Abstract: Introduction: it is well known that magnetic resonance imaging (MRI) has superiority above computed tomography (CT) in identification of epileptogenic substrates due to higher resolution of images and the best differentiation between white and gray matter. But in some peculiar cases, CT can be the method of choice. Aim: was to illustrate the role of CT in presurgical examination in children with drug-resistant focal epilepsy. Materials and methods: results of CT of 65 patients with focal epilepsy had been analyzed. All patients underwent multimodal presurgical examination with followed antiepileptic surgical operation and morphological analysis. CT was performed on GE Lightspeed and Philips Ingenity Elite scanners. Results: in presurgical period, native CT was performed in 11 (16,9%) patients and in 6 patients, structural brain changes responsible for epilepsy were identified. In 13 patients (20%) we’ve used CT angiography for estimation of angio-architectonic environment in the area of potential surgical intervention and in case of suspicion on arteriovenous malformation (AVM). CT on the 1st day of post-operative period was made in 48 (73,8%) of patients, and in 2 cases CT revealed structural changes that influenced further treatment tactics. At the background of exacerbation in 3 patients, repeated CT revealed sings of acute disorders of cerebrospinal fluid cirdulation. Conclusion: computed tomography can be an effective diagnostic method in examination of patients with epilepsy, especially when verifying bone and vascular (CT-angiography) changes, is used for neuronavigation to control the position of invasive electrodes and exclude post-implantation hemorrhages, and also helps to identify early postoperative complications, thus influencing tactics and outcomes of surgical treatment of epilepsy. In children with focal epilepsy undergoing surgical treatment, computed tomography and magnetic resonance imaging are complementary studies that provide adequate neuroradiological support. References 1. Fitsiori A, Hiremath SB, Boto J, et al. Morphological and Advanced Imaging of Epilepsy: Beyond the Basics. Children. 2019; 6(3): 43. https://doi.org/10.3390/children6030043 2. Baumgartner C, Koren JP, Britto-Arias M, et al. Presurgical epilepsy evaluation and epilepsy surgery. F1000Research. 2019; 8. https://doi.org/10.12688/f1000research.17714.1 3. Skjei KL, Dlugos DJ. The evaluation of treatment-resistant epilepsy. Semin Pediatr Neurol. 2011; 18: 150-170. https://doi.org/10.1016/j.spen.2011.06.002 4. Middlebrooks EH, Ver Hoef L, Szaflarski JP. Neuroimaging in Epilepsy. Curr Neurol Neurosci Rep. 2017; 17(4): 32. https://doi.org/10.1007/s11910-017-0746-x 5. Takanashi J. MRI and CT in the diagnosis of epilepsy. Nihon Rinsho. 2014; 72(5): 819-26. 6. Полянская М.В., Демушкина А.А., Костылев Ф.А. и др. Возможности режима SWI в магнитно-резонансной нейровизуализации у детей с фокальной эпилепсией. Эпилепсия и пароксизмальные состояния. 2020; 12(2): 105-116. Polyanskaya MV, Demushkina AA, Kostylev FA, et al. The role of susceptibility-weighted imaging (SWI) in neuroimaging in children with focal epilepsy. Epilepsy and paroxysmal conditions. 2020; 12(2): 105-116 [In Russ]. https://doi.org/10.17749/2077-8333/epi.par.con.2020.025 7. Cendes F, Theodore WH, Brinkmann BH, et al. Neuroimaging of epilepsy. Handbook of Clin. Neurol. 2016; 136: 985-1014. https://doi.org/10.1016/B978-0-444-53486-6.00051-X 8. Roy T, Pandit A. Neuroimaging in epilepsy. Annals of Indian Academy of Neurology. 2011; 14(2): 78. https://doi.org/10.4103/0972-2327.82787 9. Lapalme-Remis S, Cascino GD. Imaging for Adults With Seizures and Epilepsy. Continuum. 2016; 22(5): 1451-1479. https://doi.org/10.1212/CON.0000000000000370 10. Duncan JS. Brain imaging in epilepsy. Practical Neurology. 2018: 002180. https://doi.org/10.1136/practneurol-2018-002180 11. Tranvinh E, Lanzman B, Provenzale J, Wintermark M. Imaging Evaluation of the Adult Presenting With New-Onset Seizure. Am J Roentgenol. 2019; 212(1): 15-25. https://doi.org/10.2214/AJR.18.20202 12. Lompo DL, Diallo O, Dao BA, et al. Etiologies of non-genetic epilepsies of child and adolescent, newly diagnosed in Ouagadougou, Burkina Faso. Pan African Medical Journal. 2019; 31. https://doi.org/10.11604/pamj.2018.31.175.170 13. Goel D, Dhanai JS, Agarwal A, et al. Neurocysticercosis and its impact on crude prevalence rate of epilepsy in an Indian community. Neurol India. 