[Unilateral hemimegalencephaly and hemiatrophy of brain: principles of computer tomographic differentiation]. / Unilateral'naia gemimegaléntsefaliia i gemiatrofiia mozga: printsipy komp'iuterno-tomograficheskoi differentsiatsii.

Unilateral hemimegalencephaly (UHE) and hemiatrophy (HA) of brain are two pathological states of brain completely different in their nature. Nevertheless, neuroimaging examinations revealed pronounced asymmetry of hemispheres in both cases. This dictates a nesessity of both elaboration and wide usage of definife objective criteria for differentiation of the alterations above by means of either computer tomography or magneto-resonance tomography. Differential diagnostic criteria for UHE and HA are proposed.

[Use of x-ray endovascular occlusion in combined treatment of juvenile angiofibroma of the skull base in children]. / Primenenie rentgenoéndovaskuliarnoi okkliuzii v kombinirovannom lechenii iunosheskikh angiofibrom osnovaniia cherepa u detei.

Of a total of 103 patients with juvenile angiofibroma of the base of the skull surgical treatment was given to 98 children. 10 operations were performed after preoperative roentgeno-endovascular occlusion (REO) of the tumor afferent vessels. Such occlusion in the region of a maxillaris was a sufficient measure to warrant a 2-fold reduction in the intraoperative blood loss and was achieved with hydrogel spheres and cylinders 0.4-0.6 mm in diameter. 4 days are an optimal time for operative intervention after the REO. The nasomaxillary approach was used in most cases preceded by diagnostic carotid angiography in the frontal and lateral views. No complications arose due either to the angiography or REO. The latter was found beneficial when performed prior to surgical intervention for juvenile angiofibroma of the base of the skull.

[A computed tomographic study of epilepsy in children: the primary diagnosis of a brain tumor]. / Komp'iuterno-tomograficheskoe issledovanie pri épilepsii u detei: pervichnaia diagnostika opukholi golovnogo mozga.

There are presented experience of computer tomographic (CT) investigation of 435 children with different epileptic syndromes, which had been verified according to international Classification of Epilepsy and Epileptic Syndromes (New Delhi [correction of New-Daily], 1989). Tumors were diagnosed in 6 cases and were manifested as resistant epileptic fits. There was grounded the necessity of including of the neuroimaging methods in complex study of children with epilepsy for optimization of diagnostics, treatment and prognosing of the course of epilepsy. There were also formulated the practical recommendations concerning carrying out of CT investigations in children with prolonged resistant epileptic syndromes.

[Attempt to use partial occlusion of the spleen in extrahepatic portal hypertension in children]. / Opyt primeneniia chastichnoi okkliuzii seleznki pri vnepechenochnoi forme portal'noi gipertenzii u detei.

Hemodynamics in the portal system was assessed at digital subtraction angiography in 57 children aged 9 months-15 years suffering from extrahepatic portal hypertension. Natural splenorenal anastomoses were found in 31 patients. 13 patients developed arteriovenous shunting into gastroesophageal plexus through the conglomerate of pathological vessels in the upper splenic pole. Partial occlusion of the spleen was performed in 12 patients aged 3-12 to block arteriovenous anastomoses and to reduce the blood flow from the spleen to the portal system. In various postocclusion periods blood effusion into gastric veins through arteriovenous shunts and retrograde flow via splenic vein and natural splenorenal anastomoses to the lower vena cava inferior were absent or drastically diminished. Septic complications were absent. Partial splenic occlusion in children with extrahepatic portal hypertension is considered valid.

[Use of intra-arterial chemotherapy in the treatment of malignant tumors in children]. / Primenenie vnutriarterial'noi khimioterapii v lechenii zlokachestvennykh opukholei u detei.

Transcatheter arterial chemotherapy has been perfected in the treatment of 66 patients with various severe malignant tumors. A total of 75 arterial cytostatic injections were made, out of them 57 were given in primary tumors and 18 in tumor metastases. The children's age ranged from 1 to 14 years. High arterial therapeutic doses in combination with extracorporeal blood purification by hemosorption in the treatment of hepatic metastases yielded 100% efficiency. Prolonged arterial chemotherapy for pulmonary metastases provided an excellent therapeutic effect. Thus, 75 arterial injections of cytostatics gave rise to 32% of complete remissions, 48% of partial remissions. There was no benefit in 20% of cases. Adverse reactions were absent.

[Endovascular occlusion of the spleen in pediatric practice]. / Endovaskuliarnaia okkliuziia selezenki v pediatricheskoi praktike.

A procedure has been developed for partial X-ray endovascular occlusion of the spleen in children. Splenic occlusion has been performed in 74 patients with various blood diseases and portal hypertension for 4 years. Indications for partial "disconnecting" of the splenic parenchyma have been identified depending on a specific disease. Its low traumatism, prevention of septic complications by using selective intestinal flora decontamination and choosing antibiotics at an individual level allow splenic occlusion to be made in young children. In patients with portal hypertension, partial splenic occlusion leads to decompression in the portal vein system and improves blood ejection along the natural vascular anastomoses.

[Ultravist - drug of choice for radioopaque studies in children with renal disfunction]. / Ultravist - preparat vybora u detei s narushennoi funktsiei pochek pri rentgenokontrastnykh issledovaniiakh.

The nonionic radioopaque ultravist and the high-molar radioopaque verograffin were studied for their effects on the blood osmotic status of children with lower renal concentrating function. A total of 36 children aged 8 months to 12 years who had pyelonephritis, hydronephrosis and renal injury at their acute stage were studied angiographically under general anesthesia. The radioopaque was injected in a mean dose of 2 ml/kg for 2-3 sec. Ultravist was found to have a less osmotic action on the blood osmotic status than did verograffin. The changes in the detectable major blood osmotic parameters: sodium, potassium, glucose, urea, creatine were less pronounced. Plasma osmolality was moderately increased with ultravist and much higher than its normal values with verograffin at min 1 after its administration and at hour 2 of the study. Ultravist is preferable as a radiopaque used in children with decreased renal concentrating function.

[Roentgenologic endovascular occlusion of the spleen in the treatment of hereditary spherocytic hemolytic anemia in children]. / Rentgenoéndovaskuliarnaia okkliuziia selezenki v lechenii nasledstvennoi sferotsitarnoi gemoliticheskoi anemii u detei.

Roentgenoendovascular occlusion of the spleen has been suggested for the treatment of children with hereditary spherocytic hemolytic anemia as an alternative to splenectomy. The operation was conducted in 8 children aged from 1 to 11 years. Selective decontamination of the intestine was used for prevention of inflammatory complications. Occlusion of 60% of the splenic parenchyma results in a stable clinico-hematological effect and can be performed as a single stage. Young children could be operated on by this method.