and acute phase answer of an organism. In a sharp phase of an inflammation at the expense of tissue damage to occur activation of macrophages which synthesize a
cytokines, thereof to what there will occur a changes of vascular endothelium, leading to increase in its permeability, expression increase adhesive molecules and infringements in coagulation system ofblood.
Thus there is occurring an release of an inflammation mediators, such as histamine, glandins and other, responsible for developments of inflammatory reaction. And it in turn, promotes on stasis ofblood in capillaries, venule, leading to strengthening of pre-coagulation link and development of edema [1; 3; 4].
Hyperproduction ofcytokines — IL-1, IL-6, TNF-a at women in comparison group is explained by longer and extensive surgical interventions at performing a CME by traditional method. It is unfavorable factor of the postoperative period causing early postoperative complications (pain syndrome, early temperature reaction, tissue swelling).
Summarising the above-stated, it is possible to conclude, that during operative interventions it is necessary to consider so-called «surgical stress», i. e., the factor of traumatizing, which its degree depends on the level of maintenance of pro-inflammatory cytokines (IL-1, IL-6, TNF-a) in blood.
Analysis of body temperature reaction of patients on the postoperative period had received sensible data that at women which have been performed intra operation bandaging of 3 pairs uterine arteries and the developed method of closure of myomatous nodule floor, the temperature curve was limited from 36.6 up till 36.7 °C. On the contrary, in group II, which has been performed CME by a traditional method, already on the 1st days after operation there have been registered increasing ofbody temperature up to 37.2 °C. And it has been held at such level till on 4th days of the postoperative period. An increasing of body temperature after operation testifies to inflammatory reaction of organism to the operational trauma and on foreign bodies (suture materials). Than more stitching on an operational wound in the area of myomatous nodule floor and uterine, there is increased probability of inflammatory reaction of an organism. Body rise in temperature is caused with local inflammatory process; therefore its level remains in limits 37 °C.
Table 1. - Pre-inflammatory cytokines in dynamics prior to and on the 3rd, 5th days after conservative myomectomy (M ± m)
Parameters Prior to operation On the 3rd day after operation On the 5th day after operation
Group I (n = 46)
IL-1 1.84 ± 0.21 1.98 ± 0.03 1.53 ± 0.32
IL-6 4.87 ± 0.24 5.45 ± 0.39 3.8 ± 0.39
TNF-a 2.046 ± 0.63 2.29 ± 0.54 1.93 ± 0.36
Group II (n = 20)
IL-1 1.48 ± 0.25 135.74 ± 0.31* 2.08 ± 0.25
IL-6 6.1 ± 0.24 585.11 ± 0.30** 7.94 ± 0.34
TNF-a 2.3 ± 0.31 27.59 ± 0.29* 2.99 ± 0.36
Note: * — statistical authentic in comparison with its initial level onp > 0.05; **—statistical authentic in comparison with its initial level onp > 0.01
Fig. 1. Results of estimating of the body temperature (in Celcius) in dynamics prior to and after CME
As a proving, it is possible to result, for example, acute increasing of speed of erythrocyte sedimentation (SES) on the postoperative period. Acknowledgement of it, it is necessary to notice, that in patients from control group on the postoperative period synchronously with increasing of body temperature there is observed also acute lifting of speed of erythrocyte sedimentation on 60 % from its initial level, and in comparison with the group I it was in 2.5 times more.
Dopplerometry of uterine vessels, which carried out on the postoperative period, allowed to estimate of changes of blood flow in the blood stream of uterine arteries as after intra operative binding of three couples of major vessels and without it (table 2).
The received results attest that in the 1st group the course of the first days was defined by the unstable blood flow with a negative diastolic component that was indicative of incremental
recovery of blood flow in uterus vessels, however carrying out measurements of indicators of SCBF was complicated. In the 2nd group was defined the positive diastolic component of blood flow, and RI made 0.89 ± 0.06. From the second day of the postoperative period at women of the group II the full-fledged blood flow in vessels was visualized, it authentically decreased that was indicative ofincremental recovery ofblood flow in uterus vessels (see table 1). On the 4th day the difference in indicators of speed curve of blood flow at patients of both groups was registered, but thus at women of the group I the positive dynamics and normalization of blood flow remained. The analysis of condition of blood flow on the 6th day of the postoperative period according to a dopplerometry also revealed almost complete recovery and its improvement in arteries of uterus at patients of the group I: the studied parameters came nearer to that of the patients of the group II.