2011; 59(1): 37-40. https://doi.org/10.4103/0028-3886.76855 14. Mengistu G, Ewunetu BD, Johnston JC, Metaferia GZ. Neuroimaging of Ethiopian patients with epilepsy: a retrospective review. Ethiop Med J. 2014; 52(2): 57-66. 15. Patel N, Jain A, Iyer V, et al. Clinico - diagnostic and therapeutic relevance of computed tomography scan of brain in children with partial seizures. Annals of Indian Academy of Neurology. 2013; 16(3): 352. https://doi.org/10.4103/0972-2327.116928 16. Cherian A, Syam UK, Sreevidya D, et al. Low seroprevalence of systemic cysticercosis among patients with epilepsy in Kerala, South India. J Infect Public Health. 2014; 7(4): 271-6. https://doi.org/10.1016/j.jiph.2013.08.005 17. Panov F, Li Y, Chang EF, et al. Epilepsy with temporal encephalocele: Characteristics of electrocorticography and surgical outcome. Epilepsia. 2015; 57(2): 33-38. https://doi.org/10.1111/epi.13271 18. Van Rooijen BD, Backes WH, Schijns OEMG, et al. Brain Imaging in Chronic Epilepsy Patients After Depth Electrode (Stereoelectroencephalography) Implantation. Neurosurgery. 2013; 73(3): 543-549. https://doi.org/10.1227/01.neu.0000431478.79536.68 19. Lee DJ, Zwienenberg-Lee M, Seyal M, Shahlaie K. Intraoperative computed tomography for intracranial electrode implantation surgery in medically refractory epilepsy. Journal of Neurosurgery. 2015; 122(3): 526-531. https://doi.org/10.3171/2014.9.jns13919 20. Schmidt RF, Lang MJ, Hoelscher CM, et al. Flat-Detector Computed Tomography for Evaluation of Intracerebral Vasculature for Planning of Stereoelectroencephalography Electrode Implantation. World Neurosurg. 2018; 110: 585-592. https://doi.org/10.1016/j.wneu.2017.11.063 21. Freyschlag CF, Gruber R, Bauer M, et al. Routine postoperative CT is not helpful after elective craniotomy. World Neurosurgery. 2018. https://doi.org/10.1016/j.wneu.2018.11.079 22. Fontes RB, Smith AP, Munoz LF, et al. Relevance of early head CT scans following neurosurgical procedures: an analysis of 892 intracranial procedures at Rush University Medical Center. J Neurosurg. 2014; 121: 307-312. 23. Almohiy H. Paediatric computed tomography radiation dose: A review of the global dilemma. World J. 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Abstract: Background: pulmonary embolism (PE), is one of the most common cardiopulmonary pathologies in the world, has a high risk of developing after major operations on the osteoarticular system. Mortality from PE remains high, ranking third after myocardial infarction and stroke. Aim: was to identify tomographic signs of PE in patients with osteoarticular pathology in the postoperative period. Materials and methods: we analyzed results of computed angiopulmonography of 11 patients with suspicion on pulmonary embolism who were operated on osteoarticular pathology at the Federal Center for Traumatology, Orthopedics and Endoprosthetics of the Ministry of Health of the Russian Federation (Cheboksary). Patients showed such indirect signs of PE as discshaped atelectasis of lung tissues, expansion of diameter of pulmonary trunk and right pulmonary artery, signs of congestion in pulmonary circulation and pulmonary hypertension. Direct radiological signs included occlusion of a branch of pulmonary artery by thrombus. Results: in 91% of examined patients, occlusion of branch of pulmonary artery by thrombus was detected, in 82% of cases - the defeat of branches of right pulmonary artery. Embolism at the level of lobar arteries was detected in 30%, segmental branches - in 60% of patients; signs of pulmonary embolism of one of subsegmental branches of right pulmonary artery - in one patient (10%). Bilateral thrombosis was observed in two patients, including massive bilateral PE in one case. One patient had discoid atelectasis of lung tissues. Expansion of diameter of pulmonary trunk and right pulmonary artery was observed in 78% of patients with PE, signs of congestion in pulmonary circulation - in 27% of cases, pulmonary hypertension - in 73% of cases. Conclusion: visualization of direct and indirect signs of pulmonary embolism during computed pulmonary angiography confirmed the diagnosis in all examined patients. The detection of blood clots in pulmonary arteries themselves is the main criterion in making the final diagnosis. References 1. Nikolaev NS, Trofimov NA, Kachaeva ZA, et al. Prevention and treatment of pulmonary thromboembolism in traumatology and orthopedics. Tutorial. Cheboksary: Publishing house of the Chuvash University, 2020; 108 [In Russ]. 