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Ihor Volodymyrovych Kotulskyi 伊霍尔-沃洛季米罗维奇-科图尔斯基
Pub Date : 2024-07-09 DOI: 10.15674/0030-598720242101-102
Domestic medicine suffered a heavy loss: a talented scientist, head of the department of pathophysiology, anesthesiology and functional diagnostics, candidate of medical sciences Ihor Volodymyrovych Kotulskyi passed away.
国内医学界遭受了重大损失:一位才华横溢的科学家,病理生理学、麻醉学和功能诊断学系主任,医学科学候选人伊霍尔-沃洛德米罗维奇-科图尔斯基(Ihor Volodymyrovych Kotulskyi)去世了。
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引用次数: 0
Comparison of the infrapatellar and subcutaneous adipose tissue biopsy material as a source of mesenchymal stromal cells for regenerative medicine in traumatology 比较髌下和皮下脂肪组织活检材料作为创伤再生医学间充质基质细胞的来源
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024242-47
Yulia Avramenko, S. Maslennikov, Stanislav Bondarenko, M. Golovakha
Objective. The use of infrapatellar fat pad (IPFP) as the source of mesenchymal stem cells (MSCs), show an age-independent proliferation and differentiation potential. In addition, the pronounced chondrogenic potential of IPFP-ASCs makes them promising candidates for research for use in other methodsof regenerative therapy. Methods. A direct immunohistochemical study was carried out in serial paraffin sections of the biopsy material of Hoffa`s fat pad and subcutaneus fat tissue, using monoclonal antibodies. The minimum criteria established by the International Society for Cell Therapy to ensure the identity of MSCs use CD73 and CD105 as positive markers and CD34, CD31, CD45 as a negative. Results. According to the results of histological, immunohistochemical, morphometric and statistical studies, it was found that in the biopsy of both tissues the relative number of cells with an immunoprofile CD105+, CD73+, CD34–, CD31–, CD45– in the standard field of view (×200) was: 7.25 (5.42; 8.89 ) %, and 11.11 (8.46; 13.45) %, no statistically significant difference was found between comparison groups (р > 0,05). Conclusion. The therapeutic effect of mesenchymal stem cells of subcutaneous adipose tissue has been proven, thus the identification of similar cells in the biopsy material and relatively similar density in the Hoffa body makesit an important source of adipose-derived stem cells that can be used for regenerative engineering tissue.
目的。使用髌下脂肪垫(IPFP)作为间充质干细胞(MSCs)的来源,显示出与年龄无关的增殖和分化潜力。此外,髌下脂肪垫间质干细胞还具有明显的软骨生成潜能,因此有望用于其他再生治疗方法的研究。研究方法使用单克隆抗体对霍法脂肪垫和皮下脂肪组织活检材料的连续石蜡切片进行了直接免疫组化研究。国际细胞治疗学会制定的确保间充质干细胞身份的最低标准是以 CD73 和 CD105 为阳性标记,CD34、CD31、CD45 为阴性标记。结果根据组织学、免疫组化、形态计量学和统计学研究的结果,发现在两种组织的活检中,标准视野(×200)内具有 CD105+、CD73+、CD34-、CD31-、CD45- 免疫特征的细胞相对数量分别为:7.25(5.42;8.89)% 和 11.11(8.46;13.45)%,比较组之间无统计学差异(р > 0.05)。结论皮下脂肪组织间充质干细胞的治疗效果已得到证实,因此,活检材料中相似细胞的鉴定和霍法体内相对相似的密度使其成为脂肪来源干细胞的重要来源,可用于再生工程组织。
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引用次数: 0
SEPTIC COMPLICATIONS AFTER THE USE OF GLUCOCORTICOIDS (RESULTS OF CLINICAL LABORATORY AND PATHOMORPHOLOGICAL STUDIES) 使用糖皮质激素后的脓毒症并发症(临床实验室和病理形态学研究结果)
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024254-60
M. Hrytsai, Valerii Hryhorovskyi, V. Tsokalo, V. Sabadosh, Taisiia Kuzub
In numerous articles, monographs, and textbooks, the aspects of local application of glucocorticoid injections at the current stage of development of rheumatology are considered from the point of view of expediency, effectiveness, and safety. Factors affecting the effectiveness of this method are analyzed. Periarticular and/or intra-articular injections of corticosteroids are included in various recommendations and protocols for the treatment of arthrosis and rheumatic joint lesions available today. Objective. Determination of pathomorphological, clinical and laboratory manifestations of the infectious process after local administration of glucocorticoid drugs. Methods. Clinical, anamnestic, laboratory, bacteriological