Saratov JOURNAL of Medical and Scientific Research

2012, volume 8

The state of the vegetative nervous system in patients with gonarthrosis for surgical treatment before and after surgical treatment

Year: 2012, volume 8 Issue: №4 Pages: 975-979
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dolganova T.I., Biriukova, Karasev E.A., Buravtsov P.P., Karaseva
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog) in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I), tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II), treatment-and-diagnostic arthroscopy (Group III). Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered 10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion

Keywords: arthroscopy, decompression-draining surgeries, gonarthrosis, variational pulsometry

Combined osteoplasty of metaepiphysial defects in total knee arthroplasty with osteoplastic biomaterial

Year: 2012, volume 8 Issue: №4 Pages: 971-974
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo М.V., Gavrilov М.А., Kozlov V.V.

The research goal is to study the results of osteoplastic biomaterials application to reach the improvement of primary and long-term secondary stability of fixation. Materials and methods: 62 patients with bone defect of metaepiphy-sis of type 2 according to AORI have been included into the research. Total knee arthroplasty with osteoplasty of the defect has been carried out in all the patients. In the basic group (n=32) combined osteoplasty has been used, and in comparison group (n=30) cement osteoplasty has been applied. In cases with total arthroplasty in the basic group modifying standard resections, structural autograft of laminar form has been received simultaneously. After preparing the floor of the defect its plasty has been carried out: in the basic group the defect has been filled with osteoconductive biomaterial, and in the comparison group — with polymethylmethacrylate to restore the anatomical configuration of condyles. Besides, before cement fixation of the prosthesis in the basic group the received autograft has been put on the restored implant plateau. Results: Assessing the results during the period from 2 to 4 years objective criteria have included the data of X-ray imaging, biomechanical research and WOMAC test. In the postoperative period significant differences have not been revealed. In the follow-up period in the group with application of the combined osteoplasty joint remodulation of autograft and osteoplastic biomaterial with regenerative restoration of bone tissue of the implant plateau has been observed. Conclusion: The described technique may reduce the relative risk of revision arthroplasty.

Keywords: bone defect, osteoplastic biomaterial, total knee arthroplasty

Enzymuria at children with nephropathy from developed cement industry region

Year: 2012, volume 8 Issue: №4 Pages: 965-970
Heading: Pediatrics Article type: Original article
Authors: Kudin M.V., Tzimbal D.E.
Organization: Volsk Central Hospital

For the purpose of enzyme morphological syndromes study enzymuria has been revealed in 58 children with nephropathy who live in the zones of cement industry and in 30 children with nephropathy from pure zones. Criteria of enzyme morphological characteristics have been estimated by enzymuria of enzymes: alkaline phosphatase, г-glutamyltransferase, leucine aminopeptidase, lactate dehydrogenase, cholinesterases. Research method of the enzymuria is kinetic by means of analyzers of reaction rate. In urine of children with nephropathy living in region with the cement industry, higher activity of enzymes, in comparison with group of conditionally pure zone, containing in a brush border — GGT in 1,9 times, LAP in 1,6 times, cytoplasmatic enzyme LDG — in 2,3 times has been established authentically. Results. Activity of AP and CE in urine of children of studied groups does not differ authentically. The revealed indicators of enzymuria can be served as markers of damage of proximal tubule of a nephron in children with nephropathy as a result of influence of echopathogen. Direct correlation has been determined between toxic microelements content in urine and biosphere and indicators of enzymuria in children.

Keywords: alkaline phosphatase, cholinesterase, enzymuria, lactate dehydrogenase, leucine aminopeptidase, nephropathy, г-glutamyltransferase

Clinical features of pneumocystic pneumonia in newborns

Year: 2012, volume 8 Issue: №4 Pages: 962-965
Heading: Pediatrics Article type: Original article
Authors: Bochkova L.G., Ayberman A.S., Gasanova T.A.
Organization: Saratov State Medical University

The research goal is to study clinical features and incidence of pneumocystic pneumonia in newborns. The research methods: The research has included 227 newborns with pneumocystic pneumonia: 154 (67,8%) — premature, 64 (28,1 %) — mature with intrauterine growth retardation with body weight from 2232,0 up to 2840,0 gr., and 9 (3,9%) — mature without intrauterine growth retardation. The indication of Pneumocystiscarini has been carried out by means of immunofluorescence with «Pnevmocistofluoskril» polyclonal antibodies by ZAO Niarmedik+, as well as stained by Romanovsky Giemsa technique and by Toluidine Blue. Results: Clinical and microbiological aspects of pneumocystic pneumonia in newborns of different maturity have been studied. The frequency of pneumocystic infection agent separation during the neonatal period has been characterized. Conclusion: The received data have indicated the potential intrauterine agent transmission from mother to infant. The high risk of generalization of the given infection form in newborns has been observed. It has been pointed out that biotopes are the most relevant means in neonatal pneumocystosis diagnostics.

