Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2019 Vol. 27 No 6

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

DOI: https://dx.doi.org/10.18484/2305-0047.2019.6.650   |  

YU.S. VINNIK, R.A. PAKHOMOVA, L.V. KOCHETOVA, G.E. KARAPETYAN

ELECTRONIC MICROSCOPY OF ERYTHROCYTES IN PATIENTS WITH SEVERE OBSTRUCTIVE JAUNDICE OF BENIGN GENESIS

Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk,
The Russian Federation

Objective. To study chemical composition and morphology of an erythrocyte in patients with severe obstructive jaundice.
Methods. Erythrocyte electron microscopy was performed on Hitachi 5500 scanning electron microscope (Japan), the spectral analysis of the peripheral blood erythrocyte composition was calculated using the QUANTAX 70 program in 17 patients with the severe obstructive jaundice and 14 conditionally healthy individuals. The severity of obstructive jaundice was determined by E.I. Halperin (2012). The study included the patients with severe obstructive jaundice, with clinical signs of endotoxemia and hepatic cell failure. The level of bilirubin in the studied patients was higher than 180 μmol / L, the level of alanine and aspartic transaminases was 2-3 times higher than normal.
Results. In patients with severe obstructive jaundice, the erythrocyte cytoskeleton changed: from a biconcave spherocyte, it turned into a domed stomatocyte. The oxygen concentration in the cell significantly decreased and reached its minimum value, 14.9%. Hypokalemia increased inside the cell, the content of sodium increased to 7.1% and calcium ions to 2.9%, which made the cell heavier, retaining water in it and, most likely, led to a change in the shape of the red blood cell and its functional capabilities. Significant changes in the concentration of carbon and nitrogen inside the cell were not detected.
Conclusions. In patients with severe obstructive jaundice with marked phenomena of endogenous intoxication, a cascade of biochemical reactions is launched. An increase in the content of chemical elements inside the cell holding water, apparently, leads to a change in the morphology of the red blood cell, its molecular structure and functional capabilities. A change in the erythrocyte cytoskeleton disrupts its oxygen transport function, and a decrease in the oxygen content in the cell exacerbates tissue hypoxia.

Keywords: obstructive jaundice, intoxication, electron microscopy of a red blood cell, chemical elements, oxygen-transport function of a red blood cell
p. 650-655 of the original issue
References
  1. Mamoshin V, Alyanov AL, Borsukov AV. Miniinvasive technologies in the treatment of patients with the syndrome of obstructive jaundice. Uchenye Zap Orlov Gos Un-ta. 2013;(6):228-231. http://oreluniver.ru/public/file/archive/201306.pdf (In Russ.)
  2. Vishnevsky VA, Efanov MG, Ikramov RZ, Varava AB, Trifonov SA. Modern surgical tactics for benign biliary strictures. trends and unresolved issues. Annaly Khirurgicheskoy Gepatologii = Annals of HPB Surgery. 2017;22(3):11-18. doi: 10.16931/1995-5464.2017311-18 (In Russ.)
  3. Galperin EI, Momunova ON. The classification of obstructive jaundice severity. Khirurgiia Zhurn im NI Pirogova. 2014;1:5-9. https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2014/1 (In Russ.)
  4. Garcea G, Ngu W, Neal CP, Dennison AR, Berry DP. Bilirubin levels predict malignancy in patients with obstructive jaundice. HPB (Oxford). 2011 Jun;13(6):426-30. doi: 10.1111/j.1477-2574.2011.00312.x
  5. Braet F, Taatjes DJ, Wisse E. Probing the unseen structure and function of liver cells through atomic force microscopy. J Nanosci Nanotechno. 2018;73:3-30. doi: 10.1016/j.semcdb.2017.07.001
  6. Pakhomova RA, Vinnik YS, Kochetova LV, Voronova EA, Nagornov YS. Atomic force microscopy of the erythrocyte in various severity of obstructive jaundice (experimental study). Annaly Khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017;22(1):82-87. doi: 10.16931/1995-5464.2017182-87 (In Russ.)
  7. Papakostas C, Bezirtzoglou E, Pitiakoudis M, Polychronidis A, Simopoulos C. Endotoxiemia in the portal and the systemic circulation in obstructive jaundice. Clin Exp Med. 2003 Sep;3(2):124-28. doi: 10.1007/s10238-003-0015-y
  8. Skorkina MIu, Cherniavskikh SD, Fedorova MZ, Zabiniakov NA, Sladkova EA. Metodika otsenki morfometricheskikh parametrov nativnykh kletok krovi s ispolzovaniem atomno-silovoi mikroskopii. Biul Eksperim Biologii i Meditsiny. 2010;150(8):238-40. (In Russ.)
Address for correspondence:
660022, The Russian Federation,
Krasnoyarsk, Partizan Zheleznyak Str., 1,
Krasnoyarsk State Medical University
Named after Prof. V.F. Voino-Yasenetski,
Department of General Surgery.
e-mail: yuvinnik@yandex.ru,
Yurii S. Vinnik
Information about the authors:
Vinnik Yurii S., MD, Professor, Head of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-8995-2862
Pakhomova Regina A., MD, Assistant of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-3681-4685
Kochetova Lyudmila V., PhD, Professor of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0001-5784-7067
Karapetyan Georgii E., MD, Professor of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-1216-2029
Contacts | ©Vitebsk State Medical University, 2007