[High tibial osteotomy with computer navigation for medial gonarthritis]. / Sravnitel'nye rezul'taty lecheniya medial'nogo gonartrita metodom vysokoi tibial'noi osteotomii s ispol'zovaniem komp'yuternoi navigatsii.

OBJECTIVE: To study significance of computer navigation for improving clinical and radiological results of medial gonarthritis treatment compared to non-invasive methods of lower limb axis correction control. MATERIAL AND METHODS: The study included 73 patients who were divided into 2 groups. The main group included 40 patients, the control group - 33 patients. In the main group, high tibial osteotomy was performed using computer navigation, in the control group - using non-invasive techniques. Clinical assessment was carried out according to the KSS, KOOS and VAS scales. We assessed the main reference angles of the lower limb considering X-ray data. RESULTS: Both groups were characterized by postoperative improvement of clinical results according to various scales. Computer navigation provided higher accuracy in most cases. We focused on target correction of 3° valgus. CONCLUSION: High tibial osteotomy with computer navigation or non-invasive techniques is an effective treatment method for medial gonarthritis. There are no significant differences in clinical results according to the KSS and KOOS scales, as well as X-ray data after correction. We found significant differences in VAS scores.

[Clinical and functional outcomes of valgus osteotomy in patients with medial gonarthrosis (preliminary results)]. / Rezul'taty val'giziruyushchei osteotomii u patsientov s medial'nym gonartrozom (predvaritel'nye rezul'taty).

OBJECTIVE: To analyze gait biomechanics before and after corrective osteotomies around the knee joint in patients with medial gonarthrosis. MATERIAL AND METHODS: The study recruited 5 patients (6 surgeries) with medial gonartrosis and varus knee deformity. Gait biomechanics was analyzed in preoperative period and 6 months later. The control group consisted of 20 healthy people. RESULTS: Knee joint biomechanics was almost normal in postoperative period. Amplitude of knee joint flexion was increased. Moreover, hip joint flexion-extension amplitude was increased on both sides and often exceeded normal values. Clinical results showed significant increase in IKS (from 55 to 89.6) and VAS score (from 7.7 to 2.3). Postoperative correction angle varied within 1.5-2° of valgus. CONCLUSION: Corrective osteotomy around the knee joint is effective for medial gonarthrosis. We obtained favorable clinical results and limb axis correction after surgery without significant hypercorrection. Gait biomechanics was also improved.

[The Influence of Adiponectin on Production of Apolipoproteins A-l and E by Human Macrophages].

Adiponectin is an adipose tissue hormone affecting energy and lipoprotein metabolism and modulating inflammatory responses. However, the role of this adipokine in atherogenesis remains poorly understood. The aim of this study was to investigate the effect of adiponectin on the production of apolipoproteins (apo) A-l and E by human macrophages (MP). The study was conducted on macrophage-like cells of the THP-1 cell line of two differentiation terms, 3 and 5 days (3d and 5d). Adiponectin (10 µg/mL) stimulated the expression of apoA-1 gene at the mRNA level in 5d MP, but not in 3d MP. The level of apoE mRNA in MP under the action of adiponectin was not affected. Adiponectin suppressed macrophage TNF gene expression, while it induced the expression of IL-10 gene in 5d MP. The secreted levels of apoA-1 and apoE proteins under the action of adiponectin in macrophages of both periods of differentiation remained unchanged, while the level of the surface apoA-1 protein in 5d MP was decreasing. Incubation of 5d MP with the PPARα nuclear receptor antagonist MK-886 or with the nuclear receptor LXR agonist TO-901317 resulted in cancellation of the stimulating effect of adiponectin on apoA-1 gene expression. These data indicate that adiponectin, in addition to its anti-inflammatory action, has a modulating effect on production of apoA-1 by macrophages. The latter is probably one of the mechanisms of the influence of this adipokine on atherogenesis.

Hypoxia as a Factor Involved in the Regulation of the apoA-1, ABCA1, and Complement C3 Gene Expression in Human Macrophages.

