The state of the stroma, blood vessels and the anatomical features of the umbilical cord are of direct diagnostic value, and various pathological changes can become the primary cause of fetal death. The frequency of umbilical cord tumors is not reliably known due to a very rare incidence: in the available literature there were reported about 19 cases.
The aim of the study was to clinically and pathohistologically analyze a case of umbilical cord teratoma and to give an analytical review of recently reported cases.
The material was obtained from a healthy 35-year-old woman with a third pregnancy. Combined ultrasound screening at the 20th week of pregnancy revealed a solid structure with cystic inclusions along the periphery on the umbilical cord. In the solid component, hyperechoic inclusions giving acoustic shadows were visualized; in the color Doppler imaging mode the neoplasm was avascular. A dead premature baby girl was born at 35th week. The cause of intrauterine fetal death was mechanical compression of the vessels of the umbilical cord by teratoma. Microscopic examination of the umbilical cord neoplasm in the area of the solid component demonstrated a pronounced development of the sebaceous glands, adipose tissue, myelinic nerve fibers, hair follicles; in the cystic component – epidermoid cysts. This evidenced about organismoid mature teratomas. Due to their rare incidence umbilical teratomas should be reported to better understand their pathomorphosis and impact on infant morbidity and mortality. Given the increased risk of concomitant malformations, the detection of an umbilical teratoma should be accompanied by a detailed and comprehensive examination of the newborn for additional pathologies.

Early and timely diagnosis of the spinal column and spinal cord pathologies, their intrauterine and postnatal correction require detailed knowledge of the anatomy and topography of the cervical spine in the fetus. The complex interactions of the cervical spine with the corresponding parts of the spinal cord and adjacent structures require detailed study during the embryonic period of ontogenesis.
The aim of the study was to investigate the morphometric and topographic anatomical fetal features of the cervical spine and adjacent structures at 20–22 weeks of the intrauterine development.
Material and methods. This study was performed on the sectional material from human fetuses, 20–22 weeks of development (20 human fetuses of both sexes), obtained from the fetal collection of the Department of Human Anatomy, Orenburg State Medical University. A standard set of morphological methods were applied in the study – macromicroscopic preparation, Pirogov method of cuts in three mutually perpendicular planes, production of serial histotopograms with Van Gieson staining, photography, morphometry.
Results. It was found that during the studied periods of prenatal ontogenesis, the length of the cervical spine averaged 17.5±1.5 mm. The transverse size of the vertebral body in fetuses of 20–22 weeks of development throughout the cervical spine is of greater importance than the anteroposterior. The transverse and anteroposterior dimensions of the vertebral foramen gradually decrease in the craniocaudal direction. It was also demonstrated that it is necessary to remove the dura mater in order to obtain reliable dimensional characteristics of the spinal cord.
Conclusion. Thus, the data obtained on the anatomy and topography of the spinal column and the spinal cord at the 20^th – 22^nd weeks of the human ontogenesis can serve as the morphological basis of fetal surgery.

The aim was to study the macro-microanatomy and morphometric characteristics of the glands of the right, left and common hepatic ducts in people of different ages under conditions of relative norm.
Material and methods. The experimental material included a complex consisting of the left, right and common hepatic ducts obtained from the corpses of 126 persons of different age groups who died from causes not related to the pathology of the digestive system. The glands of the hepatic ducts were selectively stained with methylene blue according to R.D. Sinelnikov, followed by fixation in a saturated solution of ammonium picric acid. The macroscopic structure and microstructure of gels were studied using an MBS-9 stereomicroscope. The analysis included the percentage of glands with different numbers of initial divisions. The studied morphometric parameters included the total number of glands, the length and width of their initial part. Methods of parametric statistics based on the Statistica 6.0 software were used for statistical data processing. Statistical data processing included the calculation of the arithmetic mean indicators, their errors, the analysis of the amplitude of the variation series of each indicator was carried out.
Results. According to the results of the study, the number of glands in the walls of the common hepatic duct during postnatal ontogenesis was 1.30–1.84 times higher (p<0.05) compared to the right hepatic duct and 1.39–2.13 times higher (p<0.05) than the same indicator in the walls of the left hepatic duct. There was also a tendency according to which the size of the initial section of the glands of the common hepatic duct was larger than that of the right and left hepatic ducts. The minimum and maximum individual values of the total number of glands, the length and width of the initial section in the walls of the common hepatic duct were also higher in comparison with the analogous parameters of the right and left hepatic ducts.
Conclusion. Age-related, regional and individual characteristics of the number and size of the glands of the hepatic ducts have been revealed; variants of the shape of the glands in different age periods have been determined, which is important not only for the development of a new scientific direction – morphological exocrinology, but also for gastroenterology, surgery of the extrahepatic biliary tract.

