Relationship of peroxidation indicators and hemograms in children with hip joint pathology.

The increase in the number of patients with hip pathologies among children of different ages makes the diagnosis and treatment of these diseases one of the most actually existing problems in modern orthopedics. The aim of the work was to determine the features of the lipid peroxidation system - antioxidant protection and hemogram indices in children with various forms of hip joint pathology. The results of a preoperative examination of 47 patients aged 6-15 years (average age 10.3 years) who were treated at the clinic "FSBI NICC" TO "named after academician G. A. Ilizarova, Ministry of Health of the Russian Federation. There were 25 boys and 20 girls. Given nosology, patients were divided into five groups. The diagnosis was established on the basis of a clinical and radiological examination. Group I consisted of 8 male patients with stage II Perthes disease (mean age 8.75 + 1.63). Group II includes 16 patients (8 boys, 7 girls) with stage III Perthes disease. (average age 11.80 + 0.89). Group III included 12 patients (6 boys, 6 girls) with aseptic necrosis of the femoral head (average age 14.7 + 2.35). Group IV consisted of 4 patients (1 boy, 3 girls) with epiphyseal dysplasia. (average age 10.25 + 1.36). Group V includes 7 patients with hip dysplasia complicated by aseptic necrosis of the femoral head (mean age 8.33 + 2.11). The norm is the data that was obtained after examining 10 healthy male adolescents (age 13-14) and 5 female adolescents (age 8-14 years). Changes in lipid peroxidation rates and antioxidant activity are unidirectional in different forms of pathology of the hip joints in children, and the content of peroxidation products reliably correlates with hemogram values in stage II osteochondropathy and complicated hip dysplasia. In the complex of diagnostic measures for children with dystrophic lesions of the hip joint, to clarify the nature and stage of the pathological process, as additional criteria, hemogram indicators and lipid peroxidation systems - antioxidant protection can be used.

[Comparative assessment of mineral metabolism in shoulders and crura in patients with osteomyelitis.] / Сравнительная оценка минерального обмена у пациентов с остеомиелитом плеча и голени.

Chronic osteomyelitis in long tubular bones is generally aggravated by metabolic imbalance in patients' organisms affecting mineral metabolism. It is critically important that the extent of this imbalance should be determined prior to surgical intervention to choose optimal methodology, proper monitoring of recovery and adequate prognostication of final results. With this in mind a comparative assessment has been carried out to shed light on the intensity of mineral metabolism in the blood serum of patients suffering from osteomyelitis in their shoulders and crura. Dynamics of how indices of electrolytes and activity of acidic and alkaline phosphatases vary have been studied in blood serum samples in 24 patients, 18 patients suffering from osteomyelitis in crus bones and 6 - in shoulders. In addition, correlations between total calcium, inorganic phosphate and phosphatase index have been computed. The mineral metabolism indices which were exhibited by the patients having shoulder osteomyelitis and by the patients with crus osteomyelitis are statistically meaningful differences prior to surgery and 2-3 days after surgery. 21 days after surgical intervention the activity of osseous remodeling enzymes, content of total calcium and phosphates as well as the correlations with the phosphatase index show no significant differences. These specific features of mineral metabolism turn out to level out in the process of treating chronic osteomyelitis in upper and lower limbs with transosseous compression-distraction osteosynthes. It has been the first study aimed at discovering comparative characteristics of mineral metabolism in patients with shoulder osteomyelitis and the ones with crus osteomyelitis at different times following surgical intervention. The study looks into correlations between the electrolytes and the mineralization index and shows specific traits exhibited by patients who suffering from osteomyelitis in shoulder and crus went through reparative regeneration at different periods of treatment.

[Dynamics of hemogram indicators in children with pathology of the hip joint before and after treatment by the Ilizarov method.]

The pathology of the hip joints in children is the object of increased attention of specialists both in our country and abroad. Despite the wide coverage of this problem, most studies are devoted to analysis of the advantages of various surgical intervention technologies. To determine the significance of differences in hemogram indices in children with different nosological forms of hip joint pathology and indicators of healthy children. Hemogram and leukoformula parameters were determined in 10 healthy children and 47 children with hip joint pathology. The significance of differences in indicators compared with the norm and between different nosological groups of patients was evaluated. The dynamics of hemogram changes was evaluated at a long time after surgery. The largest deviations from normal hemogram values were found in a group of children with hip dysplasia complicated by aseptic necrosis of the femoral head. Two months after surgery, the main hemogram parameters in all groups of patients are normalized. The reactions of lipid peroxidation are changing, as evidenced by a decrease in the number of peroxidation products, primarily diene conjugates. Along with this, the activity of individual antioxidant enzymes changes - the activity of catalase decreases and the activity of superoxide dismutase increases. The most extreme values were noted in the group of children with epiphyseal dysplasia. In children with hip dysplasia complicated by aseptic necrosis of the femoral head, prior to surgical treatment, a statistically significant increase in the number of leukocytes and platelets in the blood serum is observed. In patients with epiphyseal dysplasia, osteochondropathy, both in the early and late stages, changes in the hemogram indices relate to the indicators of red blood cells and hemoglobin. In children with aseptic necrosis of the femoral head, hemogram values did not have statistically significant differences from the norm. In all groups of patients, destabilization of the peroxidation and antioxidant defense systems was noted.