Table 2. - Indicators of dopplerometry of vessels of the uterus in the postoperative period depending on deligation of the major vessels on the 2nd, 4th and 6th days after conservative myomectomy (M ± m)
Group Postoperative period, Day PI RI SDO
Group I 2 - - -
4 3.71 ± 0.19 0.93 ± 0.12 13.3 ± 0.31
6 2.44 ± 0.11 0.83 ± 0.09 5.9 ± 0.29
Group II 2 2.35 ± 0.17 0.89 ± 0.06 9.0 ± 0.27
4 2.29 ± 0.09 0.85 ± 0.06 6.6 ± 0.39
6 1.89 ± 0.11 0.81 ± 0.07 5.3 ± 0.21
Note: * — P < 0.05 in comparison with women of the group II
Estimation of postoperative hem condition on a uterus for 5th days after operation by the ultrasound research have found out an anechogene zone in the field of the hem, and the expressed vascular pattern, and postoperative hem length did not exceed up to 0.8 sm. in women from group I. Whereas in patients from group II the size of hem has made from 1 up to 3 sm.
According to the questioning which was carried out in a 3 months after operation, there were determined no neurologic violations at the operated women of group I. And menstrual function at them was restored from the second month.
In patients from the group I on the postoperative period there were not observed of an intestinal motility disturbances as it has been occurred in some patients from control group.
Main objective of the method of conservative myomectomy is preservation of reproductive organ, and also recovery of reproductive function. For decades of use of this method the cases of successful carrying out operation in the presence of several tens myomatous nodules are recorded. Thus, technical capability of performance of conservative myomectomy exists at most of patients with uterus fibroid, but much also depend on readiness of the surgeon and expediency of carrying out such an operation in modern conditions. When the issue of need of carrying out conservative myomectomy at the women planning pregnancy is resolved it is very important to define accurately the ratio of advantage and risk of surgical intervention. Removal of myomatous nodules, though recovers integrity and functionality of body, is at the same time interfaced to known complications and consequences for reproductive system. The main complication in modern conditions of surgery is adhesive process, which can become the reason for infertility [2; 5]. Attempt of removal of a large number of lumps can also be inexpedient as a set of stiches on uterus can render on the subsequent realization of reproductive function more negative effect than the removed lumps. Besides, when putting a stich on the floor after removal of myomatous nodule,
owing to damage of trophism of tissues, the local site of damage is formed, therefore in the area of the stich fibrin deposits, that further leads to formation of adhesion of parts [3; 5; 6; 8]. Thus, selective binding of uterine arteries with use of dissolving material during surgery creates optimum conditions for the surgeon, promotes reduction of the extend of intra operative blood loss, shortening of time of operation and, above all, eliminates some reasons complicating operational technique during operation. At the same time early recovery of blood circulation in the area of the scar on uterus provides its fast healing, and the minimum sealing of the bed prevents formation of rough scars on uterus, therefore, prevents formation of adhesion of parts in the field of the scar.
Conclusions
1. On time intraoperative binding of three couples ofmajor vessels of uterus with use of catgut suture to conservative myomectomy promotes decrease in the extend of intra- and postoperative blood loss, temporary stop of blood flow in this course of blood circulation and is an effective prevention of postoperative complications.
2. The offered new technic of closuring of myomatous nodule floor allows to hold muscular tissue in reposition condition, without ishemization of the stitched and adjacent areas, and the absence of stiches on external surface of uterus reduces the risk of development of adhesive process. The blood flow in uterus vessels after intraoperative binding of three couples of major vessels gradually recovers from the second day of the postoperative period, the complete recovery of blood flow comes by the 6th days.
3. Thus, it is possible to conclude, that the new method of CME applied by us is less traumatic, which not causing a «surgical stress», that it is proved by not changeable levels of the maintenance of markers of a condition of work of immune system and development of protective reactions — pro-inflammatory cytokines IL-1, IL-6 and TNF-a in women from main group. Hence, our results showed high efficiency of new technique CME in comparison with a traditional method in preservation of reproductive to function of women.
Patches characteristics
References:
1. Vlasova G. V, Egorov L. V., Kotov A. J., etc. Pre-inflammatory cytokines//Cytokines and an inflammation. - 2005. - 4: 39-44.
2. Demjanov A. V., Kotov A. J., Simbirsev A. S. Diagnostic value of research of cytokine levels in clinical practice//Cytokines and inflammation. - 2005. - T.2, № 3. - P. 20-35.
3. Karobekova D. A., Rahmatulloeva S. H., Safarov Ch. B. Surgical treatment of patients with a uterus myoma//Bulletin Avisenni. -2014. - № 2(59). - P. 79-83.
