Prosthetic design and outcome in total hip arthroplasty.
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Biomedical subjects
Publications and source records attributed to V Surin.
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RFLP analysis of some intra- and extra-genic polymorphic sites of Factor VIII (FVIII) and Factor IX (FIX) genes with relevant DNA probes or by polymerase chain reaction (PCR) was carried out in Slavic populations from the European part of Russia and also in the native ethnic groups of Uzbekistan and Kazahstan. The allele frequencies for the HindIII (intron 19) and XbaI (intron 22) polymorphic sites (PSs) in the FVIII gene were very similar in the two populations studied, but different for the intron 13 (CA)n repeat. Significant variations in the TaqI (intron d) and DdeI (intron a) polymorphisms of the FIX gene were evident between the Russian and Asian populations. Two unusual alleles (4.35 and 4.2 kb) for the extragenic PS St14/TaqI were registered in Slavs and one new allele (380 bp) for the DdeI polymorphic site of FIX was discovered in both Asian populations. Altogether, 210 haemophilia A (HA) and 24 haemophilia B (HB) families were subjected to molecular studies. So far, 160 HA and 12 HB families have been found to be informative for DNA analysis. Carrier status was ascertained in 42 HA and 6 HB female relatives, and rejected in 52 and 10 of them, respectively. The origin of some HA and HB mutations was traced with relevant polymorphic markers in several at-risk families. Prenatal diagnosis was accomplished in 28 HA and three HB families, resulting in the identification of 20 affected male fetuses.
High reactivity of the polyalkylating ss oligomers that were sense or antisense 30-200-mers containing sequences complementary to E1 oncogenes of simian adenovirus SA7 and one alkylating residue -CH2CH2N(C2H5OH) (CH2)3N(Ph-p-CH2OH)CH2CH2Cl per each 25 bases of oligomers was demonstrated in vitro by alkylation of ss DNA of recombinant M 13 mp8E1 and mp9E1 phages with inserted E1 sequences of adenovirus oncogene and then by followed complete and selective elimination of E1 sequences from recombinant ss DNA. Treatment of rodent cell cultures transformed by oncogenic SA7 with polyalkylating oligomers which are complementary to the long region of the minus or plus chains of E1 DNA of SA7 revealed a rather high extent of mutant cell clones formation. The cells formed were normalized; they had lost some properties of the transformed cells. Dividing cell clones inherited the new phenotypic properties: morphology, slower and more limited proliferation, and higher dependence on bovine serum growth factors. Some of the mutant cell DNAs demonstrated different mutations in the E1A sequences of the integrated proviral oncogene. There were exchanges G to C (leu to val) in the 525 and C to A (asp to tyr) in the 555 positions of E1A oncogene. Besides a deletions in the 1057-1477 E1A region or/and a mutation in the 1457-1477 of E1A were observed. Thus the inherited cell normalization observed is performed due to oncogene-directed mutagenesis in vivo.
We evaluated twelve shoulders (ten patients) that had recurrent, painful posterior instability and were treated by external rotational osteotomy of the humerus. The length of follow-up ranged from two to twelve years. The patients rated the result as excellent or good in ten of the twelve shoulders. Objectively, two shoulders were rated as excellent; eight, as good; and two, as fair. There was recurrent instability in one shoulder that had had multidirectional instability. One pseudarthrosis, which persisted for ten years, was revealed on the follow-up radiographs.
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The use of prophylactic antibiotics was studied prospectively in 2371 consecutive clean orthopedic operations. The infection rates for operations with obvious selection for antibiotic prophylaxis were twice as high (7.2%) as compared with operations with planned prophylaxis (3.4%) and with operations without such prophylaxis (3.7%). Sixteen per cent of all clean operations received antibiotics for prophylaxis and 85 per cent of all prophylactic courses lasted at least 8 days or longer. Fifty-one per cent of all antimicrobial drugs used during the study were administered for prophylaxis in clean orthopaedic operations. The length of the hospital stay was the only factor closely related to the length of antibiotic prophylaxis. The drugs most often used for prophylaxis were penicillinase-resistent penicillins. Significant increase of gram-negative pathogens was observed in cultures from wounds of patients on antibiotic prophylaxis.
The results of decompressive laminectomy in 22 patients with degenerative lumbar spinal stenosis are reported. The average follow-up period was 29 months. Twelve of the 15 patients with marked stenosis (a minimum anteroposterior (a.p.) diameter of the spinal canal in extension of 10 mm or less) and all 7 patients with moderate stenosis (a minimum a.p. diameter between 11--14 mm) obtained relief from leg pain. A pseudovascular syndrome was observed in 12 of the 15 patients with marked and in 2 of the 7 patients with moderate spinal stenosis. Of these patients, 10 obtained increased (7 patients unlimited) walking distance postoperative. Vertebral fusion was not performed in any of the patients. Slight vertebral slip (2--5 mm) occurred postoperatively in 4 out of 20 patients whose follow-up examination included dynamic roentgenogram of the spine. Five of the 15 patients with marked spinal stenosis also suffered from severe osteoarthritis of the hip. Total hip replacement subsequent to laminectomy was performed in 4 patients and excellent results were achieved for both the spinal and the hip operations.
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Based on our results with high tibia osteotomy for gonarthrosis in 96 knees, the type of primary deformity was found to significantly influence the patient's subjective assessment of the results. Knees with valgus deformity secondary to changes in other joints are not suitable for correction by HTO. Knees with varus deformity exceeding 10 degrees and with roentgenological signs of reduction of the medial tibial condyle are seldom corrected by HTO and the results in these knees are poor. There is a clear correlation between patient's satisfaction with HTO done for gonarthrosis and the correction of femorotibial deformity.
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