and pathomorphologicaldata of 34 patients with infectious complications were analyzed. Results. The administration of long-acting drugs was most often used: DIPROSPAN — 13 (38.2 %) cases; KENALOG — 5 (14.7 %); DEPOS — 3 (8.8 %); FLOSTERON — 2 (5.9 %); a short-acting drug (methylprednisolone acetate (METYPRED), hydrocortisone acetate) was used in 11 (32.4 %) cases. At the time of hospitalization in the clinic, the infectious process was in 8 (23.5 %) patients in the acute stage, 10 (29.4 %) in the subacute stage, and in another 16 (47.1 %) in the chronic stage, 13 (38.2 %) of which are in the active fistula phase. Conclusions. Pathomorphological manifestations and signs of a purulent-necrotic and purulent-inflammatory infectious process (infectious complications) after local administration of glucocorticoid drugs accompany and are closely statistically significantly interrelated with typical clinical and laboratory manifestations (leukocytosis with a «shift of the leukocyte formula to the left», an increase in ESR and level CRP) and etiology («bacteriology») of the infectious process.
在许多文章、专著和教科书中,从便捷性、有效性和安全性的角度考虑了在风湿病学发展的现阶段局部应用糖皮质激素注射的各个方面。对影响这种方法有效性的因素进行了分析。关节周围和/或关节内注射皮质类固醇已被纳入当今治疗关节炎和风湿性关节病变的各种建议和方案中。目标。确定局部注射糖皮质激素后感染过程的病理形态学、临床和实验室表现。方法。对 34 例感染并发症患者的临床、病理、实验室、细菌学和病理形态学数据进行分析。结果最常用的是长效药物:使用长效药物最多的病例是:DIPROSPAN-13例(38.2%);KENALOG-5例(14.7%);DEPOS-3例(8.8%);FLOSTERON-2例(5.9%);使用短效药物(醋酸甲泼尼龙(METYPRED)、醋酸氢化可的松)的病例有11例(32.4%)。在诊所住院时,8 例(23.5%)患者的感染过程处于急性期,10 例(29.4%)处于亚急性期,另有 16 例(47.1%)处于慢性期,其中 13 例(38.2%)处于瘘管活动期。结论局部使用糖皮质激素后,化脓性坏死和化脓性炎症感染过程(感染并发症)的病理形态学表现和体征与典型的临床和实验室表现(白细胞增多且 "白细胞公式左移"、血沉和 CRP 水平升高)和感染过程的病因学("细菌学")密切相关。
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引用次数: 0
PARAMETERS OF THE INTERCONDYLAR FOSSA OF THE FEMUR IN CHILDRENIN NORMAL CONDITIONS AND WITH CONGENITAL MALFORMATIONS OF THE LOWER LIMBS 正常情况下和患有先天性下肢畸形的儿童股骨髁间窝的参数
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024261-68
Yevhenii Yakushkin, S. Khmyzov, Ruslan Zlatnik
According to literature sources, radiography can indirectly visualize congenital insufficiency of the cruciate ligaments both in isolated form and in combination with other congenital malformations of the lower extremities. Objective. To study the parameters of the intercondylar fossa of the femur in children of different age groups with stable/unstable knee jo ints due to congenital malformations of the lower limbs using instrumental imaging methods. Methods. A prospective diagnostic study was conducted of 359 knee joints of 217 children who were treated at the pediatric orthopedics clinic from 2019to 2022 and with a retrospective control group (2010–2021). limbs, as well as with congenital malformations of the lower limbs. X-ray examinations were performed on the OPERA T90cex X-ray and fluoroscopic system. Results. 217 patients took part in the study, including 105 patients without knee jointpathology and 112 with congenital malformations of the lower limbs. Comparison of the accuracy of radiological diagnostic indicators was performed using the Studentʼs t-test with the results of computer and magnetic resonance imaging studies, which showed the absence of a statistically significant differencein the results research. A diagnostic study was also conducted to find the regularity of the development of the knee joints and to identify the parameters of the radiological norm of the development of the intercondylar fossa of the femur in children of different age categories. Conclusions. Using the resultsof instrumental studies, the parameters of the intercondylar fossa of the femur in children of different age categories with stable and unstable knee joints due to congenital malformations of the lower limbs were investigated. The results of the study should be taken into account for the diagnosis of congenital defects of the knee joint.
