Saratov JOURNAL of Medical and Scientific Research

№2, 2019, volume 15

Possibility of frameless biopsy of deep and remote brain tumors and impact of its results on treatment strategy

Year: 2019, volume 15 Issue: №2 Pages: 312-317
Heading: neurosurgery Article type: Original article
Authors: Shabunin A.V., Gorozhanin A.V., Vakatov D.V., Shestakov A.A., Chekhonatsky V.A.
Organization: Clinical Hospital n. a. S. P. Botkin
Summary:

Purpose: to assess the possibilities of frameless biopsy of brain tumors with deep and hard-to-reach localization and its impact on the treatment strategy. Material and Methods. 56 patients with supratentorial brain tumors of deep and hard-to-reach localization who underwent biopsy using frameless neuronavigation according to accepted standards. Results. In 9 (16.1 %) cases there was a discrepancy between the data of the preliminary MRI examination and the histological conclusion of the punctate after the biopsy, which changed the tactics of treatment. Conclusion. Biopsy of brain tumors of deep and hard-to-reach localization allows you to accurately and least invasive to establish the correct diagnosis. Conducting a frameless biopsy with subsequent immunohistochemical verifcation of the biopsy allows planning adequate further treatment, increasing the duration and quality of life of patients with brain tumors of deep and hard-to-reach localization.

Keywords: treatment
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The study of surgical activity dynamics at patients with hypertensive intracerebral haematoma using simulation analysis in the Chuvash Republic

Summary:

Objective: improving the efciency of treatment for patients with hypertensive intracranial hematomas by means of planning optimization, epidemiological evidences simulation analysis and dynamics of surgical treatment indices. Material and Methods. 225 patient charts with hypertensive intracerebral hematomas have been analyzed. All patients were examined and treated in Cheboksary Republican Clinical Hospital January 2008 to December 2017 Results. The retrospective analysis revealed decrease in the number of surgeries for hypertensive intracerebral hematomas from 35 to 19 From 2011 to 2017 mortality in the group of patients with 30 to 60 ml hematomas decreased as well. Surgeries in the group of patients aged 50–70 who had strokes most frequently in 2010–2017 got fewer. Conclusion. Introduction of decision-making system at diagnosis stage enables applying diferentiated approach for choosing surgical treatment approach.

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The role of connective tissue dysplasia in aetiopathogenesis of varicose disease and acute varicothrombophlebitis

Year: 2019, volume 15 Issue: №2 Pages: 302-307
Heading: Surgery Article type: Review
Authors: Tsarev O.A., Anisimov A.Yu., Prokin F.G., Zakharov N.N., Senin A.A., Kulikova A.N.
Organization: Saratov State Medical University
Summary:

The academic literature review presents the analysis of recent publications which focus on the role of connective tissue dysplasia in aetiopathogenesis of lower extremity varicose vein disease (LEVVD) and acute varicothrombophle-bitis (AVTPh). The ways of predicting the variants of LEVVD and AVTPh clinical course on the basis of analyzing the combination of phenotypic characteristics are examined. Key words: varicose disease, varicothrombophlebitis, connective tissue dysplasia.

Biliary anastomotic strictures after liver transplantation

Year: 2019, volume 15 Issue: №2 Pages: 296-301
Heading: Surgery Article type: Review
Authors: Popov M.V., Voskanyan S.E., Dunaev A.P., Bashkov A.N., Maltseva A.P.
Organization: Moscow City Oncologic Hospital N. 62, Imaging Department, State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The literature review presents the data on a current state of the problem of anastomotic strictures of the bile ducts in patients after living donor liver transplantation, called the «Achilles» heel» of transplantology. The data on the frequency and timing of the development of strictures, their causes and risk factors are given. The role of imaging methods in the diagnosis of this group of complications is shown. Methods for treating biliary post-transplantation strictures are described: antegrade, retrograde, and open. The themes of the prospects of percutaneous and endoscopic techniques and the choice of stricture treatment methods are also touched upon.

