[Methodological features of magnetic resonance imaging mammography].

By studying 211 females by currently available radiation techniques, such as X-ray study, ultrasonography, and magnetic resonance imaging mammography (MRIM), the authors consider that the specificity of contrast-enhanced MRIM (CE MRIM) is greater than that of MRIM without administering magnetic resonance contrast agents (MRCA). CE MRIM reveals clinically suspicious early-stage breast lesions and defines the stage of a tumorous process, the patients being unexposed to ionizing irradiation. CE MRIM as an auxiliary technique becomes one of the most informative ones, particularly in girls, early reproductive-age females with developed glandular tissue, and pregnant females. In the authors' opinion, the total algorithm of a breast study in this group of patients in specialized medical centers where trained physicians work should differ from the generally accepted algorithm: instead of applying X-ray mammography (XRM) as a basic method of primary diagnosis, ultrasound mammography using Doppler color mapping, followed by MRIM or XRM should be employed.

[Potentialities of magnetic resonance imaging in the study of renal morphofunctional state in girls with internal genital malformations and space-occupying lesions].

The diagnosis of the anatomic and functional state of urinary organs in girls with internal genital malformations and space-occupying lesions involves magnetic resonance imaging by administering the optimized dose of a magnetic resonance contrast agent (MRCA). The technology makes it possible to evaluate the anatomic features of the urinary tract (magnetic resonance urography), to perform abdominal vascular magnetic resonance angiography, and to draw a conclusion on renal functional status in the use of dynamic magnetic resonance renography. Within a study using one injected MRCA dose, both the anatomic and functional state of the kidney status can be examined, by evaluating MRCA passage singly in the cortical and medullary substances and pelvises, which increases diagnostic accuracy by 46% and promotes the optimization of management tactics in this category of patients.

[Magnetic resonance imaging in the differential diagnosis of chronic endometritis: capacities and methodic features].

By examining 83 females aged 17-48 years by magnetic resonance imaging (MRI), the authors conclude that the specificity and sensitivity of the technique without MR contrast agents in detecting chronic endometritis (CE) and chronic metroendometritis (CME) are 75.3 and 95.9%, respectively. On the MRI scans, hypertrophic and atrophic forms of CE have rather specific MR signs and appear as changes not only in the functional layer of the endometrium and transitional area, but also in the proper myometrium in CME. This all permits evaluating the degree of uterine wall involvement in the pathological process. Overall, the MRI criteria proposed by the authors can identify the signs of a chronic inflammatory process and its sequels and make a differential diagnosis this condition with female genital diseases to a high accuracy.

[Magnetic resonance imaging in the diagnosis of different forms of endometriosis]. / Magnitno-resonansnaia tomografiia v diagnostike razlichnykh form éndometriozov.

The present paper examines the capacities of non-invasive MRI in the diagnosis of endometriosis. A standardized study algorithm is proposed, indications and methodology for MRI in different forms of endometriosis (EM) are specified. It is shown that in the diagnosis of different types of EM there are specific changes in the MR pattern of small pelvic organs, which allow one to make a differential diagnosis of this disease with a higher sensitivity (96%) and specificity (87%) as compared with ultrasound study. MRI makes it possible to assess the degree of invasion of endometrioid heterotopies into the wall of the intestine and cervix uteri with a high degree of accuracy and to judge the degree and extent of intestinal luminal narrowing. Diagnostic errors in solving these problems (as well as those associated with the detection of extragenital foci of EM in the small pelvis) are due first of all to movement artefacts a (respiration and intestinal motility) particularly in the presence of a significant adhesive process and/or after surgical intervention. MRI does not virtually yield false-negative conclusions in the diagnosis of different forms of genital endometriosis (less than 3%), which, in the authors' opinion, rather justifies some hyperdiagnosis (about 11%) made by this method in the diagnosis of endometriosis of the rectovaginal septum. MRI is a closing, specifying stage of instrumental diagnosis of not only EM, but also other small pelvic diseases.

[A digital radiographic device for medical diagnosis]. / Tsifrovaia rentgenograficheskaia ustanovka dlia meditsinskoi diagnostiki.

The paper outlines a digital radiographic device which records radiation by scanning with a one-dimensional multiwire proportional chamber connected on-line to a computer. The device drastically reduces a dosage load on patients, improves the diagnostic potentialities of projectional radiography, yields quantitative diagnostic information, creates special diagnostic programmes, has fast-access and fire-safe archives. The device may be used for general-purpose radiographic examinations and it has advantages when used instead of conventional fluorographs.