根据文献资料,放射摄影可间接观察到单独存在的先天性十字韧带功能不全,以及与其他先天性下肢畸形合并存在的先天性十字韧带功能不全。研究目的使用仪器成像方法研究因下肢先天性畸形导致膝关节稳定/不稳定的不同年龄组儿童的股骨髁间窝参数。方法。对2019年至2022年期间在儿科骨科诊所接受治疗的217名儿童的359个膝关节进行了前瞻性诊断研究,并与回顾性对照组(2010年至2021年)进行了对比。X 射线检查在 OPERA T90cex X 射线和透视系统上进行。研究结果217 名患者参加了研究,其中 105 名患者无膝关节病变,112 名患者患有先天性下肢畸形。采用学生 t 检验法对放射诊断指标的准确性与计算机和磁共振成像研究结果进行了比较,结果表明研究结果不存在显著的统计学差异。此外,还进行了一项诊断研究,以发现膝关节发育的规律性,并确定不同年龄段儿童股骨髁间窝发育的放射学标准参数。研究结论利用仪器研究的结果,对因下肢先天性畸形导致膝关节稳定和不稳定的不同年龄段儿童的股骨髁间窝参数进行了研究。在诊断膝关节先天性缺损时应考虑到研究结果。
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引用次数: 0
EXPERIMENTAL RESEARCH OF THE PHARMACOLOGICAL EFFECT OF CARBON DIOXIDE IN THE CORRECTION OF INFLAMMATION 二氧化碳对纠正炎症的药理作用的实验研究
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024248-53
V.V. Shtroblia, Ruslan Lutsenko
Osteoarthritis is considered one of the leading causes of chronic disability and is a significant problem on human health and the economy. Chronic pain is the dominant symptom that prompts patients to seek medical attention. Pain mechanisms in osteoarthritis remained unknown for a long time. However, it is known that chronic inflammation of the joint can be a key factor in the occurrence and exacerbation of pain or changes in the perception of pain. Pharmacological therapy is often based on the use of steroidal and non-steroidal anti-inflammatory drugs, but their long-term use or large doses can cause side effects. That is why the development of new methods of treatment of inflammatory processes is the object of active research, as they can affect various mechanisms. In this context, carboxytherapy is an interesting alternative or addition to existing treatment regimens aimed at reducing pain in patients with osteoarthritis. This method involves the administration of medical carbon dioxide (CO2) to improve blood supply to tissues, which can contribute to humoral, biochemical and tissue mechanisms. Studying the effects of carboxytherapy in animal models of inflammation is important for understanding its potential benefits and mechanisms of action. Objective. Study of anti-inflammatory properties of carboxytherapy both in monotherapy and in its combined use. Methods. Carboxytherapy is the injection of carbon dioxide in monotherapy and when used in combination on the formalin model of inflammation in animals. Results. The obtained research results prove the anti-inflammatory properties of carbon dioxide on the model of formalin inflammationin animals. Conclusions. The combined use of carboxytherapy enhanced the effect of conventional drugs on the formalin model of inflammation in animals. The establishment of an anti-inflammatory effect of carboxytherapy indicates the therapeutic value of CO2, while emphasizing the need for further in-depth studies to explore its mechanisms and confirm the efficacy for clinical use.
