CC BY
25
References:
1. Akhmadalieva N. O., Ponomareva L. A., Safarov M. B. Increase of body protective properties on the basis of use of natural food additives and flavouring substances. XII Internaional Congress on rehabilitation in medicine and immunorehabilitation. - Pattay, Thailand, 2007. - P. 340.
2. Kadirova D. E., Mirzakarimova M.A. Inhalation effect of tobacco dust on the body of laboratory animals and its correction. Pharma-cevticheskiy jurnal. - Tashkent, 2012. - № 3. - P. 75-78.
3. Kasimov A.Kh. et al. Antioxidant efficiency of phytopreparation hepamal at toxic effect of combinations of metals- pollutants of the Ambient area. Toxikologixheckiy vestnik. - Moscow, 2008, N4: P. 17-21.
4. Katcnelson B. A., Degtareva T. D., Orivalova L. I. Principles ofbiological prophylaxis of the occupational and ecological pathology due to effect of inorganic substances. Yekaterinburg: ЕМНЦП and ОЗРПП, 1999. - 106 p.
5. Korovkin B. F., Debov S. S. Clinical enzymology: problems and ways of development. 5-th All-Union Biochemical Congress: The theses of reports. - M.: Nauka, 1985. - Vol. 1. - P. 78-79.
6. Kulbalieva J. J. The state of integral coefficient SROL-AOS in blood at lead intoxication under effect of biophenikol. Бю(^зичш стандарти that шформацшш технологи in медицин^ Матер. конф. - Odessa, 2007. - P. 72-76.
7. Mirzakarimova M. A. Changes of biochemical parameters in rats at chronic intoxication with ammonium and their correction. Actual problems of hygienic science in Uzbekistan: Proceedings, - Tashkent.2010, P. - With. 71-76.
8. Khamrakulova M. A. Correcting effect of the dogrose fruits on the state of carbohydrate-energetic metabolism in chronic intoxication, induced by combined effect ofvarious pesticides. Actual questions of clinical and experimental medicine. - Minsk, 2000. P. 305-306.
9. Khamrakulova M. A. Effect of biological active substances on the toxicity of pesticide ciperfos. Problems of hygiene and toxicology in Uzbekistan: Material of research-practical conference. - Tashkent, 2009. P. 81-84.
Akhmedov Ulugbek Bahodirovich, DMD, Republican Specialized Center of Surgery named after academician V. Vakhidov Chief researcher of coronary surgery department E-mail: makesha@mail.ru Murtazaev Saidorifkhon Saidaloevich, Ph. D., Republican Specialized Center of Surgery named after academician V. Vakhidov Head of coronary surgery department E-mail: mss197402@rambler.ru Baybekov Iskander Mukhamedovich, DMD, Professor Republican Specialized Center of Surgery named after academician V. Vakhidov Head of pathological anatomy department E-mail: baybekov@mail.ru Mirzaakhmedov Sohib Djamaliddinovich, DMD, Republican Specialized Center of Surgery named after academician V. Vakhidov Master Department of Thoracic Surgery department E-mail: drsokhib@mail.com
Structural features of the radial artery at the different ways in their harvesting for use in coronary artery bypass
Abstract: According to the study of muscular type artery, radial artery has all inherent in this type of vessel shell. In their different ways of allocating the radial artery revealed that the structural safety of the shells of the radial artery, especially the inner lining depends on the method of their selection."Skeletonization" leads to disruption of the integrity of the inner shell, especially its endothelial layer, which is the most vulnerable. Deendotelizatsiya inner shell can promote thrombus formation in the graft.
Keywords: radial artery, bypass, skeletonization.
The leading factor in the development of various complica- High prospects noted and in use for coronary artery bypass
tions in graft is a morphological discrepancy of graft's (vein) wall surgery radiotherapy. This is due to its sufficient length and diam-and artery in anastomosis area Ham, Cormac [3]; Rosws [6]. This eter Vechersky Yu.Yu. et al [1]; Shneider et al. 2004; Laco et al 2001; led to intensive development and active implementation in practice Tatoulis et all [8]; Wilson et all [10]. In turn, the active use of the of coronary surgery techniques total autoarterial bypass. Choices for radial artery has caused the need to study its morphological features these operations was the internal thoracic artery. Machur S. E. et al [2]; Wildhirt et all [10].
Structural features of the radial artery at the different ways in their harvesting for use in coronary artery bypass
Of particular interest is the comparative morphological analysis of the radial artery walls with different methods of harvesting.
The most appropriate way to harvesting, preserving the intact-ness of the major structural components of the arterial wall and, primarily, the intima, provides full value functional of transplant. It largely determines the success of the operation autoarterial bypass. Research, how harvesting ways influence on the morphology of radial artery walls, especially the intima, was not conducted. Not studied the three-dimensional organization of the arterial wall by using a scanning electron microscope.
Noted above, to define the tasks in this section work:
Post a structural characteristic of radial artery wall at its harvesting without skeletonization. To determine the effect of skeletization on the radial artery wall structure.
