[Monitoring of intracranial pressure and cerebral compliance in patients with hemispheric non-traumatic hemorrhages].

Indicators of intracranial pressure (ICP) and cerebral compliance in 48 patients with primary non-traumatic intracerebral hemorrhages who underwent surgery using precise aspiration and local fibrinolysis were studied. Based on clinical and neuroimaging data, ICP indicators and cerebral compliance, we can evaluate the compressive influence of the cerebral hematoma, perform the dynamic control of fibrinolysis efficacy and intracerebral hematoma aspiration as well as of dislocation syndrome's regress and predict outcomes of disease. The restoration of ICP indicators, cerebral compliance and elimination of middle structure dislocation can be used as criteria of surgery effectiveness. At the same time, the residual volume of the hemorrhage (within 20 ml) during the elimination of compression does not exert any significant effect on the course and outcome.

[Tissue equivalent for the closure of extended urethral defects].

The aim of the present work was to develop a method for culturing epidermal keratinocytes to be used in a tissue equivalent for the closure of extended urethral defects. The experiment was carried out using 15 rabbits. Skin biopsies were obtained from the inner surface of the ear. The tissue equivalent consisted of collagen gel with embedded fibroblasts and epidermal keratinocytes grown on its surface; lavsan-mesh endoprosthesis served as the framework. Prefabrication of the neourethral plate was performed on the superficial fascia of m. rectus abdominis. The neourethral tube was formed after engraftment which was complete in all 15 animals. A histological study revealed morphological similarity of the neourethral tube thus engineered and the normal urethra.

[Experience with velcade administration in multiple myeloma].

AIM: To study efficacy of velcade therapy for progressive or resistant multiple myeloma (MM). MATERIAL AND METHODS: We used velcade in therapy of 36 patients (18 males and 18 females, age 43-76, age median 58 years) with progressive or resistant MM from April 2006 to February 2008. Prior second line standard therapy failed. A total of 206 courses of treatment were performed. RESULTS: Treatment outcomes were assessed in 34 patients, 2 patients continue treatment. Overall response was 55.9% (EBMT criterion). A complete, partial and minimal responses were achieved in 10, 4 and 5 cases, respectively. No response was observed in 11 patients. Velcade was administered in polyresistance to polychemotherapy (PCT) programs including VAD (5 patients), contraindications for PCT because of old age or comorbid pathology (13 patients). These patients received 1-9 courses of velcade (as monotherapy in 28 patients, in combination with high-dose dexamethasone in 6 patients, in combination with high-dose dexamethasone and doxorubicin in 3 patients with progressive disease). Follow-up of this group from the start of velcade therapy was 4-15 months. Velcade induced stabilization of the disease in 4 patients (follow-up median was 8 months), progression of the disease in 5-9 months occurred in 6 patients.

[Contractile capacity of fibroblasts from different sources in the model of living skin equivalent].

Human fibroblasts contract collagen gel in vitro and produce a connective tissue-like structure termed the living skin equivalent. In this study, the contractile capacity of postnatal dermal fibroblasts, bone marrow mesenchymal cells and mesenchymal cells derived from the fat tissue has been compared to that of fetal dermal fibroblasts in the model of living skin equivalent. The results show that fetal fibroblasts contract the collagen gel approximately six times stronger than do all other fibroblast cell types, with the numbers of all these cells being equal. A deeper insight into the behavior of fibroblasts differing in their origin will help to develop new approaches to the treatment and regulation of wound healing and fibrosis formation.

[Epithelial tissue reconstruction using cell technologies].

The issue of the cellular basis of epithelial tissue engineering, concerning the skin first of all, is discussed. Principles of cultivating human epidermal keratinocytes and formation of living tissue equivalents for grafting to damaged tissues and organs are described. The article presents data on the restoration of damaged tissues after tissue equivalent grafting. Examples of using cellular technologies in combustiology, ophthalmology, oncology, and dentistry are given.

[The use of human fibroblasts grown on microcarriers for the formation of the connective tissue equivalent]. / Ispol'zovanie fibroblastov cheloveka, vyrashchennykh na mikronositeliakh, dlia formirovaniia ékvivalenta soedinitel'noi tkani.

Live equivalents of tissues, specifically those produced on the basis of fibroblasts and collagen gel, are widely used for repair of organ and tissues defects. In clinical practice, it is more convenient to use the fibroblasts grown on microcarriers or such a connective tissue equivalent when the fibroblasts on microcarriers are embedded in collagen gel. We studied the properties of a connective tissue equivalent produced by embedding the fibroblasts grown on microcarriers in collagen gel for its prospective use in clinical practice. According to our results, the optimal time of use of the live tissue equivalent amounts to three--four days after embedding of fibroblasts on microcarriers in gel. At that time, contraction only begins, which facilitates manipulations with the gel.

[Up-to-date methods of cell therapy in treatment of burns]. / Sovremennye metody kletochnoi terapii pri lechenii ozhogov.

Complex of methods for repair of wounded and burned skin with transplantation of keratinocytes and fibroblasts grown in vitro is proposed. Five different tissue constructions may be used. Original method of skin recovery based on use of alive equivalent of skin is developed. Results of its clinical application are presented. It is concluded that cell constructions may be used in combined treatment of wounds and burns.

Skin repair by transplantation of cultured keratinocytes.

Improvement of methods for culturing skin cells stimulates their wide application in the treatment of a variety of skin injuries. A method for restoration of the skin with cultured epithelium and cultured epithelium in combination with a derma analog (collagen gel with fibroblasts) was developed. Possible mechanisms for skin repair after transplantation of cultured allogenic skin transplants were analyzed.

[Application of viable cryopreserved alloderm transplants in the treatment of wound defects of soft tissues]. / Ispol'zovanie zhiznesposobnykh kriokonservirovannykh allodermotransplantatov v lechenii ranevykh defektov miagkikh tkanei.

An original method is proposed for treatment of long-standing intractable wounds and trophic ulcers using viable cryopreserved allodermotransplants and a distant air-plasma treatment. The main source of the allodermotransplants is the cadaverous skin. It was shown that the cadaverous skin taken during 17 hours after the donor's death was viable. The maximum period for storage of the viable skin when the worked out preservative is used at the temperature regimen -18 degrees C is 10 days, and at -70 degrees C it can be as long as 45 days. The analysis performed included 101 patients with long-standing intractable wounds and trophic ulcers. In 51 of them the new worked out method was used. An analysis of clinical and histomorphological data has proved that the application of the viable cryopreserved allodermotransplants and distant air-plasma treatment favor the better course of reparative processes. By the end of the forth week the wounds were completely closed in 19.7% of patients, the wound areas were considerably less (more than by 50% of the initial size) in 43.1%, less reduction of the wound area (less than 50% of the initial size) in 27.4%, in 9.8% there was no effect. No negative results were noted. It should be noted that closure of the tissue defect can be achieved by stimulation of the physiological regeneration of the patient's tissues. This method of regeneration of the skin is effective in trophic ulcers, long-standing intractable wounds and is also recommended in case of deficit of donor resources or when the severe state of the patient does not allow active surgical treatment.