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Документ Анатомо-морфологічні особливості гісто- та органогенезу травних залоз(Українська медична стоматологічна академія, 2018) Процак, Тетяна Василівна; Забродська, Ольга Сергіївна; Процак, Татьяна Васильевна; Забродская, Ольга Сергеевна; Protsak, T. V.; Zabrods`ka, O. S.В статті розглядаються анатомо-морфологічні аспекти закладки основних залоз травлення, в тому числі, описано послідовний розвиток великих слинних, печінки та підшлункової залози, як невід’ємний компонент існування повноцінного шлунково-кишкового тракту (ШКТ). В роботі звертається увага на основи гісто- та органогенезу привушної, піднижньощелепної, під’язикової, підшлункової залози та печінки в різні періоди розвитку. Автори вказують, що досліджувані об’єкти мають різне походження, хоча переважну частку займає ентодерма. Саме з нею пов’язана динаміка генезу органів травної системи в пре- і постнатальному періодах онтогенезу ; В статье рассматриваются анатомо морфологические аспекты закладки основных желез пищеварения, в том числе, описано последовательное развитие крупных слюнных, печени, поджелудочной железы, как неотъемлемый компонент существования полноценного желудочно-кишечного тракта (ЖКТ). В работе обращается внимание на основы гисто- и органогенеза околоушной, поднижнечелюстной, подъязычной, поджелудочной железы и печени в различные периоды развития. Авторы указывают, что исследуемые объекты имеют разное происхождение, хотя подавляющую долю занимает энтодерма. Именно с ней связана динамика генеза органов пищеварительной системы в пре- и постнатальном периодах онтогенеза; The article deals with the anatomical and morphological aspects about laying of the main digestive glands, including the consecutive development of larges salivary glands, liver and pancreas as an integral component of the existence of a full gastrointestinal tract (GIT). In the oral cavity there are important components that are small in size and cause a successful digestive process – labial, palatal, lingual and buccal salivary glands. In addition, special attention is deserved, so-called parotid, submandibular and sublingual salivary glands, each of which has a number of features. For example, the submandibular gland first appears as a small groove in the space between the rudiments of the tongue and the lower jaw (sulcus alveololingualis). At the 8th week there is a new space, the epithelium is twolayered and later turns into a multilayered one. The caudal end of the groove is separated from the epithelium and attached to the lower surface of the lower jaw, where it will begin to branch. The formation of the sublingual salivary gland occurs on the eighth week of development, in the form of several nodules that grow into the mesenchyme. They are located lateral from the rudiments of the submandibular gland. The early stages of pancreatic development are detaily studied in higher mammals and have a similarity to the human analogue. It has two sources of origin – mesenchyme and endoderm. At first, the rudiment appears on the third week of development in the form of a dorsal and ventral nodules of the embryonic tube. It gives a beginning to head, body and tail of the pancreas. The structure begins to divide into the exocrine and endocrine parts on the 3rd month of the fetal period. At the 3rd month of embryogenesis, there is a progression of the process represented by the differentiation of tubes in parallel with the emergence of new strains, in which tubes are formed. There are different theories about the formation of the duct of the salivary glands. Some scientists are of the opinion, that lumen is formed as a result of the death of central cells. Others are advocates of the idea, that the created space is the result of the expansion of the strain with a divergence in the depths of the cells. However, Rahmanov believes, that, in this case there is an eccentric type of epithelium growth. Later, the end sections of the duct are laid. K. Bernard firstly proved, that before the onset of glycogen formation in the liver, the role of the depot was played by the wall of the yolk sac and placenta, and the connective tissue of the liver in the embryonic embryo is almost invisible. Only then the circulatory joint capsule [F. Glisson]. Thus, the development of digestive glands is a series of complex processes. Taking into account, the formation of large salivary glands, it can be argued, that there are various sources of origin of the initial and final divisions. The article draws attention to the basis of histo- and organogenesis of the parotid, submandibular, sublingual glands, pancreas and liver in different periods of its development. The authors indicate, that the objects of investigation have different origins, although the overwhelming majority is occupied by the endoderm. It is connected with the dynamics of the digestive system processes in the pre- and postnatal periods of ontogenesis.Документ Патофізіологічні основи розвитку захворювання Гіршспрунга (Morbus Hirsсhsprung)(Українська медична стоматологічна академія, 2018) Процак, Тетяна Василівна; Забродська, Ольга Сергіївна; Процак, Татьяна Васильевна; Забродская, Ольга Сергеевна; Protsak, T. V.; Zabrods`ka, O. S.