2. Krivosheeva EN, Komarov AL, Shakhnovich RM, et al. Clinical analysis of a patient with antiphospholipid syndrome and submassive pulmonary embolism. Aterotromboz. 2018; (1): 76-87 [In Russ]. https://doi.org/10.21518/2307-1109-2018-1-76-87 3. Hepburn-Brown M, Darvall J, Hammerschlag G. Acute pulmonary embolism: a concise review of diagnosis and management. Internal Medicine Journal. 2019; 49(1): 15-27. https://doi.org/10.1111/imj.14145 4. Ostapenko EN, Novikova NP. Pulmonary embolism: modern approaches to diagnosis and treatment. Ekstrennaya meditsina. 2013; 1(5): 84-110 [In Russ]. 5. Sinyukova AS, Kiseleva LP, Kupaeva VA. A clinical case of recurrent pulmonary embolism and the complexity of the diagnostic search. Sovremennaya meditsina: aktual'nye voprosy. 2015; (42-43): 24-31 [In Russ]. 6. Bagrova IV, Kukharchik GA, Serebryakova VI, et al. Modern approaches to the diagnosis of pulmonary embolism. Flebologiya. 2012; 6(4): 35-42 [In Russ]. 7. Kuznetsov AB, Boyarinov GA. Early diagnosis of pulmonary embolism (review). Sovremennye tekhnologii v meditsine. 2016; 8(4): 330-336 [In Russ]. 8. Bershteyn LL. Pulmonary embolism: clinical manifestations and diagnosis in the light of the new recommendations of the European Society of Cardiology. Kardiologiya. 2015; 55(4): 111-119 [In Russ]. https://doi.org/10.18565/cardio.2015.4.111-119 9. Sakharyuk AP, Shimko VV, Tarasyuk ES, et al. Pulmonary embolism in clinical practice. Byulleten' fiziologii i patologii dykhaniya. 2015; (55): 48-53 [In Russ]. 10. M Al-hinnawi A-R. Computer-Aided Detection, Pulmonary Embolism, Computerized Tomography Pulmonary Angiography: Current Status. Intech Open. 2019; 19. http://doi.org/10.5772/intechopen.79339 11. Gilyarov MYu, Konstantinova EV. How do new approaches to the treatment of pulmonary embolism affect disease outcome? Meditsinskiy sovet. 2017; (7): 48-55 [In Russ]. https://doi.org/10.21518/2079-701X-2017-7-48-55 12. Konstantinides S. Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2014; (35): 3033-3080. 13. Tagalakis V, Patenaude V, Kahn SR, Suissa S. Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort. Am J Med. 2013; 126(832): 13-21.
Abstract: Department of Obstetrics and Gynaecology of the Therapeutic and This article opens a new series of publications dedicated to a currently important issue of endovascular treatment of uterine myoma - uterine artery embolization (UAE). The authors presently possessing the most abundant hands-on experience in UAE in References 1. Oliver J. A. Jr, Lance J.S. Selective embolization to control massive hemorrhage following pelvic surgery. Am. J. Obstet. Gynecol. 1979; 135: 431-432. 2. Ravina J., Merland J., Herbreteau D. et al. Preoperative embolization of uterine fibroma. Preliminary results [10 cases] [letter, in French]. Presse Med. 1994; 23: 1540. 3. Goodwin S., McLucas B., Lee M. et al. Uterine artery embolization for the treatment of uterine leiomyomata midterm results. J. Vasc. Intervent. Radiol. 1999; 10: 1159-1165. 4. Goodwin S., Vedantham S., McLucas B. et al. Preliminary experience with uterine artery embolization foruterine fibroids. J. Vasc. Interv. 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Cervical pregnancy: conservative treatment with primary embolization of the uterine arteries. A case report. Review of the literature. J. Gynecol. Obstet. Biol. Reprod. 1995; 1(24): 43-47. 57. Suzumori N., Katano K., Sato T. et al. Conservative treatment by angiographic artery embolization of an 11-week cervical pregnancy after a period of heavy bleeding. Fertil. Steril. 2003; 3(80): 617-619. 58. Sherer D.M., Lysikiewicz A., Abulafia O. Viable cervical pregnancy managed with systemic Methotrexate, uterine artery embolization, and local tamponade with inflated Foley catheter balloon. Am. J. Perinatol. 2003; 5(20): 263-267. 59. Itakura A., Okamura M., Ohta T., Mizutani S. Conservative treatment of a second trimester cervicoisthmic pregnancy diagnosed by magnetic resonance imaging. Obstet. Gynecol. 2003; 5(101): 1149-1151. 60. Hong T.M., Tseng H.S., Lee R.C., Wang J.H., Chang C.Y Uterine artery embolization: an effective treat ment for intractable obstetric haemorrhage. Clin. 