Research goal: revealing the liver vessels formation mechanisms after partial hepatectomy accompanied by superinvasive opisthorchiasis (SO).
Material and methods. The study was carried out on Syrian hamsters, weighing 98.0–110.0 g, mature animals of both genders. The animals were divided into three groups. Group I (n=168): a model of SO. Group II (n=40): partial liver resection in healthy animals. Group III (n=86): partial hepatectomy accompanied by SO. The histological specimens were stained with Mayer's hematoxylin and eosin by the methods of Van Gieson, Slinchenko, V.V. Kupriyanov. Immunohistochemical reactions were performed using primary antibodies to CD₃₁, CD₃₄, CD₁₁₇, Oct₄, and α-fetoprotein. The results were statistically processed, the differences were considered significant at p<0.05.
Results. In animals of group I accompanied by SO, proliferation of progenitor cells (CD₃₁⁺, CD₃₄⁺, CD₁₁₇⁺, Oct₄⁺) was observed in the portal tracts and perivascular space with the development of vascular formations, cholangiocellular and hepatocellular differnеntiations. Liver regeneration in healthy hamsters during 1– 3 days consisted in an active reaction of mitotic and amitotic division of hepatocytes with the development of avascular islets. In the subsequent periods (the 7^th day), the cells of preexisting vascular structures (sinusoids, capillaries) multiplied. After partial hepatectomy accompanied by SO (group III), there was an intensive proliferation of stem and progenitor cells with differentiation into endothelial cells, elements of cholangio- and hepatocellular differnеntiations; endotheliocytes and capillary pericytes multiplied.
Conclusion. Neoangiogenesis during regeneration after partial hepatectomy in healthy animals is implemented like angiogenesis; in case of partial liver resection accompanied by SO, it is followed by the vessels formation mainly from progenitor cells (vasculogenesis), advancing the development of elements of cholangio- and hepatocellular differnеntiations.

The aim of the study is to define age and gender regularities of the linear morphometric parameters of the liver in children and adolescents on the basis of intravital imaging findings.
Material and methods. The authors analyzed computed tomograms of the abdominal cavity in 75 children without visible pathology. All patients were divided into 4 groups depending on their age: early childhood, first childhood, second childhood, adolescence. The transverse, anteroposterior and vertical dimensions of the right and left hepatic lobes were investigated on 16-slice computed tomographs. The obtained findings were processed using variational statistical analysis, the mean value (M), standard error (m) and the statistical significance were defined using the Student's t-test.
Results. There was a significant increase in the anteroposterior size of the right hepatic lobe in separate sections at different age periods. A statistical significance between the parameters of the anteroposterior size of the right hepatic lobe was registered in girls and boys within the following groups: on one section in the 2^nd group of patients, on two sections in the 4^th group of patients. A statistical significance between the parameters of the transverse size of the right hepatic lobe was registered on one section (Th_XII) in the 2^nd and 3^rd groups, and on two (Th_XI and L_I) and three (Th_XI, Th_XII and L_I) sections in the 3^rd and 4^th groups of girls and boys, respectively. A statistical significance between the parameters of the transverse size of the right hepatic lobe in girls and boys were recorded only in the 4^th group on three sections (Th_XI, Th_XII and L_I). The vertical size of the right hepatic lobe was significantly higher in the 2^nd and 4^th groups, and the differences in the parameters between girls and boys were noted only among adolescents. A significant increase in the anteroposterior size of the left hepatic lobe was registered only in girls of the 2^nd and 3^rd groups on two sections (Th_XII and L_I); a significant increase in the transverse size was only registered at the L_I level in these groups of patients. A significant increase in the vertical size of the left hepatic lobe was only detected in girls of the first childhood compared with girls of the early childhood. No statistical significance was registered for any of the linear parameters of the left hepatic lobe between girls and boys of the same groups.
Conclusion. Thus, there was a significant increase in the anteroposterior and transverse dimensions of the right hepatic lobe in separate sections and an increase in the vertical size between individual groups of the studied patients, as well as a statistical significance between girls and boys of the same group. A significant increase in the anteroposterior and transverse dimensions of the left hepatic lobe was detected only in girls of the 2^nd and 3^rd groups if compared with the girls of the 1^st group. No significant differences were registered between girls and boys of the same groups for any of the linear parameters of the left hepatic lobe.