На сьогоднішній день захворювання Гіршспрунга (ЗГ) у новонароджених та грудних дітей – це важка та складна проблема у розвитку сучасної дитячої хірургії. Це пов’язано із широким спектром клінічних проявів, складності діагностики та вибору методики лікування. Зауважуємо, що неадекватна тактика хірургічного втручання в ранньому віці є основною причиною смертності пацієнта. В статті подано інформацію про перші згадки захворювання Гіршспрунга (ЗГ). Представлено декілька яскравих випадків лікування аномалії, а також класифікацію хвороби, котрою користуються лікарі протягом багатьох років. Автори докладно пояснюють сутність проблеми ЗГ, складність в діагностиці та лікуванні, а також причини можливого ускладнення; На сегодняшний день заболевание Гиршспрунга (ЗГ) у новорожденных и грудных детей – это тяжелая и сложная проблема в развитии современной детской хирургии. Это связано с широким спектром клинических проявлений, сложности диагностики и выбора методики лечения. Замечаем, что неадекватная тактика хирургического вмешательства в раннем возрасте является основной причиной смертности пациента. В статье представлена информация о первых упоминаниях o ЗГ. Представлено несколько ярких случаев лечения аномалии, а также классификацию болезни, которой пользуются врачи на протяжении многих лет. Авторы подробно объясняют сущность проблемы ЗГ, сложность в диагностике и лечении, а также возможного осложнения; Today, Hirschsprung`s disease (HD) in newborns and infants is a difficult and complicate problem for development of modern pediatric surgery. This is due to a wide range of clinical symptoms, the complexity of diagnosis and choice of treatment methods. Its need to replaced, that inadequate tactics of surgical intervention at an early age is the main cause of death of the patient. Aganglionic megacolon or Hirschsprung’s disease is an anomaly of the colon development, which is represented by a violation of the innervation of a specific area of the body. The anomaly is particularly characteristic of the sigmoid colon and rectum and is more common in boys than in girls. Characteristic symptoms of agangliosis are persistent constipation, which are accompanied by acute intestinal obstruction. There are early and late symptoms of disease, the first of which is the delay or failure of defecation and flatulence, which arise from the moment of birth. The symptoms are aggravated by the introduction of solid food. Physical methods of research make it possible to successfully differentiate the flaw among others. The late symptoms are anemia, fecal intoxication and asymmetry of the chest and abdomen. The Scientists point out the existence of several anatomical forms of the disease – rectal (25%), rectosigmoidal in proportion, which accounts for 70%, segmental (1.5%), subtotal (3%) and total, accounting for 0.5% of cases. Also, there are known phases of HD – compensatory, subcompensatory and decompensatory stages. The main methods of HD investigation are irrigoscopy, anorectal manometry, and biopsy of the rectum mucosa for histochemical and immunological examination. In particular, when conducting a complete X-ray, it is possible to detect pneumotization and a sharp increase in intestinal loops, especially in the region of the sigmoid colon. It is proved, that with complication of HD enterocolitis, there is a toxic organ distribution. A characteristical symptoms of agangliosis in irrigoscopy is the narrowing of the distal intestinal tract, as well as the appearance of acute enterocolitis. The sense of the aganglionical megacolon is in the absence or reduction in the muscle fiber of the Auerbach plexus and the sympathetic nerve component of the Meisner plexus. Therefore, the large intestine is constantly in tone, that is spasm, which is not desirable for the digestive system. So, it explains the problem of the complexity of passing feces by a natural way. This disease is observed in different age groups, ranging from newborns to elderly people. Despite on it such number, the disease is manifested by several characteristical symptoms, that helps to differentiate the anomaly. Thus, the task of pediatricians and neonatologists is to monitor the fetus of a pregnant woman and identify pathology in the early stages of development, and for surgeons, its the creation of conditions for the failure of possible complications. The problem requires a further detailed investigation, since this anomaly can take place both in mild form and in severe, even leading to mortality. If the etiology of HD has already been studied, but there is no specific solution to this situation; it remains only to use operational methods that partly help the patient. The article provides information about first mentions of the Hirschsprung`s disease (HD). There are presented several bright cases of abnormalities treatment, a classification of the disease, that doctors have been using for many years. The authors detaily explain the origin of the HD problem, the complication of diagnosis and treatment.