[Kawasaki disease in an adult European].

A case of Kawasaki disease is reported with manifestations of autoimmune vasculitis and predominant affection of coronary arteries. The relevant literature review describes major symptoms of this pathology and risk factors of its atypical forms. It is emphasized that rare occurrence of Kawasaki disease among non-mongoloid subjects should not make the general practitioner les suspicious of this condition.

[Potentialities of new radiation technologies (ultrasonography, computed tomography, magnetic resonance imaging) in the diagnosis of endocrine diseases].

In the paper providing the data available in the literature and many years' experience gained by the Department of the Moscow Regional Clinical Research Institute, the authors describe the potentialities of the currently available radiation techniques in the diagnosis of surgical endocrine diseases. The incidence of various organ dysfunctions is presented. The authors also consider the introscopic symptoms of various endocrinopathies and outline the common specific features of the ultrasound, computed tomographic, and magnetic resonance imaging pattern of individual masses (including adipose tissue cysts and tumors). Emphasis is laid on the leading role of ultrasonography (USG) in the diagnosis of thyroid and parathyroid diseases and on the priorities of computed tomography (CT) and magnetic resonance imaging (MRI) in visualIzing the abnormal thymus, mediastinally ectopic glands, and pituitary tumors. The capacities of each technique in the diagnosis of endocrine space lesions of the pancreas and adrenals are defined. The increase in the frequency of endocrine abnormalities accidentally identified at USG, CT, and MRI, which is noted in the paper, fosters the development of new trends in endocrinology and points to the need for screening surveys (particularly patients who live in poor environmental areas).

[Role of new radiation techniques (ultrasonography, computed tomography, and magnetic resonance imaging) in the diagnosis of incidentally discovered adrenal masses]. / Rol' novykh luchevykh tekhnologii (UZI, KT i MRT) v diagnostike intsidentalom nadpochechnikov.

The authors analyze the current views of incidentally discovered adrenal masses and the potentialities of ultrasound study (US), computed tomography (CT), and magnetic resonance imaging (MRI) in their detection and presents the US, CT, and MRI symptoms of different incidentally discovered adrenal masses. Due to the availability and almost extensive application of US apparatuses, they define the importance of US screening of the adrenal region and emphasize the capacities of echographic differentiation of cystic and solid adrenal masses in patients with different diseases of the abdomen and retroperitoneal space. The authors also note the basic role of CT and MRI in the specified topical diagnosis of retroperitoneal space lesions and in the presumption of the morphological structure of some tumor and tumoroid (hyperplasia-type) adrenal changes.

[Magnetic resonance imaging and ultrasound study in the diagnosis og facial angiodysplasias in children: competition or collaboration?]. / Magnitno-rezonansnaia tomografiia i ul'trazvukovoe issledovanie v diagnostike angiodisplazii litsa u detei: sopernichestvo ili sodruzhestvo?

This study deals with the capacities of noninvasive magnetic resonance imaging (MRI) with magnetic resonance angiography (MRA) without administration of magnetic resonance contrast substances in the diagnosis of facial soft tissue angiodysplasias in children. Indications for their use are defined. The methodology of the studies is proposed. Their diagnostic role and relationship with the other noninvasive technique of medical visualization--ultrasound study (USS) with Doppler color mapping (DCM) are assessed. As compared with USS, MRI may more accurately and objectively establish the organotopic characteristics of facial soft tissue angiodysplasias and detect lesions of the deep facial parts, maxillary bones, and paranasal sinuses in the diagnosis of these abnormalities. The use of MRI may define the belonging of angiodysplasias to the arterial or venous bed, reveal afferent and efferent vessels, including intracranial ones, and to detect intracranial angiodysplastic changes. USS with DSM was superior to MRI with MRA in defining functional (hemodynamic) parameters of angiodysplasias, which makes this method indispendable in planning treatment and in evaluating its efficiency. Comprehensive examination of patients with large and extensive angiodysplasias of facial soft tissues has indicated that facial angiodysplasias are external manifestations of a more generalized angiodysplastic process in most cases, which, in large and extensive facial angiodysplasias, makes it expedient to perform MRI with MRA of the brain and, if possible, the whole body. The high informative value of MRI with MRA in studying angiodysplasias makes them the method of choice in the diagnosis of this group of diseases.

[Magnetic-resonance tomography in diagnosis of hepatopancreatoduodenal tumors]. / Vozmozhnosti magnitno-rezonansnoi tomografii v diagnostike opukholei gepatopankreatoduodenal'noi oblasti.

