BILIARY ATRESIA: CURRENT CONCEPTS AND FUTURE PROSPECTS (REVIEW).

Treatment of biliary atresia is a major challenge in pediatric surgery. Early diagnosis and availability of Kasai procedure with its modern modifications improve outcome of biliary atresia treatment. But Kasai procedure does not fully restore anatomical integrity of biliary tract, because Oddi sphincter is not included in reconstructed system. Constant reflux of intestinal content into the biliary tree is a cause of recurrent cholangitis and change in biliary epithelium that, which is a predisposing factor for cholangiocarcinoma. Various methods have been developed to improve Kasai procedure and prevent the reflux (anti-reflux valve, different enteric conduits, etc.). Many authors used biological grafts made from artery, vein, appendix, urether as well as synthetic materials to restore hepaticocholedochus. Although, neither of these methods were implemented in clinical practice. Nowadays, huge attention is paid to organ and tissue bioengineering. Present advances of tissue bioengineering may assist to create bile duct equivalent, which can be used to restore biliary tract in patients with biliary atresia.

[The influence of perinatal hypoxic-ischemic disorders of central nervous system on adolescent academic achievements and behavioural deviations].

The objective of our research was to study long-term influence of hypoxic-ischemic disorders of central nervous system on adolescent academic achievements and behavioural deviations. It was found that perinatal pathologies highly determine the deviant behaviour. The conducted research revealed law intellectual capacity (IQ) in youth with perinatal pathology--2.26. The majority of youths involved in adolescent antisocial behavior suffered from hypoxic-ischemic disorders of central nervous system during perinatal period (76%--tend to narcotic and toxic substance addictions; 82%--to criminal behaviour).

[Thrombocytopenia-absent radius - TAR-syndrome].

Thrombocytopenia-absent radius - TAR-syndrome is a rare condition in which thrombocytopenia is associated with bilateral radial aplasia. TAR syndrome was first described in 1956 by H. Cross et al. An autosomal recessive inheritance pattern was proposed because TAR affected more than one member of some families. The disease varies and includes abnormalities in the skeletal, hematological, cardiac, gastrointestinal and other systems. In article the 30 day infant with thrombocytopenia-absent radius - TAR-syndrome is described. The diagnose was confirmed by clinical, laboratory, radiological, genetic etc. investigations.

[Influence of prenatal and perinatal risk factors on the outcome of pregnancy].

During the recent years a great number of negative social-economical problems (e.g. emotional stresses during the pregnancy, malnutrition, physical labor, etc.) characteristic of the so-called transitional period have been observed. All these factors have a negative influence on the course of pregnancy and the fetal body mass. The main target of our work was to reveal the impact of social-economical risk-factors on the gestational age and hindrances for the antenatal development. Methodology of our research was prospect-retrospective randomized case-control study. In 2001-2004 we followed up 267 (study group) and 260 (control group) newborns. According to the results received the most significant factors influencing the gestational age and weight of newborns are as follows: poor financial status, emotional stress, malnutrition, physical hyperactivity, bad habits (smoking), incidental home nursing, low education level, other bad habits (alcohol, drugs).

[Aminoguanidine decreases the brain damage in rats neonatally exposed to hypoxic-ischemic influences].

Seven days old rats (n=30) were divided into five groups (6 animals in each). Three groups underwent hypoxic-ischemic event (occlusion of right common carotid artery lasting 2,5 hours and breathing with 8% oxygen and 92% of nitrogen mixture). The rats of the fifth group, after completion of hypoxic-ischemic impact and following a daily reoxygenation (for three days) were injected (i/p) with selective inhibitor of nitric oxide inducible synthase, in a dose of 300 mg/kg. The rats of the fourth group were injected with 150 mg/kg of the selective inhibitor of nitric oxide synthase -- aminoguanidine (150 mg/kg); the animals of the third group were injected with saline (50 ml). The second group contained the shame-operated animals and the first group -- intact (control) animals. An intensity of local cerebral blood flow in fronto-parietal area of neocortex was measured by means of hydrogen clearance technique. In the right hemisphere (ipsilateral to occluded common carotid artery) of the animals of the third group significant decrease, and in contralateral hemisphere (left) temporal increase of CBF did occur. Administration of aminoguanidine prevents high degree of brain damage observed in the control group of animals.

[Aminoguanidin improves learning process in neonatal rats exposed to hypoxia-ischemia].

Seven-day-old rats (n = 40) were divided into five groups (8 pups in each of them). They were exposed to unilateral common carotid artery ligation, 2-3 h later followed by 2,5 h hypoxia (8% oxygen in 92% nitrogen) at 37 degrees C and immediately after insult once a day during three days received i/p injection of aminoguanidin (150 mg/kg) (group 1). Group 2 underwent procedures similar to the first group but received i/p injection of 300 mg/kg aminoguanidin. Group 3 instead of aminoguanidin received the same amount of saline. Group 4 composed by false-operated pups and Group 5--by intact pups. 22 days after hypoxic-ischemic exposure pups underwent 12 day learning test in multi-way maze. Process of learning in hypoxia-ischemic pups (group 3) were essentially deteriorated in comparison with false-operated and intact pups, but in groups were animals received aminoguanidin process of learning was close to control rats.

[The computer system of monitoring of antibiotic sensitivity of pathogenetic bacteria causing suppurative-septic diseases]. / Sistema nadzora za antibiotikochuvstvitel'nost'iu vozbuditelei gnoino-septicheskikh zabolevanii s ispol'zovaniem EVM.

A system for surveillance of drug resistance of etiologically important microorganisms in obstetric units and burn and sepsis centres was developed. Realization of the system with various methods is possible in case of permanent control and comparison of the results. The overwhelming majority (up to 90 per cent) of the etiologically important microorganisms were multiresistant. An information bank was filed. It could be used as a basis for developing principles of strategy and tactics in rational antibiotic therapy.

[Leukinferon in the combined therapy of infection in neonates and infants]. / Leikinferon v kompleksnom lechenii sepsisa u novorozhdennykh i u detei grudnogo vozrasta.

Leikinferon was used in multimodality treatment of sepsis caused by gram-negative microorganisms and staphylococci in 33 neonates and infants. It was injected in a dose of 10,000 IU and was given in courses of 4-6 intramuscular administrations with an interval of 48 hours. The treatment with leikinferon promoted a steady improvement of the clinical status, associated with pronounced activation of the interferon system and neutrophilic phagocytosis. The use of the drug in septic shock did not produce any noticeable affect. Fever was the only side effect induced by drug administration. In some children, the temperature rose by 1-1.5 degrees C. It returned to normal after 10-14 hours.

Superprecipitation of hybrid actomyosin containing pathologic actin from failing hearts of adults and infants.

Superprecipitation (SP) of artificial actomyosin, obtained by hybridization of Straub actin from the human myocardium with myosin of normal animal hearts was studied. Actin was prepared from the myocardium of persons who died of congestive heart failure and various non-cardiac diseases, as well as of infants whose death resulted from toxic pneumonia complicated or not with heart failure. It was shown that, in the control hybrid actomyosin, the substitution of normal Straub actin by that from the failing heart resulted in decrease of both the rate and extent of SP. The conclusion was made that both changes in myosin properties and Straub actin underlie the reduced contractility of the myofibrillar protein system in acute and congestive heart failure.