[External ear canal parameters and endoscopic otosurgery in children]. / Parametry naruzhnogo slukhovogo prokhoda u detei v aspekte endootokhirurgii.

INTRODUCTION: Main difficulties of endoscopic ear surgery in children could be connected with width of external ear canal (EEC) and endoscope diameter discrepancy. OBJECTIVE: To investigate EEC parameters in children, to determine cross section and to develop the recommendations whenever possible of endootosurgery performance in children. MATERIAL AND METHODS: Research included two stages. First - average values determination of narrowest site EEC in children according to computer tomograms. Second - determination of age of the patient and the amount of acoustical pass at which there are specifications for performance of interventions endoscopic. RESULTS: EEC square: 1-3 years - 12.6±1.91 mm2, diameter is 4.01±0.59 mm; 4-7 years - 16.8±1.34 mm2, diameter is 5.34±0.43 mm; 8-11 years - 21.7±1.38 mm2, diameter is 6.9±0.45 mm; 12-18 years - 31.3±4.27 mm2, diameter is 9.96±1.4 mm. The difference between parameters at each of age groups was statistically reliable. Comfortable work endoscopically is possible with EEC square 20.4±3.19 mm2 and more. This corresponds to average value of EEC in 8-18 years. CONCLUSIONS: Endoscopic ear surgery is inexpedient in children up to 4 years. It is necessary to expect that intervention will be exigeant and transition to the microscopic equipment is required in case of 4-7 years old patients. Endoscopic ear surgery can be used with success to performance of various manipulations and surgical interventions on a middle ear in patients 8-18 years old.

[The effect of combination of glycyrrhizic acid with alpha-glutamyl-tryptophan on the experimental adenoviral infection].

In this work, the activity of glycyrrhizic acid (GL) and dipeptide alpha-glutamyl-tryptophane (EW) as single preparations or in combination (GL+EW) against experimental adenoviral infection in the syrian hamsters was studied. Application of gl and GL+EW was shown to decrease the level of the adenovirus replication in liver tissue by 0.6 - 1.2 lgTCID50 depending on the composition and time point of the post infection. It was also demonstrated that normalization of the structure of the liver tissue was required, which was shown on the level of both optical and electron microscopy. The results obtained in this work suggest that gl and GL+EW may be considered as potential component of the complex therapy of adenoviral infection.

[DETERMINING THE DEGREE OF DISRUPTION OF THE STRUCTURE OF THE LIVER AND THE SEVERITY OF PORTAL HYPERTENSION IN CHILDREN].

AIM: To develop a system to define the degree of liver disruption and severity of portal hypertension in children based on the International Classification of Functioning, Disability and Health (ICF). PATIENTS AND METHODS: Studied the results of laboratory and instrumental methods 382 children: 267 patients with various liver diseases, including 49 patients who underwent liver transplantation, and 115 children without liver disease. RESULTS: Based on analysis of statistical data obtained were identified 10 indicators, a set of changes which can be used to assess the degree of disruption of the structure of the liver and the severity of portal hypertension: indicators that reflect the severity of fibrosis and cirrhosis of the liver (METAVIR score on a scale at fibroelastometrii, scores are Desmet at morphological study of the liver) and indicators that reflect the severity of portal hypertension (the diameter of the portal vein, splenic vein diameter, the length of the spleen, recanalization of the umbilical vein, esophageal varices, ascites, hydropericardium, hydrothorax). Each of the indicators was assessed on a 5-point system. Number of points reflects the sum of the changes of these parameters. Decrease the number of points on 0-4% (38-40 points) is regarded as a lack of structural failure of the liver and the severity of portal hypertension by 5-24% (30-37 points)--minor violations on 25-49% (20-29 points) -moderation disorders, 50-95% (3-12 points)--severe handicaps, 96-100% (0-2 points)--absolute violation. Studied the dynamics of children with autoimmune hepatitis, Wilson's disease and chronic hepatitis C. CONCLUSION: The proposed scoring system for assessing the degree of disruption of the structure of the liver and the severity of portal hypertension can be used as an objective criterion of the severity of the pathological process, to estimate the dynamics of defeat against the background of the therapy, determining the prognosis of the disease and as a criterion of the indications for liver transplantation.

[Assessment of motor and sensory pathways of the brain using diffusion-tensor tractography in children with cerebral palsy].

BACKGROUND: Diffusion tensor tractography--a new method of magnetic resonance imaging, that allows to visualize the pathways of the brain and to study their structural-functional state. OBJECTIVE: The authors investigated the changes in motor and sensory pathways of brain in children with cerebral palsy using routine magnetic resonance imaging and diffusion-tensor tractography. METHODS: The main group consisted of 26 patients with various forms of cerebral palsy and the comparison group was 25 people with normal psychomotor development (aged 2 to 6 years) and MR-picture of the brain. Magnetic resonance imaging was performed on the scanner with the induction of a magnetic field of 1,5 Tesla. Coefficients of fractional anisotropy and average diffusion coefficient estimated in regions of the brain containing the motor and sensory pathways: precentral gyrus, posterior limb of the internal capsule, thalamus, posterior thalamic radiation and corpus callosum. RESULTS: Statistically significant differences (p < 0.05) values of fractional anisotropy and average diffusion coefficient in patients with cerebral palsy in relation to the comparison group. All investigated regions, the coefficients of fractional anisotropy in children with cerebral palsy were significantly lower, and the average diffusion coefficient, respectively, higher. CONCLUSION: These changes indicate a lower degree of ordering of the white matter tracts associated with damage and subsequent development of gliosis of varying severity in children with cerebral palsy. It is shown that microstructural damage localized in both motor and sensory tracts that plays a leading role in the development of the clinical picture of cerebral palsy.