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Abstract: Aim: was to evaluate frequency and features of pedal arteries lesions in diabetic patients with critical limb ischemia (CLI). Materials and methods: a retrospective review of feet angiograms of 144 diabetic patients with ischemic ulcer-necrotic lesions was performed. We evaluated rate of different variants and features of pedal arterial lesions. Also, we analyzed lesion characteristics of the source artery and the frequency of the plantar arch occlusion. Results: 219 hemodynamically significant lesions were detected, 179 of which were occlusions (82%). The majority of occlusions (140(78%)) were an extension of tibial arterial lesions. The rate of occlusions of more than 5 cm in length was 86%(154). There were no passable vessel segments in 38 cases (21% of occlusions). Single-vessel occlusive disease was revealed in 67 patients (46%), double-vessel defeat - in 56 (39%) patients. The source artery occlusion was observed in 110 cases (76%). In 92% of cases the length of the source artery occlusion was more than 5 cm. The occlusion of a non-feeding artery was found in 69 cases (48%). The plantar arch occlusion was revealed in 37 patients (26%). Conclusion: in diabetic patients with CLI the arterial lesion of the foot is predominantly establishec by long occlusions, often with two-vessel involvement. The most often occluded vessel is a feeding artery It explains difficulties with the direct revascularization. The plantar arch is occluded in one quarter of cases. References 1. Van Den Berg J., Waser S., Trelle S. et al. Lesion characteristics of patients with chronic critical limb ischemia that determine choice of treatment modality. J. Cardiovasc. Surg. 2012; 53(1):45-52. 2. Rossiyskiy consensus «Diagnostika i lechenie patsientov s kriticheskoy ishemiey nizhnikh konechnostey». [The diagnosis and treatment of patients with critical limb ischemia]. Moscow. 2002: 40 [In Russ]. 3. Graziani L., Silvestro A., Bertone V. et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur. J. Vasc. Endovasc. Surg. 2007; 33(4): 453-460. 4. Zhu YQ., Zhao J.G., Liu F. et al. Subintimal angioplasty for below-the-ankle arterial occlusions in diabetic patients with chronic critical limb ischemia. J. Endovasc. Ther. 2009; 16(5):604-612. 5. Ferraresi R., Centola M., Ferlini M. et al. Long-term outcomes after angioplasty of isolated, below-the-knee arteries in diabetic patients with critical limb ischaemia. Eur. J. Vasc. Endovasc. Surg. 2009; 37(3):336-342. 6. Eroshkin I.A., Eroshenko Al.V., Eroshenko An.V. et al. Rol rentgenoendovaskulyarnogo vosstanovleniya arteriy nizhnikh konechnostey v lechenii sindroma diabeticheskoy stopy. [The role of endovascular restoration of lower limb arteries in the treatment of diabetic foot syndrome]. Meditsinskaya vizualizatsiya. 2009; 5:99-105 [In Russ]. 7. Pomposelli F.B., Kansal N., Hamdan A.D. et al. A decade of experience with dorsalis pedis artery bypass: Analysis of outcome in more than 1000 cases. J. Vasc. Surg. 2003; 37(2):307-315. 8. lida O., Soga Y, Hirano K. et al. Long-term results of direct and indirect endovascular revascularization based on the angiosome concept in patients with critical limb ischemia presenting with isolated below-the-knee lesions. J. Vasc. Surg. 2012; 55(2):363-370. 9. Soderstrom M., Alback A., Biancari F. et al. Angiosome-targeted infrapopliteal endovascular revascularization for treatment of diabetic foot ulcers. J. Vasc. Surg. 2013; 57(2):427-435. 10. Rashid H., Slim H., Zayed H. et al. The impact of arterial pedal arch quality and angiosome revascularization on foot tissue loss healing and infrapopliteal bypass outcome. J. Vasc. Surg. 2013; 57(5):1219-1226. 11. Nakama T., Watanabe N., Haraguchi T. et al. Clinical outcomes of pedal artery angioplasty for patients with ischemic wounds: results from the multicenter RENDEZVOUS registry. JACC: Cardiovasc. Interv. 2017; 10(1):79-90.
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Abstract: It has been described the experience of use of automatic injector Mark V Pro Vis (Medrad) for endovascular interventions in pediatry. The choice of optimal roentgen contrast media for angiography and endovascular interventions is considerated. It has been concluded that contrast enhancement by iopromide and automatic injector Mark V Pro Vis is effective and safety method of visualization of vessels, tumors and other pathology. References 1. Поляев Ю.А., Мыльников А.А. Эндоваскулярная окклюзия в лечении гиперваскулярных образований головы. Практикующий врач. 2003; 1: 38–41. 2. Поляев Ю.А., Щенев С.