MORPHOLOGICAL CHARACTERISTICS OF CHANGES IN GESTATIONAL PANCREATITIS

SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 10 OCTOBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 65 MORPHOLOGICAL CHARACTERISTICS OF CHANGES IN GESTATIONAL PANCREATITIS K. Sharofiddinov1, Y.A. Musaeva2, D.E. Iskandarova3 Assistant, Termez Branch of Tashkent State Medical University1 DSc, Associate Professor, Tashkent State Medical University2 PhD, Associate Professor, Termez Branch of Tashkent State Medical University3 https://doi.org/10.5281/zenodo.17451600 Abstract. The main morphological substrate of ischemic strokes consists of dystrophic, necrobiotic and necrotic changes in brain tissue. Most ischemic zones are characterized by vascular ischemia, stenosis, angiosclerosis and the presence of gliosis foci in the brain tissue. Agerelated aspects of these changes are mainly associated with hypertension and atherosclerosis, leading to narrowing of the vascular lumen, formation of hyalinosis foci in the vessel wall, plasmatic impregnation of brain tissue, and cerebral edema. According to the WHO classification, these pathological changes are most commonly observed among individuals aged 45–59 years. Keywords: cerebrovascular disease, atherosclerosis, hypertension, ischemic stroke, morphology. Introduction Worldwide, cerebrovascular diseases rank second among the top five causes of mortality. According to WHO data in 2022, ischemic strokes accounted for 56.1% of all stroke-related deaths. The main comorbid conditions leading to these outcomes are hypertension and atherosclerosis. According to the WHO classification by age, the highest rates are observed in individuals aged 45–59 years. WHO data from 2020 show that among all deaths from ischemic stroke, 10.2% occurred in the 18–44 age group, 50.16% in the 45–59 age group, 16.66% in the 60–74 age group, and 22.98% in those aged 75 years and older. The 45–59 age group includes the working population, where early disability and mortality due to ischemic stroke significantly affect a country’s socioeconomic development. Clinical and anamnestic data show that ischemic stroke occurs more frequently in individuals working more than 50–55 hours per week, which is especially common in countries with a large number of researchers and professionals. In the USA, UK, and European countries, the mortality rate from ischemic stroke in 2020 was 59.1%, mostly among people aged 60–74. In Russia and CIS countries, 35% of cases occurred in people working 35–40 hours per week, mostly in the 45–59 age group. In developing countries, stroke incidence is higher among those aged 45–59 years, especially in individuals working more than 50 hours per week, compared with the 60–74 age group where incidence was below 34% among those working 35 hours weekly. This highlights the socioeconomic burden of stroke, particularly in developing nations where overwork in the working-age population leads to younger onset of ischemic stroke. Research aim. The aim of the research is to study the pathomorphological characteristics of the adrenal glands in patients who died from ischemic stroke. Materials and methods. Clinical and anamnestic analysis; instrumental diagnostics; statistical analysis; morphology using hematoxylin-eosin staining; immunohistochemical markers; SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 10 OCTOBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 66 and morphometric studies were performed. Data obtained on structural features of the tissue were analyzed. Results and Discussion. During the progression phase of ischemic stroke, within 12–24 hours, gliosis foci form around astrocytes, with plasmatic impregnation and edema in the astrocytic perimeter. Plasma impregnation of conduction pathways leads to massive cerebral edema. Most astrocytes undergo dystrophic and necrobiotic changes. Picture 1. Cortical ischemia in a 58-year-old patient. Massive edema around neurons, plasmatic impregnation, necrobiosis in astrocytes, and asymmetric gliosis. H&E stain, 20×10 magnification. In areas of complete necrosis, proliferative activity of glial cells and increased vascular permeability with perivascular edema were observed. Postcapillary venules dilated, enabling leukocyte migration into the necrosis zone. These irreversible processes were predominantly observed in patients aged 45–59, manifesting as microstrokes. Gliotic scars formed in expanded conduction pathways, and plasmatic impregnation compressed healthy neurons, leading to altered cytoarchitecture. Picture 2. Cortical ischemia in a 60-year-old patient. Neurons surrounded by edema, perivascular swelling, neuronal hyperchromasia, and protein-rich inclusions. Gliosis foci formed. H&E stain, 20×10. Neurons displayed altered pyramidal shapes, with signs of karyopyknosis, karyorrhexis, and karyolysis. Phagocytic activity of macrophages increased, with cytoplasm containing cellular SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 10 OCTOBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 67 fragments and coarse protein substrates. These findings confirmed proliferation of glial cells in exposed stroma. Picture 3. Cortical ischemia in a 58-year-old patient. Angiosclerosis in small-caliber vessels with deformation of plasmaticly thickened vessel walls. Gliosis foci formed. H&E stain, 20×10. Picture 4. Cortical ischemia in a 58-year-old patient. Small-caliber vessels with angiosclerosis and thickened walls due to plasmatic impregnation. H&E stain, 4×10. Cerebral vessels showed varying degrees of atherosclerosis, plasmatic impregnation, and lumen narrowing, resulting in ischemia and massive pericellular edema, often with gliosis. In the early phase of ischemia (12–24 hours), vascular spasm, plasmatic impregnation, astrocytic shrinkage, and conduction fiber swelling were observed, leading to irreversible processes. Without inflammatory infiltrates, proliferation of glial cells produced small focal gliotic scars, offering opportunities for early diagnosis and treatment. Conclusion. Thus, in acute ischemia within 12–24 hours, the most common morphological substrates are astrocytic shrinkage, plasmatic impregnation of white matter conduction pathways, and regional gliosis. Vascular spasms and perivascular edema were also present. 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