Condition Of Bone Tissue Research Articles

Bone Tissue Condition during Osteosynthesis of a Femoral Shaft Fracture Using Biodegradable Magnesium Implants with an Anticorrosive Coating in Rats with Experimental Osteoporosis

Today, osteoporosis has become a major global health issues. The World Health Organization declares that 320 billion people have osteoporosis now, and more than 1.5 billion osteoporosis traumatic events occur every year. Bones become fragile and fracture risk is high; thus, it is crucial to choose the right biodegradable implants in order to minimize reoperations of patients with systemic osteoporosis. This investigation aimed to carry out a morphological assessment of the state of bone tissue with osteosynthesis of a femoral fracture in rats, using a model of osteoporosis with the installation of magnesium alloy implants coated with hydroxyapatite and sealed with polytetrafluoroethylene. According to this study, the indicators of angiogenesis and bone formation in experimental animals were significantly higher when an implant coated with hydroxyapatite sealed with polytetrafluoroethylene was used, compared to an implant coated only with hydroxyapatite and in rats without an implant. Based on the data obtained, it is possible to consider a magnesium implant coated with hydroxyapatite and sealed with polytetrafluoroethylene as a promising material for fracture therapy in patients with reduced bone density.

Densitometric features of bone tissue in children during the growth spurt considering the VDR gene polymorphisms and vitamin D level

Background. The period of intensive growth in children is associated with active changes in the bone tissue architecture. A high level of bone mass accumulations was observed. Whether such processes are adequate depends on numerous factors, however, all of them are based on a genetic component. Gene expression affects all the processes in the body, including bone tissue. The BSML and Fokl polymorphisms of the VDR gene responsible for the activity of cell receptors for vitamin D is studied in association with bone pathology, autoimmune diseases, diseases of the central nervous, cardiovascular and other systems. Purpose – of the research is aimed at determining densitometric features of the structural and functional condition of bone tissue in children during the growth spurt, taking into account polymorphisms of BSML, FOKL gene VDR and vitamin D levels. Materials and Methods. The examination covered 205 healthy children aged 9–17, who were divided into groups depending on the presence or absence of growth spurt (GS) and its intensity. The examination presupposed analysis of the medical history, assessment of physical and sexual development, ultrasound (QUS) and X-ray (DXA) densitometry, determination of 25-(OH)-D levels, molecular diagnostics- definition of polymorphisms of BSML, FOKL gene VDR. Results. Ultrasound densitometry showed a decrease in bone mineral density (BMD) in 24 children of Group I (48.0%), Z-score: – 1.8 ± 0,56; 28 children in Group II (60.87%), Z-score: – 1.96 ± 0,27 and 43 children of Group III (39.45%), Z-score: – 1.68 ± 0,72. DXA was used for 32 children, 18 of them (56.25%) were diagnosed with a decreased BMD. Children of Group I with a reduced BMD had an average level of vitamin 25-(OH)-D at the value of 39.04 ± 11.84 nmol/l, while in children with a normal BMD it averaged – 42.43 ± 6.3 nmol/l. In children of group II BMD in which it was reduced, the average level of 25-(OH)-D was 45.68 ± 5.48 nmol/l, with normal BMD – 45.47 ± 4.69 nmol/l. Children of Group III with a reduced BMD had an average 25-(OH)-D level of 36.73 ± 8.94 nmol/l, those with a normal BMD showed the 25-(OH)-D level of 42.91 ± 9.1 nmol/l. A molecular study found that 48.76% of children did not have any mutations in the VDR gene BSML polymorphism, 41.32% of children showed a heterozygous mutation, and 9.92% of children revealed a homozygous mutation. 27.81% of children had no mutation of Fokl polymorphism in the VDR gene, 61.95% showed a heterozygous mutation and a homozygous mutation was detected in 10.24% of children. Conclusions. Decreased bone mineral density in children during growth spurt is due to insufficiency or deficiency of vitamin D and is determined genetically. However, the most significant factor in the BMD reduction is the retardation of bone mass accumulation processes against the background of an intensive linear growth of the skeleton.