Keywords: newborns, pneumocysts, pneumonia

Quality of life and clinical features of chronic exertion headache in men and women

Year: 2012, volume 8 Issue: №4 Pages: 957-961
Heading: Neurology Article type: Original article
Authors: Selyankina Yu.N., Slyusar T.A.
Organization: Tver State Medical University of the Ministry of Russia

The research goal was to study quality of life and clinical features of chronic headache in men and women. Materials and Methods. The comprehensive survey was conducted. 162 people (75 men and 87 women aged 35-54 years, average age 45,6±2,6 years) with tension headache (TH), corresponding to the criteria of tension-type headache under international classification of headaches (2003) were examined. The results of studies of quality of life among the patients with chronic tension headache allowed to estimate the impact of disease on various components of QOL in men and women. Conclusions. Monitoring of physical, psychological and social functioning of patients to obtain differential and integral quantitative indicators enabled a doctor to correct treatment at various stages and to develop a set of practical recommendations for treatment of patients with poor quality of life.

Keywords: tension headache, quality of life

Atherothrombotic stroke: clinical data and parameters of platelet haemostasis in patients in acute stage

Year: 2012, volume 8 Issue: №4 Pages: 954-957
Heading: Neurology Article type: Original article
Authors: Goldobin V.V., Klocheva Е.G., Asadullaeva P.M., Vavilova T.V., Sirotkina O.V., Laskovets A.B.
Organization: North-West State Medical University n.a. I.I. Mechnikov, Department of Neuropathology Assistant Professor, Candidate of Medical Science

The aim of the study was the investigation of clinical data and platelet haemostasis parameters in patients with atherothrombotic stroke for secondary prophylaxis improvement. Materials and Methods. 41 patient: 26 (63,4%) males, 15 (36,6%) females, mean age 66,0±9,4 years and 18 healthy person were examined. Neurological examination was performed, patient condition was estimated with National Institute of Health Stroke Scale and Rankin scale. The set of investigation included clinical blood analysis, adenosinediphosphate-induced agregometry, flow-cytometry, molecular genetic analysis of gene Iba. Results. There was platelet activation in patients with atherothrombotic stroke according to flow-cytometry data. The conventional optic agregometry was not helpful for revealing of platelet activation. The expression of 1ba receptors correlated with the point of National Institute of Health Stroke Scale at discharge. The incidence of Iba gene mutation was higher in patients with atherothrombotic stroke comparing with control group. Conclusions. The revealed data predispose to the possibility of individual administration of antiagregant therapy in such patients.

Keywords: atherothrombotic stroke, flow cytometry, P-selectin, platelet receptors

Cardiac biopotentials influence on central nervous system functioning: first steps in hypothesis verification

Year: 2012, volume 8 Issue: №4 Pages: 947-953
Heading: Internal Diseases Article type: Original article
Authors: Shvarts Yu.G., Cherkasova S.A., Kondal'skaya Yu.O.
Organization: Saratov State Medical University

The research goal is to verify the hypothesis on influence of cardiac biopotentials on central nervous system. Materials: 20 healthy individuals aged 18-26 years old have been participated in the investigations. Two groups composed of 10 patients each have been formed. Double increase in heart biopotentials by means of artificial impulse insertion between natural cardiac contractions has been modeled. Artificial impulses have been similar to unaffected ones, produced in a normal heart work. Additional impulses have been generated using external pacemaker and have been linked up with electrodes on the chest. They have been synchronized with the heart rhythm and located in-between R waves. The duration of those impulses has been fully matched to ventricular complex. Their amplitude has been adjusted individually depending on the height of R wave. Nervous system mobility has been used as the indicator reflecting the central nervous system functioning. Degree of mobility has been defined on the basis of tapping test results. The test has been repeated at specific intervals. Groups have been exposed to two adverse testing modes. Additional impulses have been conducted to the patients of group I within an hour over a period of the first and the third 15-minute intervals and to the patients of group II over a period of the second and the fourth 15-minute intervals. In the middle and in the end of each time interval tapping test has been carried out. After preliminary analysis two other modes of stimulation have been tested. The stimulation has been performed within the 40-minute course: over a period of the first 20-minute interval and vice versa. Results: Detailed evaluation has revealed that short-time increase of nervous processes has been checked in combination with decrease in their stability. Conclusion: The data obtained have shown that there is possible influence on central nervous system functioning. The article ends with prospects of further investigation.

