The role of adrenal glands in the mechanisms of stress effects on pathogenesis of complications in acute small bowel obstruction (review)
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01.05.2018 |
Milyukov V.
Bogdanov A.
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Novosti Khirurgii |
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© 2018 Vitebsk State Medical University. All rights reserved. The aim of this review is a detailed description of the alleged mechanisms of involving the adrenal glands, as a key element of the system of nonspecific protection of an organism and adaptation to stress, in the pathogenesis of clinical manifestations of acute small bowel obstruction and developing complications, including peritonitis, sepsis and multiple organ failure. In the discussion of the pathogenesis of clinical manifestations of acute small bowel obstruction and its complications, leading to the disappointing results of treatment of patients on a large sample of contemporary scientific publications, it is noted that many researchers see a close connection between the influence of various stress effects on humans and the functioning of internal organs and systems. It is demonstrated that in the literature there is growing evidence of the negative effects of stress and related affective disorders on the course of inflammatory bowel diseases and gastrointestinal tract, which is one of the targets of stress, and hormones of the hypothalamicpituitary- adrenal system, especially the adrenal glands take an active part in the mediation of these reactions. The conducted analysis of the current literature demonstrates a large number of unsolved issues in this direction, that proves the need for a comprehensive experimental and morphological studies to clarify and detail all pathogenetic links of dependent morpho-functional transformations in the dynamics of development of acute small bowel obstruction which may lead to adrenal insufficiency and disruption of adaptation mechanisms that maintain the stability of homeostasis.
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Ultrastructural and morphofunctional changes in the mitochondrial apparatus of hepatocytes in experimental diffuse purulent peritonitis
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01.01.2018 |
Yarotskaya N.
Gostishev V.
Kosinets V.
Samsonova I.
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Novosti Khirurgii |
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© 2018 Vitebsk State Medical University. All rights reserved. Objective: To study the ultrastructural changes in the liver mitochondria in experimental diffuse purulent peritonitis against the background of the metabolic support. Methods: The morphometric evaluation of the rabbit liver mitochondria electron microscopic images (n=55) was performed in experimental diffuse purulent peritonitis. The obtained electron diffraction patterns were estimated using the ImageJ 1.45s program, in which the number of mitochondria sections, the number of intermithochondrial contacts and the number of damaged and intact mitochondria were counted. The average area, perimeter, and specific volume (measured in %) were calculated for the undamaged mitochondrial profiles. Metabolic agents with energotropic properties, phosphocreatine preparations containing creatine phosphate and preparations containing the succinic acid, niacinamide, inosine diphosphate and riboflavin were used. Results: Electron microscopic analysis of mitochondria of hepatocytes made it possible to reveal significant changes in their structure, caused by the development of purulent peritonitis. Morphometric evaluation of electron diffraction patterns showed changes in the quantitative and qualitative characteristics of mitochondria: the ratio of the damaged and intact mitochondria, their size, perimeter and specific volume of all groups. The use of metabolic support permitted to reduce the negative effect of purulent peritonitis in the postoperative period, which is exerted on the liver mitochondria, in comparison with the control group of animals that did not receive any metabolic support. Conducting a comparative analysis revealed a higher efficacy of the metabolic agent containing the succinic acid, niacinamide, inosine diphosphate and riboflavin, which resulted in more intensive restoration of the mitochondrial membrane structure. Conclusions: The development of purulent peritonitis is accompanied by a violation of the ultrastructural organization of the liver mitochondria in all studied groups. Metabolic correction allows restoring the membrane structure of mitochondria, and as the result improving the energy supply of cells to combat the negative consequences of endotoxicosis in peritonitis.
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