Effect of Cryo-Processing on Platelet-Rich Autoplasma Preparations.

Platelet-derived growth factor (PDGF) plays an important role in angiogenesis, affects activation of migration and proliferation of mesenchymal stem cells, fibroblasts, smooth muscle cells, osteoblasts; activation of migration of monocytes, macrophages, and neutrophils. The aim of the investigation was to study the effect of cryo-processing on the qualitative properties of platelet-rich autoplasma (PRP) at different time intervals. MATERIALS AND METHODS: Autologous plasma preparations were obtained from the blood of 31 donors. The biological material was prepared by double centrifugation according to the protocol for obtaining P-PRP and L-PRP. Platelet count and the concentration of growth factors (PDGF-AA and PDGF-BB) were studied in fresh PRP preparations. In frozen PRP samples, the concentration of PDGF-AA and PDGF-BB was determined 2 weeks after cryo-processing and 2 months after cryo-processing at -35 °Ð¡. P-PRP and L-PRP samples activated with 10% CaCl2 solution and those non-activated were studied. RESULTS: L-PRP preparations are significantly superior to P-PRP preparations: the concentration of platelets is 1.7 times higher in them. The level of PDGF-AA in non-activated L-PRP is 1.8 times higher than in non-activated P-PRP (p<0.05). The level of PDGF-AA is 1.5 times higher in activated L-PRP than in activated P-PRP (p<0.05). The level of PDGF-BB is 2.9 times higher in non-activated L-PRP than in non-activated P-PRP and 1.8 times higher in activated L-PRP than in activated P-PRP (p<0.05). The concentration of PDGF-BB in non-activated P-PRP sharply increases in the 2nd week after freezing and remains at the same level after 2 months (p<0.05). The concentration of PDGF-BB in activated plasma does not change (p>0.05). CONCLUSION: Cryo-processing of non-activated autologous L-PRP allows preserving and subsequently enhancing the properties of plasma concentrate, which makes it possible to apply it in clinical practice.

[Use of volumetric dynamic voiding multispiral computed cystourethrography in diagnosis and evaluation of treatment efficiency of congenital and acquired pathology of the urogenital area].

AIM: The aim of this study was to determine the possibilities of volumetric dynamic voiding multispiral computed cystourethrography (VDMMCT) for assessment of the lower urinary tract during voiding. MATERIALS AND METHODS: VDMMCT was performed in a series of 22 patients with various urethral pathologies using 320 detector rows (640 unique slices; row width 0,5 mm). This method allows to cover the scan area of 16 cm per one rotation of the X-ray tube. In all patients, the cross-sectional area of the various urethral parts was estimated and the urinary bladder volume and average urine flow rate during all voiding phases were calculated. RESULTS: VDMMCT was performed for dynamic evaluation of bladder volumes changes and analyzing a passage of contrasted urine throughout the urethra. The average volume of the urinary bladder was 356.3+/-179.9 ml, while the voiding volume was 299.5+/-154.8 ml. The average pre- and postoperative urine flow rate was 4.1+/-1.1 ml/s and 7.9+/-5.1 ml/s, respectively. The maximum urine flow rate was 19 ml/s. The average urethral diameter according to the VDMMCT after urethroplasty was 7.6+/-2.1 mm. The minimum length of urethral strictures was 17 mm, while the maximum length was 32 mm. CONCLUSION: Our results demonstrate the efficiency of the VDMMCT for assessing of the urethra throughout its length. VDMMCT can multidimensionally and dynamically represent the change of the bladder volume and the urine flow rate.

[Urinary bladder reconstruction using a free revascularized musculo-cutaneous thoracodorsal autograft. A case report].

The article presents a rare case of urinary bladder reconstruction using thoracodorsal revascularized autograft in a patient with a bladder injury resulting from a road traffic accident. The area and size of the thoracodorsal flap (2215 cm) were determined using a 500 ml latex model of the bladder. The autograft was revascularized through external iliac vessels. From the thoracodorsal autograft, the dome was formed with the dermal part inward, which was fixed along its circumference to the bladder edges with 3/0 prolene sutures. The muscular part of the thoracodorsal flap was fixed along the perimeter to the remaining aponeurosis and covered by a free expanded cutaneous autograft. The surgery resulted in a newly constructed neobladder of sufficient volume (250-300 ml) with elements of the patients own bladder (posterior wall and neck) while sparing the patient from a cystostomy and improving his quality of life.

[Common aspects of microsurgical tissue transplantation in reconstructive urology].

The article highlights possibilities and common aspects of microsurgical tissue transplantation in reconstructive urology. The authors share the experience of more than 2000 of microsurgical autotransplantations of revascularized and reinnervated free flaps. The method allows the new approach to such urological conditions as traumatic penis amputation, posttraumatic and inflammatory urethra strictures, inborn genital hypoplasia, impaired sexual identification, etc. The issue analyses the results of treatment of 152 patients with inborn urogenital pathology (220 autotransplantations of revascularized flaps) and 146 patients with acquired urogenital diseases (188 autotransplantations of revascularized flaps) during the period from 1991 to 2011 years.

[The combined abdomenotranssacral access for the extralevator rectum extirpation].

Technique of the extralevator abdomenoperineal rectum extirpation with the use of the combined abdomenotranssacral access is thoroughly described in the article. The radicality of the procedure and the immediate results has been evaluated in 27 patients with the lower ampullary rectum and anal canal cancer. The average blood loss was 625±288 (300-3500) ml. The soft tissue defect was replaced with the use of unilateral rotated gluteus maximus muscle (n=21), bilateral rotated gluteus maximus muscle (n=6). Tumor-free resection line was registered by the morphological investigation of the resected tissues in 25 cases. Long-term results (13.2±3.1) (2-22 months)) were obtained in 24 patients. The obtained results of the postoperative morbidity and survival rates allow to consider the described method as a safe and appropriate surgical procedure.

[Use of fibrin glue for covering microsurgical autotransplants with free split skin]. / Ispol'zovanie fibrinovogo kleia dlia ukrytiia mikrokhirurgicheskikh autotransplantatov svobodnoi rasshcheplennoi kozhei.

An experimental study on 90 Wistar rats has been carried out. A split skin transplant about 2.25 cm(2) in size was taken from the back of the animal with scalpel and fixed on the neck's muscles with: 1) 8 sutures; 2) pressure dressing of "Pelot" type; 3) 0.2 ml of "Tissukol" fibrin glue. There were no complications. Complete skin retention was achieved in all the cases. Histological study demonstrated acceleration of reparative processes and decreased inflammation in autotransplant and muscular bed due to improvement of revascularization, a decrease of fibrous transformation of the skin graft and muscular tissue when fibrin glue (to a greater extent) and pressure dressing (to a lesser extent) were used for fixation of skin graft. But it is preferable to use fibrin glue due to acceleration of complete skin retention compared with pressure dressing of "Pelot" type.