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Aim of the study. To explore the structural and functional changes of neurons, glial cells, and synaptic terminals in layers I, III, and V of the sensorimotor cortex (SMC) of the rat brain after bilateral common carotid artery ligation (CCAL).Material and methods. Incomplete cerebral ischemia was simulated by irreversible bilateral CCAL (2-vessel model of global ischemia without hypotension) on white rats (n=36). Comparative evaluation of the studied SMC structures was performed in the control group (intact rats, n=6) on days 1, 3, 7, 14, and 30 (n=30) after CCAL. Nissl, hematoxylin-eosin staining, and immunohistochemical reactions for NSE, MAP-2, p38, GFAP, and IBA1 were used. Numerical density of pyramidal neurons, astrocytes, oligodendrocytes, microglial cells, and relative area of p38-positive material (synaptic terminals) were determined. Statistical hypotheses were tested using nonparametric methods with Statistica 8.0 software.Results. After CCAL, the number of degenerative neurons in rat brain SMCs increased. The peak of numerical density of unshrunken neurons was detected after day 1. Later, the numerical density of hyperchromic unshrunken neurons decreased, while that of shrunken neurons increased. These parameters did not reach the control values. The changes in SMC neurons were accompanied by an increase in the numerical density of microglial cells after day 1 and its subsequent decrease. Immunohistochemistry for IBA1 revealed signs of microglial cell activation such as change in shape and loss of processes. Maximum increase in the SMC density of oligodendrocytes was observed on day 7, and that of astrocytes on day 14 after CCAL. The maximum number of NSE-positive neurons occurred on day 1 after CCAL. There was a significant decrease in the number of NSEpositive neurons in SMC layer III on days 3, 7, and 14, and an increase in the number of NSE-positive neurons on day 30. The number of NSE-positive neurons in layer V of the SMC progressively decreased throughout the whole study period. The evolution of changes in the proportion of p38-positive material (synaptic terminal area) differed significantly between the layers of SMC. In the layers I and III, this parameter first decreased (days 1 and 3) and then increased (days 7, 14, and 30). In layer V of SMC, the activation of the protein expression was observed in the acute phase (days 1 and 3), then it decreased on days 7 and 14, and increased again on day 30. The changes found in the numerical density of neurons, glial cells and synaptic terminals were associated with dehydration and overhydration of SMC. We found strong to medium significant associations between the relative area of terminals and neuropil swelling and edema zones.Conclusion. After CCAL, layers I, III, and V of the SMC of white rats revealed destructive and compensatory changes in neurons, glial cells, and inter-neuronal communication structures. Taken together, all these changes indicate a significant layer-by-layer variability of the neural tissue response to CCAL. Layer III (secondary projection complex) of the SMC was affected to a greater extent. Reorganization of neuronal-glial and interneuronal interrelations occurred along with a prominent neuropil overhydration.

The aim of the study. To examine the changes in structure and morphometry in sensorimotor cortical edema with cell swelling in mature white rats after common carotid artery occlusion of various durations.Material and methods. Acute ischemia was modeled on white adult Wistar rats by 20-, 30- and 40-min occlusion of the common carotid arteries (CCA). Histological (hematoxylin-eosin and Nissl staining), immunohistochemical (NSE, MAP-2, GFAP) and morphometric methods were used. Morphometry was assessed on hematoxylin and eosin-stained specimens using ImageJ 1.53 plug-ins (Find Maxima, Find Foci). Statistical hypothesis testing (nonparametric criteria) was performed using Statistica 8.0 software.Results. In the sensorimotor cortex (SMC) of white rats after 20, 30 and 40 minutes of CCA occlusion the signs of cytotoxic brain edema appeared, focal destructive and adaptive changes of neurons and astroglia evolved. The edema persisted throughout the observation period (7 days). The increase in the relative area, the number of cell swelling zones and their hydration (pixel brightness) was significant. On days 1 and 3 after CCA occlusion, some of the SMC astrocyte processes underwent destruction. Subpial and perivascular zones suffered to a greater extent. Mild and moderate (after unilateral 30-min CCA occlusion) to moderate and severe (after bilateral 40-min CCA occlusion) scattered structural and functional changes of the SMC with large areas of clearing in the «porous» neuropil, severe perivascular and perineuronal edema of the astrocyte processes developed. The latter was associated with a moderate reduction of the total neuronal density.Conclusion. After occlusion of CCA, signs of edema with cellular swelling appeared in the SMC amid dystrophic and necrotic pyramidal neurons and activated neuroglial cells. To a greater extent, the signs of brain swelling were evident three days after bilateral 40-min occlusion of CCA.