Blocked intramedullary osteosynthesis has become a "gold standard" for the treatment of patients with diaphyseal fractures of the tibia. However, there is still debate about the importance and necessity of reaming the bone marrow cavity when performing intramedullary osteosynthesis.
The aim is to study the individual features of the structure of the medullary cavity of the tibia in relation to intramedullary osteosynthesis, as well as to evaluate the effect of blocked intramedullary osteosynthesis with preliminary reaming and without reaming of the bone marrow cavity on the vascular supply of the tibia.
Material and methods. Using morphometric and radiological methods, an experimental topographical and anatomical study was carried out on 26 dry preparations and histotopograms-plates of tibial bone cuts, as well as on 10 lower limbs of corpses with X-ray contrast injection of arterial vessels.
Statistical analysis was performed using the Student's parametric test and the nonparametric MannWhitney test.
Results. Particular attention was paid to the detailed study of the main parameters of the tibial bone marrow cavity that are important for the technology of blocked intramedullary osteosynthesis (size, shape and curves of the bone marrow cavity, architectonics of its narrow part, density and distribution of spongy matter in it, topography of the a. nutricia tibialis channel and distribution of its branches). To assess the invasiveness of osteosynthesis on 10 anatomical objects with preliminary injection of vessels of the lower extremity with X-ray contrast mass, blocked intramedullary osteosynthesis of the tibia with and without reaming of the bone marrow cavity was modeled.
Conclusion. It was concluded that any variant of intramedullary rod insertion is accompanied by damage to a. nutricia tibialis in a narrow part of the bone marrow cavity, and reaming of the bone marrow cavity has certain advantages in view of the pronounced individual differences in the structure of the tibia.

During a skin scar formation morphofunctional change of skin structures takes place. The action of external mechanical factors can lead to prolongation of reparative processes in the scar and to the change in the morphometric parameters of its components.
Research goal: to study the features of the skin structural components morphological change in secundipara women during a connective tissue scar formation after a cesarean section.
Material and methods. The materials for the study were the fragments of a connective tissue scar with an adjacent area of intact skin taken from 30 women after operative delivery by Caesarean section. On scanning electron microscopy, morphometric parameters were measured, which enabled to assess the cell composition and the changes in the fibrous components of the connective tissue scar.
Results. Analyzing the thickness of the fibers in the same age group, the thickening of the fibers was observed in direct proportion to the number of births. Comparing different age groups with the same number of births, the thinning of collagen fibers was observed. The most pronounced changes were observed in women having three or more deliveries.
Conclusion. Under the influence of the stretching force in the skin, a structural change of the connective tissue scar occurs. This change is due to the thickening of collagen structures, the decrease in the density of collagen structures location, the increase in the number of lymphocytes and macrophages.

Despite the many factors affecting the state of the lymph nodes, a special role is played by biogenic amines synthesized by the cells of the APUD system and specialized macrophages, which in the context of this study are designated as granular luminescent cells (GLC), as well as mast cells (MC). The presence of receptors for biogenic amines on lymphoid cells proves the subordination of the immune system to neurohumoral effects.
The aim of the study was to identify neuroamine-containing cells in the lymph nodes and to determine the content of catecholamines (CA) and serotonin (ST) in them early after bone marrow allotransplantation (ALT).
Material and methods. The experiment was carried out on outbred male rats. The 1^st group consisted of intact animals (n=10), the 2^nd – control individuals, which were injected with 3.0 ml of 0.85% sodium chloride solution (n=10); 3^rd – animals (n=30), which underwent bone marrow ALT. To identify neuroamine-containing cells, a luminescence-histochemical study was carried out according to Falk–Hillarp method in Krokhina modification (1969), the proliferative activity of cells was assessed using an immunohistochemical reaction for Ki-67. Statistical analysis was performed using the Statistica-6 program.
Research results. After 40 min in the GLC of the corona of the lymph nodes, an increase in the content of CA and ST by a factor of 1.2 was observed; after 2 hours, the CA content increased 1.7 times, and ST – 1.4 times, and after 4 hours there was a sharp decrease in the CA content by 3.6 times. In the GLC of the reactive center and in the reticuloendothelial GLC, the content of both CA and ST decreased. In the GLC of the paracortical zone, the content of CA and ST increased, and after 4 hours their decay occurred. In MC, the content of CA and ST decreased. MC degranulation was observed against the background of a sharp decrease in their number. Due to the degranulation of MC, starting from the 40th min after ALT, neuroamines accumulated in the intercellular space. After ALT, the Ki-67 index changed at different periods of the experiment, in the marginal sinuses it decreased by 13%, in the intermediate sinuses – by 61%, in the lymph nodules – by 47%, and in the paracortical zone – by 40%.
Conclusion. Thus, bone marrow allotransplantation leads to a change in the number of granular luminescent and mast cells, as well as the content of biogenic amines in the cervical lymph nodes.