Мінеральна щільність та метаболізм кісткової тканини у разі тиреотоксикозу

Introduction. Hyperthyroidism is a pathological condition of the body due to increased of thyroid hormones in blood. The prevalence of this pathology increases with age. In the age period from 40 to 60 years it is 0.45%, and after 60 years the risk of the disease increases and is 1.4%. Aim is to analyze the condition of bone tissue in the conditions of thyrotoxicosis on the basis of literature data. Materials and methods are content analysis of the literature on studies of mineral density and bone metabolism in patients with thyrotoxicosis syndrome. Results. Thyroid hormones at physiological concentrations have an important role in skeletal development, reaching peak bone mass and maintaining bone mass during adulthood. It is proved that the effect of thyroid hormone on bone cells is carried out by hormone-receptor interactions. Receptors for thyroid hormones and TSH are found on osteoblasts and osteoclasts, which testifies to their direct action on the cell. The presence of calcium in the skeleton is mainly determined the bone mineral density. Hyperthyroidism is associated with negative calcium balance. When thyrotoxicosis decrease the bone density is observed in 10–20% of patients. This is due to a violation of bone remodeling by increasing metabolism with a disproportionate increase in bone resorption and increased bone formation, but the activation of bone formation cannot fully compensate for the loss of bone mass in the background enhanced resorption. With increasing severity of hyperthyroidism concentration in serum alkaline phosphatase, osteocalcin, and osteoprotegerin growth factor FGF-23 of fibroblasts, indicating increased bone metabolism accompanied by activation of bone resorption. When reducing subclinical hyperthyroidism TSH with normal T3 and T4, or elevated levels of thyroid hormones in the suppression of TSH. It is associated with decreased bone mineral density, increased fragility of bones with a high risk of fractures. Conclusions. Skeletal development and maintenance is regulated by a normal balance of thyroid hormones. Hyperthyroidism is associated with a prolonged cycle of bone remodeling, increased resorption and bone formation. However, the activation of bone formation observed in thyrotoxicosis is not able to fully compensate for the loss of bone mass against the background of increased resorption, which leads to osteoporosis and increased risk of fractures.

Dynamics of the mandible bone tissue condition after the dental implantation and shockwave therapy

Background. The problem of restoration the integrity of the dentition after tooth loss remains one of the most problematic dental issues. Мodern dental technologies open a promising direction in its solution, in particular - the method of dental implantation. Objective. The aim of our work was to study the changes that occur in the bone tissue of the mandible after implantation of titanium foam and to determine the effect of shock wave therapy (SWT) on its structure restoration. Methods. The study was performed on 15 adult rabbits aged 6-7 months, weighing 2.5-3 kg. The animals from the experimental groups were implanted with titanium pin, 3 mm long. The pin was implanted under combined anesthesia bilaterally into the body of the mandible. One day after the operation, the animals received SWT 500 pulses with a frequency of 5 Hz and a maximum pressure at the wavefront of 1.2 Bar per implantation site using the device Storz Medical Master Plus MP 100. The animals were removed from the experiment on 15-th day, after which the mandible was disarticulated and radiographically performed. The obtained results were statistically significant. The differences at p<0.05 were considered significant. Results. The results showed that the bone tissue of the jaws during implantation undergoes traumatic injury, the results of which, two weeks after surgery on radiographs we can clearly see a violation of the bone tissue structure and a significant increase in its density. Using the SWT method, we obtained a positive dynamics of bone density after titanium pin implantation and slight Rh-changes in bone structure compared with normal. Conclusion. Аfter implantation with titanium pin the bone density of the rabbit lower jaw body is significantly reduced, X-ray shows the heterogeneity of bone structure, areas of sclerosis are expressed. Shock wave therapy helps to restore the quality of bone tissue, this is confirmed by the fact that the density indicators are close to the norm and X-ray shows some separate small areas of restructuring of bone tissue heterogeneity, mainly due to merging the pattern of the bone trabeculae of the bone cancellous part.

Половые особенности минеральной плотности костной ткани у пациентов с болезнью Паркинсона

Актуальность. Болезнь Паркинсона (БП) — хроническое прогрессирующее заболевание головного мозга, проявляющееся сочетанием гипокинезии с ригидностью, тремором покоя и постуральной нестабильностью, а также широким спектром немоторных проявлений, сопровождается повышенным риском остеопоротических переломов. Цель исследования — изучение половых особенностей минеральной плотности костной ткани у пациентов с болезнью Паркинсона. Материалы и методы. Были обследованы 89 пациентов с болезнью Паркинсона и 89 пациентов соответствующего возраста и пола без неврологической патологии. Женщины и мужчины обеих групп не отличались по возрасту, росту и массе тела. Минеральную плотность костной ткани (МПКТ) определяли методом двухфотонной рентгеновской абсорбциометрии. Результаты. Остеопороз у пациентов с болезнью Паркинсона регистрировался достоверно чаще у женщин, чем у мужчин (48 и 24,3 % соответственно), и достоверно чаще, чем у лиц контрольной группы. Зафиксированы достоверно более низкие показатели МПКТ пациентов с БП в сравнении с показателями лиц конт­рольной группы: у мужчин — на уровне шейки бедренной кости, дистального отдела костей предплечья и всего скелета, у женщин — на уровне поясничного отдела позвоночника, шейки и проксимального отдела бедренной кости, дистального отдела костей предплечья и всего скелета. У женщин зарегистрированы достоверные негативные коррелятивные связи МПКТ различных регионов скелета и возраста, у мужчин связь зарегистрирована на уровне дистального отдела костей предплечья. У мужчин и женщин зарегистрированы положительные коррелятивные связи между МПКТ и индексом массы тела (ИМТ). Выводы. Результаты нашего исследования свидетельствуют, что болезнь Паркинсона способствует развитию остеопороза, но состояние костной ткани у пациентов с болезнью Паркинсона имеет половые особенности, в частности, у женщин МПКТ в большей степени зависит от возраста, а у мужчин — от ИМТ.

