[Routine preoperative examination for diagnosis of periprosthetic joint infection and its recurrence in revision hip arthroplasty]. / Rol' rutinnogo dooperatsionnogo obsledovaniya v vyyavlenii periproteznoi infektsii i ee retsidiva pri revizionnom endoprotezirovanii tazobedrennogo sustava.

OBJECTIVE: To evaluate diagnostic value of routine preoperative laboratory tests such as erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) and microbiological examination of joint aspirate in patients with periprosthetic joint infection or its recurrence in patients scheduled for revision hip arthroplasty. MATERIAL AND METHODS: There were 117 patients. Preoperative CRP and ESR, the culture of pre- and intraoperative joint aspirates and tissue biopsies were studied. We analyzed diagnostic significance of these parameters and the likelihood of periprosthetic joint infection depending on increase of CRP/ESR and previous joint infection. RESULTS: According to microbiological data, periprosthetic joint infection was diagnosed in 19.7% of patients. High CRP in this group significantly increased the chance of joint infection diagnosis (OR 6.3; 95% CI 1.491-26.615). Concomitant increase of both ESR and CRP increased this likelihood by 7.7 times (OR 7.778; 95% CI 0.931-66.296). In the 2nd group, periprosthetic joint infection was confirmed in 25% of patients. At the same time, detection of pathogen in isolated or combined increase in CRP and ESR was less likely compared to the control group. Prognostic value of negative preoperative microbiological examination of joint aspirate was only 93%. We failed to obtain aspirate in 21.4% of cases. CONCLUSION: Increase of the routine serological parameters before revision hip arthroplasty is more sensitive for prediction of periprosthetic joint infection in patients without previous infection. Previous joint infection reduces diagnostic value of ESR and CRP in detection of recurrent periprosthetic joint infection. Preoperative examination of joint aspirate is not sufficient for etiological diagnosis of periprosthetic joint infection. However, positive microbiological culture should be taken into account for the choice of further management.

[DNA-protein cross-links in nuclei and mitochondria of tissue cells from rats of various age exposed to gamma-radiation]. / DNK-belkovye sshivki v iadrakh i mitokhondriiakh kletok tkanei krys raznogo vozrasta posle vozdeistviia gamma-izlucheniia.

The formation and repair of DNA-protein cross-links (DPC) in the mitochondria and nuclei from the brain and spleen of 2- and 29-month rats after their exposure to ionizing radiation were studied. The background level of DPC in brain and spleen mitochondria of old rats was shown to be about two times as high as in young rats. In the nuclei from the brain of old rats the background amount of DPC was also increased, unlike the nuclei of spleen of the same rats. At the doses 5 and 10 Gy (137Cs), the amount of DPC produced in the mitochondria and nuclei of brain and spleen of 29-month rats was 1.8-2.5 times greater than in the nuclei of the same tissues of young animals. At the same time, in the mitochondria of brain and spleen from irradiated rats the amount of DPC was by 30-80% higher than in the nuclei of the same tissues. Analysis of changes in DPC content during the post-radiation period showed that 5 h after irradiation of rats with a dose of 10 Gy, the level of these lesions in the nuclei of brain and spleen of young rats decreased by 40 and 65%, respectively, whereas the amount of these lesions in the mitochondria did not decrease. In this post-radiation period in nuclei of brain and spleen of old rats the amount of DPC decreased by 20-40%, respectively. However, the data on DPC obtained for the mitochondria of brain and spleen from both young and old rats showed that the amount of these lesions did not decrease during the 5 h post-radiation period. These results enable the suggestion that mitochondria do not possess a system of DPC repair. To summarize, ionizing radiation initiates in the nuclei of brain and spleen of old rats more DPC and their repair proceeds slower than in the nuclei of the same tissues of young animals. In the mitochondria of gamma-radiation exposed old rats more DPC are also produced than in young rats but no repair of DPC is observed in both old and young animals within the 5 h post-radiation period.