В. Опыт лечения некоторых форм ангиодисплазий периферической локализации у детей. Практикующий врач. 2003; 1: 42–45. 3. Поляев Ю.А., Шимановский Н.Л., Лазарев В.В., Голенищев А.И. Десятилетний опыт использования неионного рентгеноконтрастного средства Ультравист в детской интервенционной радиологии. Детская больница. 2004; 1: 55–60. 4. Сергеев П.В., Поляев Ю.А., Юдин А.Л., Шимановский Н.Л. Контрастные средства. М: Известия. 2007; 496. 5. Liss P., Persson P.B., Hansell P., Lagerqvist B. Renal failure in 57 925 patients undergoing coronary procedures using iso-osmolar or low-osmolar contrast media. Kidney Int. 2006;. 70: 1811–1817. 6. Ultravist. Monograph, Schering AG, Berlin, Second edition. 2005; 72. 7. Misawa M., Sato Y., Hara M. et al. Use of non-ionic contrast medium, iopromide (Proscope-370), in pediatric cardiovascular angiography. Nihion Shoni Hoshasen Gakkai Zasshi. 2000; 2: 42–48. 8. Liss P., Hansell P., Lagerkvist B. Higher Incidence of Renal Failure in 23 224 Patients Using Iso-osmolar Compared to Low-osmolar Contrast Media during Coronary Interventions in Swedish Hospitals. RSNA, 2008; SSG 08–01.
Abstract: Aim: was to study the diagnostic and prognostic importance of impedance indicators of a kidney parenchyma at acute (ARI) and chronic renal insufficiency (CRI). Material and methods. Research was performed on the basis of a hemodialysis department. 51 patients were examined during the period from 2009 till 2010. They underewent a monopolar bioimpedance measurement of kidneys under ultrasound control. Results. Changes of absolute and relative indicators of electric impedance of a kidney parenchyma show morphological violations in organ at acute and chronic renal insufficiency, characterize evidence of compensatory processes and give information on a tissue functional activity. These data are necessary for verification of the diagnosis, prescription of reasonable pharmacotherapy and definition of a pathological process forecast.
Abstract: Aim: was to assess biophysical parameters of a renal parenchyma at experimental acute and chronic renal insufficiency at rats. Material and methods. Experiment was carried out on 36 rats of both sexes in mass of 180-250 g. The bioimpedance analysis of a renal parenchyma was carried out in intraoperative way on the 7th day after modeling of acute renal insufficiency and 2 months later after modeling of acute renal insufficiency, using «G. Greven's method». Absolute and relative indicators of electric impedance were investigated. Results. Chronic renal insufficiency in contrast to the acute renal insufficiency is characterized not only by reduction of absolute indicators of renal parenchyma electric impedance, but also by change of relative indicators. Apparently, relative indicators of the bioimpedance analysis reflect change of the renal parenchyma functional status and absolute peculiarities of its morphological structure. Conclusion. The analysis of results of a bioimpedansometriya in separate zones of a kidney, showed that in a normal kidney the electric impedance in various parts of body is non-uniform, however at renal insufficiency indicators of an impedance are leveled. This phenomenon is necessary for checking in clinical researches and, in case of confirmation of experimental results, it can be used as diagnostic criterion at statement of the diagnosis of acute renal insufficiency. References 1. Smirnov A.V., Dobronravov V.A., Kajukov I.G. i dr. Rekomendacii Nauchno-issledovatel'skogo instituta nefrologii Sankt-peterburgskogo gosudarstvennogo medicinskogo universiteta im. Akad. I.P. Pavlova: opredelenie, klassifikacija, diagnostika i osnovnye napravlenija profilaktiki hronicheskoj bolezni pochek u vzroslyh. Nefrologija [Recommendation of scientific-research institute of nephrology, of St.Petersburg medical univercity named after I.P.Pavlov: definition, classification, diagnostics and major ways of prophylaxis of chronic renal diseases in adults. Nephrology.]. 2008; 12(2): 75-93 [In Russ]. 2. Tomilina N.A., Podkorytova O.L. Ostraja pochechnaja nedostatochnost'. Nefrologija i dializ. [Acute renal insufficiency. Nephrology and dialysis.] 2009; 11(1): 4-20 [In Russ]. 3. Golidorsky M.S., Liberbal W. Pathophysiology-ischemic acute renal failure. In: Atlas of Diseases of the Kidney. Ed. By R.W. Schreier. 1999; 460. 4. Pal'cev M.A., Anichkov N.M. Patologicheskaja anatomija: Uchebnik [Pathological anatomy.]. V 2-h t. T. 2. Ch. II. M.: Medicina. 2001; 680 [In Russ].. 