Saratov JOURNAL of Medical and Scientific Research

Puchinyan D.M.

Saratov Scientific Research Institute of Traumatology and Orthopedics, Deputy Director of Science, Doctor of Medical Science, Professor

Scientific contribution of professor V.G. Ninel to the study and treatment of chronic pain and spastic-pain syndromes of neurogenous nature and regeneration of trunks of peripheral nerves of extremities (to the 80th birth anniversary)

Year: 2019, volume 15 Issue: №4 Pages: 944-947
Heading: anniversary Article type:
Authors: Norkin I.A., Ostrovsky V.V., Grishin S.E., Ulyanov V.Yu., Bazhanov S.P., Puchinyan D.M.
Organization: Saratov State Medical University
Summary:

The article presents the main stages in the career of professor Vyacheslav G. Ninel and estimates his scientific contribution to neurosurgery development. There are three main areas scientific where V.G. Ninel contribute to: researching and reduction of pain, spastic-pain and spastic syndromes in patients with vertebral and spine trauma consequences; researching and improving of surgical management for patients with cervical vertebrae traumas as well as spinal cord; experimental studies of regeneration processes in peripheral nerves.

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Pathogenic specifics of articular cartilage metabolism regulation at the initial stage of gonarthrosis

Year: 2019, volume 15 Issue: №4 Pages: 939-943
Heading: Рathophysiology Article type: Original article
Authors: Puchinyan D.M., Gladkova E.V., Karyakina E.M., Belova S.V., Romakina N.A.
Organization: Saratov State Medical University
Summary:

Objective: to clarify specifics of articular cartilage metabolism regulation in early stages of gonarthrosis. Material and Methods. 66 women aged 41 to 60 у. o. (median age 49 years; Q25%=44; Q75%=55) were examined. The control (n=30) and the main (n=36) groups were arranged depending on knee osteoarthritis clinical and instrumental presentations, or their absence. The levels of cartilage oligomeric matrix protein (COMP), acidic fibroblast growth factor (FGF-1), vascular endothelial growth factor (VEGF-A), interleukin-1 (3 (IL-1 (3) and superoxide dismutase-2 (SOD-2) in serum have been determined by solid-phase enzyme immunoassay. Results. There was a statistically significant increase in the level of COMP in blood serum as well as the increase in number and strengthening of negative correlation between cytokinesand SOD-2 in women of the main group. Conclusion. The increased content of COMP in blood serum and the rise in number of negative correlations between SOD-2 on the one hand, and COMP, IL-1 (3 and VEGF-A on the other may be early osteoarthritis presentations in the examined individuals.

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Diagnostic implication of cytokines in musculoskeletal neoplasms

Year: 2019, volume 15 Issue: №4 Pages: 934-939
Heading: Рathophysiology Article type: Original article
Authors: Ponamarev I.R., Puchinyan D.M., Shchanitsyn I.N.
Organization: Saratov State Medical University
Summary:

Objective: to analyze diagnostic significance of neopterin, VEGF, sICAM, sVCAM, IL-6, TNF-a and MMP-9 in determining the nature of tumor process in musculoskeletal neoplasms. Material and Methods. 64 patients with benign (44) and malignant (20) musculoskeletal tumors aged 18to65y. o. were examined. Neopterin, VEGF, sICAM, sVCAM, IL-6, TNF-a and MMP-9 in serum were studied by enzyme immunoassay (p=0.07). Results. A statistically significant increase in the expression of regulatory molecules, neopterin (p<0.001), VEGF (p=0.02), slCAM-1 (p<0.001), IL-6 (p<0.001), TNF-a (p=0.02) in particular has been discovered and a pronounced tendency for the increase of MMP-9 level has been in evidence. Using ROC analysis, threshold values for each parameter have been determined. The most informative cytokines (neopterin, sICAM and IL-6) have been identified with multivariable regression method. Conclusion. The levels of neopterin, slCAM-1, IL-6 in the serum of patients with malignant musculoskeletal neoplasms above the threshold values predict an unfavorable course of the disease.