Currently, the most optimal option for breast reconstruction after mastectomy is the use of a pedicle DIEP flap from the inferior epigastric artery.
The aim of the study was to study the features of the typical and variant anatomy of the inferior epigastric artery in women in the applied aspect.
Material and methods. The study was carried out on 20 unfixed female bodies who died at the age of 54.6±4.7 years. We studied the level of intersection of the main trunk of the inferior epigastric artery with the lateral edge of the rectus abdominis muscle, the distance from this artery to the midline at different measurement levels, as well as the outer diameter of the studied vessel.
Results. On the right, at different measurement levels, the distance from the main trunk of the inferior epigastric artery to the midline, the diameter of the artery, as well as the level of its intersection with the lateral edge of the rectus abdominis muscle in relation to the upper edge of the pubic bone, significantly exceed those on the left.
Conclusion. It is necessary to take into account the peculiarities of the topographic anatomy of the inferior epigastric artery, planning and carrying out breast reconstruction with a DIEP flap, in order to prevent the development of necrosis in the postoperative period. For better reperfusion of the reconstruction area in the postoperative period, it is preferable to cut out the flap with the isolation of the right inferior epigastric artery (due to its larger diameter).

The aim of the study was to compare ecological and morphological features and evolutionary dynamics of the salivary glands in representatives of different classes of vertebrates living in different ecological conditions.
Material and methods. The glandular structures of the tongue of vertebrates belonging to various taxonomic and ecological groups (fish, amphibians, reptiles, mammals) were studied. The material obtained was processed using histological and histochemical methods.
The results of the study demonstrated that in the course of the evolutionary transformations of vertebrates, an increase and complication of the glandular structures of the tongue occurred due to changes in the environmental factors and in the nature of nutrition and food consumed. The evolutionary transformations of the glandular structures of the organ was directed from unicellular intraepithelial glandular structures (for example, in fish) to the complex multicellular salivary glands of higher mammals, in which there was a division into terminal secretory sections and secretory pathways. In the course of evolution, the number of functions performed by the salivary glands of the tongue has also increased. The digestive and endocrine functions were added to the function of protecting the mucous organ from damage. The serous glands of the tongue are phylogenetically younger. Their occurrence is associated with the participation of the glands of the tongue in the initial stages of chemical food processing. The preservation of more ancient mucous glands against the background of the emergence of new organisms in the course of evolution - mucoserous, seromucous and serous glands, - indicates that in the course of evolutionary development, the glandular structures of the tongue demonstrate parallelism of divergent changes.

In the modern aspect, the relevance of damage to the medial cutaneous nerve of the arm during surgical interventions in the axilla and brachial region is displayed. Due to the superficial location in the subcutaneous layer, the nerve is most often subject to accidental damage, including in brachioplasty, axillary lymphodissection, breast cancer surgeries and breast augmentation. The material on variant anatomy, macroscopic structure and topography of the nerve is presented. The medial cutaneous nerve of the arm is formed from the medial cord of the brachial plexus, in some cases - from the posterior cord; isolated cases of the absence of the nerve are described. When exiting the axilla at arm level, the nerve penetrates into the deep brachial fascia, passes in the subcutaneous layer medially from the basilic vein of the arm and provides sensitive innervation to the skin of the medial surface of the arm, the skin of the medial epicondyle and the olecranon of the ulna. The medial cutaneous nerve of the arm has an average of 7-8 cutaneous branches, which are characterized by significant variability in the location under the skin. The significance of the medial cutaneous nerve of the arm in clinical practice, namely, in surgical interventions in the arm region, the development of neuropathic pain syndrome, brachial plexus blockages and the diagnosis of nerve damage, medial cord and inferior trunk of the brachial plexus. This review summarizes recent data, which allow to form a more complete picture of the clinical anatomy of the medial cutaneous nerve of arm and the possibilities of its use in reconstructive surgery. An especially relevant area is the possibility of using a medial skin flap of the arm with directed innervation by the medial cutaneous nerve of the arm for reconstruction and restoration of the sensitivity of the nipple-areola complex.