Keywords: cardiac biopotentials, heart, nervous mobility, tapping test

Influence of personality characteristics on spectrum of catecholamines and course of ischemic heart disease in elderly patients

Year: 2012, volume 8 Issue: №4 Pages: 942-946
Heading: Internal Diseases Article type: Original article
Authors: Prokhorenko I.О., Zarubina Е.G.
Organization: Samara Medical Institute «Reaviz»

Purpose: the study of interrelation between characteristics of psychological profile of elderly patients, level of stress hormones in blood serum and character of IHD course. Materials and Methods. The level of catecholamines and cortisol in blood was investigated in two groups of elderly patients (379 patients) formed according to their psychological profile with the help of Cattell questionnaire. Multispiral coronarography was conducted in patients suffering IHD. Results. The established differences of stress level correlated with the characteristics of the course of IHD at all the
examined patients. In spite of various levels and reactions of adaptive hormones on stress situations the prevalence of IHD appeared to be the same in both groups although manifestation and clinical severity of coronary insufficiency varied in patients of different groups. The number of patients suffered myocardial infarction, among them with Q-wave, occurred to be higher in one of the groups despite the fact that changes in their coronary arteries were less expressed. Conclusion. The character of psychological profile causes different stress resistance of patients and leads to various levels of stress hormones in blood serum. Depression can become a marker of severe course of cardiovascular pathology. The character of psychological profile influences the course of IHD.

Keywords: ischemic heart disease, psychological profile, stress

Expression of lectins in nonspecific ulcerative colitis

Year: 2012, volume 8 Issue: №4 Pages: 937-942
Heading: Internal Diseases Article type: Original article
Authors: Markova А.А., Kashkina E.I., Maslyakova G.N.
Organization: Saratov State Medical University

Purpose: To analyze the expression of lectins in mucosa of a colon in patients with ulcerative colitis (UC), depending on the duration, severity, location and activity of the inflammatory process. Materials and methods: A total of 48 patients with ulcerative colitis and 15 healthy people have been examined. The expression of specific lectins has been determined in mucosa of colon. Results: in healthy patients the expression of the studied lectins has not been observed. In patients with ulcerative colitis there have been differences in the expression of the wheat ovaries lectin. Conclusion: In patients with ulcerative colitis the dependence of expression of the wheat ovaries lectin, WGA-isotropic to N-acetylglucosamine, on the severity and activity of the inflammatory process has been determined.

Keywords: lectins, nonspecific ulcerative colitis

Association of polymorphism of CYP2D6 and CYP2C9 genes encoding P-450 proteins of cytochrome with arterial hypertension

Year: 2012, volume 8 Issue: №4 Pages: 933-937
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Kiselev A.R., Reshetko O.V., Posnenkova O.M., Saratsev A.V., Losev O.E.
Organization: Saratov State Medical University

Gene polymorphisms of cytochrome P-450 CYP2 encoding proteins of cytochrome P-450 are essential forantihy-pertensive drugs metabolism. Purpose: We study the associations of functionally defective allele variants of CYP2D6 gene and CYP2C9 gene with the degree of arterial hypertension (AH). Materials and methods: Samples of DNA of leukocytes of blood of 150 patients with AH without the associated clinical conditions (56% of women) at the age of 20-59
years have been investigated. For the study of polymorphism of genes the pharmacogenetic biochip developed in the Institute of Molecular Biology n.a. V. A. Engelgardt has been used. Comparison of frequencies of occurrence of signs has been carried out on the basis of chi-square criterion. Results: It has been revealed that homozygotes by mutant A1075C, C430T alleles of CYP2C9gene and G1934A of CYP2D6 gene have been significantly more common among patients with hypertension III (p=0.01). Conclusion: The research works on genes of system of P-450 cytochrome have important clinical value for rationalization of pharmacotherapy of hypertension. The increased frequency of occurrence of mutant allele of CYP2D6 and CYP2C9 genes in patients with hypertension III requires special attention to the problem of efficiency and safety of application of hypotensive drugs for the patients.

Keywords: arterial hypertension, biochip, cytochrome Р-450, gene polymorphism, pharmacogenetics