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Hemostasis test parameters in patients requiring revision knee arthroplasty

Year: 2018, volume 14 Issue: №2 Pages: 266-271
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization:
Summary:

Objective: comparative analysis of the blood coagulation system in patients requiring revision arthroplasty of the knee joint in connection with the developed infectious and aseptic complications after total arthroplasty. Material and Methods. 37 patients with complications of total knee replacement were examined. Patients were divided into 2 groups: 1st — with signs of suppuration (n=19); 2nd — withsigns of aseptic instability of the endoprosthesis components (n=18). The control group consisted of 22 conditionally healthy people. Studied screening coagulation: activated partial thromboplastin time, prothrombin time, fbrinogen concentration, thrombin time, antithrombin III, protein C, the content of soluble fbrin-monomer complexes and D-dimers. Results. There was an increase in activated partial thromboplastin time in patients of group 2, prothrombin time — in patients of groups 1 and 2 compared with the data obtained in the control group (p<0.001). An increase in the content of soluble fbrin- monomer complexes and D-dimers was recorded in the blood plasma of patients of the 1st and 2nd groups compared to their level in the control group (p<0.001). Conclusion. The data of local coagulogram tests in patients requiring revision arthroplasty of the knee joint refect the signs of maladaptation in the hemostatic system at the preoperative stage of examination. It is worth noting the lack of information content of the screening coagulogram, as its basic tests do not refect changes in the whole system of homeostasis, the search for new informative research methods remains relevant today.

Keywords: -
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The capacity of the thrombin generation test in the diagnostics of hemostasis system disorders in patients with osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 602-606
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shakhmartova S.G., Vorobyova I.S., Puchinyan D.M.
Organization:
Summary:

Aim: to determine the diagnostic significance of thrombin generation test parameters in the diagnostics of hemostatic disorders in patients with osteoarthritis of large joints in preoperative period. Material and Methods. 137 subjects have been investigated, among whom there were 115 hip and knee osteoarthritis patients, submitted for primary arthroplasty (68) and re-prosthetics (47); control group — 22 conventionally healthy blood donors. All subjects underwent plasma hemostasis study and thrombin generation test with two activators — RB (TF 2 pmol/ml) and RC-low (TF 5 pmol/ ml). Osteoarthritis patients were divided into two groups according to the results of thrombin generation test. The 1st group included patients with an adequate response to the stronger activator (t-lagR >t-lag ow, tt-peak^tt-peak^^), the 2nd —with an inversion response (t-lagRBlow). Results. In trie control group and group 1 patients, the thrombin formation process is more pronounced when using an activator with a high TF(RC-low) content than when using an activator with a lowTF (RB) content, which is regarded as an adequate reaction of thrombin formation to the action of a stronger agonist. Patients of the 2nd group inresponse to the action of the activator with a high content of TF was observed inhibition of the reaction of formation of thrombin, which was reflected in the slowdown in the speed of the generation of this enzyme and reduce its quantity. Conclusion. The use of two activators with different concentrations of tissue factor in the test of thrombin generation allows the nature of the response of the hemocoagulation system to initiate the process of thrombin formation to identify patients with adequate and inadequate response.

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The history of the development of national traumatology on the example of medical and scientific activities of Saratov Research Institute of Traumatology and Orthopedics (SarNIITO) (1950-1980)

Year: 2018, volume 14 Issue: №3 Pages: 596-602
Heading: Traumatology and Orthopedics Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Chibrikov G.l., Norkin I.A., Ilyina E.S., Skobelkina A.V.
Organization: Saratov Socio-Economic Institute of G. V. Plekhanov Russian University of Economics
Summary:

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.

