Relevance. Ectopic pregnancy is an urgent condition which may lead to intraabdominal hemorrhage and woman death. In recent years, the frequency of this pathology is significantly increasing. However, morphological changes in the fallopian tubes in patients with this disease remain understudied. Aim. To study morphological changes in the fallopian tubes in patients with ectopic pregnancy with various variants of the clinical course. Materials and methods. The morphological study included 130 patients who had laparoscopic surgery for ectopic pregnancy. Comprehensive morphological study of the fallopian tubes removed during surgery was conducted. Results and discussion. The article presents the morphological changes in the fallopian tubes in patients with ectopic pregnancy. Implantation of a fertilized egg in the fallopian tube led to significant changes in its macro- and microstructure, which were due to invasion of the chorionic villi and involved all layers of the tube wall, differing only in depth and prevalence. The most pronounced morphological changes in various segments of the tube were revealed in the endosalpinx. Conclusion. The combination of morphological changes in different layers of the tube is related to a chronic non-specific productive endomyosalpingitis with luminal deformation, which was one of the main causes of this disease development.

The study objective is to evaluate the effectiveness and the safety of different cerebrospinal fluid drainage methods and intrathecal fibrinolytic therapy in the prevention of cerebral vasospasm and improving outcomes in patients with massive subarachnoid hemorrhage. Materials and methods. The study was performed on 86 patients with massive aneurismal subarachnoid hemorrhage (Hijdra score >15) who had clipping surgery within 72 h after symptoms onset. We used lumbal drainage in 12 patients (group 1), combined lumbal and cisternal drainage in 24 patients (group 2), lumbal and cisternal drainage with intrathecal fibrinolytic therapy with recombinant staphylokinase in 25 patients (group 3); control group (group 4) included 25 patients with similar clinical and instrumental data. Results. Incidence of unfavorable outcome and symptomatic cerebral vasospasm was 83 and 83 %, respectively (in group 1), 36.8 and 47.4 % (in group 2), 9.1 and 9.1 % (in group 3), 76 and 60 % (in group 4). Conclusion. The proposed intrathecal fibrinolytic therapy with recombinant staphylokinase may be effective and safe to reduce the severity of cerebral vasospasm, improve clinical outcome and lower frequency of normal pressure hydrocephalus after aneurysm rupture.

Uterine leiomyoma (UL) is often complicated by the development of uterine bleeding. In urgent gynecology for the implementation of endovascular hemostasis, uterine artery embolization (UAE) is used. Performing UAE allows to stop and/or significantly reduce the intensity of bleeding and prepare a patient for surgical intervention. At the same time, the morphological changes that occur in uterine tissues in operated UL patients after performing the UAE are not studied. The aim was to study the peculiarities of pathomorphological changes in uterine tumors and tissues in operated UL patients complicated by uterine bleeding after performing UAE. Material and methods. The results of morphological changes appearing in tumors and tissues of the uterus in 39 operated UL patients, who were used for stopping uterine bleeding, were analyzed. Results. After applying different types of embolizing agents in macroscopic study of the uterus, signs of ischemia of its tissues were revealed, and the most pronounced disorders were detected in the UL nodes. Morphologically it was established that UAE microemboli resulted in vessel occlusion with increasing thrombosis in their distal sections. UAE was not accompanied by occlusal occlusion of the arteries and resulted in small-scale necrosis of the tumor with complete regeneration of the endometrium. Conclusions. The results of the morphological study showed that after the UAE was performed, the myomatous nodes underwent dystrophic, necrobiotic and necrotic changes. Depending on the nature of occlusion of the uterine arteries, various variants of necrosis (scale and completeness of the process) developed in the tumor tissue, which was aseptic in nature.

We report results of treatment for 72 patients with uterine leiomyoma (LM) of various sizes and location, who had arrived with excessive uterine bleeding. All patients underwent urgent or urgently-delayed endovascular hemostasis by performing uterine arteries embolization (UAE). We analyzed clinical features of the disease after UAE in various sizes of tumors and studied immediate and long-term results of UAE in patients with LM.

Проанализированы результаты лечения 65 больных лейомиомой матки (ЛМ) разных размеров, поступивших с обильным маточным кровотечением. Всем больным был выполнен эндоваскулярный гемостаз путем проведения эмболизации маточных артерий (ЭМА). Изучены клинические особенности течения заболевания после выполнения ЭМА при разных размерах опухоли. Отмечена недостаточно высокая эффективность ЭМА при сочетанном поражении матки ЛМ и аденомиозом.

The results of treatment of 65 patients with uterine leiomyoma (LM) of various sizes received with abundant uterine bleeding are analyzed. All patients underwent endovascular haemostasis by performing uterine artery embolization (EMA). The clinical features of the course of the disease after performing EMA at different tumor sizes were studied. The insufficiently high efficiency of EMA at combined defeat of uterus LM and adenomyosis is noted.

Introduction. The Blood and its degradation products are considered to be the main cause of cerebral angiospasm (CA) due to non-traumatic subarachnoid haemorrhage (SAH). Intrathecal fibrinolytic therapy is one of the most effective methods for clearing the basal cisterns from the blood. Objective. To study the effectiveness and safety of intrathecal fibrinolytic therapy (recombinant staphylokinase, recombinant human plasminogen activator) for CA prevention using double haemorrhage model. Materials and methods. The study was performed on 81 laboratory white rat. The double haemorrhage model was used for reproduction of CA. All animals were divided into 4 groups: 25 were treated with recombinant staphylokinase (fortepase) - group 1, 15 were treated with recombinant tissue plasminogen activator (alteplase) - group 2, 30 animals were included in control group (cerebrospinal fluid drainage only) - group 3, cisternal microcatheter was introduced to 11 animals (group was excluded from further analysis because of CSF drainage inefficiency). Rat brain for morphological study was taken at 5th day. Microscopy assessment was done at the level of the upper third of the basilar artery using special histochemical stains. Results. The morphological scale of CA severity was performed and the specific microcirculatory changes of brain tissues were identified. We included 25 animals (nine from group 1, four from group 2, twelve from group 3) in the main morphological analysis. Mild CA was observed in 4 cases (33,3%), moderate - in six cases (50%), severe - in 4 cases (33,3%) among animals of control group. Severe CA was absent in fibrinolytic groups. Moderate CA was observed in 6 cases (66,7%), mild - in 3 cases (33,3%) in forteplase group. Both mild and moderate CA was observed in 50% of cases in alteplase group. Intracranial haemorrhage was not observed in any group. Conclusion. The proposed intrathecal fibrinolytic therapy is effective and safe method to reduce the severity of CA in rat double haemorrhage model.

The paper examines the results of transplantation of autologous graft and epidermal layer, grown outside the body of a patient, to granulating wounds after deep burns in 18 patients as well as methods which found no practical application due to poor healing abilities. It has been shown that the main cause of poor engraftment of the dermal graft is nutritional deficiency at the cellular level. This conclusion is confirmed by morphological studies of epidermal and dermal autograft. On the views of the authors, the further study of dermal autograft transplantation will put it to the worthy place among the other surgical methods restoring skin lesioned with burns.