[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.

[Concentration of several osteotropic growth factors, markers of osteogenesis and biologically active molecules in the blood serum of patients with congenital pseudarthrosis of tibia during orthopaedic treatment with combined technologies]. / Soderzhanie nekotorykh osteotropnykh faktorov rosta, markerov osteogeneza i biologicheski aktivnykh molekul v krovi patsientov s vrozhdennym lozhnym sustavom goleni pri ortopedicheskom lechenii s ispol'zovaniem kombinirovannykh tekhnologii.

Congenital pseudarthrosis of tibia is a genetic, systemic pathology with impaired bone remodeling and unknown pathogenetic mechanisms. Orthopaedic treatment of the disease can fail in some cases. The process of bone remodeling is known to occur under control of local and systemic growth factors, and we sought to explore several osteotropic growth factors, markers of osteogenesis and biologically active molecules in the blood serum of patients with congenital pseudarthrosis of tibia. The study included 12 patients with congenital pseudarthrosis of tibia and anatomical shortening of 2.5±1.1 cm. The' age of patients ranged from 7 years to 18 years. Blood serum was used for enzyme immunoassay analysis. The own blood serum levels of 103 conditionally healthy individuals (of mean age of 13.0±0.27 years) were considered as the norm. Greater changes in the concentration were detected among vascular endothelial and transforming growth factors. The patients showed imbalance in serum TGF, low reparative potential of bone tissue due to osteoclast activation prevailing over differentiation of osteoblasts, progenitor and mesenchymal cells. Dynamics in serum concentration of IGF at the time of frame removal indicated to terminating osteoblast activation and collagen synthesis and concomitant active bone restructuring.

[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.

Effects of composition of biocomposite materials implanted into hole defects of the metaphysis on the reparative regeneration and mineralization of bone tissue.

We carried out a comparative analysis of morphological pattern and element composition of regenerated bone tissue forming in the metaphysis defects after substitution of these defects with calcium phosphate substance containing low-molecular non-collagen bone proteins with various affinities to ion exchangers. We have found that regenerated tissue in the defects grew from the edges to the center and its element composition depended on the maturity of newly formed bone tissue. Implantation material containing non-collagen bone proteins with various affinities to ion exchangers induced no significant changes in the content of analyzed elements of bone tissue around the defect. The content of analyzed elements in the areas distant from the defect area did not change during the experiment.

[The concentration of growth factors in patients with inherent and acquired shortenings of limbs bones].

The article deals with the results of study of level of growth factors in blood serum of patients with inherent and post-traumatic shortenings of limbs' bones. The detection in blood serum the level of epidermal growth factor insulin-like growth factor I and angiopoetins is proposed to monitor in given patients the reparative bone formation.

[The characteristics of chemical composition of content of unicameral bone cysts depending on their growth stage].

The article deals with the results of study of chemical composition of solitary cysts and blood serum of 27 patients. The results demonstrated that qualitative composition of f content of unicameral bone cysts is identical to chemical composition of blood serum. The results of analysis of total proteolysis activity and acid phosphatase activity in content of cysts can be used as criteria to determine the stage of cyst growth and to evaluate the effectiveness of applied treatment.

[Lipid peroxidation and endogenous intoxication during hirudotherapy for gonarthrosis].

The time course of changes in lipid peroxidation and the characteristics of endogenous intoxication were studied in the treatment of patients with gonarthrosis. The findings suggest the positive changes in the biochemical parameters that characterize endogenous intoxication and recovery of the body's antioxidant status despite the activation of prooxidative processes.

[The influence of hirudotherapy on the biochemical status of patients with gonarthrosis].

The results of conservative treatment with the use of hirudotherapy of patients presenting with bilateral gonarthrosis were evaluated by biochemical analysis of their serum and urine samples. The study revealed changes of mineral, carbohydrate, and lipid metabolism suggestive of the positive homeostatic effect of hirudotherapy at the local and systemic levels. This finding gives reason to recommend hirudotherapy for the treatment and prevention of osteoarthrosis.

[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.

[Biochemical parameters in the prediction of the course of osteoreparative processes in skeletal injury].

A mathematical analysis was made to examine changes in the biochemical parameters of blood and daily urine in patients with closed shin fractures in the early posttraumatic period in order to determine the most important markers for the evaluation of the course and the prediction of the duration of osteoreparative processes.

[Biochemical parameters in the evaluation of trauma severity].

The paper analyzes the results of biochemical blood tests in patients with varying skeletal injury. The parameters, the changes of which are more frequently observed in multiple and concomitant injuries with regard to a single injury, have been revealed.

[Evaluation of the gas regimen in the damaged tissues]. / Otsenka gazovogo rezhima povrezhdennykh tkanei.

Dynamics of CO2 and oxygen was studied in the skin of 35 patients with open fractures of the crural bones. The results were compared with homeostasis in the whole blood. It was found that immediately after surgery there is marked acydosis, gas regimen of the skin adjacent to the wound is characterized by hypoxia and hypercapnia. By month 2 after the trauma the excessive amount of organic acids was compensated by falling content of CO2, i.e. development of CO2 alkalosis. A complete compensation was not achieved within the treatment period and normalization of acid-base balance in patients was not observed.

[Clinical and biochemical indicators in patients undergoing limb lengthening using Ilizarov's method]. / Kliniko-biokhimicheskie pokazateli u bol'nykh pri udlinenii konechnosti po Ilizarovu.

The authors report that in 33 patients who underwent stretching of the extremity by the method of dosed distraction after G. A. Ilizarov following corticotomy there were no significant changes in a number of biochemical values (serum concentrations of general protein, albumin, urea, uric acid, glucose, cholesterol, triglycerides, magnesium, chlorides). The level of other values (alkaline phosphatase and lactate dehydrogenase enzymes, etc.) increased and sometimes exceeded the physiological limits of its age group, but did not exceed the normal limits in the population as a whole. A reliable change in the values was observed with their level being higher during the period of natural growth because of intensification of anabolic processes and growth of the mass of organs and tissues or increase in their function. A rise in serum concentrations of calcium, phosphate and hydroxyproline with the urine demonstrates in combination with the data of biphoton densimetry of the skeleton and distraction regenerate that at the same time with improved absorption of electrolytes in the intestines during distraction there was an activation of mobilization of the minerals from the intact skeleton. A problem of adequate consumption of mineral substances with the food is put forward.