骨关节炎被认为是导致慢性残疾的主要原因之一,是人类健康和经济的一个重大问题。慢性疼痛是促使患者就医的主要症状。长期以来,骨关节炎的疼痛机制一直不为人知。然而,人们已经知道,关节的慢性炎症可能是导致疼痛发生和加剧或疼痛感觉改变的关键因素。药物治疗通常以使用类固醇和非类固醇抗炎药物为基础,但长期使用或大剂量使用会产生副作用。因此,开发治疗炎症过程的新方法成为积极研究的对象,因为这些方法可以影响各种机制。在这种情况下,碳氧疗法是现有治疗方案的一种有趣的替代或补充方案,旨在减轻骨关节炎患者的疼痛。这种方法是通过施用医用二氧化碳(CO2)来改善组织的血液供应,从而促进体液、生化和组织机制。在炎症动物模型中研究二氧化碳疗法的效果对了解其潜在益处和作用机制非常重要。研究目的研究羧基疗法在单一疗法和联合疗法中的抗炎特性。方法。二氧化碳疗法是在福尔马林动物炎症模型中注射二氧化碳的单一疗法和联合疗法。结果。研究结果证明,二氧化碳在福尔马林动物炎症模型中具有抗炎特性。结论。在福尔马林动物炎症模型中,二氧化碳疗法的联合使用增强了传统药物的效果。二氧化碳疗法抗炎效果的确立表明了二氧化碳的治疗价值,同时也强调了进一步深入研究的必要性,以探索其机制并确认其在临床应用中的有效性。
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引用次数: 0
BIOMECHANICAL ASPECTS OF ENDO-EXO-PROSTHETICS OF THE LOWER LIMBS 下肢内外侧假肢的生物力学问题
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024269-75
Oleksandr Sitenko, Taras Sitenko
The prospects of creating new opportunities in the rehabilitation of patients with limb amputations are generally associated with the method of osseointegration and endo-exo-prosthetics (EEP). The results of the practical application of the method indicate attention to the analytical consideration of all its components, all stages. Objective. To substantiate the expediency and directions of research and development of the theoretical and practical principles of EEP from the standpoint of the full cycle, including both the problems of osseointegration and functional qualities, constructive and technological principles regarding the prostheses themselves, the methodology of the process of mastering and using them. Results. Considered biomechanical and other arguments, which substantiate the objects of research and development of medicaltechnical and medical-technological means, including the constructions of endo-exo-prostheses, methods of learning to use them, evaluation of the quality of locomotion, increasing the reliability of the «implant-bone» c ontact. The d esign principle of a hip prosthesis with a removable unloading module is proposed, which is installed at the stage of mastering the prosthesis, and in necessary cases, during constant use. The possibilities of the method of recognizing biomechanical patterns of movements for teaching patients to walk on prostheses, for adjusting functional nodes and assessing the quality of prosthetics are shown. Conclusions. The problemof endo-exo-prosthetics is considered for the first time  from the standpoint of the requirements for the functions and qualities of the prostheses themselves. Reasoned directions of application and significance of clinical, experimental and mathematical biomechanics methods for analysis and development of the functional structure of endo-exo prostheses, to reduce risks when using them.
为截肢患者的康复创造新机遇的前景通常与骨结合和内外科假肢(EEP)方法有关。该方法的实际应用结果表明,应重视对其所有组成部分和所有阶段的分析考虑。目标。从整个周期(包括骨结合和功能质量问题、假体本身的构造和技术原理、掌握和使用假体的方法)的角度,证实研究和发展 EEP 理论和实践原则的适宜性和方向。结果。考虑了生物力学和其他论据,这些论据证实了医学技术和医疗技术手段的研究和发展目标,包括内外科假体的构造、学习使用假体的方法、运动质量的评估、提高 "植入物-骨骼 "接触的可靠性。提出了带有可拆卸卸载模块的髋关节假体的设计原则,该模块在掌握假体使用阶段安装,必要时在持续使用过程中安装。研究显示,这种识别生物力学运动模式的方法可用于教病人在假肢上行走、调整功能节点和评估假肢质量。结论。首次从假肢本身的功能和质量要求的角度考虑内外科假肢问题。提出了临床、实验和数学生物力学方法在分析和发展内外侧假体功能结构方面的合理应用方向和意义,以降低使用假体时的风险。
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引用次数: 0
Report on the All-Ukrainian Scientific and Practical Conference "Actual Issues of Modern Traumatology and Orthopedics", which took place on May 17, 2024 in the city of Zaporizhzhia 关于 2024 年 5 月 17 日在扎波罗热市举行的全乌克兰科学实践会议 "现代创伤学和矫形外科的实际问题 "的报告