Results of magnetic-resonance tomography (MRT) in 112 patients with diseases of hepatopancreatoduodenal zone were analyzed, 24 of them had tumors of bile ducts and pancreas. New noninvasive diagnostic method--magnetic-resonance cholangiopancreatography (MRCPG)--performed in addition to routine MRT was evaluated. The technique of MRCPG, analysis of results, manetic-resonance semiotics are presented. This method is compared with endoscopic retrograde cholangiopancreatography. It is concluded that combination of consentional MRT with MRCPG increases possibilities in diagnosis of hepatopancreatoduodenal cancers, complicated by obstructive jaundice, as a rule.

[Algorithms of diagnostic radiation methods in current urological pathology]. / Diagnosticheskie algoritmy luchevykh metodov issledovaniia pri urologicheskoi patologii v sovremennykh usloviiakh.

Based on the results of 3600 studies using all basic methods of modern radiation diagnosis, the authors show it necessary to develop diagnostic algorithms applicable to certain groups of urological diseases (urolithiasis, inflammatory processes and bulky masses in the kidney). This necessity has recently stemmed from the advent of new technologies of radiation diagnosis and from the expediency of using a certain method at the specific stage of examination. At the same time, the authors underline the importance of using standardized examination programmes (algorithms) in practice, which is also due to the fact that unreasonable use of the whole set of new radiation techniques that are of highly diagnostic value may bear great material costs.

[Potentialities of computed tomography and ultrasound in diagnosis of hormonally active adrenal diseases: results of comparison CT and US with operative adn histological data]. / Vozmozhnosti komp'iuternoi tomografii i ul'trazvukovogo issledovaniia v diagnostike gormonal'no-aktivnykh zabolevanii nadpochechnikov (po rezul'tatam sopostavleniia KT i UZI s operatsionnymi i gistologicheskimi dannymi).

The data given in the paper suggest that X-ray computed tomography (CT) is highly effective in detecting all types of hormonally active adrenal abnormalities. CT used in hormonally active adrenal diseases yielded data on major quantitative and qualitative (primarily densitometric) criteria that could be used in assessing the images of the adrenal area in these patients. Ultrasound study (USS) made at the first stage of topical diagnostic searches was of informative value in detecting adrenal tumor lesions, the technique being highly sensitive in the diagnosis of adrenal pheochromocytomas and adenocarcinomas, but less informative in the detection of hormonally active adrenocortical adenomas (aldesterone-producing ones in particular) than CT. The diagnosis of various adrenocortical hyperplasies and the differentiation of hyperplastic and tumor forms of hypercorticoidism are a prerogative of CT that substantially supplements USS findings in such cases.

[Magnetic resonance imaging in the diagnosis of gastric cancer: X-ray versus MRI anatomic findings]. / Magnitno-rezonansnaia tomografiia v diagnostike raka zheludka (po materialam rentgeno-MRT-anatomicheskikh sopostavlenii).

The paper assesses the present-day role of MRI in the diagnosis of gastric cancer. The authors consider the major prerequisites for the main aim of their study to be: 1) a dramatic incidence of diffuse (endophytic) gastric carcinoma, which requires significant correction of today's approaches to its diagnosis and 2) a rather biased and, in the authors' opinion, present-day mainly negative attitude towards MRI of the stomach as a diagnostic method for its tumor lesions. By applying the X-ray-MRI anatomic principle to the comparative study of MRI findings in 50 patients with predominantly gastric intramural carcinoma and in 25 patients without gastric tumors (controls), the authors present their methods for gastric MRI, the MRI semiotics of gastric cancer by concurrently touching upon a variety of problems that characterize the potentialities of MRI of the stomach in the diagnosis of its tumor lesions, including their differential diagnosis. As a result, the authors highly appreciate gastric MRI and consider this method to be included into the diagnostic algorithm of radiation techniques used in the diagnosis of gastric cancer, which should occupy its definite diagnostic place.

[Characteristics of the strategy of intensive care of unconscious children]. / Osobennosti reanimatsionnoi taktiki u detei v bessoznatel'nom sostoianii.

Three major groups can be distinguished among children hospitalized in resuscitation and intensive care wards in a state of unconsciousness: patients with bacterial meningitis and meningoencephalitis, viral meningoencephalitis, and noninfectious involvement of the NCS. Common strategy of treatment of these patients is characterized by some specific features: etiotropic antibiotic therapy in group 1 patients, antiviral drugs in group 2, and mainly symptomatic measures in group 3. Immunotherapy used in each of these groups is substitute in group 1, immunomodulating and immunostimulating in group 2 and even more so in group 3. Better results in group 1 are due to highly effective etiotropic antibiotics and drugs.

[Current X-ray diagnosis of stomach cancer (comparison of radiologic and morphological methods of investigation)]. / Sovremennaia luchevaia diagnostika raka zheludka (sopostavlenie luchevykh i morfologicheskikh metodov issledovaniia).