Hypoxia plays a critical role in progression of atherosclerosis. Local oxygen deficiency in a plaque creates a specific microenvironment that alters the transcriptome of resident cells, particularly of macrophages. Reverse cholesterol transport from plaque to liver is considered a main mechanism for regression of atherosclerosis. Ubiquitously expressed ATP-binding cassette transporter A1 (ABCA1) and liver- and small intestine-derived apolipoprotein A-1 (ApoA-1) are two main actors in this process. We recently reported endogenous apoA-1 expression in human macrophages. While ABCA1 and ApoA-1 have antiatherogenic properties, the role of complement factor C3 is controversial. Plasma C3 level positively correlates with the risk of cardiovascular diseases. On the other hand, C3 gene knockout in a murine atherosclerosis model increases both plaque size and triglycerides level in blood. In the present study, we show for the first time that a hypoxia-mimicking agent, CoCl2, induces the upregulation of the apoA-1 and C3 genes and the accumulation of intracellular and membrane protein ApoA-1 in THP-1 macrophages. The MEK1/2-Erk1/2 and MKK4/7-JNK1/2/3 cascades are involved in upregulation of ABCA1 and C3 via activation of transcription factor NF-κB, which interacts with the HIF-1α subunit of hypoxia-inducible factor 1 (HIF-1). The three major MAP-kinase cascades (Erk1/2, JNK1/2/3, and p38) and the NF-κB transcription factor are involved in the hypoxia-induced expression of the apoA-1 gene in THP-1 macrophages.

[Our experience with the correction of large protruding ears].

The objective of the present work was to improve the results of correction of large protruding auricles. The results of long-term observations and many-year experience of the authors provided the basis for the development of the method that allows to simultaneously diminish the size of a protruding ear and correct an auricular defect. A detailed description of selected steps of the proposed approach is presented together with relevant illustrations. The follow-up analysis of the outcomes of the treatment gives evidence of its high therapeutic efficiency.

[In vitro comparison of antibacterial properties of antiseptics used in periodontology].

Antibacterial properties of antiseptics most commonly used in periodontology were examined in vitro showing al agents containing chlorhexidine to be the most effective against gram-negative (E. coli), gram-positive (staphylococcus, streptococcus, enterococcus) germs as well as а C. аlbicans.

[The treatment and rehabilitation of patients with secondary adentia and atrophy of alveolar process of maxilla].

The novel method of surgical treatment and rehabilitation of patients with secondary adentia and atrophy of alveolar process of maxilla was suggested. The method allows to preserve satisfactory microcirculation of the implantation area and to achieve hermetizm by wound closure. The use of the endoscope for visualizing the operation field minimizes the possibility of the sinus membrane intraoperative perforation and decreases the overall surgical traumatizm.

Non-magnetic shell coating of magnetic nanoparticles as key factor of toxicity for cancer cells in a low frequency alternating magnetic field.

This work is devoted to studying the effects of non-magnetic shell coating on nanoparticles in a low frequency alternating magnetic field (LF AMF) on tumor cells in vitro. Two types of iron oxide nanoparticles with the same magnetic core with and without silica shells were synthesized. Nanoparticles with silica shells significantly decreased the viability of PC3 cancer cells in a low frequency alternating magnetic field according to the cytotoxicity test, unlike uncoated nanoparticles. We showed that cell death results from the intracellular membrane integrity failure, and the calcium ions concentration increase with the subsequent necrosis. Transmission electron microscopy images showed that the uncoated silica nanoparticles are primarily found in an aggregated form in cells. We believe that uncoated nanoparticles lose their colloidal stability in an acidic endosomal environment after internalization into the cell due to surface etching and the formation of aggregates. As a result, they encounter high endosomal macromolecular viscosity and become unable to rotate efficiently. We assume that effective rotation of nanoparticles causes cell death. In turn, silica shell coating increases nanoparticles stability, preventing aggregation in endosomes. Thus, we propose that the colloidal stability of magnetic nanoparticles inside cells is one of the key factors for effective magneto-mechanical actuation.

[Use of NO-therapy in correction nose deformations in patients with thick porous skin].

