[Bone quality of lower limbs in patients with chronic osteomyelitis aged over 60 years according to multi-slice computed tomography.]

Radiography and multi-slice computed tomography (MSCT) were used to examine 30 patients with chronic osteomyelitis of lower limb whose age was over 60 years. There were more male patients with posttraumatic osteomyelitis of tibia. 16 patients were treated for chronic osteomyelitis for more than 5 years and 9 patients for more than 15 years. Control groups included 30 patients with chronic osteomyelitis of long bone aged 20 to 45 years and 30 patients aged 46 to 59 years. Radiographs of 19 patients of index group (63,3%) showed osteomyelitic cavities in the femur and tibia. Radiomorphological changes were observed in the adjacent segment of all the patients. Changes in bone architechtonics were manifested in expressed polymorphism, without evident signs of osteoporosis due to the spread sclerosis in osteomyelitic nidus. Information obtained with MSCT preoperatively was comprehensive and revealed location of purulent and necrotic nidus, type of destruction, extent and location of involved bone tissue that provided a possibility of choice of the most efficient surgical intervention.

[Radio morphological changes in the femoral and tibial condyles in patients with arthrosis deformans of the knee].

OBJECTIVE: to investigate the quantitative X-ray manifestations of gonarthrosis in patients in different age groups. MATERIAL AND METHODS: The results of radiography, computed tomography, and 64-slice multidetector computed tomography (MDCT) were analyzed in 86 patients aged 18 to 70 years with arthrosis deformans of the knee. RESULTS: Knee radiographic anatomic changes in arthrosis deformans are accompanied by the characteristic rearrangement of the femoral and tibial condyles. Quantitative bone density changes appear as an overall decrease in the bone mineral density of the femoral and tibial condyles in 18-35-year-old patients with arthrosis deformans (p<0.05) and a relative increase in that of medial tibial condyles in patients older than 55/60 years, in those with genu varum in particular. CONCLUSION: In the patients with arthrosis deformans, the bone radio morphological changes detected by MDCT have a much wider range of qualitative and quantitative characteristics. The data on condylar bone density are directly related to a treatment choice. Data postprocessing using the current visualization programs of working stations identifies minor bone structural changes that are also of importance in solving the tactical problems of medical and surgical treatments.

[DENSITY OF THE BONES FORMING HIP AND KNEE JOINTS IN PATIENTS AGED OVER 60 YEARS WITH COXARTHROSIS AND GONARTHROSIS ACCORDING TO MULTISLICE COMPUTED TOMOGRAPHY].

The purpose of the study was to review quantitative and qualitative radiological manifestations of coxarthrosis and gonarthritis in patients aged over 60 years. Radiography, computed tomography and multislice computed tomography were performed for 48 patients aged 60-70 years with deforming arthritis of the hip and knee joints. Idiopathic and dysplastic cases prevailed. The results of the study showed that roentgen anatomical changes in the hip and knee joints were accompanied by changes in the density of femoral head, typical restructuring of the femoral and tibial condyles, patella that could earlier be detected with computed tomography. A decrease in the total density of the femoral and tibial condyles and a relative increase in subchondral density with varus of the knee in particular were shown to be a specific feature of quantitative changes in the density of bone tissue in patients with deforming arthritis.

[Nephropexy using a transverse musculofascial flap and the indications for it]. / Nefropeksiia poperechnym myshechno-fastsial'nym loskutom i pokazaniia k nei.

A nephropexy technique modified by the author implies dissection of the flap from musculus transversus abdominis and lumbodorsal fascia. The dissection of the fixing flap is made in the muscular-tendinous part of the musculus transversus abdominis with involvement of the lumbodorsal fascia and lumbocostal ligament. The flap is fixed to anterior surface of the kidney supracapsularly. The technique is adjusted for the following indications: vertically movable kidney with lateral dislocation of the upper pole and medial of the low pole; hypertension; simultaneous pelvic intervention; movable dystopic kidney with backward position of the renal sinus. The surgery was performed in 35 nephroptosis patients. Long-term results proved satisfactory.

[Interstitial nephritis in urological practice]. / Interstitsial'nyi nefrit v urologicheskoi praktike.

The presented material consists of 9 postoperative patients' investigations. Interstitial nephritis was diagnosed in them after histological examination. Seven patients had a chronic disease, 2--acute disease. The revealed possible predisposing factors were: a prolonged use of analgetics, contact with formalin and typographical dyes, systematic alcohol usage, frequent catarrhal diseases with long-term fever, a history of acute renal destructive process. The clinical picture of patients with chronic interstitial nephritis was characterized by long periods of temperature elevation, small changes in blood counts, weakness, pain in the lumbar region. In urine analyses: moderate microhematuria, leukocyturia, proteinuria. There were signs of early damaged renal tubular functions. Antiinflammatory therapy was ineffective so the patients were operated on for various indications. During the operations there were severe macroscopic renal cirrhotic deteriorations. 2 patients underwent nephrectomy, 15 intraoperative biopsy. Histologically there were revealed: signs of interstitial tissue various cirrhotic changes in hydrops and lymphoplasmacytic infiltration with tubular compression and dystrophic changes. The following complex therapy including nonsteroid antiinflammatory agents, in some cases corticosteroids, desensitizing and antihistaminic remedy allowed one to achieve alleviation of the process.