Содержание минеральных компонентов в ротовой жидкости у детей с синдромом недифференцированной дисплазии соединительной ткани и их влияние на кариесрезистентность эмали зубов

Актуальность. Резистентность зубов к кариесу может быть связана с морфологическим строением эмали, обусловливающим изменение ее основных свойств (кислотоустойчивость, проницаемость, микротвердость). Среди множества характеристик структуры эмали, влияющих на уровень ее кариесрезистентности, выделяют качество минерализации. На минерализацию органического костного матрикса, коллагенообразование, функциональное состояние костных клеток, обмен витамина D, а также на рост кристалла гидроксиапатита непосредственно влияет магний. С физиологической точки зрения до 53 % магния концентрируется в костной ткани, дентине и эмали зубов. Магнию принадлежит существенная роль в формировании нормальной структуры соединительной ткани, и одним из этиологических факторов формирования дисплазии соединительной ткани является нарушение его гомеостаза. Цель исследования: определить содержание минеральных компонентов в ротовой жидкости у детей с синдромом недифференцированной дисплазии соединительной ткани и выявить их взаимосвязь с показателями кариесрезистентности эмали зубов. Материалы и методы. Осмотрено 50 детей в возрасте 10–12 лет. С помощью биохимических исследований определяли содержание концентрации кальция и магния в ротовой жидкости. Кариесрезистентность эмали зубов определяли с помощью теста эмалевой резистентности по В.Р. Окушко. Статистическая обработка данных проводилась с помощью пакетов Statistica 6.0 и StatPlus 5.9. Дети были разделены на две группы: группа I — основная (с синдромом недифференцированной дисплазии соединительной ткани, 30 человек) и группа II — контрольная (условно здоровые дети, с высокой кариесрезистентностью, 20 человек). Результаты. Средние результаты минеральных компонентов были гораздо ниже в основной группе, чем в контрольной: концентрация Са составила 0,88 и 1,23 ммоль/л соответственно, а Mg — 0,25 и 0,44 ммоль/л. Средние результаты теста эмалевой резистентности составили 5,83 и 4,15 балла в основной и контрольной группах соответственно. Показатели концентрации кальция в ротовой жидкости основной группы по сравнению с контрольной снижены на 28,5 %, а содержание магния меньше на 43,2 %. Данные теста эмалевой резистентности показали, что результаты в основной группе на 28,8 % ниже, чем в контрольной. Заключение. В основной группе концентрация Са и Mg в дефиците, и дети этой группы нуждаются в коррекции содержания указанных микроэлементов. Недостаточное количество содержания кальция и магния в организме ребенка приводит к нарушению строения эмали, что негативно отражается на кариес­устойчивости эмали зубов.

Anatomical subject validation of an instrumented hammer using machine learning for the classification of osteotomy fracture in rhinoplasty

Osteotomies during rhinoplasty are usually based on the surgeon's proprioception to determine the number and the strength of the impacts. The aim of this study is to determine whether a hammer instrumented with a force sensor can be used to classify fractures and to determine the location of the osteotome tip. Two lateral osteotomies were realized in nine anatomical subjects using an instrumented hammer recording the evolution of the impact force. Two indicators τ and λ were derived from the signal, and video analysis was used to determine whether the osteotome tip was located in nasal or frontal bone as well as the condition of the bone tissue around the osteotome tip. A machine-learning algorithm was used to predict the condition of bone tissue after each impact. The algorithm was able to predict the condition of the bone after the impacts with an accuracy of 83%, 91%, and 93% when considering a tolerance of 0, 1, and 2 impacts, respectively. Moreover, in nasal bone, the values of τ and λ were significantly lower (p < 10-10) and higher (p < 10-4) than in frontal bone, respectively. This study paves the way for the development of the instrumented hammer as a decision support system.

