[Reconstructive surgery in gynecology].
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Biomedical subjects
Publications and source records attributed to V I Kulakov.
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The authors describe the technique and share their experience gained in repair of the lower segment of the uterus during cesarean section with a single-row suture. The incidence of postoperative complications was markedly reduced after such an operation, severe complications were not recorded, and the incidence of spontaneous deliveries after repeated pregnancies increased.
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A method of flow horizontal chromatography has been developed permitting investigation of blood and tissue cellular phospholipids ruling out lipid peroxidation effects on cellular membranes. Phospholipid levels of blood and myometrial tissue cells were measured by this method in 67 patients with histologically verified internal endometriosis. Phospholipid and phosphatidyl inosite levels in platelets and immunocompetent cells of these patients reliably differed from those in healthy women. Phosphatidyl inosite levels of heterotopic endometrial tissue was increased by 1.4 times vs. the norm on an average. In parallel with this, a reliable change of phosphatidyl cholines and inosites levels in endometriosis foci were detected as against their levels in intact tissue. The authors suggest a method for the diagnosis of internal endometriosis by phosphatidyl inosite levels in blood lymphocytes.
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OBJECTIVE: To assess the use of flow cytometry (FCM) analysis of living spermatozoa subjected to indirect immunofluorescence staining with the mouse anti-human immunoglobulin (Ig)G monoclonal antibodies (FCM test) as an objective method for the detection of antisperm antibodies in semen and serum. DESIGN: The comparative studies were conducted with the direct and indirect mixed antiglobulin reaction (MAR) and FCM test performed by FCM analyzer FACSCAN (Becton Dickinson Immunocytometry Systems, Mountain View, CA). SETTING: Clinical infertile service. PATIENTS: Seventy-six semen and 20 sera samples of infertile patients were analyzed. RESULTS: For IgG in semen there was a highly significant correlation between the direct MAR and FCM test. Six of 12 IgG-positive samples revealed also IgA, and just one sample, which showed negative MAR, was positive for IgM in FCM test. Flow cytometry test and indirect MAR showed also a highly significant correlation of the results of IgG detection in sera. CONCLUSIONS: Flow cytometry test may be used to verify that IgG antisperm antibodies are on the surface of living spermatozoa either retrieved directly from an ejaculate or after exposure to serum and to determine proportion of antisperm antibodies-positive spermatozoa, titer, and quantity of antibodies bound to the cell surface.
This paper reports the results of a comprehensive survey of the effects of the accidental release of radiation caused by the accident at the Chernobyl nuclear power station in April 1986. The accident and the resulting release of radiation and radioactive products into the atmosphere produced the most serious environmental contamination so far recorded. We have concentrated on evaluating the outcomes and health risks to women, their reproductive situation, and consequences for their progeny. We have concentrated on two well-defined areas: the Chechersky district of the Gomel region in Belorussia and the Polessky district of the Kiev region in the Ukraine. A number of investigations were carried out on 688 pregnant women and their babies, and data were obtained from 7000 labor histories of the development of newborns for a period of 8 years (3 years before the accident and 5 years after it). Parameters examined included birth rate, thyroid pathology, extragenital pathology such as anemias, renal disorders, hypertension, and abnormalities in the metabolism of fats, complications of gestation, spontaneous abortions, premature deliveries, perinatal morbidity and mortality, stillbirths and early neonatal mortality, infections and inflammatory diseases, neurological symptoms and hemic disturbances in both mothers and infants, trophic anomalies, and biochemical and structural changes in the placenta. Several exogenous, complicating influences were also considered such as psycho-emotional factors, stress, lifestyle changes, and others caused directly by the hazardous situation and by its consequences such as treatment, removal from affected areas, etc.(ABSTRACT TRUNCATED AT 250 WORDS)
The authors analyze the results of comprehensive examinations and treatment of 79 patients with corporal isthmic adenomyosis. Comprehensive examinations making use of clinical, instrumental (hysteroscopy, hysterosalpingography, echography), biochemical (measurements of blood and myometrial phosphatidylinosites), and morphologic methods are needed for a reliable diagnosis of this condition. Blood phosphatidylinosite measurements may be used as an objective test to assess the efficacy of hormonal therapy. Trental and lipostabil forte are advisable for adenomyosis therapy. If amputation of the uterus has to be resorted to, intraoperative histologic express testing of the lower edge of the uterus for endometriosis may help choose the optimal volume of surgical intervention and prevent extirpation of the uterus that is not at all neutral for the body.
Levels of phospholipids, phosphoinosites, phosphatidylinosite-3-phosphates, diacylglycerols, arachidonic acid, prostaglandins E, F, J, and thromboxane A2 in patients with endometriosis and cancer of the corpus uteri were found to differ from those in healthy women. Biochemical parameters of whole blood and myometrial tissue of endometriosis patients differ significantly from those of patients with corpus uteri cancer. The authors suggest that reduction of phosphatidylinosite and phosphatidulinosite-3-phosphate levels in whole blood and their parallel increase in myometrial tissue are conducive to cellular proliferation and malignant degeneration.
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Eighty-six patients with histologically verified internal endometriosis were examined using histochemical, morphometric methods, and measurements of blood and myometrial tissue phosphatidyl inosites. Blood levels of phosphatidyl inosites were found reliably decreased in the patients vs. normal subjects, whereas their levels in myometrial tissue were significantly increased. Increased counts of tissue basophils, microcirculation disorders, lymphostasis and membranogenic stromal edema development were observed round endometriosis foci. Changes in the basic substance and fibrous structures of myometrial connective tissue complex were revealed, most marked in the areas adjacent to the endometrium. A possible mechanism of the development of pathologic shifts in internal endometriosis is discussed.
Time course of rapid changes in blood phospholipids and blood cells was studied in 44 patients with endometriosis. Rapid reversible blood phospholipid changes were observed when these patients' red cells and lymphocytes were incubated with calcium chloride. Time course of rapid changes in phosphoinosites, sphyngomyelines, phosphatidylserines, phosphlatidylethanolamines of patients' red and white blood cells, whole blood, and myometrial tissue differed significantly from that in healthy women. The authors suppose that cellular proliferation processes in endometriosis are connected with phospholipid homeostasis disorders in blood cells and tissue.
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