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Experience of endovideosurgical hemithyroidectomy use for patients with benign thyroid diseases

Year: 2019, volume 15 Issue: №2 Pages: 290-295
Heading: Surgery Article type: Original article
Authors: Vertyankin S.V., Turlykova I.A., Meshcheryakov V.L., Grekov V.V., Chupakhin N.V., Vanzha Ya.E., Ivanova V.A., Zhurkin K.I..
Organization: Saratov State Medical University
Summary:

Objective: development and assessment of the way of an endoscopic hemithyroidectomy improving visualization of anatomical structures and excluding «the confict of tools». Material and Methods. Results of treatment of 103 patients who transferred hemithyroidectomy from endoscopic and traditional approaches to the period from 2014 to 2018 on the basis of the Hospital of S. R. Mirotvortsev (Saratov) are analyzed. According to access option patients were divided into 2 groups. The compression syndrome, functional autonomy of a thyroid gland and results of a puncture biopsy were indications to operation. Results. Unilateral paresis of a throat is diagnosed for 1 patient after traditional intervention, stopped within 1.5 months, after an endovideosurgical hemithyroidectomy — for 3 patients, and was stopped in terms from 7 days up to 1.5 months. Signs of hypoparathyrosis were not found in the groups of patients. The complications connected with administration of carbon dioxide did not arise. Conversionwas not required in any case. Conclusion. Development and assessment of a new way of an endoscopic hemithyroidectomy which is feasible, safe and provides high degree of esthetic result.

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Experimental substantiation of the results of combined techniques in treatment of soft tissue abscess

Year: 2019, volume 15 Issue: №2 Pages: 287-290
Heading: Surgery Article type: Original article
Authors: Alipov V.V., Kulikova A.N., Musaelyan A.G., Mustafayeva D.R.
Organization: Saratov State Medical University
Summary:

Objective: to develop a model of purulent abscess of soft tissues and experimentally substantiate the efectiveness of the use of nanoparticles of zinc oxide (ZОN) and a drug based on lanthanum nitrate in the combined treatment of purulent abscess of soft tissues. Material and Methods. The purulent abscess of soft tissues modeling was performed using a modifed Fogarty catheter using a culture of Staphylococcus aureus in an experiment on 80 white laboratory rats of males weighing 190±25 g. Four groups of animals (20 each) were selected, which, after surgical dissection and laser rehabilitation of the cavity, carried out local therapy. In the frst (control) group, standard treatment was used, in the second group a drug based on lanthanum nitrate was used, in the third — ZОN, in the fourth — a combination of the drug with lanthanum nitrate + ZОN. Results. By the 10th day, 87±4.9 % of animals of the fourth group showed activation of the processes of collagenosis and epithelialization and complete obliteration of the abscess cavity. Conclusion. The developed purulent abscess of soft tissues modeling method is low-impact and allows optimizing the time of abscess formation with specifed characteristics. The combined treatment of animals of the fourth group due to the synergism of action creates optimal conditions for the accelerated obliteration of the purulent abscess of soft tissues cavity, shortening the treatment time by two times compared with the standard techniques.

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Clinical and laboratory indices of periprosthetic infection in patients with knee endoprosthesis instability

Year: 2019, volume 15 Issue: №2 Pages: 283-286
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Galashina E.A., Babushkina I.V., Girkalo M.V., Kauts O.A., Grazhdanov K.A.
Organization:
Summary:

 Objective: to make assessment of clinical and laboratory indices in patients with deep periprosthetic infection and knee endoprosthesises aseptic instability. Material and Methods. 80 patients with septic and aseptic instability of knee endoprosthesises have been surveyed. All patients were subjected to comprehensive clinical and laboratory examination (intra-articular fuid cytology and microbiology testing, joint tissue histology testing, ELISA was employed for determining the levels of skeletal tissue remodeling markers). Results. The complete combination of several examination criteria specifc for knee periprosthetic infection was

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Optimization of transpedicular spondylosynthesis application for type A3 lesions of the thoracolumbar transition: clinical experimental study

