[Morphofunctional Analysis of the Role of Epicardial Adipose Tissue in the Formation of the Obesity Paradox in Chronic Heart Failure].

Based on the available modern medical literature, the article summarizes data on the morpho-functional significance of epicardial adipose tissue (EAT) in health and heart failure, analyzes the likelihood and reliability of the formation of the obesity paradox, and also discusses its possible morpho-functional mechanisms. The authors reviewed and analyzed the consequences of the obesity paradox in the aspect of the normal EAT phenotype protectivity. The review proposed ways of further research in this direction aimed at a deep anatomical and physiological analysis and at determining the morpho-functional role of EAT in the adaptive mechanisms of myocardial trophic provision, which may be an important part of the pathogenetic connection between obesity and CHF and, therefore, can improve outcomes in such patients.

[Multiple organ manifestations of liver failure in acute small bowel obstruction]. / Poliorgannye proyavleniya pechenochnoi nedostatochnosti pri ostroi tonkokishechnoi neprokhodimosti.

Modern surgical and intensive care achievements did not result decrease of mortality in patients with acute small bowel obstruction (ASBO). Direct cause of mortality in ASBO patients is peritonitis followed by multiple organ failure syndrome including acute failure of liver, kidneys, lungs and other organs. Publications devoted to the problem of acute liver failure and its complicationsare reviewed in the article. Mechanisms of pathogenesis and clinical manifestations of multiple organ failure syndrome in patients with acute small bowel obstruction are analyzed.

[Pathogenic aspects of stomach ulcerogenesis in acute intestinal obstruction]. / Patogeneticheskie aspekty ul'tserogeneza v zheludke pri ostroi tonkokishechnoi neprokhodimosti.

AIM: To identify the patterns and the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. MATERIAL AND METHODS: The study was performed on 33 adult mongrel dogs of both genders weighing 17-20 kg. All researches were conducted in accordance with the documents, such as the 'Guide for the Care and Use of laboratory animals of the National Institute of Health (National Institute of Health - NIH, Bethesda, USA)' and 'Rules of work with experimental animals'. The same methods were used to study the morphology of stomach wall in normal conditions and after intestinal obstruction simulation. We used H & E stain, Van Gieson's picrofuchsin staining combined with Mallory. The choice of histochemical methods was determined by the need to study metabolic processes in epithelial cells and gastric mucosa glands. Einarson method for detecting total nucleic acids was used. The last group of methods was statistical analysis. RESULTS: We determined the regularities of structural organization of microcirculation in various parts of the stomach, the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. CONCLUSION: Our data indicate proximal-distal gradient of gastric perfusion: the most pronounced vascular network and maximum blood flow are observed in proximal stomach in both normal conditions and acute intestinal obstruction. More tenuous and reduced blood flow was revealed in the antrum, that is morphological basis of the most frequent localization of acute ulcers in this department.

[UNRESOLVED PROBLEMS OF THE EVALUATION OF MYOCARDIAL BLOOD SUPPLY].

Over the past few decades, a steady rise in the incidence, morbidity and mortality from cardiovascular diseases has been observed throughout the world. The most common pathology is coronary heart disease (CHD) which, in addition, is responsible for chronic heart failure in more than one third of the cases. Patients with coronary heart disease are in need of early diagnosis and timely treatment. This article provides an overview of current scientific literature concerning anatomy of coronary vessels, their age-related changes, and modern radiological diagnostic methods of the lesions associated with coronary artery disease.

[The Importance of Perfusion Assessment for Determination of Functional Sufficiency of Myocardium].

Myocardial vascular bed is represented by a network of arterial and venous vessels as well as microcirculatory vessels including arterioles, precapillaries, capillaries, postcapillaries, venules, and arteriolo-venular anastomoses. Myocardial capillaries are an exchange link providing perfusion of the myocardium with nutrients therefore sufficiency of the capillary circulation ensures the adequacy of metabolic processes in the cells of the heart muscle. There is no consensus among physicians of various specialties on the methodology of assessing coronary blood flow and blood supply to the myocardial tissue. The lack of universality and unity on measuring units, methods, and classification results in contradictions, both in defining approach to treatment strategy and to assessment of treatment effects. Currently, it is necessary to develop a common approach to assessment of coronary perfusion, which would allow to unify the criteria of sufficiency of blood supply to the heart and activity of metabolic processes in the myocardium. It is necessary to determine parameters of studying changes of myocardial vascular bed, closely related to metabolic processes in muscle tissue of the heart.

[CRITERIA FOR THE FORMATION OF PATIENTS' AGE GROUPS FOR MEDICAL RESEARCH].

At present, a variety of methods for age group formation and classification of clinical and morphological manifestations of diseases and their complications are available for the analysis of strategies of the choice of therapy and evaluation of its efficiency. Analysis of the results of diagnostic studies and the choice of therapeutic modalities need to be based on an individual approach to patients of different age groups. Age-related morphological, functional and histochemical changes responsible for combined normal and pathological alterations in the tissues, organs and their systems are associated with mild, moderate and severe clinical symptoms or their absence; they can be regarded as reflecting peculiarities of the development of the organism and subsequent tanatogenesis. Because age-specific changes are known to be risk factors of cardiovascular pathology, it suggests the necessity of more detailed objectivization and substantiation of division of such patients into age groups taking account of specific morphological and functional changes in the heart anatomical structures.