[CLINICAL AND PATHOLOGICAL ANALYSIS OF THE HYPOPLASTIC LEFT HEART SYNDROME IN ONE OF THE TWINS IN PREGNANCY WHICH OCCURRED USING IN VITRO FERTILIZATION. OWN OBSERVATION].

The article represents clinical and pathoanatomical analysis of a case of full-term pregnancy with hypoplastic left heart syndrome (HLHS) in one of the twins, which occurred using in vitro fertilization (IVF). The dead macerated fetus with malformations after selective feticide at the 20th week of pregnancy and dichorial diamniotic placenta were studied. In connection with the expressive autolytic changes in the internal organs of the fetus, which do not allow to confirm the diagnosis of left ventricular hypoplasia at autopsy and establish its type of structure, additional measurements of the heart structures of the fetus with HLHS on archived video materials of ultrasound diagnostics were performed. After calculating the diagnostic indices: the index of myocardial layer thickness (ratio of the thicknesses of the trabecular and compact myocardium), the index of cavity shape of the heart in frontal axis (ratio of width to cavity length), cavity-myocardial index (ratio of wall thickness to cavity width), the cylindrical LV structure was retrospectively determined, which is prognostically unfavorable any kind of surgical correction, which justified selective feticide. The article presents the values of diagnostic indices for identifying the types of structure of hypoplastic LV. Prenatal determination of LV type determines treatment tactics: terminate pregnancy in case of adverse LV types, recommend Norwood procedure in the neonatal period with type I or perform fetal aortic valvuloplasty with type II of LV. The maturation disorders (distal villous hypoplasia) that we found in the placenta of a living fetus confirms that, despite the relatively satisfactory condition of the newborn, pregnancies that occur with the use of IVF are high risk group of developmental disability both the fetus and placenta.

[HYPOPLASTIC LEFT HEART SYNDROME: MORPHOGENESIS OF PATOMORPHOLOGICAL TYPES OF THE LEFT VENTRICLE].

The purpose of the study was to investigate the morphogenesis of the left ventricle in the hypoplastic left heart syndrome (HLHS). There are five types of hypoplastic left ventricles were identified: with a slit-like shape and hypoplasia of LV wall, with a slit-like cavity shape and wall hypertrophy and types with endocardial fibroelastosis (with a cylindrical cavity shape, with lacunar cavities and lacunar-cylindrical cavity of the left ventricle), as a result of differences in the wall structure, cavity shape, presence or absence of endocardial fibroelastosis. The analysis of morphometric data of pathomorphological types of the left ventricle in the HLHS revealed the possible ways of their morphogenesis. Left displacement of interventricular septum in embryogenesis at 4-5 weeks of intrauterine development is associated with the occurrence of atresia of the left atrioventricular orifice and aortic valve and the appearance of a slit-like shape and hypoplasia of LV wall in the HLHS. The displacement of only the conotruncus septum leads to the appearance of a slit-like shape of cavity and hypertrophy of LV wall in the HLHS. The pathomorphological types with endocardial fibroelastosis in the HLHS depends on the stage of embryogenesis of myocardium at which fibroelastosis appears: before the myocardial compaction (up to 4th week of gestation) - the lacunar shape of LV cavity with thin compact layer of myocardium; during the compaction of myocardium (5-6th week of gestation) - the lacunar-cylindrical shape of LV cavity and after compaction (after 7-8th week of fetal development) - a cylindrical shape of LV cavity.

EFFECT OF ESTROGENS ON THE FLUORESCENCE INTENSITY OF CATECHOLAMINES IN THE LIMBIC-HYPOTHALAMIC STRUCTURES OF THE BRAIN.

In scientific works of recent years, there is much evidence that sex hormones are actively involved in the processes of neurogenesis, synaptogenesis. Electron microscopy data indicate the presence of membrane estrogen receptors in limbic-hypothalamic structures, which confirms the role of sex hormones in learning and memory processes. In the basis of neurochemical mechanisms of the development of cognitive disorders, in addition to the hormonal component, a leading role belongs to noradrenergic and serotonergic neurotransmission. The purpose of our study is to establish the effect of hypoestrogenia on the level of catecholamines of the limbic-hypothalamic system of the brain. The study was carried out on female rats. Animals were divided into three groups: false-operated, with eryniectomy, with no estrous cycles. Ovariectomy was performed according to the method of Ya.M. Kabak. The determination of monoamines was carried out by the Falk-Ovman method in the modification of A.Yu. Budantsev in the limbic-hypothalamic structures of the brain and expressed in conventional units. Statistically significant changes were considered for p <0.05. Ovariectomy caused a decrease in the level of catecholamines in the limbic-hypothalamic structures of the brain, but fluorescence rates were higher than in animals with aging. The age-related decrease in the fluorescence of catecholamines was observed in all the studied structures of the brain. In the nuclei of the hypothalamus and in the CA3 field of the hippocampus, there was a more significant decrease in the fluorescence level of catecholamines, which may indicate the presence of some desynchronoses.

[THE IMPLEMENTATION OF NAT-SCREENING OF INFECTIONS IN BLOOD DONORS OF THE REPUBLIC OF KAZAKHSTAN].

The article presents analysis of screening of markers of infections in donors using the nucleic amplification technique (NAT) within 4 years. The comparison is made with similar international indices and evaluation was applied to efficiency of the given technique in Kazakhstan. The study established that productivity of NAT technique in Kazakhstan significantly exceeds average international values. The implementation of the given technique permitted to prevent transfusion of infected blood.

[Prevalence and incidence of infections among blood donors in Astana].

The prevalence and incidence of infections among 28,248 blood donors in Astana in 2012 was determined. The estimated residual risk of the transfusion infection was as follows: for HIV--1,2, HCV--137,7, HBV--125,4 per 1 million donations. High risk of transfusion infection with HIV, hepatitis B, and C stimulates the active implementation of the measures for increasing the safety of blood: the selection of donors, increasing the sensitivity of infections screening methods, inactivation of pathogens in blood components and transfusion management appointment at the clinic.

[Functional and morphological changes of the diencephalon vascular endothelium of rats in experimental ischemia-reperfusion injury and diabetes mellitus].

We have studied the influence of bilateral carotid ischemia-reperfusion on the indices of the functional and morphological condition of the vascular endothelium of the brain hypothalamolimbic complex. It has been established that a decrease of the density of endothelial location in an early ischemic-reperfusion period in the control rats has a relative characterstipulated by edema of cells whereas on the 12-th day of observation an increase of the absolute density of cells takes place. During both periods of observation there is an increased content of the tjtal RNA in the capillary endotheliocytes of all the structures. An early reaction of the morpho-functional states of endotheliocytes to ischemic-reperfusion is absent in animal with diabetes mellitus, exept the vessels of the ventromedial hypothalamus while a late one is restricted by a growth content in RNA cells.