The aim of the study was to determine experimentally the effect of hemodilution by the 2:1 sterofundin/gelofusine (SG) solution on hemostatic parameters in vitro and in vivo.Material and methods. Experiments were carried out on 75 male Wistar rats weighing 270–380 g and anesthetized with intramuscular tiletamine-zolazepam (40 mg/kg) + xylazine (10 mg/kg). Animals were divided randomly into 4 groups: Group 1 — in vitro 25-percent dilution of carotid blood samples by the SG solution (n=12), Group 2 — in vitro 37.5-percent dilution of similar samples (n=11), Group 3 — in vivo 25-percent dilution (n=10), Group 4 — the controls (n=42) with no dilution. The first stage of the study compared the in vitro dilution groups with the control group and with each other; the second stage compared the in vivo dilution group with the control group. The parameters of low-frequency piezoelectric tromboelastography (LFPTEG), clotting tests and complete blood count were studied to evaluate the effect of hemodilution.Results. At a 25-percent hemodilution with 2:1 CG solution in vitro and in vivo, the hemostatic parameters retained within the reference limits, but a trend to increased intensity of the enzymatic reactions of the coagulation cascade and a significant increase in clot polymerization in vitro due to relative anticoagulant deficiency became evident. In vitro 37.5-percent blood dilution significantly reduced the blood level of fibrinogen and platelet count, inhibited the intensity of the proteolytic stage of coagulation, reduced the clot density at the T3 gelation point, at 5 minutes after reaching it and the maximum amplitude (MA) of the LFPTEG curve, as well as significantly reduced anticoagulant activity of the blood. The observed changes in hemostatic parameters were significantly outside the reference limits, which may affect the interpretation of the experimental results and be clinically important. We found negative correlation between clot density and platelet activity at 25-percent dilution in vivo, whereas at 37.5-percent dilution in vitro an additional positive correlations between platelet count and fibrinogen levels were determined.Conclusion. A 25-percent hemodilution with 2:1 CG solution should be considered «safe» for the in vivo hemostatic system providing minimal effect on the in vitro parameters in the exper-iment.

The aim of the study. To study the double-nucleated cellular structures of the brain sensorimotor cortex (SMC) of sexually mature white rats after a 40-minute occlusion of the common carotid arteries.Methods. Acute ischemia was simulated in white Wistar rats by 40-minute occlusion of the common carotid arteries (OCCA). We performed comparative morphometric evaluation of cyto-, dendro-, synapto-, and glioar-chitectonics of the neocortex in intact animals (n=5), and 1 (n=5), 3 (n=5), and 7 days (n=5) after OCCA. We used Nissl, hematoxylin and eosin staining, and immunohistochemical reactions for NSE, MAP-2, HSP-70, p38, caspase-3, GFAP, AIF1, and Ki-67. Numerical density of pyramidal neurons, oligodendrocytes (ODCs), mi-croglyocytes (MGCs), presence of dystrophic and necrobiotic neurons with one or more nucleoli, hetero- and dikaryons were assessed. Statistical hypotheses were tested using Statistica 8.0 software.Results. The percentage of dystrophic and necrobiotic neurons, nerve cells with two nuclei or two or more nucleoli, the total number (proliferation) and percentage of hypertrophic astrocytes, ODCs and MGCs increased significantly after OCCA. The total numerical density of SMC neurons decreased by 26.4% (P=0.001) in layer III and by 18.5% in layer V (Mann-Whitney U Test; P=0.01) after OCCA throughout the observation period. Pathological and compensatory changes were diffusely focal and more pronounced in layer III of the neocortex. The density of bi-nucleated heterokaryons and dikaryons remained unchanged on days 1 and 3 after OCCA vs control and was 3.5 (1.5-4.0)/mm2, and increased to 6.5 (5.0-8.5)/mm2 on day 7 (Mann-Whitney U Test; P=0.002). This increase occurred along with a higher density of ODCs and MGCs than in the control. The maximum number of neurons with two or more nucleoli was also noted in layer III and V during this period.Conclusion. After 40-minute OCCA in SMC, parallel to the dystrophic and necrobiotic changes of pyramidal neurons and activation of neuroglial cells, there was an increase in the formation of heterokaryons and neurons with amplified nucleolus. These changes were considered as a variant of neuronal response to ischemic damage.

This work aimed to reveal the statistically reliable clinical and laboratory markers, which are associated with fatal outcomes in patients with hemorrhagic shock of the III degree on the stage of hospital treatment. It was stated that decrease of body temperature (till 35,9 °C), pH of venous blood (till 7,19) and content of ionized calcium (till 0,32 mmole/l) in venous blood and increase of lactate content (up to 4,1 mmole/l) in venous blood and rise of activated partial thromboplastin time (up to 59 sec) are connected with fatal outcomes.

The authors suggested the advanced method of vessel separation and hemostasis, which was applied in 13 patients. This method was compared with the traditional method used for 8 patients. Proposed approach allowed separation of vascular fascicle twice faster than in usual way. There were noted a less decrease of hemoglobin level and shortening of hospital stay. The results of treatment were improved due to the application of the method of vessel mobilization and temporal hemostasis in surgery of stab-cut wound of the neck.

Formation of bronchopleural fistulas after surgical reduction of pulmonary volume is one of the most frequent complications of surgical treatment of pulmonary emphysema. In order to control bronchopleural fistulas in the patients after surgical reduction of pulmonary volume the technique of valve bronchial block has been o}ered. This technique has been applied in 7 patients, and the favorable outcomes have been achieved in 6 (85.7%) patients. The use of endobronchial valve for occlusion of fistulous bronchi allowed stopping air leaking through drainages, reducing time for pleural cavity drain and decreasing duration of patients' hospital stay.