[A program of intensive nondrug treatment for functional tubal infertility]. / Programma intensivnogo nemedikamentoznogo lecheniia funktsional'nogo trubnogo besplodiia.

The program of combined use of nonpharmaceutical modalities to treat functional tubal infertility proposed by the authors is effective in correction of contractile activity of the uterine tubes and psychoemotional condition of the patients. Due to the treatment, the reproductive function recovered in 56% of the patients under 30 years of age who had been infertile less than 5 years.

Female reproductive function in areas affected by radiation after the Chernobyl power station accident.

This paper reports the results of a comprehensive survey of the effects of the accidental release of radiation caused by the accident at the Chernobyl nuclear power station in April 1986. The accident and the resulting release of radiation and radioactive products into the atmosphere produced the most serious environmental contamination so far recorded. We have concentrated on evaluating the outcomes and health risks to women, their reproductive situation, and consequences for their progeny. We have concentrated on two well-defined areas: the Chechersky district of the Gomel region in Belorussia and the Polessky district of the Kiev region in the Ukraine. A number of investigations were carried out on 688 pregnant women and their babies, and data were obtained from 7000 labor histories of the development of newborns for a period of 8 years (3 years before the accident and 5 years after it). Parameters examined included birth rate, thyroid pathology, extragenital pathology such as anemias, renal disorders, hypertension, and abnormalities in the metabolism of fats, complications of gestation, spontaneous abortions, premature deliveries, perinatal morbidity and mortality, stillbirths and early neonatal mortality, infections and inflammatory diseases, neurological symptoms and hemic disturbances in both mothers and infants, trophic anomalies, and biochemical and structural changes in the placenta. Several exogenous, complicating influences were also considered such as psycho-emotional factors, stress, lifestyle changes, and others caused directly by the hazardous situation and by its consequences such as treatment, removal from affected areas, etc.(ABSTRACT TRUNCATED AT 250 WORDS)

[Early rehabilitative physiotherapy following microsurgical operations on the fallopian tubes]. / Ranniaia vosstanovitel'naia fizioterapiia posle mikrokhirurgicheskikh operatsii na matochnykh trubakh.

Clinical data, the findings of biorhythmologic studies and the results of kymographic perturbation evidence the efficacy of early restorative treatment with the use of preformed physical factors early (starting from the first day) after reconstructive microsurgery. Such treatment accelerates the postoperative adaptation of the body, improves the anatomy and function of the uterine tubes and promises a more favorable prognosis for the reproductive function recovery. Criteria for the differentiated application of 3 physical factors are presented, intermittent low-frequency magnetic field, supersonic current, low-frequency monopolar rectangular pulses for electrostimulation of the uterine tubes.

[Early rehabilitative physiotherapy following the microsurgical reconstruction of the fallopian tubes (a clinico-chronobiological validation)]. / Ranniaia vosstanovitel'naia fizioterapiia posle mikrokhirurgicheskoi rekonstruktsii matochnykh trub (kliniko-khronobiologicheskoe obosnovanie).

Three preformed physical factors (low-frequency alternating magnetic field, supersonic frequency current, low-frequency monopolar square-wave impulses for electrostimulation of the uterine tubes) were tested in aftercare following plastic microsurgery in gynecology. The treatment can be started as early as postoperative day 1. The criteria of the differential choice of the modalities have been developed. The use of the above physiotherapy was found valid.

[Predicting the outcome of labor in women with contracted pelvis]. / Prognozirovanie iskhoda rodov dlia ploda u zhenshchin s anatomicheski uzkim tazom.

The authors suggest that the coefficient, representing the ratio between the sizes of the small pelvis section and fetal head section, be used for the prediction of labor outcome for the fetus in women with a contracted pelvis. When the coefficient values K1-K4 were lower than 1.32, 1.35, 0.68, and 0.79, more than 90% of the newborns developed signs of cerebral circulation disorders, this prompting the use of cesarean section for this group of pregnant women. Timely correction of the policy of labor management with due consideration for the anatomical features of the pelvis helped reduce the perinatal mortality in multigravidae to 5/1000, mainly at the expense of carrying out planned cesarean section and monitoring in labor.

[Status of the feto-placental system in pregnant women with a history of habitual abortion during complex therapy including metabolic correction]. / Sostoianie feto-platsentarnoi sistemy u beremennykh, stradaiushchikh privychnym nevynashivaniem, na fone kompleksnoi terapii s primeneniem metabolicheskoi korrektsii.