[Oxygen-dependent mechanisms and oxidative stress in children for femoral head osteochondropathy.]

Degenerative-dystrophic processes in the articular tissues are accompanied by the changes in the values of congenital immunity, being a result of immune responses to aseptic inflammation. The purpose of this study - to investigate the oxygen-dependent mechanisms of neutrophil phagocytic activity (NBT-test, myeloperoxidase activity), the biochemical values of lipid peroxidation, the oxidative modification of proteins and the activity of enzyme antioxidant protection in children (at the age of 12-16 years) with osteochondropathy of the femoral head.The increase in spontaneous NBT-test and myeloperoxidase content in neutrophils, the decrease in NBT stimulation index, as well as the statistically significant increase in the activity of superoxide dismutase, the main producer of hydroperoxide, was revealed in the group examined. At the same time, no increase in catalase activity and in the content of lipoperoxidation products was observed, however, redistribution of the products of oxidative modification of proteins with ketone predominance was found. In case of osteochondropathy development in children the activation of the oxygendependent mechanisms of neutrophil phagocytic activity is observed, as well as the increase in the number of the secondary products of protein peroxidation - ketones. An increase in SOD activity, with a simultaneous and significant decrease in catalase activity evidence of accumulation of hydroperoxide causing neutrophil activation and chemotaxis. The study data can be used for predicting osteonecrosis development as additional criteria when decision-making of the advisability of performing reconstructive surgeries of the joint.

[The study of indices of electrolytic composition and phosphatase activity of synovial fluid in patients with osteoarthritis of knee joint].

The study was carried out concerning indices of electrolytic content and phosphatase activity of synovial fluid in patients with degenerate dystrophic affections of knee joints stage II and III. The detection of rate of occurrence of alterations of studied indices established that most often occurred increasing of ratio calcium-phosphorus and decreasing of concentration of phosphate-ions. Therefore, concentration of the mentioned indices can be applied in evaluation of conditions of joint medium.

[THE ANALYSIS OF INDICATORS OF MINERAL METABOLISM IN PATIENTS WITH DEGENERATIVE DYSTROPHIC AFFECTIONS OF JOINTS].

The analysis of indicators of mineral metabolism in patients with degenerative dystrophic affections of joints demonstrated that under development of osteoarthrosis process the alteration of indicators of concentration of electrolytes in blood serum, urine and synovial fluid occurs. The stage II of process is characterized by maximal alterations of indicators. The indicator of relationship between concentration of phosphate-ion and index of phosphatases of blood serum turned out the significant coefficient of correlation.

[The biochemical composition of synovial liquid of human knee joint in normal condition (indicators of electrolytes and protein specter)].

The public research data does not contain information on issues of electrolytes' concentrations and changes of protein specter depending on gender and age. Thereby, the study was targeted to evaluate age and gender characteristics of biochemical composition of synovial liquid of human knee joint in normal condition. The composition of electrolytes and protein fractions of synovial liquid of human knee joint in normal condition has no dependencies from gender and age. The single indicator correlating with age is ionized calcium. The samples of synovial liquid of suddenly died persons were taken to determine indicators of calcium, phosphorus, magnesium, chlorides, crude protein and protein fractions of knee joint in normal condition. The study demonstrated the absence of reliable differences in the composition of synovial liquid depending on age and gender.

[An association of the protein spectrum and various immunoglobulin classes in synovial fluid in gonarthrosis].

Synovial fluid from patients with gonarthrosis was examined using biochemical and immunological studies; the levels of total protein, protein fractions, and immunoglobulins A, M, and G were measured. In a joint osteoarthrotic process, the patients' synovial fluid showed a significant increase in the levels of immunoglobulins of all classes and total protein, a change in the distribution of protein fractions, and a close correlation between IgM and a protein beta-globulin fraction.