Materials and methods
For light microscopy, tissue samples were fixed in 10% formalin solution for the phosphate buffer. Paraffin sections were stained with hematoxylin and eosin. Light optical microscope micrographs obtained on Axioscop 40 — ZEISS »conjugate with a digital camera,
For electron microscopy scanning, tissue was fixed by 2.5% glu-taraldehyde solution, with osmium tetroxide on phosphate buffer, dehydrated in alcohol, acetone, and dried by the method critical point in the device HCP-2, gold was sputtered in the apparatus IB -2 and viewed in an electron microscope Hitachi — S 405. Photographed from Monitor screen with a digital camera Canon.
Own research
The walls of the muscular type arteries (the radial artery) three different shell defined. The inner shell — intima which from internal side is covered by endothelial cells.
This is the most specific cells throughout the vascular system, forming it a continuous layer from cavities of the heart to the capil-
Figure 1. Skins radial artery walls with severe internal elastic membrane. G. -EYU x10
Figure 3. Skins radial artery with severe internal elastical membrane. G. -EYU x 10
laries and veins of all sizes up the vena cava. In some types of capillary endothelium is a single layer of wall forming.
Outside the endothelial layer is bordered by a pronounced plate elastin called the internal elastic membrane, which is part of the inner shell of the artery. In light optical preparations it is defined as a corrugated ring-shaped structure (Fig. 1.2)
The endothelium can be located directly on the internal elastic membrane and to separate it from a layer of fibroblasts, intracellular material, separate smooth muscle cells and isolated connective tissue fibers (Fig. 2).
The basis of the middle shell wall of the radial artery is smooth muscle cells make up, which are arranged helically (Figure 2). Between the smooth muscle myocytes has intercellular substance produced by the myocytes. The boundary between the outer shell is the external elastic membrane. It is in the wall of the radial artery is not expressed as clearly as the internal elastic membrane (Fig. 2).
Scanning electron microscopy shows expressed longitudinal folds of intima. The formed rolls are covered by endothelium, which forms a smooth surface (Fig. 3).
The inner shell is formed by smooth muscle cells, and intertwining with connective tissue fibers.
The outer shell has a large thickness, it turn in circumjacent connective tissue (Fig. 3).
Substantial structural changes in the walls of the radial artery is identified at various ways of their allocation.
When "skeletonization" of the vessel, there are significant changes in the intima as a violation of the integrity of the epithelial layer (Fig. 10). Desquamating of endothelial cells of internal elastic membrane, exposing it. The place has been a violation of the integrity and the membrane itself. "Bare" internal elastic membrane can take place at a considerable her over (Fig. 4).
Figure 2. The inner shell and the average radial artery with severe internal elastic membrane. D-E x 10 40
Figure 4. Skins radial artery developed severe outer shell with vasa vasorum and lymphatic capillaries. D -E 10 x 10
Figure 5. Skins radial artery developed severe outdoor shell with vasa vasorum and lymphatic capillaries. D — E 10 x 10
When you select the radial artery while preserving the outer shell and its contacts with the surrounding connective tissue, the integrity of the intima and its contact with the inner elastic membrane saved (Fig. 5).
When "skeletonization" has been performed, observed sharp hyperemia of vasa vasorum in the remaining parts of the outer shell (Fig. 6). And in the lumen of blood vessels, usually dominated by pathological forms of red blood cells.
Scanning electron microscopy also shows that "Skeletonization" leads to significant violations of the integrity of the inner shell
Figure 6. Severe intimal folds developed middle and outer shell. SEM x 100.
(Fig. 7), as well as to a breach of contact of the outer shell with the average. On the inner damaged surface marked accumulation oflipid granules and erythrocytes (Fig. 8). In some places there is a marked desquamation of the endothelial lining.
Deendothelized of part expose the internal elastic membrane. In the nude areas seen that the inner elastic membrane is composed their dense network of thin interwoven fibers (Fig. 9).
On the surface often located deendothelized lipid granules of different size, and homogeneous masses of erythrocytes (Fig. 9). Along with thin fibrils intertwined meet their larger bundles (Fig. 10).
Figure 7. Severe intimal folds developed middle and outer shell. SEM x 100.
Figure 9. Severe intimal folds developed middle and outer shell. SEM x 100.
In cardiovascular surgery for coronary artery bypass grafting on to the most wide used autovenous shunts. However, venous shunts do not always ensure the stability of the late results of coronary artery bypass surgery. An alternative to venous conduits
Figure 8. Severe intimal folds developed middle and outer shell. SEM x 100.
Figure 10. Defects in the intima. "Skeletonization" radial artery at its harvesting. T-E 10 x 10.
autoarterial are jesters. The most commonly used autoarterial conduit for coronary artery bypass surgery are internal thoracic and radial arteries. The latter has become the object of choice for such operations by the structure of the vascular wall, the lumen di-
Efficiency in phytotherapy endogenous intoxication syndrome in pregnant women with infectious risk
ameter, comparable with the coronary arteries, a sufficient length and resistance to pressure, the relative ease of isolation, a good postoperative results [1].
