Aim: Analysis of arthroscopy importance of knee joints for characteristics of stage of cartilage destruction and synovitis in gonarthrosis cases. Material and methods: Arthroscopical study included 24 gonarthrosis pts (I-III degree by A.Larsen) by "STORZ ” apparatus with photoinstrumental set. Six basic zones of knee joint were analyzed: patella, trochlear are, a lateral and medial articular tibial and femoral surfaces. Criteria of assessment included presence and distribution of cartilage damage according to 5 degrees: normal cartilage (0), fibrillar cartilage (I degree), surface fissures and/or surface erosions (2 degree), deep cartilage tissures and/or erosions baring subchondral bone (3 degree), baring subchondral bone (4 degree). Synovitis intensity was analyzed by three degrees: low, moderate or high. Results: It was determined that in different zones of knee joint the character and depth of cartilage destruction is not the same. In 100% of patients with gonarthrosis independently of radiological stage there were changes in patellar cartilage. Pathology' of articular cartilage in the area of lateral condyle of the femur in the lateral and medial areas of the tibia was found in the I-st, Il-nd and Ill-d stages with the same incidence. Development of fissures of cartilage was found in all gonarthrosis stages and even in the 1-st stage the incidence was the same as in the 111-d disease degree. Erosions were found in more than a half of pts with the I-st and Il- nd stages of gonarthrosis (57% and 67% correspondingly). Even in the I-st gonarthrosis stage in all areas of knee joint excluding lateral articular surface of the tibia changes characteristic for the Ill-d degree of cartilage destruction were found with different frequency. Incidence of subclinical synovitis according to arthroscopy data in the /, 11, III radiological stages of gonarthrosis was 57%, 33.5% and 100% correspondingly. Fissures and erosions were found in all pts with expressed synovitis. Conclusion: In our study no correlation was found between the stage of cartilage destruction (according to arthroscopy data) and early (1 and 11) radiological gonarthrosis stages: Ill-d stage of gonarthrosis is corresponding with the Ill-d stage of cartilage destruction.

Summary» Aim: To study the incidence ofjoints complaints aimed at determining group for further clinical examination. Material and methods: Simultaneous continuous epidemiological study among residents of four typical rural settlements in the Republic of Saha (Yakutia) with scanning questionaire was used. Results: At the result of questionaire of570 persons with joint pains and 735 with spinal pains were found which amounted to 46.9% and 60.4% of examined population correspondingly. Conclusion: Joint and spinal complains are frequent manifestations with increasing distribation in older aged groups.

Aim: То determine the efficacy of intraarticular injections of Gentamycin in gout arthtiris a randomized double blind, placebo-controlled trial was carried out. Material and methods: 27 patients answering the criteria of the definite gout diagnosis were randomly recruited from rheumatological clinic. The patients received an intraarticular injection of either 4- mg of Gentamycin in 4 ml of sterile 0.25% procaine or 5 ml of the vehicle alone. Results: It was found that weekly intraarticular injections of Gentamycin performed better than the inert vehicle alone over a 2-week period and were conjirmed during 4 week period of crossing-over. Conclusion: The possible mechanisms of Gentamycin activity are discussed. It is concluded, that intraarticular administration of Gentamicin offers signijicant benejit over placebo. The serious side effects were not obsen’ed. Therefore, the technique could be applied in the routine treatment of gout.

Aim: Determining of possible relations between the presence of anticardiolipin antibodies (АСА) and occlusional thrombotic manifestations of Behcet’s disease(BD) Material and methods: Results of АСА study in 31 pts with BD depending on eye and other forms of occlusion or vascular thrombosis. Results: Increased АСА titers were found in 16.6% of pts and all of them belonged to the group with thrombosis of other than eye localization. No АСА was found in pts with isolated occlusional processes in fundus of the eye, in pts with combined occlusions of retinal vessels and thromboses of other then eye localization and also in pts without occlusional and thrombotic processes. Median level of АСА IgG was the highest also in BD pts with other than eye thrombosis (20.0±10.8 GPL). In pts with isolated occlusion of retinal vessels and pts without occlusional processes the level of median АСА IgG values was reliably lower (correspondingly 9,4±4,2 GPL, p<0,01; 6,9±6,4 GPL, p<0.01). Median АСА IgM level was higher in pts with simultaneous occlusion of retinal vessels and vascular thrombosis of other than eye localization (11,4±6,4 GPL, p<0,01). The lowest median level oj АСА IgM was observed in pts with isolated occlusion of retinal vessels (6,5±33,9 MPL). but the differences between groups of pts in АСА IgM determination were not statistically reliable. Conclusion: The obtained data enable us to suppose that АСА do not play a significant role in the development of occlusion of retinal vessels during BD.

Aim: To study the efficacy and lolerability of new benzatin-penicitlin (Extencillin, A VENTIS, France, Germany) as a means of prevention of A-streptococcal tonsillites and following repeated rheumatic attacks and also the data of comparative pharmacokinetics assessment for three therapeutical forms of benzatin-penicillin (Extencillin powder for injections 2.4 tnln U.; Bicillin-5 powder for injections 1.5 mln U, SYNTHESIS. Kurgan, Russia). Results: On prescribing Extencillin in dosage of 2.4 mln U i.m. once per three weeks to 60 pts with reliable rheumatism for 3 years the stable normalization of titers of antistreptolysin-0 was noticed in 8S.2% pts, absence of hemolytic streptococci in fauces - in 86.7%. There were no repeated rheumatic attacks in any patient. In 6.67% cases side effects were noticed (eosinophilia, skin itching) which were short-termed, reversible, and did not require cancellation of the drug. In comparative study off pharmacokinetics it was determined that after Extencillin administration in dosage of 2.4 mln U. concentration of benzyl-penicillin was enough for inhibition of 13-hemolytic A-streptococci (> 0.025 mkg/ml) was preserved for 3-weeks term in 83.3% of cases. After injection of Extencillin 1.2 mln U of Bicillin-5 1.5 mln U this level of benzyl-penicillin was noticed on 21 day’ in 30 and 0% cases cotrespondingly Conclusion: High and prolonged antistreptococcal activity> and good tolerability of Extencillin 2.4 mln U. allow us to recommend it as an effective remedy for secondary prevention of rheumatism. Due to discrepancy to pharmacokinetic requirements to preventive drugs, medical forms of benzatin-penicillin such as Extencillin 1. 2 mln U and Bicillin-5 1.5 mln U. are not acceptable for adequate rheumatism prevention in adult patients.

Aim: To present modern approaches to the systemic therapy by glucocorticosteroids (GCS) basing on own experience and literature data. Methods and material: Long-term observation of 350 patients with juvenile rheumatoid arthritis (JRA) taking peroral GCS in different dosage. Results: Good therapeutical efficacy and sufficient tolerability of low starting doses (lower than 0.5 mg/ kg a day) of GCS allow to inhibit inflammatory activity in the majority of patients. Alternative method (doses alternation) is recommended in the period of long-term supporting GCS-therapv of JR.4. Conclusion: Basic strategy of treatment of systemic and polyarticular JRA j'orms is rational GCS application in combination with basic drugs which ensures control of pathologic process and modifies the disease.