Human platelet lysate as a promising growth-stimulating additive for culturing of stem cells and other cell types.

We compared the composition and biological activity of fetal calf serum and platelet lysate from donor platelet concentrate. In platelet lysate, the concentrations of alkaline phosphatase, lactate dehydrogenase, creatinine, and mineral metabolism parameters were lower, while parameters of lipid and protein metabolism were higher than in fetal calf serum. The concentrations of growth factors (platelet-derived (AA, AB, BB), vascular endothelial, insulin-like, and transforming growth factor ß) in platelet lysate 1.7-148.7-fold surpassed the corresponding parameters in fetal calf serum. After replacement of fetal calf serum with platelet lysate in the culture medium (0, 25, 50, 75, and 100%), the count of multipotent mesenchymal stromal cells on day 7 (in comparison with day 1) increased by 154.8, 206.6, 228.2, 367.7, and 396.5%, respectively. Thus, platelet lysate can be an adequate non-xenogenic alternative for fetal calf serum.

[The choice of reconstructive operation in the treatment of patients with breast cancer].

170 patients, operated on the reason of breast cancer, received reconstructive surgery. Of them 63 had simultaneous organ preserving surgery with extramammary tissues translocation; 52 had organ preserving operation with the use of reductional mammoplasty and 55 patients had subcutaneous mastectomy with nipple preservation. Results of the study demonstrate that the method of organ preserving surgery with extramammary tissues translocation has more possibilities. The second place is occupied by the method of subcutaneous mastectomy with nipple preservation or in combination with muscular thoracodorsal flap replantation. The most complicated and giving the worst cosmetic result is the use of TRAM plasty. The algorithm of choice of the reconstructive operation for patients with breast cancer was worked out. Long term follow up showed the tumor progression in 29 (17.1%), remote metastases in 15 (8.8%) and local recurrence in 6 (3.5%) patients after organpreserving surgery and in 2 (1.2%) patients after subcutaneous mastectomy.

[Cancer service modernization is the most important area in the systemic improvement of cancer care to the population of Russia].

The paper presents data on planned measures to modernize our cancer service, one of the key areas of public health modernization, the main goal of which is to maximally ensure the citizens' right to have accessible and qualitative medical care. To adequately finance the field and to set up a current legislative base will give rise to the reorientation of the cancer service to priorities for primary prevention and active detection of malignancies, to an improvement of quality of life in cancer patients; to the formation of the populations' positive and integral awareness of health and healthy society, to the rational use of available manpower resources and inventory of all health facilities, which is extremely important under current conditions.

[Total mesorectumectomy in surgical treatment of rectal cancer].

561 patients with rectal cancer were included in the study. The main group consisted of 119 patients, operated on during 2006-2009 years. They received total mesorectumectomy with the following pathomorphological control of the radicality. The group of control consisted of 442 patients, who had the rectum mobilized in a "standard" blunt fashion, without using principles of interfascial separation. The operation of total mesorectumectomy proved to take more time, though, it allowed to decrease the intraoperative blood loss, frequency of postoperative urogenital complications and did not increase rates of colorectal anastomosis insufficiency.

[An in vivo study of the biologic activity of the recombinant pseudoadenovirus nanostructure containing lactoferrin gene].

The Ad5-Lf recombinant pseudoadenovirus nanostructure (RPAN) based on adenovirus of the 5th serotype and containing lactoferrin (Lf) gene was constructed. The goal of this work was to develop a system for efficient production of human lactoferrin (Lf) in human body. It was shown using the model of cisplatin (DDP)-induced toxicosis that human Ad5-based RPAN with human Lf gene expressing cassette in its genome provides high rate of expression of Lf gene in animal body. In vivo recombinant human Lf demonstrates detoxification effect against acute DDP-induced toxic reactions similar to that of the native Lf. RPAN does not stimulate growth of primary and metastatic nodes of experimental tumors. Moreover, it inhibits the growth of Lewis lung carcinoma (LLC), Ehrlich carcinoma (ELD), and S37 sarcoma in early periods after tumor transplantation. The obtained experimental data are indicative of the good prospects of further biologic and medical study of RPAN and development of RPAN-based genetic engineering medicine of the new generation.

[Surgical treatment of metastatic lung lesions: state of art].