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Growth factors of fibroblasts and vascular en-dothelium in the early stages of knee osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 583-586
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Puchinyan D.M., Gladkova E.V., Karyakina E.V., Romakina N.A., Belova S.V.
Organization:
Summary:

Aim: to compare and study the relationship between the maintenance of vascular endothelial growth factor and acidic fibroblast growth factor in individuals with the initial clinical and radiological manifestations of the degeneration of the hyaline cartilage of the knee joints and healthy people. Material and Methods. 27 women with initial symptoms of knee osteoarthritis (main group, average age

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The state of the hemocoagulation system and endothelial dysfunction in benign and malignant skeleton neoplasms

Year: 2018, volume 14 Issue: №3 Pages: 574-578
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ponamarev I.R., Puchinyan D.M., Gladkova E.V., Korshunov G.V.
Organization:
Summary:

Aim: to study the functional status of the vascular endothelium and the activity of the hemocoagulation system, as well as the relationship between some indicators characterizing their state in patients with benign and malignant skeleton neoplasms. Material and Methods. 62 patients with benign (45) and malignant (17) bone neoplasms and 10 healthy individuals of the control group were examined. The coagulation properties of blood plasma and the content of vascular endothelial growth factor (VEGF), intercellular adhesion molecules of sICAM and adhesion molecules of vascular endothelium (sVCAM) in blood serum were investigated. Results. In patients with benign bone tumors, prothrombinase formation mechanisms were activated, the concentration of soluble fibrin-monomer complexes (FSC) was

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The role of pro- inflammatory cytokines and the enzyme element of antioxidant system in the destruction of hyalin cartilage at the early stages of primary gonarthrosis

Year: 2018, volume 14 Issue: №3 Pages: 545-549
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Karyakina Е.М., Gladkova Е.М., Puchinyan D.M., Romakina N.A., Belova S.V.
Organization:
Summary:

Aim: comparative assessment of the state of joint (hyaline) cartilage, pro-inflammatory component of cytokine profile and enzyme element of blood antioxidant system in healthy individuals and patients at the early stages of gonarthrosis. Materials and Methods. The content of cartilage oligomeric matrixprotein (COMP), superoxide dismutase-2 (mitochondrial) (SOD-2) and interleukin-1 (3 (IL-1 (3) was studied in 34 individuals with initial signs of gonarthrosis (main group) and in 20 conventionally healthy individuals (control group) in blood serum by ELISA. Results. In the serum of patients with GA, the content of COMP (Me=20.67 pg/ml; 25% quartile 14.70; 75% quartile 27.15) and IL-1(3 (Me=4.74 pg/ml; 25% quartile 3.93; 75% quartile 5.90) was statistically significantly higher (p<0.05) than in the control group: COMP (Me=15.27 pg/ml; 25% quartile 8.86; 75% quartile 20.76 and IL-1(3 (Me=3.59 pg/ml; 25% quartile 2.75; 75% quartile 3/83). A correlation analysis in the control group revealed a positive strong correlation between COMP and IL-113 (r=+0.70; p=0.01) and a tendency toward a negative moderate association between COMP and SOD2 (r=-0.43; p=0.08); in the main group between these indicators, the connections were weak, statistically insignificant. Conclusion. Patients in the early stages of primary GA compared with healthy individuals confirmed the presence of destructive processes in the articular (hyaline) cartilage and the activation of the proinflammatory element of the cytokine profile and the enzyme level of the antioxidant system of the blood. The correlation analysis revealed a decrease in the strength of functional links in patients with GA, between the indicators of COMP — IL-1 (3 and COMP — SOD2, which indicated a change in the regulatory effects of proinflammatory cytokines and the enzyme element of the antioxidant system of the blood on the structural-metabolic state of the articular (hyaline) cartilage in the initial stage process.

Professor I.Ya. Livshits and his contribution to the development of national neurosurgery

Summary:

The article traces the professional path of Professor Lev Yakovlevich Livshits, assesses his scientific contribution to the development of national neurosurgery. The concept of minimally invasive surgical treatment of trigeminal nerve neuralgia, developed by L. Ya. Livshits, allowed developing an original method of puncture surgical treatment of pain syndrome by directed hydrothermal destruction of the sensitive trigeminal root. The concept of "growing radicalism" created by Professor L. Ya. Livshits allowed his students elaborating algorithms for treating severe chronic pain syndromes of any localization and etiology.

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