Steroidal spirooxetanes. I. Synthesis and antiandrogenic properties of some 17-spirooxetanoandrostanes

Pharmaceutical Chemistry Journal -     

Treatment of urinary fistulas with allogenic fibroblasts growth culture

15(2.4%) of 601 patients (392 have undergone transvesical adenomectomy, 111 had gunshot wound of the external genitalia and small pelvis organs, 98 had closed pelvic traumas, injuries of the urinary bladder and posterior urethra) were treated for persistent urinary fistulas with human allogenic fibroblasts growth cultures grown in the artificial medium. Before transplantation into the fistula tracts, the fibroblasts were grown in bioreactor on the microcarriers. Application of allogenic fibroblast growth culture has reduced hospital stay to 7.5 days. This method is simple and effective in inpatients. Use of allogenic fibroblasts allows to create bank of cell transplants for application in clinical practice.     

State of microcirculation channel in the area of laser "welded" anastomosis of the small intestine]

Experiments were conducted with CO2 and AIG laser on neodymium to study the condition of microcirculation and the degree of its disturbance in the wall of the small intestine in formation of a laser "welded" entero-enteral and termino-terminal anastomosis. The microcirculatory disorders and their extent were found to be directly dependent on the degree of the thermal effect and the width of the coagulation zone in the region of the suture. The results of the experiment confirmed that the suggested powers of the laser effect on the intestinal wall were optimal.     

Reversal of granulocyte adherence to nylon fibers using local anesthetic agents: possible application to filtration leukapheresis

The effects of the cationic anesthetic agents tetracaine and lidocaine on granulocyte function, morphology, and adherence to nylon fibers were studied in an attempt to improve current methods of granulocyte collection by filtration leukapheresis (FL). When dissolved in acid- citrate-dextrose (ACD) plasma, these drugs significantly increased granulocyte elution from the fibers in a dose-related fashion. Granulocytes exposed to tetracaine and lidocaine remained more than 95% viable, retained normal bactericidal capacity after the drugs were washed from the cells, and had preserved membrane integrity, as evidenced by the normal ultrastructural appearance of tetracaine- exposed cells and an absence of leakage of lysozyme or lactic dehydrogenase. Granulocytes eluted with the anesthetic agents were rounded in shape with a reduction in the number of filopodial cytoplasmic projections and a relative absence of cytoplasmic vacuolization when compared to granulocytes eluted with ACD plasma alone. Dose-related inhibition of phagocytosis and adherence, which was largely reversible after washing the granulocytes, was noted. Greater than 95% of the lidocaine could be removed from the eluate with a single centrifugation and resuspension, indicating that granulocytes prepared by FL with anesthetic-enhanced elution could be potentially transfusable.     

Risk factors for early postpartum hemorrhage (PPH) in the first vaginal delivery,and obstetrical outcomes in subsequent pregnancy

Objective: To investigate risk factors for postpartum hemorrhage (PPH) in vaginal deliveries and the influence of previous PPH on the subsequent pregnancy.

Study design: A retrospective cohort study including first singleton deliveries between the years 1988 and 2012 was performed comparing deliveries with and without PPH. In addition, perinatal outcomes of the subsequent pregnancy were evaluated. Multivariable analysis was performed to control for confounders.

Results: PPH complicated 0.8% of all first vaginal deliveries. Significant risk factors for PPH in vaginal delivery, using a multiple logistic regression model, were: post-term pregnancy, fertility treatments, hypertensive disorders, labor dystocia during the 2nd, and perineal tears grade 2 and 3, respectively. Previous PPH was found to be an independent risk factor for PPH in the subsequent pregnancy. Moreover, previous PPH was found to be a significant risk factor for cesarean section (CS) deliver, to complicate delivery with revision of uterus cavity, anemia, and to require blood transfusion.

Conclusion: Previous PPH poses a risk for recurrent PPH in subsequent delivery and an increased risk for CS. As PPH remains one of the major causes of maternal morbidity, this study strengthens the need for a comprehensive evaluation of prior PPH as a major risk factor for PPH recurrence.