Pub Date : 2024-07-09 DOI: 10.15674/0030-598720242105-106
M. Golovakha
Report on the All-Ukrainian Scientific and Practical Conference "Actual Issues of Modern Traumatology and Orthopedics", which took place on May 17, 2024 in the city of Zaporizhzhia
关于 2024 年 5 月 17 日在扎波罗热市举行的全乌克兰科学实践会议 "现代创伤学和矫形外科的实际问题 "的报告
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引用次数: 0
A REVIEW OF ANIMAL MODELS FOR BONE FRACTURE NONUNION AND THEIR ROLE IN STUDYING BIOLOGICAL THERAPY EFFICACY 骨折不愈合动物模型及其在生物疗法疗效研究中的作用综述
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024281-87
P. Vorontsov, Valentyna Maltseva
The bone healing impairment, such as non-union fractures after injuries of long bones, lead to loss of working capacity and result in significant financial costs, which emphasizes the socioeconomic significance of the problem. However, it is not known which method of modeling the non-union bone fractures is more optimal for further research into the effectiveness of biological therapy aimed at treating bone healing impairment. For a detailed study of methods of non-union fracture treatment of, it is necessary to determine the developed animal models. The objective was to analyze the existing animal models of fracture nonunion in long bones in vivo and to consider the possibility of their further use to evaluate the effectiveness of the use of modern biotechnologies for the in the management of fracture nonunion. It was found that the majority of developed animal models of atrophic long bone non-union were created using small animals, namely rats, mice, and rabbits. A more common method of modeling bone non-union is performing an osteotomy with the formation of a defect of different widths between the bone fragments and subsequent removal of the periosteum proximal and distal to the osteotomy site; damage to the endosteum or removal of bone marrow. Also, in such animal models, researchers use a silicone spacer, a polysulfone plate, or a latex-silicone foil to physically prevent fracture union. In these animal models, studies using mesenchymal stromal cells, platelet-rich plasma or bone morphogenetic protein-2 (BMP-2) have already been conducted for the management of non-union bone fractures. At the same time, the clinical results of the application of various biological therapies are ambiguous, which determines the conduct of further experimental studies, in particular, in vivo. However, there are disagreements about which in vivo modeling methods give a reproducible result and prevent bone union, which determines the need for further analysis of existing modeling tools for  conducting research in this direction.
骨愈合障碍(如长骨受伤后的不愈合骨折)会导致丧失工作能力,并造成巨大的经济损失,这凸显了这一问题的社会经济意义。然而,对于进一步研究旨在治疗骨愈合障碍的生物疗法的有效性而言,哪种建立不愈合骨折模型的方法更为理想尚不得而知。要详细研究治疗不愈合骨折的方法,就必须确定已开发的动物模型。研究的目的是分析现有的活体长骨骨折不愈合动物模型,并考虑进一步使用这些动物模型的可能性,以评估使用现代生物技术治疗骨折不愈合的有效性。研究发现,大多数已开发的萎缩性长骨不愈合动物模型都是使用小动物(即大鼠、小鼠和兔子)制作的。比较常见的骨不连模型制作方法是进行截骨手术,在骨片之间形成不同宽度的缺损,然后切除截骨部位近端和远端的骨膜;破坏骨内膜或切除骨髓。此外,在此类动物模型中,研究人员使用硅酮垫片、聚砜板或乳胶硅酮箔来物理性地防止骨折结合。在这些动物模型中,已经开展了使用间充质基质细胞、富血小板血浆或骨形态发生蛋白-2(BMP-2)治疗骨折不愈合的研究。与此同时,应用各种生物疗法的临床结果并不明确,这就决定了需要进行进一步的实验研究,尤其是体内实验研究。然而,对于哪种体内建模方法能得出可重复的结果并防止骨结合,目前还存在分歧,这就决定了有必要进一步分析现有的建模工具,以开展这方面的研究。
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引用次数: 0
Anatoly Ivanovich Zhigun 阿纳托利-伊万诺维奇-日君
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024299-100
The article is dedicated to Dr of Medical Sciences Anatoly Ivanovich Zhigun.
