The actuality of the problem is associated with an increase in the number of patients with cholelithiasis of working age and a significant increase in cholecystectomies not only in Russia, but throughout the world. It is known that more than 2,5 million are performed annually. Moreover, 5-40% of operated patients develop postcholecystectomy syndrome, which is manifested by recurrent abdominal pain and cholegenic diarrhea. The aim of the study is to assess morphofunctional changes in the mucous membrane of various parts of the intestine in patients with postcholecystectomy syndrome. Histological, histochemical, morphometric and bacterioscopic, parasitological methods were used to study 42 biopsy specimens of the mucous membrane of various parts of the intestines of patients who underwent cholecystectomy. The control group consisted of 18 biopsies of practically healthy individuals. To objectify the study, a morphometric study of the mucous membrane of the duodenum according to 34 parameters, of the cecum and sigmoid colon according to 22 parameters was carried out. In the mucous membrane of the duodenum, chronic duodenitis of varying degrees of activity of the pathological process and atrophy of the intestinal villi were revealed, the intestinal glands were shortened, the intestinal villi are less wide. The epithelial layer of intestinal villi and intestinal glands was abundantly infiltrated with neutrophilic granulocytes. The density of the inflammatory cellular infiltrate in the stroma of the intestinal villi and intestinal glands increased. On the surface of the epithelial layer of the intestinal villi and between the intestinal glands, campylobacters were often found, less often - cryptosporidia. In the mucous membrane of the cecum and sigmoid colon, chronic colitis of varying degrees of activity of the pathological process and atrophy of the intestinal glands were revealed. The thickness of the mucous membrane and the depth of the intestinal glands were lower than normal. Thus, in patients with postcholecystectomy syndrome, pronounced morphometric and histological changes were revealed in the mucous membrane of various parts of the intestine, while the depth and degree of its damage were more significant in its proximal parts.
Резюме: Значительная часть клеток Догеля 2-типа в кишечнике млекопитающих имеют очень короткие нейроматозные выросты цитоплазмы -парафиты, тесно прилегающие к стенке кровеносных и лимфатических микрососудов. Они могут быть случайными или истинными афферентными синапсами этих нейронов, участвующимив иннервации сосудов кишечника. Цель работы -на морфологическом уровне доказать участие парафитов клеток Догеля 2-го типа в иннервации микрососудов кишечника. Изучены импрегнированные серебром тотальные препараты стенки тонкой кишки интактных беспородных кошек (n=5). Установлено, что нейроциты, расположенные на периферии ганглиев, имеют короткие неветвящиеся отростки и образуют локальные контакты со стенкой микрососудов. На микроскопическом уровне эти контакты выявляются как четко сформированные рецепторные структуры в виде претерминальных или терминальных бляшек. Тонкие неветвящиеся отростки отходят не только от области перикариона нейронов, но и от парафитов. Удалось также обнаружить синцитиальные связи этих отростков с перикарионами рядом расположенных нейронов. Часто парафиты, имеющие большие по площади ламеллы, были связаны с перикарионами узкими цитоплазматическими перемычками. Это дает основания считать, что подобные ламеллы являются потенциальными цитомерами в зоне микрососудистого русла кишечника. Парафиты клеток Догеля 2-го типа участвуют в иннервации микрососудов кишечника и являются потенциальными цитомерами, способствующими регенерации клеточных элементов стенки микрососудов.Ключевые слова: клетки Догеля 2-типа, сосуды кишечника, иннервация кишечника Summary: A significant part of the II nd type of Dogiel cells in the intestines of mammals have very short neuromatous processes of the cytoplasm -paraphytes, closely adjacent to the wall of blood and lymphatic microvasculature. They can be random or true afferent synapses of these neurons involved in the innervation of the intestinal vessels. The purpose of the work is to prove at the morphological level the participation of paraphytes of the II nd type of Dogiel cells in the innervation of intestinal micro vessels. Total, impregnated by silver preparations of the wall of the small intestine of intact outbred cats (n=5) were studied. It was found that neurocytes located on the periphery of the ganglia have short, unbranched processes and form local contacts with the wall of micro vessels. At the microscopic level, these contacts are detected as clearly formed receptor structures in the form of preterminal or terminal plaques. Thin non-branching processes depart not only from the area of the pericarion of neurons, but also from paraphytes. It was also possible to detect the syncytial connections of these processes with the pericarions of adjacent neurons. Often, paraphytes with large lamellae were contacted with narrow cytoplasmic ligaments with pericarions. This suggests that such lamellae are potential cytomers in the area of the microvascular channel of the intestine. Parafites of the II nd type of Dogiel cells are involved in the innervation of intestinal mi...
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