Saratov JOURNAL of Medical and Scientific Research

Norkin I.A.

Saratov State Medical University n.a. V I. Razumovsky, Director of Scientific and Research Institute of Traumatology, Orthopedics and Neurosurgery, Head of Department of Traumatology and Orthopedics, Professor, Doctor of Medical Science

Professor I.Ya. Livshits and his contribution to the development of national neurosurgery

Year: 2018, volume 14 Issue: №3 Pages: 466-469
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Ulyanov V.Yu., Ninel V.G., Norkin I.A., Grishin S.Ye., Bazhanov S.P., Fedonnikov A.S., Chibrikov G.l., Puchinyan D.M.
Organization: Saratov Medical University "Reaviz", Saratov Socio-Economic Institute of Plekhanov Russian University of Economics, Saratov State Medical University
Summary:

The article traces the professional path of Professor Lev Yakovlevich Livshits, assesses his scientific contribution to the development of national neurosurgery. The concept of minimally invasive surgical treatment of trigeminal nerve neuralgia, developed by L. Ya. Livshits, allowed developing an original method of puncture surgical treatment of pain syndrome by directed hydrothermal destruction of the sensitive trigeminal root. The concept of "growing radicalism" created by Professor L. Ya. Livshits allowed his students elaborating algorithms for treating severe chronic pain syndromes of any localization and etiology.

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The estimation of biocompatibility of polycaprolactone matrices mineralized by vat-erite in subcutaneous implantation tests in white rats

Year: 2018, volume 14 Issue: №3 Pages: 451-456
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Kozadaev M.N., Tyapkina D.A., Kustodov S.V., Saveleva M.S., Bugaeva I.O., Parakhonsky B.V., Galashina E.A., Gladkova E.V., Norkin I.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Aim: to estimate biocompatibility of matrices produced from polycaprolactone (PCL) and mineralized by vaterite (CaC03) by studying local and systemic manifestations of inflammatory reaction in subcutaneous implantation tests in white rats. Material and Methods. The experiment was conducted on 40 rats divided into four equal groups: control, comparison (rats with imitation of implantation), negative control (rats with implanted non-biocompatible matrices) and experimental group, comprised of animals with implanted PCL/CaC03-matrices. Local inflammatory manifestations were analyzed by morphological assay of implantation area tissues. Systemic inflammatory manifestations were estimated by TNF-a concentration and interleukin-lp (IL-1) in blood serum by ELISA. Results. The changes in cellular population content demonstrate that a PCL/CaC03-matriceonthe21 day after the implantation to rats is evenly colonizing by fibroblast cells and vascularizing. This type of matrices does not provoke intense inflammatory reaction seen in negative control animals and accompanied by systemic manifestations such as statistically significant rise in TNF-a and IL-1 concentrations. Conclusion. The data obtained in the study proving the biocompatibility of PLC/CaC03-scaffolds experimentally substantiate the potential for their use in tissue engineering.

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Peculiarities of microcirculatory reactions after subcutaneous implantation of polycaprolactone matrices mineralized by vaterite

Year: 2018, volume 14 Issue: №1 Pages: 35-41
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Norkin I.A., Ivanov A.N., Kurtukova M.O., Savelyeva M.S., Martyukova A.V., Gorin D.A., Parakhonsky B.V.
Organization: Saratov State Medical University, Saratov state university, Skolkovo Institute of Science and Technology
Summary:

The aim is to assess skin microcirculation changes arising during subcutaneous implantation of polycaprolactone scaffolds mineralized by vaterite. Material and Methods. The experiment was carried out on 30 albino rats divided into two groups: a negative control group and an experimental one. We implanted polycaprolactone scaffold with exhausted foreign protein subcutaneously into rats of the negative control group. We implanted polycaprolactone matrix mineralized by vaterite subcutaneously into the animals of the experimental group. Research methods include laser Doppler flowmetry and morphological examination of the tissues of the matrix implantation area. Results. Changes of skin microcirculation over the matrix allocation area correspond to the morphological pattern of tissue reactions. Biocompat-ibility disorders take the form of inflammation in the scaffold implantation area that is accompanied by stable perfusion rise associated with local bloodstream modulation changes. We did not observe inflammation signs in the surrounding scaffold tissues during implantation of polycaprolactone matrices mineralized by vaterite. Besides local microcircula-tory reactions possess a transient character disappearing completely by the 21st day after the implantation. Conclusion. Complex of the given functional and morphological studies allow us to ascertain high-grade biocompatibility of polycaprolactone matrices mineralized by vaterite thus giving rise to prospect of their use for tissue regeneration stimulation.

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Rehabilitation after hip and knee joints replacement: several results of medical and sociological monitoring

Year: 2017, volume 13 Issue: №4 Pages: 796-799
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А., Erugina M.V, Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

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Medical and sociological issues of rehabilitation of patients after hip and knee joints replacement

Year: 2017, volume 13 Issue: №3 Pages: 761-764
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Fedonnikov A.S., Erugina M.V., Andriyanova E.A., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.