If the patient has thick porous skin in the region of end part of nose the result of the operation satisfies neither patient nor surgeon. During recent 2 years the authors used NO-therapy (apparatus Plazon) both in preparation thick porous skin for the operation and in postoperative period for prevention crude scars development and their treatment. NO-therapy was conducted to 22 patients pre- and postoperatively, to 26 patients operated 1,5-2 years ago (who had some compactness in the region of end part of nose) and to 5 patients with crude scar deformations. NO-therapy promoted quicker reduction of oedema and liquidation postoperative scars had formed in cases of endonasal incisions.

[Surgical treatment of cystous lesions of the jaws in children using biocomposite material].

Assessment of surgical treatment of cystous lesions of the jaws in children was performed on the basis of the results of treatment of 25 patients with the use of granulated biocomposite material GAP-99. It was shown by the authors that this material allows one to shorten the time of bone wound healing, to improve cosmetic and functional effects during the hospital stage of treatment. In long-term period full rehabilitation was achieved in patients operated with the use of this biocomposite material.

[Yersinia infections and acute surgical diseases of the organs of the abdominal cavity]. / Iersinioz i ostrye khirurgicheskie zabolevaniia organov briushnoi polosti.

Intestinal yersiniosis was identified bacteriologically and serologically in 4.87% of patients who underwent operation for pain in the right half of the abdomen. The disease was manifested in the form of acute appendicitis, acute mesadenitis, terminal ileitis, and colitis. Chloramphenicol, tetracycline, gentamicin, and nitrofuran preparations proved to be most effective. The late-term results were studied.

[Surgical treatment methods for the short saddle nose and high skin portion of the upper lip]. / Khirurgicheskie metody lecheniia korotkogo slepnogo nosa i vysokogo kozhnogo otdela verkhnei guby.

Remote results of treatment are analyzed in 10 patients with deformations of the nose combining a shortened nose and pulled in skin of the septum. The patients were operated on according to Burian. Good results were obtained in 4 cases, satisfactory in 5. A higher share of satisfactory results of Burian's operation is explained by the fact that it is very difficult to draw down the thick porous skin into a proper position, particularly at the tip of the nose. Additional operations are needed, deteriorating the cosmetic effect. The method proposed by the authors yields better results: 89% good and 16% satisfactory. The intervention is aimed directly at removal of the deformation and tissue defect. Mutual transposition of three flaps, one of which is a drawn columella and two other flaps from the upper lip fill the mucosal defect, repairs the pulled in skin part of the septum and elongates the tip of the nose. In addition, transposition of skin flaps from the upper third of the upper lip to the site of mucosal defect shortens the height of the upper lip, thus creating a correct proportion of the middle and lower thirds of the face.

[Use of the alar cartilage in repairing of defects of the cartilage part of the dorsum nasi]. / Primenenie transplantata kryl'nykh khriashchei dlia ustraneniia defektov khriashchevogo otdela spinki nosa.

The authors present long-term results of using costal and alar allo-cartilages for repairing defects of the cartilage part of nasal ridge. Transplantation of the costal allo-cartilage to 362 patients entailed cartilage deformations in 50, inflammation in 34 and resolution of the cartilage in 26 patients. Transplantation of alar cartilage brought resolution and deformation in 10 and 7 cases of 276 transplantations, respectively, in the absence of inflammation. Moreover, the latter material provides better cosmetic results.

[An analysis of the late results in the surgical treatment of patients with complex combined nasal deformities]. / Analiz otdalennykh rezul'tatov khirurgicheskogo lecheniia bol'nykh so slozhnymi kombinirovannymi deformatsiiami nosa.

Analysis of late results showed that satisfactory and unsatisfactory results are most frequent (70%) in patients with combined deformations of the nose. The principal causes of recurring deformations after rhinoplasty are a) absence of adequate internal fixation of both the dislocated pyramid and the mobilized nasal septum; b) omitting the mobilization of the bone part of the septum in case of its deformation; c) unjustified wide use of methods of mobilization of crossing incisions on the cartilaginous part of the septum; d) no correction of thick porous skin at the end part of the nose; e) use of costal allocartilages in slight retractions of the cartilaginous part of the ridge of the nose which are contoured at the interface, dislocated, and deformed; f) use of costal allocartilages as rafters in flattened noses makes the end part of the nose thickened and little mobile; and g) use of collodion dressing does not meet the requirements of fixation, particularly so in the bone part of the ridge. Hence, analysis of late results showed that some of the routinely used methods should be revised.