Efficacy of using a complex of minerals and vitamins for prevention of complications in bone tissue and the digestive tract in rats with hypothyroidism

Significant consequences of hypothyroidism are impairments in all types of metabolism, including bone metabolism, pathological changes in the digestive tract and the development of deficiency of vitamins, macro-and micronutrients.The relevance of the study is due to the widespread occurrence of hypothyroidism and the feasibility of developing effective methods for the prevention of the pathology and its complications. The study was aimed at the condition of bone tissue and digestive tract in rats with hypothyroidism, as well as the effectiveness of preventive addition of a complex of vitamins and minerals. The studies were performed on rats with hypothyroidism that was caused using thyrostatic mercazolyl for 50 days, administered orally. Prophylaxis was performed by adding a prophylactic complex of vitamins P, C, D and minerals Ca, Mg, Cu, Se, Mn to the daily diet. In the bone tissue of rats, the indicators of destruction (elastase and acid phosphatase activity) and mineralization (alkaline phosphatase activity, calcium content) as well as the antioxidant state (activities of catalase, glutathione reductase, malonic dialdehyde content) were studied. In the gums and mucous membranes of the digestive tract of rats, we determined indicators of antioxidant status (catalase activity, malonic dialdehydecontent), inflammation (activities of elastase, acid phosphatase) and dysbiosis (activities of urease activity, lysozyme). In the bone tissue of rats with hypothyroidism, activation of destruction processes, reduction of calcium levels, activation of lipid peroxidation and antioxidant enzymes were found. Hypothyroidism also led to pathological disorders in the gums of rats and gastric mucosa, small and large intestine, namely – the development of inflammation, increased membrane permeability, activation of lipid peroxidation, increased contamination with opportunistic bacteria against the background of reduced antioxidant protection. In general, preventive use of the complex contributed to the normalization of the studied parameters in the gums, mucous membranes of the stomach, intestines, as well as remodeling processes and antioxidant-prooxidative state in the bone tissue of animals with hypothyroidism. In the conditions of hypothyroidism, the proposed complex of vitamins and minerals provided notable antioxidant, anti-inflammatory and antidysbiotic effects in the tissues of the gastrointestinal tract, thus overcoming the calcium deficiency in the blood and stopping the destructive and oxidative processes in the bone tissue of animals with hypothyroidism.

Medication Correction of the Bone Tissue’s Structural Condition in Patients with Different Forms of Braitsev-Lichtenstein Disease

The article presents a modern view on anti-osteoporotic medication therapy in patients with various forms of Braitsev-Lichtenstein disease. Against the background of fundamental studies of the bone tissue’s structural condition in this pathology improved and tested medication correction of its disorders depending on changes in bone metabolism, shape, clinical and orthopedic manifestations of the disease, the patient’s age. The article presents the rationale, general principles and features of anti-osteoporotic therapy; indications and contraindications to it; dose calculations and regimens for the use of certain medications, including from the group of bisphosphonates in various forms of Braitsev-Lichtenstein disease. The presented medication therapy has been successfully tested in 16 patients with Braitsev-Lichtenstein disease. The effectiveness of the treatment is confirmed by the reduction or elimination of pain, stopping the progression of pathological diseases on average in the bones of the lower extremities, improving the structural condition of bone tissue and its metabolism.

Медикаментозна корекція структурно-функціонального стану кісткової тканини в пацієнтів із фіброзною дисплазією

In a significant number of patients with fibrous dysplasia, among various orthopedic pathologies, bone pain, its deformation and pathological fractures, disorders of bone tissue and its metabolism are leading. Issues of correction of clinical and orthopedic manifestations of the disease and changes in the structural and functional state of bone tissue are insufficiently studied and need improvement. Purpose – to improve drug antiosteoporotic therapy for patients with fibrous dysplasia in order to reduce their pain, improve the condition of bone tissue and its metabolism. Materials and methods. In the department of pediatric traumatology and orthopedics of the SI «ITO NAMSU» in the period from 2015 to 2020, 16 patients with FD were treated (with polyosal form – 6 patients, with Albright syndrome – 5, with Campanacci syndrome – 5), who have been used drug antiosteoporotic therapy, in particular with the use of antiresorbents (pamidronic acid preparations). The age of patients ranged from 6 to 28 years, 13 patients were children. Qualitative and quantitative assessment of the therapy results and reduction of pain was performed by applying the «VAS» scale, improving the condition of bone tissue and its metabolism by studying the mineral density of bone tissue and markers of bone metabolism. Results. The article presents the rationale, general principles and features of antiosteoporotic therapy; indications and contraindications to it; calculations of doses and schemes of application of these or those drugs, including from group of bisphosphonates at a fibrous dysplasia. The presented drug therapy has been successfully tested in 16 patients with fibrous dysplasia. The effectiveness of the treatment is confirmed by the reduction or elimination of pain, stopping the progression of pathological bone disease of the lower limbs, improving structural condition of bone tissue and its metabolism. Conclusions. The results of drug therapy in patients with fibrous dysplasia indicates its effectiveness and appropriateness of use, which is shown by the relief of pain, improving the structural condition of bone tissue and its metabolism.

Bone mineral density and body composition in Polish girls with Myelomeningocele: effects of adapted physical activity and past fractures.

