2010, volume 6

The article presents the analysis of perioperative period of 52 children with different variants of correction of vesicoureteral reflux. It was based on acute-phase proteins amount, cytokines level and adhesion molecules content in blood and urine. the study revealed that if the correction is performed during the latent phase of chronic obstructive pyelonephritis the preference should be given to the endoscopic operations as they do not lead to acute inflammatory process in the urinary tract

The number of patients with disorders of sexual development (DSD) has increased in 3.54 times during the last three years. The aim is to define the structure of intersexual disorders in children from Saratov, criteria of gender assignment and surgical approach. During the period of three years (from 2006 till 2008) 58 children with DSD aged 0 - 17 were examined. Assessment of external genitals, cytogenetic investigation, hormonal tests were performed. Imaging studies included ultrasonography, cystourethroscopy and laparoscopy with histological investigation. Considering the data DSD in children from Saratov compose sex chromosome DSD - 21,4 %, Gonadal dysgenesis - 26,2%, ovotesticular DSD - 2,3%, 46,ХХ testicular DSD - 2,3 %, complete androgen insensitivity syndrome - 4,7%. The criteria of gender assignment and surgical approach have been described in the article. The research concludes that the infants with intersexual genitels should be examined in special care centers by multispecialty team. It is nessesary to perform the karyotype test and ultrasonic study in newborns to detect the genetic and gonadal gender of the child

The research goal is to study functional condition of upper and lower urinary tracts at fetus with obstructive uropathy and development of differential diagnostic and prognostic criteria of transition of functional disorders to organic.
The diagnosis of prenatal and verified postnatal obstructive uropathy at 42 fetuses has been made by prenatal ultrasonic cystometry. Process of filling and evacuation of bladder has been under study. Obtained data have been compared with the results of dynamic measurement of kidney sizes in a standard projection.
According to the results only at 19,1% of cases statistically significant urodynamic differences have not been revealed in comparison with control group. Diagnostic accuracy of organic form of urodynamic obstructions is 84%, of functional in 64,7% of observations and in 52,9% of cases the infection of urinary tracts with incomplete evacuation of bladder has been diagnosed.
The degree of kidney and ureter expansion is not a differential diagnostic criterion of organic or functional urodynamic obstructions. However, using a principle of estimation of upper and lower urinary tracts condition, it is possible to make a prenatal differential diagnosis of variants of defects

The aim of the study is to evaluate the influence of angiotensin converting enzyme (ACE) inhibitors of quinapril on the condition of renal hemodynamics, changes of profibrotic cytokines level and transforming growth factor at patients with nephrolithiasis undergone various kinds of surgery. Patients were divided into 2 groups initially and in 1 month after surgery. Concentrations of IL-6, TGFp and МСР-1 were determined in blood serum. Assessment of renal blood flow state by Doppler ultrasonography was performed in the same terms. As a result of quinapril treatment the decrease of МСР-1, TGFp and IL-6 was marked in comparison with the group which did not receive nephroprotective therapy. The analysis of Doppler ultrasonography data showed authentic improvement of renal blood flow in 1 month after surgery. The most informative parameter proved to be the resistance index that indicated the decrease of vascular resistance after surgical treatment in condition of quinapril therapy

The prostate cancer is a widespread disease in Russia with high growth rate and high death rate. Active work in discovery of methods of early diagnostics of prostate cancer is carrying out. it will allow to increase considerably the efficiency of treatment. the data on topography, structural and functional organization, physiology and regulatory effect of neuroendocrine cells and neuroendocrine hormones and peptides of prostate produced by neuroendocrine cells are presented in the review. Neuroendocrine mechanisms of development, prospects of early diagnostics and prognosis of prostate cancer are analyzed

The combination of transosseous osteosynthesis by new rod devices with techniques of osteotomy through small accesses is effective and not traumatic in treatment of patients with chronic pelvic damages. that allows to eliminate any types of pelvic deformations. peculiarities of stage elimination by developed techniques according to the suggested classification are presented. Developed techniques of surgical rehabilitation of patients with consequences of damages allow to achieve favorable results in 96 cases

The article concerns the current status of the topical problem in traumatology - treatment of juxta-articular fractures of proximal part of a femur and their effect. Analytical review of domestic and foreign literature has allowed to determine the basic problems in treatment of the particular group of patients and to define long-term trends of osteosynthesis of juxta-articular fractures of proximal part of a femur at the present stage

Analytical review of scientific medical and patent information dealing with surgical correction of dysplastic hip joint components has been made. Retrospective analysis of the given problem development has been carried out. Modern methods of surgery on bony structures of the dysplastic hip joint have been studied in details. The main following directions of the acetabulum surgical correction have been marked out: formation of bony rests, variants of pelvic osteotomy, operations of joint surface curvature changing (acetabuloplasty). Methods with the use of materials exceeding bony tissue in solidity (metal, ceramics) have been studied separately. Expediency of further improvemement of methods for dysplastic coxarthrosis surgical prevention by removal of biomechanical imbalance in the hip joint has been demonstrated

The research objective is to develop methods for reducing terms and possible complications of humeroscapular periarthrosis treatment. 30 patients with various nosologic disease units were under observation. the comparison group consisted of 50 patients having the same age, sex and nosologic criteria (according to ambulatory card) in comparison with the main group. the treatment was conducted by manual therapy and remodelling of motor act. this method proved to be effective at acute tendonitis and could be used as monotherapy

The scientific article provides information about 340 patients with osteochondrosis of lumbosacral spine subjected to the surgical intervention. According to the results the research work presents comparative characteristics of surgical methods of hernia of disks (percutaneous puncture laser nucleotomy, microdiscectomy, lamineсtomy). Indications and contraindications for each method of surgery have been revealed. follow-up results of different surgical techniques have been evaluated in 178 cases using different indicators of life quality