[The elimination of the retractility of the skin portion of the nasal septum]. / Ustranenie vtianutosti kozhnogo otdela peregorodki nosa.

The authors propose a method which decreases the traumatism of surgery for nasal septum repair and helps attain more stable cosmetic results. An open endonasal incision is made behind the alar cartilage pedicles and continued along the fold between the alar and triangular cartilages to the nostril wing base. Perpendicular to this incision and starting from its end, another incision is made, also through the mucosal and cartilagenous tissue to the site where lateral parts of alar cartilages are changed for median. The mucocartilaginous flap is thus cut from the external upper part of the lateral compartment of the alar cartilage. The same intervention is made from the other side. Then the flaps and wound edges are mobilized, the columella is rendered a proper position, and the detected hidden tissue defect is filled with mucocartilaginous flaps. This method is based on correct understanding of the deformation, detection of the latent defect of tissues, and its repair by means of the adjacent tissues making incisions from the nasal cavity. The modification differs favorably from the prototype method.

[The correction of a high ridge and bridge of the nose]. / Korrektsiia vysokoi spinki i perenos'ia nosa.

The proposed method for correcting congenital deformations of the nose is less traumatic and its cosmetic results are more stable. The procedure is as follows. After endonasal dissection and wide stratification of the skin of the ridge and bridge of the nose, the osseocartilagenous protrusion of the ridge and the bridge are removed not by depression, but by resection and removal with subsequent bilateral paramedial and transverse-lateral osteotomy of the nasal bones and their mobilization into a proper position. The method may be used for correcting a high ridge of the nose in any of its deformations: an osseocartilagenous protrusion, high wide ridge, uneven ridge after an injury, etc.

[Combined nose deformities and the restoration of nasal breathing by a surgical method]. / Kombinirovannye deformatsii nosa i vosstanovlenie nosovogo dykhaniia khirurgicheskim sposobom.

Disorders in nasal respiration after posttraumatic combined deformations depend on deformation of the septum, pathological changes in the mucosa, and deformation of the external nose. Restoration of nasal breathing is determined by the type of surgical intervention. The nasal respiratory function recovered in 20 days to 5 months in the majority (47) of patients operated for traumatic combined deformations of the nose with impairment of nasal respiration.

[Surgical methods of correcting skin in various deformities of the nose]. / Khirurgicheskie metody korrektsii kozyi pri razlichnykh deformatsiiakh nosa.

Many-year experience gained in operations on patients with thick porous skin indicates that if such skin is not corrected simultaneously with supporting structures of the nose, the immediate and remote results of surgery were usually satisfactory. After operations with correction of thick porous skin or its dissection in case of excess skin, good results were attained in 78% cases. The authors consider such measures obligatory in repair of congenital deformations of the nose in patients with thick porous skin.

[Correction of congenital of the lateral nose deformities]. / Korrektsiia vrozhdennykh deformatsii kontsevogo otdela nosa.

Immediate and remote results of perennial use of most popular correction methods in different types of congenital deformations of nose end (wide end -- according to J. Converse; prolonged end -- according to D. Armstrong and protruded end -- according to F. Burian) were analyzed and their drawbacks disclosed. The authors presented their own new techniques.

[A differentiated approach to the choice of physiotherapy methods in trigeminal prosopalgia]. / Differentsirovannyi podkho k vyboru metodov fizioterapii trigeminal'nykh prozopalgii.

148 patients with trigeminal neuralgia, odontogenic neuropathies of the alveolar nerves, neuropathy of the main trigeminal nerves and their sensitive branches, neuropathic complications after alcoholization received individually selected physiotherapy in each prosopalgia in acute and subacute period. Adequate choice of physical factors and physiotherapy is dependent on careful examination of the patient with consideration of topical and pathogenetic features of the disease.