5. Stecjuk E.A. Sovremennyj gemodializ [Modern dialysis]. - M.: MID, 1998; 356 [In Russ]. 6. John T., Dandirdas., Kunig P. et al. Neurological disease of Renal Failure. Neurology and general medicine. - 3rd ed. 2002; 131-142. 7. Ermolenko V.M., Nikolaev A.Ju. Ostraja pochechnaja nedostatochnost': rukovodstvo [Acute renal insufficiency. Guide-book.]. M.: GJeOTAR-Media, 2010; 240 [In Russ]. 8. Rjabov S.I., Natochin Ju.V. Funkcional'naja nefrologija [Functional nephrology...]. S-Pb.: Lan', 1997; 304 [In Russ]. 9. Shejman D.A. Patofiziologija pochki [Pathophysiology of kidney]. Per. s angl. 2-eizd., ispr.- M.- S-Pb.: «Izdatel'stvo BINOM» «Nevskij dialekt», 1999; 260 [In Russ]. 10. Spencer J.A., Giussani D.A., Moore P.J., Hanson M.A. In vitro validation of Doppler indices using blood and water. J. Ultr. Med. 1991; 10: 305-308. 11. Nagao M., Murase K., Saeki H. Pulsating renal blood flow distribution measured using power Doppler ultrasound: correlation with hypertension. Hypertens. Res. 2002; 25: 697-702. 12. Hascaev B.D. Impedansnyj metod v mediko-biologicheskih issledovanijah i ego pribornoe osnawenie. Medicinskaja tehnika [Impedance method of medical-biological investigation and its equipment.]. 1996; 3: 34-40 [In Russ]. 13. Livenec V.P. Impedansometrija nebnyh mindalin kak sposob ob#ektivizacii klinicheskih form hronicheskogo tonzillita. Dis. kand. med. Nauk [Impedancometry of glands as a method of objectivization of clinical forms of tonsillitis]. M., 2006; 159[In Russ]. 14. Noskova A.P. Vlijanie furosemida i mannitola na vyzhivaemost' krys pri ostroj pochechnoj nedostatochnosti. Farmakologicheskaja reguljacija funkcii pochek [The influence of furosemid on survival rate of rats with acute renal insufficiency. Pharmacological regulation of kidneys.]. Pod red. A.A. Lebedeva. - Kujbyshev, 1981; 40-44 [In Russ].
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Abstract: Background and purpose: flow-diverting devices are increasingly used for the treatment of giant and wide neck cerebral aneurysms. The aim of the research was to evaluate the feasibility of computed tomography angiography CTA in the postoperative evaluation of aneurysms treatec with Pipeline Embolization Device (PED). Materials and methods: fifteen patients with 19 aneurysms treated by total of 17 PED were examined by means of CTA. Postprocessing of CTA acquisitions were done at workstation using maximum intensity projections, multiplanar reformations, curved planar reformations and volume rendering of PED region and other intracranial arteries. The position of PED and dergree of aneurysm occlusion were evalluated. Results: CTA follow-up of at least 26 months demonstrated complete occlusion of aneurysms treated with the PED in 9 cases (50%). There were 2 cases (11,1%) of proximal stent migration and 2 cases (11,1%) of stent narrowing due to incomlete expansion. Flow reduction was observed in 4 aneurysms (22,2%). CTA was accurate in determining the position of PED and evaluating the patency of aneurysm. Conclusions: CTA can be used as a reliable tool for postoperative evaluation of aneurysms treated with PED defining the stent position and aneurysmal flow reduction. Postprocessing using curved planar reformations with window width 1000-2500 and level 600-800 is optimal for stent visualization. References 1. Suzuki S., Tateshima S., Jahan R., Duckwiler G.R., Murayama Y, Gonzalez N.R., V^uela F. Endovascular treatment of middle cerebral artery aneurysms with detachable coils: angiographic and clinical outcomes in 115 consecutive patients. Neurosurgery. 2009; 64(5): 876-88. 2. V^uela F., Duckwiler G., Mawad M. Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. J. Neurosurgery. 2008; 108(4): 832-9. 3. Kallmes D.F., Ding YH., Dai D., Kadirvel R., Lewis D.A., Cloft H.J. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke. 2007; 38(8): 2346-52. 4. Lylyk P, Miranda C., Ceratto R., et al. Curative endovascular reconstruction of cerebral aneurysms with the Pipeline embolization device: the Buenos Aires experience. Neurosurgery. 2009; 64: 632- 42, discussion 642-43, quiz N636. 5. Cloft H.J., Joseph G.J., Dion J.E. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke. 1999; 30(2): 317-20.12. 6. Mayberg M.R., Batjer H.H., Dacey R., Diringer M., Haley E.C., Heros R.C., Sternau L.L., Torner J., Adams H.P Feinberg W. et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1994; 25(11): 2315-28. 