[Experimental morphological rationale for the use of cultures of multipotent mesenchymal stem cells in combination with biomaterials in the reconstruction of the pelvic floor].

To date, descension of the pelvic floor is a fairly common gynecological pathology that requires surgical treatment. The development of cellular technologies suggests that the use of multipotent mesenchymal stem cells (MMSC) in the treatment of this pathology can stimulate the regeneration of damaged tissue and contribute to the reconstruction of the structures of the pelvic floor. OBJECTIVE: to evaluate the effectiveness of using MMSC in combination with biological and synthetic materials in vitro and in vivo with descension of the pelvic floor. MATERIALS AND METHODS: Sprague Dawley rats 10 weeks old weighing 200 grams were used in the experiment. Under sterile conditions, mechanical damage to the posterior wall of the vagina was carried out, with the restoration of which vicryl 3-0 was used. On the 2nd and 4th day, the wound was cut off in a volume of 1.5 ml with xenograft, allograft and multipotent mesenchymal stem cells (MMSC) (5 thousand cells) obtained from the adipose tissue of rats. In the control group was not used biological material. At the second stage of the experiment, the compatibility of the mesh prosthesis with MMSC and allograft in vitro was evaluated. RESULTS AND DISCUSSION: xenograft does not lead to full tissue regeneration, but contributes to rapid epithelialization and reduces the degree of inflammatory reaction in the wound during the regeneration of connective tissue. The use of allograft leads to quick and complete epithelialization of the wound and the formation of a structurally complete connective tissue lamina of the vaginal mucosa. The introduction of MMSC resulted in complete epithelialization of the wound and the formation of a structurally complete connective tissue plate of the mucosa and submucosa, but with a slightly smaller number of blood vessels in them than with the use of a biomaterial. At the second stage of the experiment, weak cell adhesion to the polypropylene substrate of the tablet was observed during cell culture in the presence of only a fragment of the mesh prosthesis. After MMSC cultivation in the presence of a mesh prosthesis fragment and an allograft, a relatively uniform distribution of cells around the mesh prosthesis loops was observed. CONCLUSIONS: it was determined that the use of MMSC and allograft has a positive effect on the process of vaginal tissue regeneration in rats. When combining these materials with mesh prostheses, it was found that MMSCs are not fixed directly to the synthetic material, but when the allograft is added, they concentrate and presumably have the maximum anti-inflammatory effect and promote tissue regeneration at the site of the mesh prosthesis. Thus, the use of autologous MMSC cells in combination with allograft and mesh polymeric materials for pelvic floor reconstruction can significantly improve the results of reconstructive operations.

Dietary risk factors for squamous cell carcinoma of the upper aerodigestive tract in central and eastern Europe.

OBJECTIVE: The incidence of squamous cell carcinoma of upper aerodigestive tract (UADT: oral cavity, pharynx, larynx, and esophagus) has been increasing in central and eastern European countries. We investigated the relationship between diet and UADT cancers in these high risk areas. METHODS: We used data from hospital-based case-control study of 948 UADT cancer cases and 1,228 controls conducted in Romania, Hungary, Poland, Russia, Slovakia, and Czech Republic. Standardized questionnaire were used to collect information on 23 different food items, along with alcohol and tobacco consumptions. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the UADT cancers after adjusting for center, age, sex, tobacco & alcohol intake, and other food groups. RESULTS: Consumption of dairy product was negatively associated with selected UADT cancers: larynx (OR: 0.38, CI: 0.23-0.62) and esophagus (OR: 0.55, CI: 0.33-0.93). While consumption of yellow/orange vegetables were inversely associated with oral/pharyngeal and laryngeal cancer (OR: 0.53, CI: 0.35-0.81 and OR: 0.62, CI: 0.38-1.00, respectively), preserved vegetable was positively associated with oral/pharyngeal and laryngeal cancer risk (p (trend) < 0.01 for both). CONCLUSION: Specific dietary components may play a role in the development of UADT cancers in the high-risk region of central and eastern Europe.

[The influence of depression on the aggregate state of blood in elderly patients with cardiovascular diseases].

The work is dedicated to the effects of the psychoemotional status of patients older than 65 suffering from coronary artery disease (CAD) and arterial hypertension (AH) on the aggregative status of blood. Sixty-eight patients with mild stable stenocardia accompanied by AH and comorbid depression (CD) were examined; 28 elderly patients with CAD, AH, and no CD constituted the comparison group. The study found that CD in elderly patients with stable stenocardia did not only lower the quality of life, but also worsened hemodynamic parameters. CD increases hypercoagulatory shift, inhibits the fibrinolytic system of blood, and elevates the risk of thrombus formation.

[Effect of radiation sterilization on biomaterial structure and properties].