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Coxar-throsis in infancy and adolescence: opportunities of preventive treatment

Year: 2017, volume 13 Issue: №3 Pages: 751-755
Heading: Traumatology and Orthopedics Article type: Review
Authors: Norkin I.A., Sertakova A.V., Rubashkin S.A., Zotkin V.V., Gerasimov V.A., Timaev M.Kh., Chibrikova Yu.A., Kupina E.S.
Organization:
Summary:

The review systematizes scientific data on the major groups of heterogeneous diseases which have infant and adolescence coxarthrosis as their outcome and contains materials on etiology, pathogenesis, diagnostic, treatment and precaution methods of complication (dystrophic changes in hip joints) for each disease.

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Complex stimulation of peripheral nerve regeneration after deferred neurorrhaphy

Year: 2017, volume 13 Issue: №3 Pages: 732-737
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ivanov A.N., Korshunova G.A., Matveyeva O.V., Ninel V.G., Shutrov I.E., Shchanitsyn I.N., Andronova Т.А., Norkin I.A.
Organization: Saratov Regional Child Clinical Hospital, Saratov State Medical University
Summary:

The aim is to study the complex stimulation effect including skin autotransplantation and electrical stimulation of the sciatic nerve on microcircular, electrophysiological and morphological changes after deferred neurorrhaphy in rats. Material and methods. The experiment was performed in 50 albino rats divided into control, comparative and experimental groups. In the experimental group, on the background of deferred neurorrhaphy, skin autotransplantation and electrical stimulation of the sciatic nerve had been carried out. In the comparative group only deferred neurorrhaphy was performed. Research methods included laser doppler flowmetry, electroneuromyography and morphological analysis of the operated nerve. Results. Complex stimulation including skin autotransplantation and direct action of electrical pulses on the sciatic nerve after its deferred neurorrhaphy causes restoration of bloodstream in the operated limb, promotes intensification of restoration of nerve fibers. Conclusion. Intensification of sciatic nerve regeneration after deferred neurorrhaphy in rats under the influence of complex stimulation including full-thickness skin graft autotransplantation and direct action of electrical pulses substantiates experimentally appropriateness of clinical testing of the given method for treatment of patients with peripheral nerve injuries.

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Comparative retro- and prospective analysis of treatment outcomes in patients with SCI and cervical spine injuries in acute and early periods of traumatic disease

Year: 2017, volume 13 Issue: №3 Pages: 710-715
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Chibrikova Yu.A., Biryukova A.V., Norkin I.A., Gulyaev D.A., Salihu H.
Organization: Almazov National Medical Research Centre, Saratov State Medical University
Summary:

The aim: to conduct comparative retro- and prospective study of treatment outcomes in patients with cervical spine and SC injuries on the basis of assessment scale analysis. Material and Methods. 217 patients with closed cervical spine and SC injuries commeasurable by age, degree of neurological deficit, acute physiological and chronic state disorders were enrolled into the study. 177 patients comprised the main group (prospective study) and 40 — comparison group (retrospective study). To compare treatment outcomes we used Karnofsky score (Karnofsky, 1949), a quantitative assessment score for general patient status scales, APACHE II, Acute Physiology and Chronic State Evaluations (Knaus — Draper, 1985) and SCIM II, Spinal Cord Independence Measure Scale. Results. Comparative analysis based on the quantitative values of assessment scales, indicates an improvement of short-term treatment outcomes in patients with SC and cervical spine injuries in the main group. Conclusion. Complex approach to differentiated surgical treatment management and unique neuroprotection methods significantly improves short-term treatment outcomes having positive effect on general patient status, severity of acute physiological and chronic state disorders and patients' independence in the post-surgical period.

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Comprehensive approach to the assessment of the functional status of patients with degenerative joint diseases of the lower extremities

Year: 2017, volume 13 Issue: №3 Pages: 510-514
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Romakina N.A., Korshunova G.A., Kireev S.I., Sertakova A.V., Norkin I.A.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Aim: development of an integrated biomechanical index that reflects the state of kinematic and static function in patients who need replacement of large joints as well as evaluation of the myoneural complex of lower extremities activity of category of patients. Material and Methods. 103 patients with osteoarthrosis of the hip and knee joints. A biomechanical survey included podography, stabilometry and dynamometry. An electrophysiological study of the peripheral nerves of the lower extremities with the determination of the amplitude of the muscle response and late neuronal responses was carried out. The level of activity of the gluteal muscles was determined. Results. The most sensitive indicators reflecting the state of biomechanical status were identified, specialized software for the integral biomechanical index calculation was developed. Conclusion. Methods of clinical biomechanics allow specialists to assess the state of kinematic and static function of the musculoskeletal system, matching of the integral biomechanical index with the data of neurophysiological monitoring makes possible to select individual tactics of treatment.

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A competency-based model for training of specialists in vertebrology at higher medical school

Year: 2016, volume 12 Issue: №2 Pages:
Heading: Pedagogics and Education Article type: Short message
Authors: Norkin I.A., Fedonnikov A.S., Zaretskov V.V., Andriyanova E.A., Levchenko K.K., Zaretskov A.V., Belonogov V.N.
Organization: Saratov State Medical University
Summary:

The field of medicine facing the issues of diagnosis and treatment of spine diseases and injuries requires training of specialists in vertebrology taking into consideration the modern standards of higher professional education and medical care conditions. The article deals with the training of the specialists using a competency-based model

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