Year: 2019, volume 15 Issue: №2 Pages: 275-283
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Zaretskov V.V., Arsenievich V.B., Shchanitsyn I.N., Shulga A.E., Zaretskov A.V., Ivanov D.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Objective: the optimization of transpedicular systems application for type A3 lesions of the thoracolumbar transition using computer simulation based on the fnite elements method. Material and Methods. The examination data (post-traumatic kyphotic deformation, intensity of pain syndrome, length of operation and extent of blood loss) of 81 prospec-tively enrolled male patients who in 2017–2018 had been operated for Th11-L2 vertebrae simple fractures of А3N0M1 type (AOSpine classifcation). The patients were divided into 3 groups in accordance with the type of intervention performed on them: short-segment (n=42), 8-screws polysegment (n=25) and 6-screws polysegment (n=14). Biome-chanical simulation based on the computer tomography data was performed for each variant of the metal construction arrangement. Results. In the process of biomechanical simulation with all the variants of the instrumented spine 3D- models loading 8-screws construction proved to be the most consistent one, at that the stability of polysegmental constructions exceeds that of bisegmental one by an order. The results of surgical management were evaluated in terms of up to a year following the intervention. The loss was less and the correction worked better with polysegmental fxation despite more complicated initial conditions for the correction compared to those of group 1 Conclusion. Biomechanical simulation shows prerequisites for the development of bisegmental systems instability as the equivalent stresses and peak displacements are higher compared to those of polysegmental fxation. The efciency analysis of application of various transpedicular fxations for type A3 thoracolumbar transition lesions attests to the advantage of polysegmental arrangements of transpedicular systems, at that the implantation of the 6- screws polysegmental system should be considered the frst choice on the number of indices.

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Quality of life in children with fat feet (planovalgus foot, longitudinal platypodia)

Year: 2019, volume 15 Issue: №2 Pages: 271-274
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dokhov M.M., Sertakova A.V., Rubashkin S.A., Timaev M.Kh.
Organization:
Summary:

Objective: to evaluate the quality of life in children with fat feet using standard quality of life questionnaire technique. Material and Methods. 97 children with fat feet (mean age 9.7±1.2 y. o.) and 32 children with neutral position of the feet (control group) participated in the research. Both the fat foot and neutral position of the foot diagnoses were based on patients» clinical examination and instrumental methods of diagnosis. The questionnaire survey was conducted using the Oxford Ankle Foot Questionnaire (OAFQ) for children (7–17 y. o.) designed for evaluation of potential cost for treatment of children with foot and ankle joint pathologies. It is made up of 15 questions showing the quality of life (physical development, school life and exercise, emotional development) as well as problems with shoes selection. General central module of the Kiddy-KINDL Questionnaire covers various aspects of children»s life providing a fexible modular psychologically applicable method. The structure of the questionnaire scales consists of 24 questions united in evaluation groups. Results. In the group of fatfoot children the quality of life is reliably lower in terms of physical development and shoes selection. Flat feel has almost no impact on children»s emotional development as well as their social function; it doesn»t usually lead to fxation on disfguration. Conclusion. To evaluate every individual clinical case of decline in physical development quality and worsening of the emotional state in pediatric patients trauma orthopedists are recommended to employ various questionnaires that allow for detailed defning of lesions degree and quality for individual selection of the treatment method.

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Bioflm formation by Staphylococcus strains isolated from various biological materials at infectious complications following total knee replacement

Year: 2019, volume 15 Issue: №2 Pages: 261-266
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Mamonova I.A., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Objective: to study Staphylococcus spp. Strains bioflm forming ability in vitro. These strains are infectious agents for implant-associated infection in patients following total knee replacement depending on the biomaterial under study. Material and Methods. Bioflm forming ability in vitro of 275 Staphylococcus spp. strains has been studied. Bioflm formation was performed using modiefed method of G. D. Christensen. Results. Bioflm forming ability was discovered in 51.2 % of the studied strains, at that it was reliably (p<0.05) higher forcoagulase-positive staphylococci compared to coagulase-negative ones. Staphylococcus strains isolated from sonication fuid obtained after removed prothesiscom- ponents ultrasonication and soft tissue bioptates were chatracterised with high ability for bioflm forming. This ability was reliably (p<0.05) higher than in strains isolated from wounds and aspirate. Interspecies diferences were observed in a group of strains isolated from bioptates: optical density of the S. epidermidis stains extracts was reliably (p<0.05) higher than that of S. aureus strains. Conclusion.Bioflm forming ability of Staphylococcus spp. strains isolated from patients with implant-associated infection depends on the biomaterial under study thus defning the most informative methods of microbiological study.

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