The aim of this cross-sectional study was to evaluate the relationship between the condition of bone mineral density and body composition and the adapted physical activity, the number of past fractures and selected somatic characteristics of girls with myelomeningocele (MMC). The study examined 37 girls with myelomeningocele (MMC) at the age of 11.9 ± 1.8 years. Bone mineral content (BMC) and bone mineral density (BMD) of the forearm were measured by dual-energy X-ray absorptiometry (DXA). Anthropometric measurements were also made and selected anthropological indices were calculated. A percentage of body fat, fat mass (FM in kg) and fat-free body mass (FFM in kg) were calculated, whereas the incidence of fractures of lower and upper limbs was evaluated during interviews. Underestimated BMD characteristic for osteopenia occurred only in physically inactive girls. Low % age-matched was observed in all physically inactive girls, whereas it was less pronounced in physically active girls. Statistically significant positive correlations were found between BMD and: body height, sitting height, body weight, BMI, fat mass and fat-free mass. Regardless of physical activity, significantly higher Z-score values (F = 12.9; p ≤ 0.001) were observed in girls who had not suffered from fractures compared to their peers who reported one or more past fractures in different skeletal locations. Active participation in physical activity of children with MMC may be a factor determining good bone tissue condition. The prevention of fractures in children in wheelchairs can be an important part of maintaining healthy bone tissue and a better quality of life.

Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise

BackgroundThe purpose of the study was to examine how bone mineral density (BMD) is related to body composition depending on the practiced sport (endurance, speed-power, throwing sports) in participants of the World Masters Athletics Championship.MethodsDual-energy X-ray absorptiometry (DXA) was used to determine BMD and bone mass (BMC). Body composition was analyzed by means of the JAWON Medical X-scan analyzer using bioelectrical impedance methods. Percentage body fat (%BF), body fat mass (BFM), lean body mass (LBM), total body water (TBW), soft lean mass (SLM), intracellular water (ICW), and extracellular water (ECW) were evaluated.ResultsAmong men, the most important variables affecting the BMD norm were LBM (OR = 32.578; p = 0.023), ECW (OR = 0.003; p = 0.016) and ICW (OR = 0.011; p = 0.031), in the distal part and SLM (OR = 5.008; p = 0.020) and ICW (0.354, p = 0.008) in the proximal part. In women, the most important predictors of normal BMD were ICW (OR = 10.174; p = 0.003) and LBM (OR = 0.470; p = 0.020) in the distal part and ICW (OR = 5.254; p = 0.038) in the proximal part.ConclusionThe representatives of strength based events had the most advantageous BMD levels. The condition of bone tissue evaluated by BMC and BMD of the forearm in masters athletes was strongly determined by the level of lean body components and the type of sports training associated with the track and field event. In the most important predictors of the BMD norm were also hydration components ECW and ICW. However, this relationship requires more research on the nature and mechanisms of these interactions.

Genes associated with inflammation and bone remodeling are highly expressed in the bone of patients with the early-stage cam-type femoroacetabular impingement

BackgroundRecent studies have shown high expression levels of certain inflammatory, anabolic, and catabolic genes in the articular cartilage from the impingement zone of the hips with femoroacetabular impingement (FAI), representing an increased metabolic state. Nevertheless, little is known about the molecular properties of bone tissue from the impingement zone of hips with FAI.MethodsBone tissue samples from patients with early-stage cam-type FAI were collected during hip arthroscopy for treatment of cam-type FAI. Control bone tissue samples were collected from six patients who underwent total hip replacement because of a femoral neck fracture. Quantitative real-time polymerase chain reaction (PCR) was performed to determine the gene expression associated with inflammation and bone remodeling. The differences in the gene expression in bone tissues from the patients with early-stage cam-type FAI were also evaluated based on clinical parameters.ResultsIn all, 12 patients with early-stage cam-type FAI and six patients in the control group were included in this study. Compared to the control samples, the bone tissue samples from patients with FAI showed higher expression levels of interleukin-6 (IL-6), alkaline phosphatase (ALP), receptor activator of nuclear factor-kB ligand (RANKL), and osteoprotegerin (OPG) (P < 0.05). IL-1 expression was detected only in the control group. On the other hand, there was no significant difference in IL-8 expression between the patients with FAI and the control group. The patients with FAI having a body mass index (BMI) of >24 kg/m2 showed higher ALP expression (P < 0.05). Further, the expression of IL-6 and ALP was higher in the patients with FAI in whom the lateral center-edge angle was >30° (P < 0.05).ConclusionsOur results indicated the metabolic condition of bone tissues in patients with early-stage cam-type FAI differed from that of normal bone in the femoral head-neck junction. The expression levels of the genes associated with inflammation and bone remodeling were higher in the bone tissue of patients with early-stage cam-type FAI than in the patients with normal bone tissue.