454 patients, aged 17-79 years, were operated on metastatic lung lesions during the period from 1970 to 2007 years. Overall 538 operations were performed, of them 40 bilateral lung resections, 33 patients were reoperated on the subject of recurrent lung metastases. Postoperative complications were registered in 44 (9,6%) patients. Lethality rate was 1,1%. Overall 5-year survival after solitary metastasis removal was 34,9+/-3,1%, after removal of several lesions the survival rate was 21,7+/-4,8%, and after operation on the subject of multiple lung metastasis the survival rate was 14,7+/-4,5%. The level of intrathoracic lymph nodes involvement and type of the performed surgery showed to be independent prognostic factors.

In vitro study of matrix surface properties of porous granulated calcium phosphate ceramic materials made in Russia.

We performed in vitro screening of monophasic (hydroxyapatite, beta-tricalcium phosphate, carbonate-substituted hydroxyapatite with 0.59 and 5.9 wt% substitution with CO(3)(2-)) and biphasic (hydroxyapatite-tricalcium phosphate with various percentage of the components 80/20, 60/40, 20/80, silicon-substituted hydroxyapatite with 0.79 wt% SiO(2)) porous granulated ceramics composed of calcium phosphate powders synthesized by methods of heterophasic interaction of reagents and precipitation from aqueous solutions using MTT test and cultured human fibroblasts. Acute toxicity of materials (24-h incubation with cell culture) and matrix properties (3, 5, 7, 14, 18, 21, 28 days in culture) were evaluated. We selected a batch of materials obtained by precipitation from aqueous solutions, which were non-toxic and were characterized by good matrix properties (for cells). Biphasic ceramics with hydroxyapatite-tricalcium phosphate ratio of 80/20 exhibited best characteristics, and ceramics on the basis of silicon-substituted hydroxyapatite showed moderate characteristics.

[Laser information technologies in oncosurgery].

The introduction of laser information technologies to medical practice has improved the results of reconstructive and plastic operations in oncology thanks to a possibility to plan the surgery beforehand. Sixty-eight patients were operated on at Gertsen Moscow Research Oncology Institute between 2001 and 2006; 99 stereolithographic models were used to plan different stages of the surgical intervention. The tasks fulfilled with an individual stereolithographic model, may be relatively divided into three groups: 1) planning the resection stage; 2) planning the reconstructive surgery; 3) assessing the necessity to correct the complex autograft after the reconstructive surgery. The use of laser stereolithographic modelling in surgical treatment of patients with locally advanced malignancies made it possible to complete the reconstructive operation successfully in 98.4% of the patients, and rehabilitate functionally 88.6% of the patients.

[Antioxidants treatment of severe post-operative pyoinflammatory and septic complications].

New medical human lactoferrin product called Laprot possessing antioxidant, detoxicant, anti-inflammatory immunomodulating properties was developed and registered (serial number LS-002374) in the P.A. Hertsen Institute. System (intravenous) administration of Laprot is efficacious detoxicant and anti-inflammatory treatment in patients with severe postoperative pyoinflammatory and septic complications accompanied by polyorgan failure. Local administration contributes to clinically apparent cleansing of festering wounds and cavities, regress of local pyoinflammatory processes, reduction of local purulo-necrotic processes of trachea's mucosa. Laprot administrated intravenously as in the case of topical administration is well tolerated by the patients and doesn't cause any side affects.

Photodynamic therapy of virus-associated precancer and early stages cancer of cervix uteri.

