Saratov JOURNAL of Medical and Scientific Research

Original article

The experience of using biodegradable drainage in combination with traditional sinustrabeculectomy

Year: 2018, volume 14 Issue: №4 Pages: 633-638
Heading: Ophtalmology Article type: Original article
Authors: Krasyuk E.Yu., Noskova O.G., Akulov S.I., Strelnikova N.V., Tokareva E.G.
Organization: Tambov Ophthalmological Clinical Hospital, S. Fedorov Eye Microsurgery Federal State Institution
Summary:

Purpose: analysis and comparison of the degree of intraocular pressure (IOP) compensation, the presence and nature of postoperative complications in traditional sinustrabeculectomy (STE) and STE using biodegradable drainage. Material and Methods. Surgical intervention — sinustrabeculectomy (53 — traditional, 53 — using drainage, DDA drainage type) was performed with stationary diagnosis (106 patients) with a verified diagnosis of "primary open-angle glaucoma" (106 eyes). A comparative analysis was carried out for the stages of glaucoma, the degree of compensation of IOP, the presence and nature of postoperative complications. Results. In the course of sinustrabeculectomy with the use of drainage, a high level of the degree of IOP compensation and a low level of postoperative complications were noted in comparison with traditional sinustrabeculectomy. Gradual resorption of drainage prevents sharp decrease in ophthalmotonus, which allows to significantly reduce the risk of postoperative complications. At the same time, the presence of drainage interferes with the adhesion of the scleral flap and contributes to the gradual formation of a filtration pillow, which, accordingly, leads to a prolonged hypotensive effect. Conclusion. Sinustrabeculectomy with the use of drainage is pathogenetically grounded, which does not complicate the operation, it allows to achieve a persistent and prolonged hypotensive effect and to reduce the risk of postoperative complications.

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Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.

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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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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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Sexual dimorphism of dynamics of concentration of endothelium alteration factors in blood in surgical treatment of chronic generalized periodontitis.

Summary:

Aim: to study the sexual dimorphism of the concentration in the blood of endothelial alteration factors in the dynamics of the surgical treatment of moderate chronic generalized periodontitis (CGP) in comparison with clinically healthy volunteers. Material and Methods. A total of 20 clinically healthy volunteers (average age is 30 (24; 37), 50% are men) and 31 patients with moderate chronic generalized periodontitis (average age is 31 (27; 38), 40% are men) were examined. Serum concentrations of homocysteine and C-reactive protein were determined. Patients with chronic generalized periodontitis were treated following the surgical scheme. Results. In patients with chronic generalized periodontitis, prior to treatment, an increased level of homocysteine and C-reactive protein (CRP) was detected in the serum. Conservative treatment in the preoperative period caused a decrease in the level of homocysteine in patients, while there was no significant change in the rate of C-reactive protein. 10 days after the surgery, an increase in the concentration of homocysteine and C-reactive protein in serum was observed in patients of both sexes, indicating a reactive change. At the same time, reactive changes were more pronounced in women. Long-term results of surgical treatment of chronic generalized periodontitis indicate a decrease in C-reactive protein and homocysteine levels in patients of both sexes. Sexual dimorphism was manifested by the fact that women had lower homocysteine content than men: 9.4 (8.9; 9.7) versus 13.3 (10.8; 14.1) umol/l (p=0,004). Conclusion. Patients of both sexes with moderate chronic generalized periodontitis have elevated C-reactive protein and homocysteine levels. Sexual dimorphism is manifested by higher levels of homocysteine, but not C- reactive protein in men. The acute period of surgical treatment of chronic generalized periodontitis is characterized by an increase in the concentration of factors affecting the endothelium in the blood, which are more pronounced in women. Long-term surgical treatment results of chronic generalized periodontitis demonstrate a decrease of homocysteine and C-reactive protein levels in blood with homocysteine levels being lower in women than in men.

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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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Biomechanical aspects of circular spondylosynthesis of transitional thoracolumbar spine

Year: 2018, volume 14 Issue: №3 Pages: 560-566
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Zaretskov V.V., Arsenievich V.B., Shul'ga A.E., Shchanitsyn I.N., Skripachenko K.K.
Organization:
Summary:

Aim: to present the potential of biomechanical modeling in individual choice of optimal surgical correction method for transitional thoracolumbar spine injury. Material and Methods. We built solid-base 3-dimensional model of the investigated spine segment in Mimics13 on the basis of CT data of injured thoracolumbar spine. Cage and anchorage models were created in CAE system SolidWorks. Numeric modeling was performed in ANSYS in Workbench medium. We analyzed full movement fields, their maximum values for each model as well as equivalent stress in vertebra and anchorage systems. Results. The analysis of equivalent stress and full movement fields emerging in the models under seven basic types of load revealed the most stable spondylosynthesis model which is circular spine

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Comparative analysis of external osteosyn-thesis in the treatment of patients with extraarticular fractures of proximal femur

Year: 2018, volume 14 Issue: №3 Pages: 552-557
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Kauts О.А., Barabash Yu.A., Barabash А.Р., Grazhdanov К.А., Shpinyak S.P.
Organization:
Summary:

Aim: to perform comparative analysis of surgical outcomes of patients with extraarticular fractures of proximal femur with the use of various types of external osteosynthesis. Material and Methods. 169 patients with extaarticular fractures of proximal femur who underwent surgical interventions with various kinds of external osteosynthesis were the subject of the study. Results. Extra-cortical osteosynthesis with DHS-construction provided the restoration of anatomic and functional characteristics by 90.3±0.6% of normal values in the short-term and by 95.2±0.4% in the long-term postoperative period. The implantation of intramedullary constructs resulted in high percentage of positive short-term (92.1±0.6%) and long-term (96.7±0.75%) treatment outcomes. Conclusion. The use of intramedullary osteosynthesis

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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.

Morphofunctional state of spleening under light desynchronosis in the experiment

Year: 2018, volume 14 Issue: №3 Pages: 533-536
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zlobina O.V., Ivanov A.N., Karetnikova A.Yu., Terekhina E.S., Bugaeva I.O.
Organization: Saratov State Medical University
Summary:

 Aim: to study the effects of light desynchronosis on the morphofunctional state of the spleen of white male rats. Material and Methods. The study of light desynchronosis was carried out on 48 male rats using the Light Light model with an illumination power of 300 Ix in the daylight and 500 Ix in the dark. The laboratory animals in the experiment were divided into four groups: the control and three experimental ones, in which they were exposed to light for 1 day, 10 days, 21 days respectively. In the course of morphometry of histological sections of the spleen, the following parameters were assessed: the area of white pulp lymphoid follicles, B- and T-clependent zones of white pulp, the number of germinative centers and immunoblasts in B- and T-zones. Results. On day 1 of the experiment, an increase in the area of the lymphoid follicle, periarterial and B-dependent zones, an increase in the number of immunoblasts and reproduction centers was registered. By the 10th day there was a partial restoration of these indicators relative to the control values. On the 21st day of the experiment, a decrease in the growth dynamics of all the morphometric parameters of the spleen was observed. Conclusion. Light desynchronosis induces by the Light Light model leads to the development of the pathology of the immune system with an extensive shift of all measurable indicators. Key words: morphofunctional state of the spleen, morphometric criteria, light desynchronosis, immunity.

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