Стан кісткової тканини в дітей з ювенільним ідіопатичним артритом

Osteopenia (osteopenic syndrome) and osteoporosis (OP) are among the frequent and highly disabling conditions that accompany the development of rheumatic diseases (RD), including juvenile idiopathic arthritis (JIA). Changes in the requirements for the diagnosis and treatment of children with JIA according to the treatment strategy to achieve the goal (treat to target) have led to a decrease in the frequency of development and manifestations of OP in patients with RD. The condition of bone tissue in children with JIA, against the background of modern therapy and in conditions of widespread vitamin D deficiency requires further study. Purpose — to study bone mineral density (BMD) in children with JIA in modern disease management and to identify adverse factors for the development of OP among clinical signs. Materials and methods. We examined 35 children with JIA aged 7 to 17 years, mostly female (77.1%), with oligo (25.7)%, poly (60.0%) and undifferentiated (14.3%) option, 53.4% of whom have not yet received basic therapy. All patients underwent BMD by dual-energy X-ray absorptiometry on a bone densitometer Explorer QD W (Hologic), parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], total and ionized calcium and phosphorus in syvo. The control group consisted of 12 healthy children of the same age with a normal level of 25(OH)D. Results. The mean level of vitamin D in the serum of children in the main group was 20.41±1.35 ng/ml, which was significantly lower than in the control group (30.03±2.53 ng/ml, p&lt;0.05); the frequency of low levels of vitamin D reached 88.57%. The content of calcium and phosphorus in the blood did not deviate from the normative values, despite the widespread deficiency of vitamin D. 98.37% of patients had normal PTH values, the average level in the blood was 30.43±0.90 pg/ml. The content of PTH was the highest in non-differential arthritis (34.33±1.80 pg/ml), the lowest in the oligoarticular variant (28.36±1.43 pg/ml, p&lt;0.05). PTH concentrations correlated with vitamin D levels (r=-0.41; p&lt;0.05) and were independent of patient gender and disease activity. The frequency of decreased BMD was 28.57% of the surveyed children. The prevalence of osteopenia was the same in different variants of arthritis and did not depend on the sex and age of patients, positivity in the RF. Osteopenic syndrome was significantly more common in ANA-positive JIA than in ANA-negative variant (46.15% vs. 18.18%; pϕ&lt;0.05). The condition of bone tissue (Z-criteria) depended on BMI (r=0.33; p&lt;0.05), disease activity on the JADAS scale (r=0.35; p&lt;0.04), the number of active joints (r=0.34; p&lt;0.05); ANA level (r=-0.34; p&lt;0.05). In the group of children with osteopenic syndrome, BMD correlated with the duration of the disease (r=-0.67; p&lt;0.05), the number of active joints (r=-0.62; p&lt;0.05), the level of blood phosphorus 0.74; p&lt;0.05) and the sum of points on the JADAS scale (r=0.59; p&lt;0.05). In the group of children with preserved BMD, the spectrum of correlations was supplemented by indicators of vitamin D status (r=-0.33; p&lt;0.05) and BMI (r=-0.40; p&lt;0.05). Conclusions. In children with JIA, the incidence of osteopenia is 28.57% with vitamin D deficiency in 88.57% of patients, preserved levels of total calcium, phosphorus and PTH in the blood. Decreased BMD in the early stages of JIA is associated with a younger age of patients and the age of onset of the disease, increased prevalence of joint syndrome, inflammatory and serological activity of the disease, ionized calcium and blood phosphorus, PTH levels and decreased vitamin D (р&lt;0,001). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: bone mineral density; juvenile idiopathic arthritis; osteopenia; 25-OH-vitamin D; parathyroid hormone.

The role of radiation diagnostic methods in pathological changes of the hip joint before and after endoprosthetics

Endoprosthesis replacement-operational treatment of diseases and damages of hip joint. The problem of prevention of complications and their negative effects is extremely actual today. However the role of different beam techniques in identification of adverse effects and complications of endoprosthesis replacement of joints is studied insufficiently. Results of clinic and diagnostic and beam researches of 40 patients with pathology of hip joint are analyzed. The used beam methods of research - roentgenography, multispiral computed tomography. At presurgical stage the main objec­tive was detection of pathology of joint, definition of indications and planning of operative measure. Situation and relationship of components of endoprosthesis, condition of bone tissue, and also bone cement round cup and leg of prosthesis were key parameters of radiological assessment of outcomes of endoprosthesis replacement. Complex use of radiological techniques (roentgenography and spiral computed tomography) allows to specify and add semiotics of changes of bone tissue at the level of acetabular hollow and proximal department of femur after endoprosthesis re­placement.

Analysis of Bone Tissue Condition in Patients with Diffuse Large B-Cell Lymphoma without Bone Marrow Involvement.

