[Renal phlebohypertension and intervenous anastomoses in varicocele].

A total of two hundred and twenty-eight patients suffering from sinistral varicocele were diagnosed with renal phlebohypertension pressure varying from 10/8 (9) to 30/28 (29) mmHg and stenosis (18), retroaortal compression (12), aortomesenteric compression (198) of the left renal vein with dilatation of the left testicular vein (198). The following operations aimed at the formation of vein-to-vein anastomoses were performed: a testiculoiliac anastomosis (182), testicular-inferior-epigastric anastomosis (22) and renocaval anastomosis (5). The operation according to the Ivanissevich's technique was carried out in nineteen patients. Varicocele was removed in all the operated on patients. A catamnestic follow-up examination was carried out in ninety-six operated on patients, and in eighty-two cases, hypertension in the left renal vein was eliminated.

[New methods of X-ray surgical diagnosis and treatment of varicocele in children and adolescents]. / Novye metody rentgenokhirurgicheskoi diagnostiki i lecheniia varikotsele u detei i podrostkov.

The authors studied 520 patients with left-sided varicocele by left-sided phleborenotesticulography of Doppler ultrasonography, tensiometry of the left renotesticular venous system, blood gas composition, hormonal parameters, and etc. They present rationale for and evidence illustrations of aortomesenteric compression of the left renal vein, left-sided phleborenal hypertension prior to and after surgery for endovascular occlusion of the left testicular vein, before and following intervenous proximal testiculoiliac venous bypass surgery. The data of andrological dysfunction in patients with varicosis of the pampiniform plexus and spermatic cord (varicocele) are presented. An algorithm of examination and treatment of this cohort of patients, by using both miniinvasive techniques (for X-ray endovascular occlusion of the temporal veins under local anesthesia) and high tech operations using microsurgical techniques (testiculoiliac venous anastomosis), is outlined.

[Changes in renal and testicular veins in left-sided varicocele and choice of the surgical method in children and adolescents]. / Izmeneniia pochechnykh, iaichkovykh ven pri levostoronnem varikotsele i vybor metoda operatsii u detei i podrostkov.

Selective phleborenotesticulography, ++tensiometry of the left iliac, right and left renal veins, vena cava inferior, duplex scanning of the left renal vein were performed in 356, 296 and 57 patients, respectively, of a total of 356 examinees aged 8-17 years with left-side varicocele. Among other tests were measurements of hormones in the blood from the left and right testes (n = 24), pO2, pCO2. Stenosis, aortomesenteric compression (AMC) of the left renal vein, left-side venous renotesticular hypertension (RTH) of the left renal vein were diagnosed in 12, 342 and 158 patients, respectively. Secondary genesis of left varicocele has been proved. The diagnosis of left-side phlebohypertensive nephropathy was made preoperatively. Estradiol content in the blood of the left testis was 1.7 times higher than from the right one. 4 groups of patients were formed: group 1 patients (n = 142) had stenosis, AMC, dilatation of the testicular vein (DTV) and RTH; group 2 patients (n = 18) had AMC, DTV, borderline high pressure; group 3 patients (n = 18) had AMC, RTH, multiple thin testicular veins; group 4 patients (n = 174) had moderate AMC without hypertension. 160 patients of group 1 and 2 have undergone two-direction venous testiculo-iliac anastomosis operation. 193 patients of groups 3 and 4 have undergone Ivanissevich's operation. After Ivanissevich's operation 2 patients with secondary varicocele of the third degree retained varicocele of the first degree. After establishment of anastomoses, neither varicocele recurrences nor anastomosis thrombosis were registered.

[Renal artery aneurysms in children]. / Anevrizmy pochechnykh arterii u detei.

Renal artery aneurysms were diagnosed in 11 patients (9 boys) aged 1 to 14. The examinations were carried out for vasorenal hypertension in 4 cases, for bladder-ureter reflux, hematuria, nephroptosis in 4, ureterohydronephrosis in 2 cases, and for interstitial nephritis. Aneurysms of the major trunk of the renal artery, mostly oval-shaped, 11 x 14 to 25 x 28 mm in size, were detected in 4 patients, intrarenal aneurysms 2 x 3 to 5 x 6 mm in size in 7 cases. The share of aneurysms among uronephrologic conditions in children was found to be 1.54%, among vasorenal hypertension cases, 4.3%. Vasorenal hypertension is the main optional sign of aneurysms of the main trunk of the renal artery, whereas for intrarenal aneurysms such sign is hematuria.

[Venous drainage of the testis and the causes of the development of varicocele in children]. / Venoznyi ottok ot iaichka i prichiny razvitiia varikotsele u detei.

The article discusses the results of angiological examination of 42 children with primary and 13 with recurrent varicocele by the method of ++trans-scrotal antegrade venotesticulography. Three groups of patients were distinguished: I--with drainage of blood into the left testicular vein, II--with drainage into the left cremasteric vein, III--with simultaneous drainage into the two above-indicated veins. Incompetence of the valvular apparatus of the left testicular vein and impaired blood drainage from the left external iliac vein with the development of retrograde flow of blood along the left cremasteric vein are the most frequent causes of varicocele in children.

[Pulmonary hemodynamics in acute and chronic inflammatory lung diseases in children]. / Legochnaia gemodinamika pri ostrykh i khronicheskikh vospalitel'nykh zabolevaniiakh legkikh u detei.

The author carried out a study of pulmonary hemodynamics in 155 patients aged 1 month to 15 yrs. old with acute and chronic pulmonary inflammatory diseases by radionuclide diagnostic, angiographic and other methods. It was established that angiological mechanisms of the pathogenesis of acute suppurative-destructive pneumonia were based on the reduction of the microcirculatory network of the pulmonary vessels with regional redistribution of the blood flow. Lesser circulatory rearrangement in chronic nonspecific pulmonary inflammatory diseases was characterized by regional hypoperfusion in the affected zone, a decrease in oxygen saturation of the blood, reduced blood flow volumes, and regional arterial pulmonary hypertension.

[Restructuring of the hemodynamics of the lesser circulation in surgical pathology of the lungs in children]. / Perestroika gemodinamiki malogo kruga krovoobrashcheniia pri khirurgicheskoi patologii legkikh u detei.

The authors compared the main parameters of pulmonary circulation in accordance to the data obtained at pulmonary artery catheterization (137 patients) and at the electropneumoplethysmography (102) patients). Comparative assessment of the obtained data permitted to find the regularity of the reconstruction of pulmonary circulation hemodynamics in children.

[Clinico-anatomical types of deforming bronchitis in children]. / Klinike-anatomicheskie vidy deformiruiushchego bronkhita u detei

A complex clinico-roentgeno-morphological investigation was performed in 38 patients, aged from 4 to 15 years, with chronic deformative bronchitis. The analysis of the results obtained enabled to reveal three clinico-anatomical forms of deformative bronchitis: a. chronic infiltrative endobronchitis; b. chronic deformative bronchitis with cylindric enlargement of bronchi; c. chronic deformative bronchitis with marked angiobronchosclerosis. Broncho-angiopneumographic and morphological correlations contributed to further pinpointing differential indications to radical surgical procedures for such pulmonary pathology.