[ Thrombolytic therapy in acute occlusions of peripheral arteries].

Atherosclerotic occlusions of the abdominal aorta and arteries of the lower limbs are the commonest pathology of the arterial system. General growth of primary reconstructive operations on the abdominal aorta and peripheral arteries is accompanied and followed by the increased number of patients presenting with various postoperative complications of a specific character, such as early and late re-occlusions of the postoperative segments. Besides, currently important remains the problem concerning effective and safe management of acute occlusions of peripheral arteries not subjected to reconstruction. One of the promising methods of treatment for acute arterial occlusion is thrombolytic therapy. Presented herein is a review of the literature concerning the state of the art of thrombolytic therapy in acute occlusions of peripheral arteries.

[Comprehensive diagnostics of the patients presenting with Eustachian tube dysfunction].

The objective of the present work was comprehensive diagnostics of Eustachian tube dysfunction as exemplified by 82 patients with this disorder. The examination using the standard techniques was supplemented by active anterior rhinomanometry, audiometry, and tympanometry. Three-dimensional computed tomography (3D X-ray CT) was used for detailed diagnostics of the state of the nasal structures and paranasal sinuses. The study has demonstrated that 96.3% of the patients with Eustachian tube dysfunction suffer a concomitant pathology of the paranasal sinuses, nasal cavity, and nasopharynx. Difficulties of nasal breathing were experienced by 62% of the patients.

[Diagnosis and treatment of varicose disease of small pelvic veins].

The study was based on the findings of examination and treatment of fifty-four 19-to-55- year-old female patients (mean age 35.3 ± 7.3 years) presenting with varicosity of small pelvis veins. Of these, seventeen women with stenosis of the left renal vein were subjected to the following reconstructive operations on small pelvis veins: creating proximal ovarian-iliac anastomoses - 10 procedures, establishment of sapheno-ovarian anastomoses - 5 operations, one procedure of prosthetic repair of the left renal vein and one operation of transposition of the left renal vein. All interventions were completed with resection of the distal segments of the ovarian vein. A further 19 women with idiopathic reflux along the ovarian veins underwent uni- or bilateral embolization thereof, with multi-stage embolization of the branches of the internal iliac vein performed in one patient. The remaining eighteen endured the following interventions: unilateral resection of the left ovarian vein performed in twelve cases (3 endoscopic operations), bilateral resection in four cases (3 endoscopic resections). In seven cases the operations were supplemented with microphlebectomy of the varicosely altered perineal veins. Two patients underwent operations of crossectomy and resection of the pathologically altered internal pudendal vein. Five-year follow up showed that good-to-satisfactory results were obtained in 45 (83.3%) cases, with a disease relapse revealed in seven cases.

[First experience in stenting iliofemoral segment veins].

The authors share herein their first experience gained in stenting for stenosing and occlusive lesions of the iliac-femoral segment veins, reporting the outcomes of treating a total of thirteen patients subjected to balloon angioplasty and stenting of iliac veins for chronic venous obstruction. While treating non-thrombotic venous lesions, stenting was successfully performed in 100% of the patients concerned. Inpost-thrombotic lesions therapeutic outcomes were successful in 9 (75%) patients. No immediate postoperative complications were observed. The remote results were followed up in eleven out of the 13 patients. Patency within the terms up to 16 months amounted to 81.1%. Clinical improvement was noted in 12 (92.3%) patients. According to the VCSS scale, there was a reliable decrease in the intensity of chronic venous insufficiency manifestations along all parameters. The integral index decreased from 6.56+/-0.71 to 4.45+/-0.65 (t=3.82, p<0.002). The malleolar volume decreased from 275.3+/-6.7 to 241.6+/-6.1mm (t=12.3, p<0.001). Hence, angioplasty and stent-grafting of iliofemoral veins turned out to be a minimally invasive, safe, and highly efficient therapeutic modality. The efficacy of the procedure was confirmed by a considerable improvement of the limb's condition and good remote results concerning patency of the reconstructed segments of the venous bed. Endovascular methods may be considered as a promising modality of treatment for this patient cohort.

[Potentialities of magnetic resonance imaging in the complex of prenatal radiation diagnosis of fetal malformations]. / Vozmozhnosti magnitno-rezonansnoi tomografii v kompleksnoi prenatal'noi luchevoi diagnostike anomalii razvitiia ploda.

The purpose of the study was to investigate the potentialities of magnetic resonance imaging (MRI) in the complex of prenatal radiation diagnosis of fetal malformations. Twenty-eight female patients with suspected fetal malformations were examined. Ultrasound study was supplemented by MRI according to a specially developed protocol. Various fetal CNS malformations were diagnosed. These included the Arnold-Chiari syndrome, the Dandy-Walker syndrome, occlusive hydrocephaly, lobular holoprosencephaly, porencephaly, diaphragmatic hernias, anomalies of the abdomen and retroperitoneal space, as well as anomalies of facial structures, including median clefts, and dacryocystocele. The use of MRI in the complex prenatal radiation diagnosis makes it possible to visualize fetal malformation more clearly, contributes to the more adequate prediction of the outcome of pregnancy and to the choice of a management policy for a female patient.

[Clinical and neuro-visual study of syringomyelia]. / Kliniko-neirovizualiziruiushchie issledovaniia pri siringomielii.

One hundred fifty one patients with syringomyelia of different duration were studied using magnetic resonance imaging (MRI). An association between syringomyilia cavitation and Arnold--Chiari malformation as well as cerebellar tonsils location was found. No definite relationship between syringomyelia course and degree of cerebellum ectopia was detected. With disease duration increasing, cross dimensions of spinal cord cavitation are getting smaller. This may be due to spontaneous cavitations collapse. The hypothesis is supported by flattened out cavitation phenomenon found by MRI on the axial spinal cord sections of 39 patients. Such deformation corresponds to spinal cord atrophy developing during long-term disease course.

[Computed tomographic variants of vertebrogenic lumbosacral radicular lesions in patients with radicular and non-radicular lumbar ischialgias]. / Komp'iuterno-tomograficheskie varianty vertebrogennykh poiasnichno-kresttsovykh radikuliarnykh porazhenii u bol'nykh s koreshkovymi i nekoreshkovymi liumboishialgiiami.

The paper considers the CT features of vertebrogenic lumbosacral radicular lesions in patients with radicular and nonradicular lumbar ischialgias. Ninety patients were divided into three groups according to the degree of clinical manifestations of radicular disorders. Four CT patterns of radicular alterations were identified: dislocation, compression, aggregation, and conglomeration. There were differences in the frequency of different CT patterns in patients from different clinical groups. Combining the CT patterns of radicular lesions into occupational and contact types determined a correlation of the severity of radicular disorders and the occupational type of changes in the root.

[Differential diagnosis of benign spinal neoplasms]. / Differentsialnaia diagnostika dobrokachestvennykh opukholei pozvonochnika.

The authors analyze problems arising in differential diagnosis of benign spinal tumors not adequately described in available literature. The most characteristic x-ray symptoms of rare spinal tumors are presented. Methods of radiologic investigation such as polipositional roentgenography, tomography, roentgenography with direct image amplification are described in detail. A total of 102 observations of benign spinal tumors are analyzed: osteoblaclastomas responsible for 14.7% of osteoblastoclastomas, angiomas responsible for 66.7% of cases, osteochondroma occurring in 6.7% of cases, chordomas and osteoid ostema occurring in 10.7 and 1.0% of cases, respectively.