7. Min J.K., Swaminathan R.V., Vass M., Gallagher S., Weinsaft J.W. High-definition multidetector computed tomography for evaluation of coronary artery stents: comparison to standard-definition 64-detector row computed tomography. Cardiovasc. Comput. Tomogr. 2009; 3(4): 246-51. 8. Sun Z., Davidson R., Lin C.H. Multi-detector row CT angiography in the assessment of coronary in-stent restenosis: a systematic review. Eur. J. Radiol. 2009; 69(3): 489-95. 9. Szikora I., Guterman L.R., Wells K.M., Hopkins L.N. Combined use of stents and coils to treat experimental wide-necked carotid aneurysms: preliminary results. AJNR Am. J. Neuroradiol. 1994; 15(6):1091-102. 10. Ternovoy S.K., Akchurin R.S., Fedotenkov I.S., Veselova T.N., Nikonova M.E., Shiryaev A.A. Neinvazivnaya shuntografiya metodom mul’tispiral’noy komp’yuternoy tomografii. REJR. 2011; 1(1): 26-32 [In Russ]. 11. Lieber B.B., Stancampiano A.P, Wakhloo A.K. Alteration of hemodynamics in aneurysm models by stenting: influence of stent porosity. Ann. Biomed. Eng. 1997; 25(3): 460-9. 12. Szikora I., Berentei Z., Kulcsar Z., et al. Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the Pipeline embolization device. AJNR Am. J. Neuroradiol. 2010; 31:1139-47. 13. McAuliffe W., Wycoco V., Rice H., Phatouros C., Singh T.J., Wenderoth J. Immediate and midterm results following treatment of unruptured intracranial aneurysms with the pipeline embolization device. AJNR Am. J. Neuroradiol. 2012; 33(1):164-70. 14. Saatci I., Yavuz K., Ozer C., Geyik S., Cekirge H.S. Treatment of intracranial aneurysms using the pipeline flow-diverter embolization device: a single-center experience with long-term follow-up results. AJNR Am. J. Neuroradiol. 2012; 33(8):1436-46. 15. Deutschmann H.A., Wehrschuetz M., Augustin M., Niederkorn K., Klein G.E. Long-term follow-up after treatment of intracranial aneurysms with the Pipeline embolization device: results from a single center. AJNR Am. J. Neuroradiol. 2012; 33(3): 481-6.
Abstract: Diffuse liver lesion is one of the leading positions in the structure of hepatobiliary pathology Dispite the large number of available diagnostic methods biopsy followed by histological examination is a «gold standart» untill now. Bioimpedancemetry is a potential method of evaluation of morpho-functional analysys of the organ. Aim: was to clarify dependence of indices of an electrical impedance of liver tissue on its morfo-functional status and to define general valuation principles of absolute and relative measures of an electrical impedance of an organ in case of liver diffusion pathology in an experiment. Metarials and methods: the experimental study was carried out on 66 Wistar rats 180-230 g. The diffuse liver failure was modeled by using 0,02% solution of N-nitrozodiethylamin with water that animals were drinking during all the period of experiment (120 days). Bioimpedancemetry and morphological investigation as a next step were performed on 14, 30, 60, 90, 120 days in parallel with biochemical blood analysis, sonography of the liver and morphological analysis. Results: biophysical parameters of liver's parenchyma in cases of toxic hepatitis were characterized by increasing of absolute bioimpedance indices more than 50% and increasing of impedance dispersion coefficient of 16%. But in cases of drrhosis of the liver biophysical paremeters were characterized by decreasing of absolute indices of electrical impedance and increasing of heterogeneity coefficient of the liver of 50 to 100% at different measurement frequencies. Conclusion: obtained data confirm the diagnostic value of bioimpedancemetry and give prerequisites for further studying of parameters of an electric impedance of liver parenchyma in clinical practice. References 1. Shirokikh I.N., Mavlitova L.A., Tuev A.V., Khlynova O.V Diagnostika fibroza pecheni: ideal'ny li metody? [Liver fibrosis diagnosis: are methods perfect?] Permskiy meditsinskiy zhurnal. 2013; 30(3): 93-102 [In Russ]. 2. Yuschuk N.D., Znoyko O.O., Dudina K.R., Belyy PA. Problema virusnogo gepatita C v Rossijskoj Federacii. [The problem of viral hepatitis C in the Russian Federation.] Terapevticheskiyarkhiv. 2014; 86 (10): 77-81 [In Russ]. 3. Fedeli U., Avossa F., Guzzinati S., Bovo E., Saugo M. Trends in mortality from chronic liver disease. Ann. Epidemiol. 2014; 24(7): 522-526. 4. Morozov S.V., Isakov V.A., Kaganov B.S. Sovremennye metody neinvazivnoj ocenki vyrazhennosti fibroza pecheni. [Modern methods of non-invasive evaluation of the severity of hepatic fibrosis. ] Infektsionnye bolezni. 