The purpose of the investigation was the study of structural changes connective tissue biomaterials after different combinations of their radiation sterilization, physico-chemical treatment and conservation. Using a complex of histological methods (polarization microscopy of unstained sections, van Gieson's stain, scanning electron microscopy), an analysis was performed to detect the structural changes in tendons and dermis which underwent various physico-chemical treatment and subjected to the radiation sterilization using different types (3- radiation and fast-moving electron stream) and doses (1.5, 2.5 and 4 Mrad) of radiation. The dependence of the structural changes in the biomaterials on the fibroarchitectonics of the tissue as well as on the physico-chemical treatment and radiation type and dose was demonstrated. The tendons underwent clear-cut significant changes in all regimes and radiation doses studied. Dermis was found to be most resistant to radiation challenge.

[Experience in application of various antidepressants in gerontology].

The article presents data on the effectiveness of comorbide therapy with amlodipine and antidepressants of various groups in patients more than 65 years old suffering from coronary artery disease (CAD), arterial hypertension (AH), and comorbide depression. Eighty-eight patients with stable FC I-III stenocardia, accompanied by AH and comorbide depression, were examined. The patients were divided into three groups. Patients in group I (n = 21) received amlodipine therapy in a dose of 2.5 to 5 mg/day with amitriptyline in a dose of 25 mg/day. Group II patients (n = 25) received tianeptine in a dose of 25 mg/day in addition to amlodipine in a dose of 2.5 to 5 mg/day. Group III patients (n = 20) were treated with a combination of amlodipine 2.5 to 5 mg/day with sertraline in a dose of 50 mg/day. The comparison group consisted of 22 patients who received monotherapy in a dose of 2.5 to 5 mg/day. The study revealed that all these combinations with different antidepressants significantly lowered the average depression score and significantly improved the quality of life, unlike amlodipine monotherapy. The best combination was amlodipine plus tianeptine, which did not only demonstrate antidepressive and anxiolytic effects, but also led to improvement in prognostically significant parameters of cardiac rhythm variability in elderly patients with comorbide depressive disorders underlied by stable stenocardia and arterial hypertension.

[Effects of therapy with various groups of antianginal agents on life quality of the elderly with coronary heart disease and comorbid depression].

The purpose of the work was to study effects of antianginal agents of various groups on the psychoemotional status and life quality (LQ) of elderly patients with coronary heart disease (CHD) and concomitant depression. The subjects of the study were 70 patients (35 men and 35 women) with stable angina and depression. The subjects were divided into 3 groups. The 20 patients of group I were administered nitrates, the 32 patients of group II--beta-adrenoblockers, and the 18 patients of group III--a Ca antagonist. The control group consisted of 27 patients without anxious depression. The treatment led to significant reduction of weakly attack frequency and weakly sublingual nitroglycerine consumption in all the three groups. Significant reduction of average depression score and personal anxiety was noted in group III; decrease of situational anxiety level was observed in group I. There was no change of the psychoemotional status in group II. Examination of patients with depression showed that their LQ, according to Nottingham Health Profile questionnaire, was significantly lower than that of patients without depression. In spite of more pronounced antianginal effect of beta-adrenoblockers, LQ in this group did not differ significantly from that in other groups. There was significant improvement of LQ in group I and III. The latter demonstrated even more prominent changes, consisting in positive dynamics of the emotional status and improvement of sleep. Despite antianginal agents, LQ of patients with depression remained significantly worse than that of patients who did not have depression prior to the therapy. Thus, correction of concomitant depression will lead not only to improvement of LQ, but perhaps, also to improvement of the prognosis of patients with CHD.

The role of macrophages in the tissues regeneration stimulated by the biomaterials.

Allogenic grafted tissues are subjected to biodegradation and replaced by the regenerate. To minimize the immune response and improve the rebuilding of tissues there was developed a technology to treat tissues with a cells elimination and dosed out extraction of proteoglycanes (Alloplant. With aim to clarify the role of macrophages in the tissues regeneration resulting implantation the biomaterials 112 rats were injected the allogenic and xenogenic (rabbit's) pulverized biomaterials in the form of suspension. Injections were performed subcutaneously into the animals' back by the base of the tail. The control group (14 rats) were injected a physiologic saline. Animals were killed by ether inhalation on day 2, 4, 7, 14, 30, 90 and 180 and tissue sections were studied by light and electron microscopy. The study showed the key role of the macrophages in resorption of the allogenic biomaterial and formation of the newly-formed tissue. Implantation of the biomaterial induced activity a great number of the mature macrophages, which completely lysed and resorbed the biomaterial particles. Expression TNFalpha was significantly higher whereas expression TGF-beta1 was significantly lower. With xenogenic biomaterial implantation there were less macrophages, their activity was restricted. Macrophages containing large vacuoles with an active endo- and exocytosis were revealed in the allogenic biomaterial implantation and were named 'matrix-forming macrophages'. We may suppose that these macrophages synthesize (or re-synthesize) proteoglycan component of the newly-formed collagen fibers. There was put forward a hypothesis about the two component mechanism of the collagen fibers formation.