By using the principles of wide comparisons of the data of radiation diagnosis (routine X-ray study, ultrasonography (USG), CT, MRI) with the morphological findings of resected gastric specimens from patients with endophytic gastric cancer (EGC) (n = 85), the authors propose some points in the problem associated with its diagnosis. They believe that by taking into account the fact that there is an obvious growth of endophytic parietally growing gastric cancer with the concurrent reduction in its intestinal forms, it is necessary to restore current radiation to its leading place, along with endoscopy, in detecting the cancer. The authors makes a highly positive assessment of USG, CT, MRI in addition to routine X-ray study and endoscopy particularly in those cases when difficulties emerge in histological verification of the existing signs of parietally growing cancer. The paper makes indications for USG, CT, MRI concrete. The authors also show how to stage gastric cancer.

[Computed tomography in refined diagnosis of abdominal aortic aneurysm: comparison of radiation therapies versus surgical outcomes and morphological studies of resected abdominal aortic fragments]. / Komp'iuternaia tomografiia v utochnennoi diagnostike anevrizm briushnoi aorty (po materialam sopostavleniia luchevykh metodov i rezul'tatov khirurgicheskogo i morfologicheskogo issledovanii rezetsirovannykh fragmentov briushnoi aorty).

The results of computed tomography (CT) was compared with ultrasonographic and angiographic findings in 168 patients. All data of radiation diagnosis of abdominal aortic aneurysms (AAA) were compared with those of operations and morphological studies of the resected fragments of the aortic parts changed due to aneurysms. These comparisons provided a detailed characterization of the potentialities of CT performed on a third-generation unit in the presurgical diagnosis of this abnormality. At the same time, detailed XCT findings (semeiotics of AAA and their complications, such infiltration, dissection, and rupture) are given. The study shows benefits of the refined AAA by applying routine CT. The paper gives a diagnostic algorithm of using radiation studies (ultrasonography, CT, angiography) in the diagnosis of AAA. Third-generation CT units widely used in clinical practice are shown to provide necessary and complete information on the magnitude of AAA. This makes it possible to extend the capacities of timely detection of this abnormality and to make a successful surgical intervention.

[Classical roentgenology and computerized tomography in the diagnosis of pituitary adenomas]. / Klassicheskaia rentgenologiia i komp'iuternaia tomografiia v diagnostike adenom gipofiza.

The potentialities of diagnosis of pituitary adenomas using radiation techniques are analyzed on the basis of a material comprising 456 cases with this abnormality. The potentialities of CT and classical X-ray diagnoses are compared and recommendations are given for specific cases when, despite CT, routine craniograms must be made. The involvement and contribution of CT in the diagnosis of pituitary adenomas are considered. The results from the application of a fixed and mobile CT mounts are presented. At the same time the possibilities of achieving a greater efficiency by employing its mobile mount by the author's protocol are emphasized.

[Computed tomography in the diagnosis of gastric cancer]. / Nekotorye voprosy KT-diagnostiki raka zheludka.

The potentialities of x-ray computer-aided tomography (CAT) in the studies of intraparietal blastomatous infiltration are analyzed as shown by examinations of 134 patients with gastric cancer. The diagnostic efficacies of various modifications of CAT (filling of the stomach with liquid, pneumoscanning of the stomach with or without tubes) are assessed. Good diagnostic potentialities of tubal scanning of the stomach in the assessment of intraparietal tumor infiltration are demonstrated. CAT semeiotics of gastric cancer is presented, characterizing the tumors with predominantly intraparietal dissemination of blastomatous infiltration. The existent projection limitations of axial CAT of individual portions of the stomach and high price of the examination imply that the indications to the use of this method in gastrooncology should be clearly defined. At the same time, scrupulous adherance to methodologic requirements aimed at imaging of intraparietal changes in gastric cancer may help to solve a number of differential diagnostic difficulties, primarily those connected with predominantly submucously growing carcinomas.

[Diagnostic perspectives of mobile radiographic computerized tomography]. / Diagnosticheskie perspektivy mobilnoi rentgenovskoi kompíuternoi tomografii.

The authors assess mobile methods of x-ray computer-aided tomography (CAT) and suggest an organization and methodological scheme of its application. Their program of the first and up to now the only one in this country mobile CAT device is based on the new principles of mobile CAT application. It is realized in special hospitals of large regions, where the patients with the optimal indications for CAT are assembled. Over 15,000 examinations were carried out with the use of the suggested CAT program over 4 years, that resulted in detection of 1295 brain tumors, 804 cases with neoplastic involvement of the abdominal cavity and the retroperitoneal space. The authors claim that wide application of mobile CAT devices according to the program they suggest will help decide the problem of unavailability of such examinations, for it will rule out the principal cause of this unavailability--economic problems arising because of high price of this equipment. One mobile device may replace 3 permanent CAT devices, if used according to the program suggested by the authors.