[Reparative potential of bone tissue and associated influencing factors]. / Reparativnyi potentsial kostnoi tkani i vliyayushchie na nego faktory.

OBJECTIVE: The aim of the sthudy. To study the influence of general and local factors on the regenerative potential of bone tissue to optimize augmentation mechanisms in the treatment of jaw atrophy. MATERIALS AND METHODS: The influence of general and local factors on the regenerative potential of the bone during the augmentation operation of the alveolar process (part) of the jaw in 68 patients was studied. The survival rate of dental implants and the incidence of complications after completion of dental rehabilitation in the long-term follow-up period (more than 5 years) were evaluated. 18 indicators were studied, which were evaluated by qualitative and quantitative methods. The study of the effect of indicators on regeneration was carried out using an accurate Fischer test for conjugacy tables. The assessment of the strength of the influence was calculated as the ratio of the chances of developing an unfavorable outcome of bone grafting and dental implantation. RESULTS: He highest chances of developing adverse outcomes were found in smoking patients with diabetes mellitus, high body mass index, low survival of bone walls, severe bone atrophy (5.6 and higher class according to Cawood & Howell), three-dimensional bone defect, in the absence of 3 or more bone walls, the presence of subcompensated and decompensated psychological state the patient. In the course of histological examination, the influence of these factors on the mechanisms of reparative osteogenesis morphologically manifested a lower degree of progress of regenerative processes and a lower degree of maturity of bone tissue. CONCLUSION: To reduce the chances of developing an unfavorable outcome, in the presence of negative general and local factors, it is not advisable to use dental implantation simultaneously with bone augmentation procedures. In order to reduce the pathophysiological impact of negative factors during sinus lifting, increase the proportion of autosteal material for potentiating the metabolic activity of bone tissue, as well as prescribe antioxidant, antihypoxant and membrane stabilizing therapy before surgery and in the early postoperative period.

[Analysis of fatal outcomes of meningococcal infection in adults].

Clinical characteristics and pathomorphological manifestations in 69 patients aged 18 to 86 years with a fatal outcome of the disease were examined in order to analyze the causes of severe course and high mortality of generalized forms meningococcal infection. It was found that the main clinical form was meningococcemia (90%), in the majority in combination with meningitis (52%). The fulminant course in 77% of patients with meningococcal sepsis manifested itself as a sudden onset, rapid development of typical symptoms. Hemorrhagic exanthema was detected on the first day of meningococcemia. The leading complications and critical conditions were infectious-toxic shock, disseminated intravascular coagulation and acute adrenal insufficiency (Waterhouse-Friederiksen syndrome). The severe course of meningitis (in 10%) led to the development of cerebral coma, the morphological substrate of which was edema - swelling of the brain.

[The markers of damage of neurons and glia in cerebrospinal liquor under meningitis in children.]

The actuality of analysis of cerebrospinal fluid under meningitis in children is conditioned by severity of course of disease with development of residual aftermaths in part of patients. The appearance of proteins specific for neurons, astro- and oligodendroglia in liquor and blood serum can serve as a marker of severity of damage of cerebral parenchyma and as a predictor of development of neurological deficiency. The analysis was applied to samples of liquor obtained during diagnostic lumbar puncture in 44 children (33 with viral serous meningitis, 11 with bacterial purulent meningitis). The detection of protein S-100, glial fibrillar acid protein and and neuron-specific enolase was implemented using solid-phase immune enzyme technique. The maximal increasing of concentrations of protein S-100 and glial fibrillar acid protein was detected at initial stage of bacterial purulent meningitis with consequent decreasing of at the stage of re-convalescence. Under serous meningitis at acute stage maximal high proved to be average value of concentration of neuron-specific enolase with tendency to its increasing at the stage of re-convalescence. The multi-directional correlation relationships are established concerning levels of of neuron-specific enolase, glial fibrillar acid protein and protein S-100 with standard liquorologic indices and their direct mutual relationships. The variability of levels of neuron-specific proteins in liquor is established associated with clinical characteristics of course of meningitis in children that testifies possibility of their application for specifying involvement into pathological process of different brain structures and necessity of further studying of relationship of infection affection of brain with development of neurological aftermaths at the residual period.