2009; 7(4): 44-49 [In Russ]. 5. Saba L., di Martino M., Bosco S., Del Monte M., de Cecco C.N., Lombardo V., Piga M., Catalano C. MDCT classification of steatotic liver: a multicentric analysis. Eur. J. Gastroenterol. Hepatol. 2015; 27 (3): 290-297. 6. Toosi A.E. Liver Fibrosis: Causes and Methods of Assessment, A Review. Rom. J. Intern. Med. 2015; 53 (4): 304-314. 7. Beloborodova E.V., Beloborodova E.I., Purlik I.L., Kalacheva T.P. State of the liver at chronic hepatites of various etiology (according to data of morphological study of liver biopsy specimens). Klinicheskie perspektivy gastroenterologii, gepatologii. 2014; 1: 31-36 [In Russ]. 8. Kobyliak N., Abenavoli L. The role of liver biopsy to assess non-alcoholic Fatty liver disease. Rev. Recent Clin. Trials. 2014; 9 (3): 159-169. 9. Nikolaev D.V., Smirnov A.V., Bobrinskaya I.G., Rudnev S.G. Bioimpedansnyj analiz sostava tela cheloveka. [Bioelectric impedance analysis of human body composition.] Moscow: Nauka. 2009: 392 p. [In Russ]. 10. Rodin A.V., Pleshkov V.G., Leonov S.D. Opredelenie zhiznesposobnosti kishechnika pri ostroj kishechnoj neprohodimosti v ehksperimente. [Determination of the viability of the intestine during experimental acute intestinal obstruction.] Vestnik eksperimentalnoy i klinicheskoy khirurgii. 2011; 4(1): 145-147 [In Russ]. 11. Panchenkov D.N., Leonov S.D., Rodin A.V. Razrabotka algoritma bioimpedansnogo analiza novoobrazovanij na modeli perevivaemoj opuholi RS-1 v ehksperimente [Development of bioimpedance analysis algorithm of tumors on an experimental model with transplanted RS-1 tumor.] Vestnik eksperimentalnoy i klinichesk,oy khirurgii. 2013; 6 (3): 287-291 [In Russ]. 12. Panchenkov D.N., Leonov S.D., Rodin A.V. Bioimpedansnyj analiz v medicine. [Bioimpedance analysis in medicine.] Patologicheskaya fiziologiya i eksperimentalnaya terapiya. 2014; 2: 80-86 [In Russ]. 13. Tornuev Yu.V., Koldysheva E.V., Lapiy G.A., Molodykh O.P., Balakhnin S.M., Bushmanova G.M., Semenov D.E., Preobrazhenskaya V.K. Bioimpedancemetry in the diagnostics of inflammatory process in the mammary gland. Bulletin of Experimental Biology and Medicine. 2014; 156 (3): 381-383. 14. Abdullaev N.A., Balahnin S.M., Bushmanova G.M., Karpova A. A., Koldysheva E.V., Krinicyna Ju.M., Lapij G.A., Mzhelskaja M.M., Majborodin I.I., Manvelidze R.A., Preobrazhenskaya V.K., Senchukova S.R., Tornuev Y.V., Shelkovnikova N.V., Sholenberg E.V., Yakovleva A.Y. Kriterii differencial'noj diagnostiki novoobrazovanij, gastritov i yazvennoj bolezni zheludka po pokazatelyam bioimpedansa. [Differential diagnostic criteria of tumors, gastritis and gastric ulcer by bioimpedance measuring]. Fundamentalnie issledovaniya. 2015; 1: 1775-1779 [In Russ]. 15. Antonienko S.G., Berdinskikh I.K., Mishnaevskaya E.G. Rol' nekotoryh komponentov sistemy ciklicheskih nukleotidov pri gepatokancerogeneze, inducirovannom N-nitrozdiehtilaminom u krys. [The role of some components of the cyclic nucleotide system in hepatocarcinogenesis induced by N- nitrozdietilaminom in rats.] Eksperimentalnaya onkologiya. 1990; 12 (5): 18-21 [In Russ]. 16. Portyanaya N.I., Osipenko B.G., Moskadynova G.A., Novokhatskiy N.K., Guschina A.A., Dobrolyubova B.A., Chernyak Yu.I., Sokolovskiy V.V. K biohimicheskomu mekhanizmu toksicheskogo dejstviya gidrazinov. [Biochemical mechanism of toxic action of hydrazines.] Materials of the 1 Congress of Toxicologists of Russia. М. 1998; 306 [In Russ]. 17. Bogdanov N.A. Patologiya, klinika i terapiya porazhenij zhidkimi raketnymi toplivami. [Pathology, clinic and therapy of damages with liquid rocket fuel. Leningrad:] VMA. 1970: 152 p [In Russ]. 18. Avakyan A.Kh. Novye molekulyarnye kriterii ocenki toksicheskogo dejstviya proizvodnyh gidrazina. Aktivnye formy kisloroda kak klyuchevye agenty v mekhanizme toksichnosti. [New molecular criteria for assessment the toxic effects of hydrazine derivatives. Reactive oxygen species as key agents in the mechanism of toxicity.] Farmakologiya i toksikologiya. 1990; 53 (1): 70-73 [In Russ]. 19. Obraztsov S.A., Leonov S.D., Troitskiy Yu.V., Fedorov G.N. Ustrojstvo dlya izmereniya impedansa biologicheskih tkanej. [Device to measure biological fabric impedance. ]Patent RF, no 2366360, 2009. 20. Smorodinov A.V., Leonov S.D. Elektrod dlya provedeniya bioimpedansometrii. [Electrode for performing electric impedancemetry.] Patent RF, no 2318435, 2008.