We have analyzed the results of photodynamic therapy using light-sensitizing agent "Photogem" in 72 patients - 56 women with pre-cancerous lesions of cervix and 16 women with early cervical cancer (group 1); Photosens in 47 patients - 35 women with pre-cancerous lesions (CIN III), 12 women with non-invasive cervical cancer (carcinoma in situ) (group 2); and Alasens in 22 patients - 8 women with virus-associated pre-cancerous lesions (high-grade CIN III), 14 with virus-associated early cervical cancer (carcinoma in situ, cervical cancer 1A1) (group 3). The results were as follows: group 1 - complete regression of CIN III and non-invasive cervical cancer (carcinoma in situ) was achieved in 50 (89.2%) and 11 (68.8%) cases, significant regression was achieved in 2 cases (3.6%) and in 2 cases (12.5%), stabilization was achieved in 2 cases (3.6%) and in 2 cases (12.5%), progression was achieved in 2 cases (3.6%) and in 1 case (6.2%) accordingly. In the group of patients after PDT using Photosens complete regression of CIN III and non-invasive cervical cancer (carcinoma in situ) was achieved in 33 cases (94.2%) and in 10 cases (83.4%) cases, significant regression was achieved in 1 case (2.9%) and in 1 case (8.3%), stabilization was achieved in 1 cases (2.9%) and in 1 cases (8.3%). In the group of women after surgical treatment anti-viral efficacy was assessed. It s necessary to note that not a single relapse was observed. Anti-viral effect was registered in 49 (90.4%) cases The longest HPV-free period that we observed was 5 years. 12 women with CIN III and 4 women with carcinoma in situ became pregnant.

Study of in vivo biocompatibility and dynamics of replacement of rat shin defect with porous granulated bioceramic materials.

Biocompatibility of porous granulated bioceramic materials (hydroxyapatite, beta-tricalcium phosphate, hydroxyapatite-b-tricalcium phosphate complex (80:20 wt%), carbonate-containing hydroxyapatite, and silicon-containing hydroxyapatite) was shown in a subcutaneous test on BDF1 mice. Dynamic (up to 8 months) observation showed gradual replacement of the granular substance with de novo forming bone tissue with hemopoiesis foci on a model of fenestral defect in the shin bone in Wistar rats. By the rate of resorption, the materials rank as follows: silicon-containing hydroxyapatite

[Application of cell technologies to tissue defect closure in oncology].

In vivo and in vitro experiments on the application of cell technologies to tissue defect closure were conducted; autologic mesenchymal stem cells on 3-demensional matrices were used. The authors analyze the results of the application of bioengineering tissue equivalents for the closure of soft tissue and upper airway defects after extensive resections performed in 52 oncological patients. Tissue equivalents with stem cells provide engraftment and long-term graft functioning; they also modify wound surface, thus stimulating wound epithelization. In this study the application of tissue equivalents led to wound healing and functional recovery in 87% of patients.

[Role of the antioxidant ceruloplasmin in complex intensive therapy for severe posthemorrhagic complications in cancer surgery].

The paper summarizes the results of 10 years' experience in using the biocompatible antioxidant ceruloplasmin in cancer patients to prevent and treat life-threatening complications in critical states caused by various complications after extensive surgical interventions for malignant tumors or massive intraoperative blood loss. Hemorrhagic shock-complicated intraoperative massive blood loss is shown to exert a significant damaging effect on the redox system, which correlates with the objectified severity of a critical condition and with the degree of experienced hypoxia. The use of ceruloplasmin in cancer patients with postoperative complications or massive intraoperative blood loss contributes to the recovery of the potential of the antioxidative defense system, to the correction of oxidative stress, acute multiple organ deficiency, and endotoxemia, and to the reduction of the incidence of pyoseptic complications.

[Microsurgical autotransplantation of organs and tissues in oncologic patients]. / Mikrokhirurgicheskaia autotransplantatsiia organov i tkanei u onkologicheskikh bol'nykh.

402 patients with tumors of the head, neck and gastrointestinal tract as well as of the locomotor system underwent microsurgical autotransplantation of tissues during the treatment and rehabilitation. 483 microsurgical autografts from fascio-cutaneous, muscular and osseous tissues were used as well as from visceral organs (the stomach, omenthum, the bowels). Successful outcomes of plastic and reconstructive operations were obtained in 95% of all the cases. Successful microsurgical plastics favoured timely application of combined antitumor treatment. In 50-60% of oncological patients a complete social and labour rehabilitation was achieved. The method proved to be perspective for further development and implementation in oncology.

[Stomach precancer]. / Predrak zheludka.

The study was made of 568 cases of "initial" cancer cases, 825 morphological substrates of the polyps and 90 ones of chronic gastric ulcer. Chronic gastritis was the most frequent precancer disease (88.7% of cases). Malignant polyps accounted for 10.7% and chronic ulcer for 0.6% of cases. Relevant criteria for risk groups are proposed. Severe epithelial dysplasia as a morphological manifestation of gastric precancer can serve a marker of the risk of malignant transformation.