Наукові праці. Кафедра акушерства та гінекології № 2
Permanent URI for this collectionhttps://repo.knmu.edu.ua/handle/123456789/331
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Item Redox status and cell membrane alterations of circulating leukocytes and erythrocytes in abnormal uterine bleeding(2023-03-15) Alieksieieva, Olena; Harkavenko, Karyna; Posokhov, Evgeny; Prokopiuk, Volodymyr; Lazurenko, Viktoriia; Safonov, RomanAim. To analyze the eryptosis degree, the state of cell membranes and redox status of circulating red blood cells and leukocytes in patients with abnormal uterine bleeding and its combination with hypothyroidism. Materials and methods. Patients, 74 women aged 18 to 49 years, were examined, which were divided into 3 groups: group I — women with abnormal uterine bleeding (AUB) (24 patients); group II — with AUB and thyroid pathology (30 patients, of whom 18 women had primary hypothyroidism and 2 — secondary hypothyroidism); group III — control group (20 healthy women, who had never had menstrual irregularities). Eryptosis of circulating erythrocytes was assessed by flow cytometry using annexin V staining and 2′,7′-dichlorodihydrofluorescein diacetate (H2DCFDA) staining. Fluorescent probes O1O (2-(2¢-hydroxy-phenyl)-5-phe-nyl-1,3-oxazole) and PH7 (2-(2¢-hydroxy-phenyl)-phenanthro[9,10-d]-1,3-oxazole) were used to characterize changes in phospholipid bilayers of circulating erythrocytes and leukocytes. Lysed blood samples were stained with antibodies to CD45, 7-aminoactinomycin D and H2DCFDA to analyze the redox status of circulatingviable leukocytes.Item Comparison of the effect of different mash implants on the reprodactive sestem in experimenral models of gynecologocal surgeries(2022) Сафонов, Роман Анатолійович; Прокопюк, Володимир Юрійович; Прокопюк, Олександра Вікторівна; Лазуренко, Вікторія Валентинівна; Тіщенко, Олександра Миколаївна; Овчаренко, Ольга Борисівна; Safonov, Roman; Prokopiuk, Volodymyr; Prokopiuk, O.; Lazurenko, Viktoriia; Tishchenko, O.; Ovcharenko, OlgaGenital prolapse complicates the lives of many women after the age of 50. The use of mesh implants is a promising method of surgical correction of this disease. The study on mice compared the effect of the most common surgical meshes on the morphofunctional state of the reproductive system of animals, the postoperative period, and the completeness of morphological and functional recovery of the defects in the lower abdominal wall. It was found that thinner meshes cause less inflammatory reactions, faster recovery and less atrophic phenomena in the internal genitals. The recovery rate also depends on the material and structure of the mesh.Item Modern approaches to the treatment of genital prolapse in obese women(2021) Safonov, Roman; Lazurenko, Viktoriia; Liashchenko, Olga; Afanasyev, I.; Garkavenko, K.; Chernyak, O.Introduction. The problem of female genital prolapse (GP) remains in the sportlight of gynecologists, because despite the variety of surgical methods, there are still recurrences of the disease, which are associated not only with the failure of the restored ligaments, fascia, muscles, damaged pelvic floor and perineum, but with the imperfection of the operation. The solution of this problem is especially important in the treatment of patients with extragenital pathology, in particular obesity. The purpose: to optimize the treatment of genital prolapse in obese patients by determining an individual approach to planning surgical treatment taking into account the degree of obesity and concomitant pathology. Materials and methods. We examined 65 patients of which 20 had genital prolapse and obesity (main group), 25 had genital prolapse and normal weight (comparison group), 20 women did not have gynecological diseases and extragenital pathology made up control group. To diagnose obesity and determine its degree we calculated body mass index (BMI). To determine the degree of GP its quantitative assessment was used (POP-Q; 1996). Surgical intervention included transvaginal extirpation of the uterus without appendages, anterior colporrhaphy, 325 colpoperineoraphy with levatoplasty, sacrospinal colpopexy. Transabdominal and laparoscopic colposacropexy in obese women were not used due to the presence of relative contraindications for laparoscopy (cardiovascular disease, respiratory pathology, adhesions, the condition after hernias’ surgery). Therefore, all operations on women with GP and obesity were performed transvaginally due to the inability to perform abdominal access. In comparison group transvaginal surgery was performed. All the groups under study were representative. Before the use of polypropylene mesh "Polymesh" to minimize purulent-septic complications associated with the use of synthetic prostheses aquadissection was performed with 0.9% saline with the addition of 1 g of ceftriaxone per 200 ml. After the operation, the women used suppositories with hyaluronic acid (revitax). Results. The results of surgical treatment have been analyzed and the following data were obtained: recurrences in the main and in the comparison group were 4% (2 women in whom operations were performed with the use of their own tissues without mesh prosthesis). Infectious complications, dyspareunia and pelvic pain were not observed. Conclusions. Surgical treatment of GP in obese women by using polypropylene mesh "Polymesh" for colposacropexy after transvaginal uterine extirpation increases the effectiveness of treatment and redduces the number of recurrences. Hydropreparation of the mesh with an antibacterial agent and postoperative use of hyaluronidase intravaginally helps to reduce purulent-septic complications of surgery and improves the patients’quality of life.Item Isolation and Cryopreservation of Placental Cells: Search for Optimal Biotechniques in Experimental and Regenerative Medicine(2021) Prokopiuk, Volodymyr; Shevchenko, M.; Safonov, Roman; Prokopiuk, O.A