We studied changes in the bone tissue in patients with diffuse large B-cell lymphoma at the onset of the disease (N=41; before chemotherapy) and 5-16 years after the end of treatment (N=47). Osteodensitometry, biochemical markers of osteoporosis in the blood and urine, and gene expression in multipotent mesenchymal stromal cells were analyzed. In multipotent mesenchymal stromal cells of all patients, the expression of genes associated with bone and cartilage differentiation (FGF2, FGFR1, FGFR2, BGLAP, SPP1, TGFB1, and SOX9) was changed. In primary patients, the ratio of deoxypyridinoline/creatinine in the urine and blood level of β-cross-laps were increased, while plasma concentration of vitamin D was reduced, which indicates activation of bone resorption. No differences between the groups were revealed by osteodensitometry. No direct relationship between changes in gene expression in multipotent mesenchymal stromal cells and osteoporosis markers was found. The presence of a tumor in the body affects the bone marrow stroma, but achievement of remission and compensatory mechanisms provide age-appropriate condition of the bone tissue.

Effects of 3D Imaging on Surgical Tactics in Primary and Revision Hip Arthroplasty

3D imaging tools significantly expand the ability to assess the bone tissue condition, both in terms of its qualitative properties and in terms of accurate determination of bone defect geometry and volume.The purpose of the study was to determine the 3D imaging potential for the preoperative planning and correction of surgical tactics in hip arthroplasty.Materials and Methods. A retrospective analysis of the preoperative planning of 110 primary and revision hip arthroplasties with 3D imaging was performed. The following specialized software were employed: RadiAnt DICOM Viewer file converter — for 3D models production; 3D/CAD designers — for volumetric models processing and correction; InVesalius 3.0 program — for bone density evaluation by the Hounsfield scale; K-Pacs — for viewing MSCT and X-ray images. All patients underwent pelvic bones radiography in the front and anterior-lateral planes. Post-traumatic acetabular deformity was described in accordance with the X-ray picture in each individual clinical case. For revision arthroplasty, the acetabular defect was determined according to the W.G. Paprosky classification. In 36 patients (32.7%), the acetabulum defect was the result of trauma. In 74 patients (67.3%), the cause of surgery was endoprosthesis components loosening.Results. In 80% of cases (88 patients), the analysis of the 3D model did not change the surgical tactics determined in the preoperative planning using pelvic radiographs; in 20% of cases (22 patients), the use of 3D imaging revealed new circumstances and changed the surgical tactics.Conclusion. In standard cases, it is possible to use the traditional preoperative planning using radiographs in several planes. In primary hip arthroplasty in the patients with post-traumatic deformity, including a false joint of acetabulum bottom or 2 to 3 degree osteopenia, it is advisable to perform 3D imaging. In the case of revision arthroplasty, 3D visualization is indicated in acetabulum Paprosky IIIA, IIIB defects with pelvic discontinuity.

Essential elements role in pathogenesis of occupational chronic lumbosacral radiculopathy in coal miners.

The problem of diagnosis in the early and preclinical stages of diseases is important in the prevention of occupational diseases and their complications, because this is the key to the timely initiation of treatment, the implementation of preventive measures. Chronic lumbosacral radiculopathy (CLSR) or low back pain (LBP) is one of the most common diseases in the structure of occupational pathology in Ukraine, which usually develops in those of working professions associated with physical activity, forced work posture, effect of high levels of general vibration, etc. The highest levels of occupational morbidity are recorded in the coal industry, which accounts for about 80% of occupational pathology in Ukraine. Above 1600 cases of CLRS are diagnosed annually in the country. A risk factor for the development of the CLSR is osteoporosis, which arises due to the impairment of quantitative and qualitative characteristics of bone tissue and is characterized by a decrease in its strength, animpairment of microarchitecture with a further increase in risk of fractures. One of the modern methods of assessing condition of bone tissue is determination of the content of macro- and trace elements (MaE and ME) in the biological environments of patients. Ca, Al, Mg, B, P are the most important in the formation and development of bone and connective tissue. To date, studies of bone tissue status in patients with CLSR of professional etiology have not been conducted (small in numbers). Goal – to determine the role of essential elements Ca, Al, Mg, B, P in serum and urine in the formation of occupational CLSR in miners. The research was conducted in 20 miners with CLRS (slaughterer, mining worker of a clearing face (MWCF), drifter) of coal mining industry of Donbass and Lviv-Volyn basins. The results were analyzed in two groups: І group consisted of patients with 10-15 years of work experience (n=10), II group with 16-32 years of work experience (n=10). The control group included 22 patients without pathology of the musculoskeletal system and connective tissue. The inductively coupled plasma atomic emission spectroscopy method (ICPAE) was used to determine the MaE and ME concentrations. The study revealed that the average serum aluminum (Al) concentration in miners with occupational CLSR (115.07 μmol/l) exceeded control group level (3.3 μmol/l) by almost 30 times (p&lt;0.05). Serum boron (B) concentration in both age groups (25.90 μMol/l and 19.43 μMol/l, respectively) were lower than in the control (62.90 μMol/l), (p&lt;0.05). The average serum calcium (Ca) concentration in patients with occupational CLSR (2.82 mmol/l) was 1.3 times higher than the same indicator in the control group (2.16 mmol/l), with a significant difference between the two age groups (p&lt;0.05). It was revealed that the average level of phosphorus (P) in the urine of patients with occupational CLSR (19.0 mmol/l) significantly exceeded its content in patients of control group (11.96 mmol/l) (p&lt;0.05). The concentration of Al in the urine of patients with CLSR in both age groups (1.26 μMol/l and 1.334 μMol/l, respectively) was higher that in control (0.85 μMol/l), (p&lt;0.05). Reduction of Ca and Mg levels in the serum of miners in increasing work experience in harmful working conditions, exceeding average concentration of aluminum in patients' blood compared to the normative value and indicators of the control group patients was established.

