Morphofunctional reorganization of plantar aponeurosis in experimental modeling of fasciopathy by synthetic analogue of prostaglandin E1

Foundation. Chronic plantar fasciopathic pain syndrome is a pathology that significantly affects the quality of life of patients of all age categories. Insufficient knowledge of the etiological and pathogenetic factors in the development of fasciopathies explains the multiplicity, and sometimes inconsistency, of conservative and surgical treatment regimens. The choice of the optimal variant of therapeutic or surgical intervention may be associated with experimental modeling of fasciopathies and the study of the dynamics of the pathological process.The aim. To study the morphological changes in structures identical to the human plantar aponeurosis in experimental modeling of fasciopathy in animals.Research methods. The material for the study was fragments of the tendonaponeurotic complex of the foot of laboratory animals (control group: animals with the introduction of physiological sodium chloride solution (n = 12); main group: animals with the introduction of alprostadil (n = 12)). The methods of light microscopy (staining with alcian and toluidine blue, according to Van Gieson, Weigert – Van Gieson and Picro-Mallory) and morphometry were used.Results and discussion. As a result of the study, it was found that the four-fold administration of alprostadil had a significant effect on the structure of the dense fibrous connective tissue of the plantar foot of laboratory animals. The mechanisms of damage (edema, microhemorrhages, infiltration by lymphocytes, plasmocytes and leukocytes, dystrophy by the type of mucoid and fibrinoid swelling, delamination and rupture of collagen fibers), adaptation and regeneration (the appearance of a large number of activated fibrocytes, fibroblasts, microvessels, neoplasm of collagen fibers) were activated. All this together led to spatial focal histotopographic changes, consisting in an increase in the cellular composition of connective tissue structures against the background of a noticeable violation of their spatial orientation.Conclusion. Modeling of fasciopathy using alprostadil was accompanied by the appearance of mosaic reversible and irreversible heteromorphic and heterochronous changes in all connective tissue aponeurotic structures. Such histotopographic changes should be considered as one of the reasons for the clinical manifestations of plantar fasciopathies, causing functional insufficiency and explaining the clinical recurrent nature of the pathological process

Avulsion Fractures Osteosynthesis in Patients with Normal Bone Mineral Density and Osteoporosis

Objective: to compare the effectiveness of osteosynthesis for avulsion fractures using bioabsorbable versus titanium implants in patients differing in bone mineral density.Material and Methods. In the experimental phase of study, two groups of bone blocks were singled out from patients' femoral heads to assess the anchoring properties of the implant in osteoporotic and healthy bone. The first group included blocks of 31 patients with osteoporosis, the second one — 27 blocks of patients without osteoporosis. In the first group, cortical bioabsorbable Poly-L-Lactic/ co-glycolic acid (PLGA) screws were implanted into 13 bone blocks, titanium screws — into 10 bone blocks, and bioabsorbable pins (PLGA) — into 8 bone blocks. In the second group, 10 titanium screws, 10 bioabsorbable screws and 7 bioabsorbable pins were implanted. The anchorage of the implant in bone was evaluated by a pull-out test. Then, depending on the anchorage used, the studied bone blocks with osteoporosis, newly obtained from the first group, were divided into three groups for the purpose of evaluating the resistance to the damaging effects of the implant. In experiment, the osteosynthesis for avulsion fracture was simulated on these bone blocks. In the first group (11 bone blocks), the transosseous osteosynthesis of the bone fragment was carried out with a titanium screw, in the second group (9 bone blocks) with a bioabsobable screw, in the third group (11 bone blocks) with a bioabsorbable pin. The results of osteosynthesis were assessed based on how often a small bone fragment was damaged by an implant and on stability of the anchored implant. In the clinical phase of study, a comparative analysis of 65 surgical interventions (38 people with osteoporosis and 27 without osteoporosis) in patients with avulsion fractures was performed. In 24 cases, bioabsorbable screws were used for osteosynthesis, AO/ASIF titanium screws were used in 31 cases, and pins were used in 10 cases.Results. Experimental studies showed that the resistance to pull-out test of a bioabsorbable screw anchored in osteoporotic bone is 25.7% higher than a titanium screw. No statistically significant difference was found in bone without osteoporosis. Resistance to pull-out test of a bioabsorbable pin is 3% higher than a titanium screw. The model-based experiment with an avulsion fracture in osteoporotic bone using a titanium screw showed lower effectiveness of osteosynthesis: in 27.2% of cases the cortical titanium screw damaged a small bone fragment. Based on the clinical trial findings, no negative results were obtained using bioabsorbable anchorage. In 12.5% cases of osteosynthesis with a titanium screw, migration of a bone fragment was noted. The data obtained during the clinical study correlated with the experimental data. This makes the use of bioabsorbable implants advantageous.Conclusion. For avulsion fracture osteosynthesis in patients with normal bone mineral density, it is possible to use both titanium and biodegradable fixators with equivalent strength of fragment fixation. n osteosynthesis of fractures in patients with osteoporosis it is preferable to use bioabsorbable implant

Increasing the resolution of ECG and EEG mapping equipment using nanosensors

The problem of a large number of people with cardiovascular diseases and brain diseases is relevant all over the world. The problem of mortality and the consequences of these diseases is particularly acute. Therefore, an important way in medical instrumentation is to improve and increase the amount of information with the help of external methods of diagnosing these diseases. Nanosensors have been developed at Tomsk Polytechnic University to significantly improve the quality of electrophysiological measurements. It is proposed to apply the developed nanosensors for ECG and EEG mapping