这篇文章献给医学博士阿纳托利-伊万诺维奇-日君。
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引用次数: 0
THE STUDY OF THE WORK OF THE MUSCLES RESPONSIBLE FOR THE FUNCTIONALITY OF THE HIP JOINT AFTER TOTAL HIP ARTHROPLASTY USING DIFFERENT SURGICAL APPROACHES 使用不同的手术方法研究全髋关节置换术后负责髋关节功能的肌肉的工作情况
Pub Date : 2024-07-09 DOI: 10.15674/0030-59872024224-32
Stanislav Bondarenko, Dmytro Sereda, O. Karpinska
Muscles that can be damaged during endoprosthesis are indicated. Objective. To study the features of muscle work to ensure walking function after hip arthroplasty depending on the surgical approach. Methods. The basis of the simulation is the basic OpenSim Gate2392 model. Six models were created that predicted the condition of the muscles of the lower limb in normal conditions, during coxarthrosis and after 6 and 12 months. after surgery with lateral and anterior approaches. The results. For lateral access in 6 months. after the operation, the adductor muscles responsible for stabilizing the pelvis in the single-support phase of the step and during the transfer of the foot do not work enough, while the hip flexor muscles (in the model, the rectus femoris muscle) take over the responsibility for the step, but with overvoltage. On the contrary, with the front approach, we observe a weakening of the flexor muscles, which leads to overstrain of the gluteal muscles and hip stabilizer muscles. After 12 months, the muscle strength normalizes for most of them to 90–95 % of the norm, a 2–3 times increase in the torque of the hip flexor muscles and hip stabilizer muscles is observed. Taking a normal step causes muscle strain. During the anterior approach, the foot is transferred during the phase, that is, when most of the muscles are involved. The rectus femoris muscle, which is the strongest of the muscles discussed in the paper, does the main work of moving the foot. In the case of possible damage to the rectus muscle during anterior access, even after a year there is a violation of its work — excessive overexertion and involvement of the reserves of other muscles. Conclusions. Mathematical modeling of the work of muscles that may be damaged during hip arthroplasty surgery, conditional muscle strength for 6 months. after the operation, they are not able to develop the necessary torque to take a normal step. For muscle strength, which in the model corresponded to 12 months,the muscles are able to perform a normal function regardless of surgical access, but their overstrain is observed.
适用于内固定术中可能受损的肌肉。目的研究髋关节置换术后确保行走功能的肌肉工作特点,具体取决于手术方法。方法。模拟的基础是基本的 OpenSim Gate2392 模型。创建了六个模型,分别预测正常情况下、髋关节病变期间以及侧方和前方入路手术后 6 个月和 12 个月的下肢肌肉状况。结果如下对于手术后 6 个月的侧方入路,负责在迈步的单支撑阶段和转移足部时稳定骨盆的内收肌没有充分发挥作用,而髋屈肌(在模型中为股直肌肌群)则接管了迈步的责任,但却出现了过电压。相反,我们观察到,采用前置方法时,屈肌的力量减弱,导致臀肌和臀部稳定肌过度紧张。12 个月后,大多数人的肌肉力量恢复正常,达到正常值的 90-95%,髋关节屈肌和髋关节稳定肌的扭矩增加 2-3 倍。正常迈步会造成肌肉拉伤。在前方入路时,脚在阶段性转移,也就是大部分肌肉参与的时候。股直肌是本文所讨论的肌肉中最强壮的肌肉,承担着移动脚的主要工作。如果股直肌在前方入路过程中可能受到损伤,那么即使在一年后,它的工作也会受到影响--过度用力和其他肌肉储备的参与。结论对髋关节置换手术中可能受损的肌肉工作进行数学建模,有条件的肌肉力量在手术后 6 个月内都无法达到正常迈步所需的扭矩。至于肌肉力量,在模型中相当于 12 个月,无论是否进行手术,肌肉都能发挥正常功能,但会出现过度应变。
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引用次数: 0
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ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS
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