Use of autologous bone marrow mesenchymal stem cells for healing of free full-thickness skin graft in a zone with pronounced hypoperfusion of soft tissues caused by arteriovenous shunting.

A combined graft consisting of a free full-thickness skin flap and cultured autologous fibroblast-like bone marrow mesenchymal stem cells was effectively implanted and healed on the facial soft tissue defect after removal of a pathological vascular conglomeration in a female patient with congenital arteriovenous macrofistulous dysplasia. In order to reduce bloodflow intensity and arteriovenous shunting, repeated endovascular occlusion and transcutaneous ligature of regional vessels from the carotid artery basin feeding the pathological zone was carried out followed by resection of this tumor-like vascular formation.

[The use of chronic epidural electrostimulation of the spinal cord in children with spastic diplegia--a type of infantile cerebral palsy]. / Primenenie khronicheskoi épidural'noi élektrostimuliatsii spinnogo mozga u detei s detskim tserebral'nym paralichom v forme spasticheskoi displegii.

The authors' first experience with spinal cord stimulation (SCS) at the lumbar level in the treatment of cerebral palsies (CP) in children aged 3-11 years who had lower spastic paraparesis of varying severity is presented. Complex clinical and physiological studies of all 9 children were made before and after surgery (follow-ups lasting 6-12 months). Preliminary results have indicated that the most significant changes occur primarily in pathological postural tonic reflexes. SCS has virtually no effect on fixed limb deformities, which requires further orthopedic surgical correction. A medical care schedule for CP children affected predominantly with lower spastic paraparesis should include, among its first priorities, electrode implantation for SCS. Due to the specific rehabilitative dynamics of motor functions, SCS should be made to treat these children before the deformities in the lower extremity joints get fixed.

[Treatment of children with myelodysplasia, complicated by vesicoureteral reflux]. / Lechenie detei s mielodisplaziei, oslozhnennoi puzyrno-mochetochnikovym refliuksom.

Timely detection of various neurogenic urinary bladder dysfunctions in children with congenital lesions of caudal regions of the spine and their treatment in due time enable the urinary dynamics of the lower urinary tract to be stabilized early. The efficient application of conservative treatments contributes to the recovery of detrusor performance and urethral and anal sphincters in some spinal patients; however, the maximum effect was achieved in patients who had undergone intercostal autoneuroplasty. Microneurosurgical interventions on the lumbosacral roots of the spine are most likely to produce a pelvic reinnervation effect to some extent and promotes the regression of vesicoureteral reflux.

[Reconstructive microsurgery in the combined treatment of children with spinal cord disorders]. / Rekonstruktivnye mikrokhirurgicheskie vmeshatelstva v kompleksnom lechenii detei so spinnomozgovoi patologiei.

The use of microsurgical techniques in operations for autoneuroplasty with intercostal nerves in patients with congenital abnormality of the spinal cord makes it possible to adequately approximate of the interrupted roots of the spinal cord and creates promising prerequisites for restoration of pelvic and motor functions. Observations have shown that the functions of the pelvic organs in children are gradually restored and active movements appear in the lower extremities. The use of the omentum on a nutrient pedicle made it possible to arrest hydrocephalic phenomena. Due to its obvious efficacy, the suggested method can be recommended for wider use in pediatric neurosurgery.