Condition of bone tissue in postmenopausal women with type 2 diabetes mellitus of Buryat population

BACKGROUND: In most countries, there is a rapid increase in the population of patients with type 2 Diabetes Mellitus (DM). Bone changes in postmenopausal women with type 2 DM are associated with increased bone mineral density (BMD). The study of metabolic processes in bone tissue in comorbid pathology in different ethnic groups is continuing.&#x0D; AIMS: To study the concentration of markers of bone remodeling and indicators of BMD in postmenopausal women with type 2 DM of the Buryat population.&#x0D; MATERIALS AND METHODS: Thirty-nine postmenopausal women with type 2 DM (22 Russian population and 17 Buryat population) were examined. The comparison group consisted of 42 postmenopausal women (21 Russian population and 21 - Buryat population). The study of BMD in the lumbar spine (L1-L4), the femoral neck (Neck), and the proximal femur (Total hip) was performed using dual-energy X-ray absorptiometry. Parameters of osteocalcin (OC), type 1 N-terminal procollagen propeptide (P1NP), C-terminal telopeptides of type I collagen (-Cross laps), 25(OH) vitamin D and ionized calcium were evaluated.&#x0D; RESULTS: The presented study revealed a simultaneous increase in osteosynthesis: ОС (p=0.048) and P1NP (p=0.016) and in the bone resorption marker -Cross laps (p=0.020) accompanied by the absence of changes in BMD in women with type 2 DM in the postmenopausal period of the Buryat population relative to women with type 2 DM in the postmenopausal state of the Russian population. A decrease in osteosynthesis parameters (ОC, p=0.021; P1NP, p=0.029) with an increase in BMD L1-L4 (p=0.024) and BMD Total hip (p=0.039) in postmenopausal women with type 2 DM of the Buryat population was found relative to the women of the Buryat population in comparison group.&#x0D; CONCLUSIONS: The state of bone tissue in postmenopausal women with type 2 DM of the Buryat population is characterized by the activation of bone remodeling processes.

Особливості мінерального обміну у кролів за умови корекції біологічно активними кормовими добавками на тлі імплантування PLA імплантатів

Humic substances are able to influence mineral metabolism due to their properties to form chelate complexes. Directly, the state of bone tissue is closely related to general processes that ensure the exchange of minerals in the body as a whole. Polylactic acid (PLA) is a biopolymer which, due to its high biocompatibility and osseointegration properties, is increasingly used for the manufacture of implants. Among the methods of improving the osseointegration of implants, gaining popularity, the use of pharmacological drugs and dietary supplements that have a direct effect on bone tissue or act indirectly by affecting the body’s systems and metabolism. For the experiment 32 rabbits were divided into groups of 8 rabbits each In two model groups, 16 rabbits were implanted with PLA implants in the bilateral defect of the parietal bone, one of which was immersed in a 1% humilid solution and the other in a 0.9% NaCl solution before administration. From the operated rabbits, 8 received humilid during treatment, and 8 others were intact. 16 rabbits who did not undergo surgery were divided into two groups, one of which drinked humilid and the other clean water. The aim of our work was to determine the mineral metabolism in rabbits during implantation of PLA implants. The ability of humic substances to influence the redistribution of calcium ionized and copper in the blood serum and femur in rabbits of the model group in comparison with intact animals was proved.. There was also an increase in the content of iron and calcium ionized in the serum, and calcium, iron, copper and a decrease in the content of zinc in the femur of rabbits treated with humilide. It has been proved that the introduction of humilid into the diet caused an increase in newly formed bone tissue in PLA implants of rabbits of the model group. Therefore, an increase in macro- microelements in blood serum and their redistribution in the bone tissue of rabbits receiving humilides suggests the possibility of using humilid to correct mineral metabolism and improve the condition of bone tissue. Leveling reduction macro- microelements in the blood and bone tissue, together with an increase in newly formed bone tissue in PLA implants of a model group of rabbits receiving humilide indicate a systemic effect of humilid on the osseointegration of PLA implants.