4. Luneva S. N., Popova A. H., Tkachuk E. A. Biochemical indicators in an estimation of efficiency of treatment of a myoma of a uter-us//Basic researches. - 2013. - № 9. - P. 847-851.
5. Pekarev O. G, Majborodin I. V., Pekareva E. O. Experience spontaneous delivery at women with a scare on a uterus after myomec-tomy//Obstetrics and gynecology. - 2012. - № 5. - P. 88-92.
Yuldashev Akram Yu.,
Akhmedova Dilshoda R., Research Institute of Epidemiology, Microbiology and Infectious Diseases, Ministry of Health of the Republic of Uzbekistan, Tashkent E-mail: saodat.us@mail.ru
Patches characteristics
Abstract: based on the analysis Labeled Nuclei Index (LNI) after two-fold injections 3H-T should be noted it is also nonuniform growth and decrease in various structural-functional zones of lymph nodules (LN) of Payer's patch. On the one part, it reflects the constant and irregular migration of T- and B-lymphoid cells from blood into the area. On the other hand, heter-ochronous changes of LNI in T- and B-dependent and mixed areas of lymphoid nodules should be considered as a measure of the optimum adaptation of the small intestine by reacting of mucous membrane's immune system (MMIS) afferent and efferent units, peripheral and central parts of the immune system in the regulation of immune homeostasis.
Keywords: of mucous membrane's immune system, Labeled Nuclei Index, lymph nodules, Payer's patch, immune regulation is an urgent and fundamental clinical problem
Introduction
The mucous membrane of the small intestine along with the implementation of the digestive-absorptive function also performs endocrine, immune and other functions. Due to the complex mechanisms of integration of the epithelium, the afferent and efferent parts of the mucous membrane of the digestive tract immune system provides perfect processes of digestion and absorption, the homeostasis of the internal environment, despite the unpredictability of the quality and quantity of food, microorganisms in their structure. One of the components of this complex mechanism of regulation ofhomeostasis are the structure and function of single or grouped lymph nodules (LN) and Payer's patches (PP), the spacetime organization proliferation, integration and adaptation of its structural-functional zones and epithelium. As is generally known in the crypt system studied in detail such processes as proliferation and differentiation of intestinal mucosa, extrusion operation (death) of the epithelium at different endoecology, dietary habits and exposure to adverse factors [5; 6]. However, the role and importance of the epithelium, the individual structural functional areas LN and PP, their concern and significance between themselves and circulating blood, blood-forming organs, involved in immune regulation is an urgent and fundamental clinical problem, the subject of attention of studies in recent years [1; 2; 4; 7; 9; 10].
Purpose of the study
To explore the features of the epithelial proliferation and migration and structural-functional zones of lymphatic nodules Payer's patch on the basis of the dynamics of the Labeled Nuclei Index (LNI) after multiple injections of labeled DNA precursor of thymidine (3H-T).
Material and methods
Outbred white-male rats weighing 120-140 g. have been made intra-abdominal introduction of 3H-T (Ci/kg) with 6 hours intervals: one-fold (I group), two-fold (II group) and threefold (III group). Between multiple injections of 3H-T is less than the length of the synthetic (S) period of the mitotic cycle of proliferating cells of hematopoietic organs and LN of PP. This allows you to explore the relationship between the pool of proliferating cells in a variety of structural and functional areas LN. Removing animals from the experiment carried out under Nembutal anesthesia and in compliance with the European Convention for the Protection of Animals used in research and development (1984): after 1, 2, 3, 7 and 24 hours (I group); in 1, 2, 3 and 24 hours (II, III groups.). Pieces of tissue PP irom the middle jejunum after fixation in Carnua's fluid. Oriented sections of 5-6 mm. thickness, obtained through the middle LN of PP and longitudinally in the crypt-villus system after dewaxing covered with fine-grained photographic emulsion type M. The exposure time was 20-22 days. After development, the emulsion and fixing the obtained marks above the body-core sections stained with hematoxylin Karachi. After dehydration, enlightenment and conclusion sections of crypts surrounding PP in each structural and functional area LN of PP (germinal (embryonic) center, follicular, pair-follicular zone and dome) separately, the dynamics of the experiment was determined LNI (0/00; ratio oflabeled and unlabeled nuclei of epithelial and lymphoid cells by 1000 their total number). Statistical analysis of the results of the LNI count was carried out according to Statistics 2008 program.
Results
After a one-fold injection of 3H-T in 1 hour there were the lowest LNI lymphoid cells in the follicular area LN. In comparison, the