high effi cacy of placental cells application necessitates their investigation. Preclinical studies require an improvement of the methods for obtaining, standardizing and storage of placental cells of experimental animals. Cells were isolated from rats and mice placentas by means of diff erent enzymatic methods and the one of explants. Cells were cryopreserved with DMSO in DMEM using two-stage freezing. The number, morphological, cultural, metabolic features of cells were studied after isolation and storage. The maximum number of viable cells from the placentas of mice and rats was found to be obtained using the explant method or trypsin with ETDA. Cell cultures from mice and rats placentas after the third passage had stable morphofunctional characteristics. Viability of warmed rat placental cells according to dye exclusion was (92.3 ± 1.6)%, according to the adhesive test this was (81.3 ± 5.8)%. For mice placental cells, these values were (86.7 ± 3.7)% and (79.2 ± 8.1)%, correspondingly. The research results enabled the determining of eff ective biotechniques for obtaining the cryopreserved placental cells of rats and mice to perform preclinical studies of their biological eff ect in models of allo- and autotransplantations.Item Experience in clinical application of cryopreserved placental derivatives: cells, tissue, membranes, extract, and cord blood serum(2020) Prokopiuk, Volodymyr; Lazurenko, Viktoriia; Safonov, RomanBackground. The human placenta is a promising source of biomaterial for regenerative medicine. This is primarily due to the availability of a sufficient amount of material, low immunogenicity, a large number of stem cells, and high proliferative cell potential. The effectiveness of stem cells, their lysates, and conditioned media in various pathological conditions has been proven in many studies. Most studies are experimental, or are in different phases of clinical trials. At the same time, in Ukraine there is a wealth of experience of clinical using the cryopreserved placenta medico-immunobiological preparations, which can be the basis for further application of placental material. Objective. We aim to perform a critical analysis of data on the effectiveness and prospects of application of the cryopreserved placenta preparations (cells, tissues, membranes, extract and cord blood serum) in clinical practice. Methods. The results of clinical application of 2,579 medical immunobiological Platex and Cryocell placenta preparations were analyzed. An attention was paid to the effectiveness, course of concomitant, comorbid pathology in patients, as well as the presence of negative responses and complications. The number of the preparations used and the one of the patients according to the nosological forms were counted. Results. The experience of application of medical immunobiological preparations of placental origin in obstetric-gynecological, therapeutic, neurological and endocrinological pathologies is analyzed in the work. The obtained data are compared with the research results in the corresponding model experiments of in vitro and in vivo systems. The positive effect of placental preparations on the course of miscarriage, climacteric syndrome, infertility, diabetes mellitus, coronary heart disease, multiple sclerosis, amyotrophic lateral sclerosis, trophic ulcers has been determined. Contraindications for placenta preparations are some malignancies and an infectious disease process without proper pathogen elimination. Conclusions. Cryopreserved placenta preparations are effective when used in obstetric, gynecological, neurological, endocrinological and therapeutic practice. Their effect is primarily observed in diseases, which are accompanied by autoimmune reactions, hormonal disorders, dysplastic or degenerative processes. The restricted application of placenta preparations is infectious disease process without proper pathogen eliminationItem Reconstruction of the upper third of the ureter with a tubularized pelvis flap in difficult clinical situations(2020) Demchenko, V.; Safonov, Roman; Shchukin, D.; Strakhovetskyi, V.Ureteroplasty with a tubularized pelvis flap is a very rare option for urethral reconstruction. This surgical approach allows replacing extended defects of the upper third of the ureter, and in some cases the entire ureter. Pelvic tubuloplasty can also be used to correct hydronephrosis associated with additional vessels to the lower pole of the kidney. Nowadays there are only a few reports on using tubular pyeloplasty in literary sources. Not all indications for this type of reconstruction have been studied yet. Thus, not all possible methods for the pelvis flaps formation have been developed. This article presents the experience of using this surgical technique in two patients with complex clinical situations. Our experience shows that displacement the anastomosis below the lower polar arteries or veins by using tubular pyeloplasty can exclude the pathological effect of these vessels on it. Therefore, this reconstruction can be considered a standard technique for the surgical treatment of hydronephrosis caused by uretero-vasal conflict. However, this requires practical confirmation, because there is no experience of using such surgical tactics presented in the world literature now. The second clinical observation showed the possibility of reconstruction of an extended defect in the upper and middle third of the ureter by the tubular flap of the pelvis. The proposed technique for the formation of the flap allowed extending it by 2 cm and successfully performing an anastomosis between the flap and the ureter. The main advantage of this approach is the possibility of extending the flap not by reducing the width of its base, but by means of small transverse incisions at various points. This let us to save the blood supply to the flap.