Studies have shown that as the muscular artery, radial artery has all inherent in this type ofvessel shell. Since the coronary arteries, also referred to as the arteries of muscular type Ham, Koprmak [3], Ross [7] morphologically justified the use of the radial artery for coronary artery bypass grafting. Besides these basic morphometric parameters coincide vessels Mamchur S. E., et al [2].
Comparative studies of the radial artery at various ways of their allocation showed that the structural safety of the shells of the radial artery, especially the inner lining depends on the method of their selection.
"Skeletonization" leads to disruption of the integrity of the inner shell, it is especially the endothelial layer, which is the most vulnerable. Deendothelization of inner shell can promote thrombus formation in the graft.
References:
1. Vechersky Y. Y., Dndreev S. L., Zatolokin V. V., comparative study ofthe functioning ofvarious autoarterial and venous grafts according shuntography after isolated GABG. Siberian Medical Journal (Tomsk). - 2010. - № 4, no. 1. - S. 43-49.
2. Mamchur S. E., Vechersky Y. Y., Mikhail Fadeev. The morphology of the internal thoracic and radial arteries in patients undergoing coronary artery bypass grafting//Bul. Sib. medicin. - 2004. - № 2. - S. 85-89.
3. Ham A., Cormac D. Gtistologiya. Cardiovascular system. - 1983. 4 P. 6-48.
4. Schneider J. A., Tolkachev V. V., Jorin S. P. Revascularization by using the radial artery//Herald surgery. - 2004. P. 14-18.
5. Iaco A. L., Teodori G., Di Giammarco G. Radial artery for myocardial revascularization: long-term clinical and angiographic re-sults//Ann. Thorac. Surg. - 2001. - Vol. 72. - P. 464-468.
6. Rosai J. Ackerman's surgical Pathology 9th ed. V. n, Cardio vascular system. 2003. - P. 2173-2226.
7. Ross M. H., Romrell L. J., Kaye G. I., Histology a text and atlas. Cardiovascular system 4-th ed., - 2003, - M.1. P. 302 - 329; 438.
8. Tatoulis J., Buxton B., Fuller J. Patencies of 2127 arterial to coronary conduits over 15 years//Ann. Thorac. Surg. - 2004. - Vol. 77. -P. 87-92.
9. Wildhirt S. M., Voss B., Von Canal F. et al. Graft function, histopathology and morphometry of radial arteries used as conduits for myocardial revascularization in patients beyond age 70//Eur. J. Cardio-thoracic Surg. - 2006. - Vol. 30. - P. 333-340.
10. Wilson J. M., Ferguson J. J., Hall R.J. Coronary artery bypass surgery and percutaneous coronary revascularization: impact on morbidity and mortality in patients with coronary artery disease//Cardiovascular Medicine. - NY: Springer, 2007. - P. 1073-1112.
Rabbimova Gulnora, Samarkand State Medical Institute, assistant department of obstetrics and gynecology E-mail: gulnora_1968_r@mail.ru
Efficiency in phytotherapy endogenous intoxication syndrome in pregnant women with infectious risk
Abstract: To evaluate the dynamics of changes of lipid peroxidation (LPO) and antioxidant activity in the peripheral blood, the level of endogenous intoxication in pregnant women with infectious risk in depending on the reception phytocombination. To study the parameters of endogenous intoxication are a predictor of condition assessment and the course of pregnancy in infection risk. The inclusion of herbal tea in a comprehensive prevention and treatment promotes faster the removal of endogenous intoxication of 96.4% and a decrease in complications by 82.1% in pregnant women with infectious risk.
Keywords: phytocombination, pregnant women, infectious risk.
Prevention and treatment of infectious complications of the urogenital tract in pregnant women remains an urgent problem researchers in the basic sciences and clinical doctors ofvarious specialties [2; 6]. Despite significant advances in diagnosis and treatment ofurogenital infections, their frequency has a strong tendency to increase, presenting a danger, both for the mother and fetus [1; 5]. In recent decades, a steady trend worldwide increasing incidence of infections transmitted mainly through sexual contact, the dominance of surgical abortion method ofproduction, the growth of extragenital infection focal diseases of inflammatory etiology that reduce the body's immunoresistance and irrational use of antimicrobial agents contributed to a significant increase in the prevalence of infectious diseases and dysbiotic genitalia in the female population [1; 3].
One notable vectors medicine of the 21st century is no medicaliza-tion treatment process, avoiding polypharmacy in general and on the
prevalence of synthetic substances in the therapeutic arsenal of doctors all specialties. Deciphering the human genome has given significant reason for denying a large part (80%) "is traditionally appointed by" drugs, as irrefutable evidence of their inefficiency were obtained [5]. Given the increasing antibiotic resistance, increasingly attempts to move away from the use of antibiotics, even in cases of non-severe forms of lower urinary tract infection [4; 5]. Rational use of the algorithm of medical possibilities formulated Hippocrates: "For a man of healing, there are three things: first — floor, second — the grass, the third — the knife" [5; 7]. Studies demonstrating non-ideal treatment by synthetic means in comparison with the quite effective and quite safe herbal remedies, once again confirms that it is not necessary to "reinvent the wheel" if nature has created all the necessary [4; 5].
In recent years, an important role in the pathogenesis of many infectious complications during pregnancy given to system-