Endometriosis nowadays still a disease with an undisclosed pathogenesis. This article demonstrates and explains the possibility of different variants of dissemination of endometrioid cells in the body with the formation of foci of extragenital endometriosis in organs and tissues remote from the pelvis, complementing and confirming the theory of utero-peritoneal reflux in the development of endometriosis as the most reasonable. Endometrioid heterotopias have a more developed lymphatic network compared to the normal endometrium due to active lymphangiogenesis, and, having a tendency to invasive growth, endometrioid heterotopia is a source of endometrioid cells spreading along the direction of lymph outflow from the most typical locations (pelvic organs) with damage to the inguinal and pelvic lymph nodes. Lymphatic dissemination in adenomyosis is observed in every fourth patient, which requires revision of the surgery protocol with excision of regional lymph nodes to prevent relapses. The presence of cases of pulmonary endometriosis and endometrioid liver cysts makes hematogenic dissemination of endometriosis from the primary source in the pelvic region obvious. The most frequent localizations of endometrioid heterotopias are located near the corresponding venous plexuses of the small pelvis, the outflow from which occurs mainly through the inferior vena cava, without anatomical obstacles for hematogenic dissemination of endometrioid cells with subsequent lung damage. For liver involment, it is likely that endometriosis in the distal parts of the colon is important, the venous outflow from which is directed to the portal vein system. Endometriosis of the diaphragm – is an example transcoelomic spread with predominant location on the right dome of the diaphragm, as the right subphrenic space communicates with the pelvic cavity through the right lateral channel, which justifies the possibility of such involments of the diaphragme in context of the theory of uteroperitoneal reflux.
Thus, the theory of menstrual regurgitation and the theory of hemato-lymphatic dissemination are components of a single pathogenetic model of the distribution of endometrioid cells in the body.

The aim of the study was a comparative study of the karyometric parameters of fibroblasts using various acid-modified solutions in the early stages of healing of skin wounds in rats.
Material and methods. The experiment was carried out on 75 Wistar rats. For the treatment of wounds, 0.9% NaCl solution was used at a pH of 5.0; 7.0; and 7.5. The material was fixed in Shtiva liquid, 10% formalin solution. Thin paraffin sections (4–5 μm) were stained with hematoxylin and eosin, azan according to Heidenhain. The area of fibroblast nuclei was determined planimetrically
Results. Three types of fibroblasts were found in the skin of intact rats. The papillary layer contained papillary fibroblasts; the reticular layer – reticular fibroblasts. The third type of fibroblasts was located between the hair follicles. In rats of all experimental groups, on the 1^st day after the wound was inflicted, extensive inflammatory processes, hemorrhages, and necrotic changes in the structural components of the skin were revealed. On the 3^rd day after the wound was inflicted in rats of the 1^st and 4^th groups, the area of the nuclei of papillary fibroblasts in the peripheral areas of the wound statistically significantly increased by 24.4% and 22.4%, respectively, compared with the control. In animals of the 3^rd group, the area of fibroblast nuclei remained unchanged. On the 5^th day, an increase in the number of fibroblasts over the entire surface of the wound was observed in rats of all experimental groups. The area of fibroblast nuclei in rats of the 4^th group increased statistically significantly by 26.5% (Р<0.001) as compared to the control. In animals of the 3^rd group, the increase in the area of the nuclei in comparison with the control was only 6.5%, while no statistically significant changes were found in comparison with the control. The area of the fibroblast nuclei located between the hair follicles reached a maximum value, which indicated a high functional tension of the hair follicle fibroblasts.
Conclusion. The use of 0.9% NaCl solution with pH 5.0 in the first phase of wound healing and 0.9% NaCl solution with pH 7.5 in the second phase of wound healing reduces inflammation processes, while the secretory activity of fibroblasts increases, and collagenization is accelerated.