Fifty-two women suffering from habitual abortions, referred to high-risk group in respect of placental insufficiency development, were followed up over the course of pregnancy. Metabolic correction was added to the complex of therapy of some of these patients, the rest were administered basic therapy alone. The examinations revealed placental insufficiency signs in 78.8% of these women. Placental insufficiency in the examined group was characterized by enlarged intervillous space and a longer period necessary for filling this space, reduced linear rate of the blood stream in this space, as well as by reduced levels of the fetoplacental hormones and activation of lipid peroxidation. Addition of metabolic therapy to the complex of therapeutic measures helped reduce the incidence of placental insufficiency by 17.4% and reduce more than twofold the incidence of fetal hypoxia and hypotrophy .

[Diagnosis and treatment of placental insufficiency in patients with congenital heart defects]. / O diagnostike i lechenii platsentarnoi nedostatochnosti u bol'nykh s vrozhdennymi porokami serdtsa.

The fetoplacental system was studied in 80 patients with congenital heart disease by placental scintigraphy, cardiotocography, and ultrasonic examination. Disordered uteroplacental blood flow was detected in 52 of the 64 patients, small-for-date fetuses in 36 of the 80, and chronic fetal hypoxia in 48 of the 72 patients. The authors come to a conclusion that a congenital heart disease is a risk factor in respect of placental insufficiency development.

[The interference-current therapy of chronic salpingo-oophoritis (a trial of studying the regional hemodynamics)]. / Interferentsionnaia terapiia khronicheskogo sal'pingooforita (opyt izucheniia regionarnoi gemodinamiki).

Blood redistribution in blood circulatory beds (the uterus, external genitalia and vagina) and as a whole have been established in exposure to interference currents. Ka index of rheoencephalography may be used as an additional objective criterion of individual sufficiency of physiotherapeutic exposure.

[State of the mammary glands in hypergonadotropic amenorrhea]. / Sostoianie molochnykh zhelez pri gipergonadotropnoi amenoree.

This study included 62 women with hypergonadotropic amenorrhea. Clinical, hormonal, genetic, laparoscopic and histologic studies revealed three types of the disease: resistant ovary syndrome, dystrophic ovary syndrome, and "pure" gonadal dysgenesis. Mammary function and architectonics were correlated with gynecologic conditions. Fibrocystic breast disease was identified in 64.9% of patients with resistant ovary syndrome, and fatty glandular degeneration was seen in dystrophic ovary syndrome; pure gonadal dysgenesis was associated with breast hypoplasia, poor structural differentiation and prevalence of adipose tissue in the mammary glands.

[Breast diseases in patients with hyperandrogenism]. / Mastopatiia u bol'nykh s giperandrogeniei.

The study has been undertaken in 40 women with excessive androgen levels in the age range of 22 to 38 years. Various types of mastopathy were found in 34 and fatty degeneration of the glandular tissue in 6 women. On the basis of clinical and laboratory studies, the patients were assigned to 3 groups: ovarian hyperandrogenism, adrenal and ovarian-adrenal hyperandrogenism. Breast hyperplasia was seen in all groups, but adenofibrosis occurred in groups I and III at a 2-2.5-fold higher rate as compared with group II. The patients with hyperandrogenism, anovulation, increased body mass index, low hirsute number and polycystic ovaries were at the highest risk of dyshormonal mammary hyperplasia. An adequate therapeutic approach was suggested for mastopathies in hyperandrogenic patients.

[Diagnosis of placental insufficiency in patients with acquired heart defects]. / K voprosu o diagnostike platsentarnoi nedostatochnosti u bol'nykh priobretennymi porokami serdtsa.

The feto-placental unit has been evaluated in 102 patients with acquired heart disease presenting as different circulatory states (Grade 0 insufficiency in 43, Grade I in 34 and Grade II A-B in 25 women). Placental scintigraphy was performed in 102, cardiotocography in 77, ultrasonographic fetal and placental biometry in 102 and placental pathological examination in 15 women. The neonatal study included 104 infants, with 2 twin pairs. Scintigraphy revealed utero-placental blood flow (UPBF) impairment in 72 (70.6%) pregnancies; cardiotocography showed chronic fetal hypoxia in 51 (66.1%) and ultrasonography showed intrauterine growth retardation in 44 (43.1%) pregnancies. Disorders of UPBF coexisted with chronic fetal hypoxia and intrauterine growth retardation in 33 (42.8%) pregnancies, with chronic fetal hypoxia in 18 (23.4%) pregnancies. Impairment of UPBF alone was seen in 13 (16.9%) pregnancies. The digoxin test was done concomitantly with placental scintigraphy in 28 patients; it improved diagnostic precision and provided a measure of compensation of impaired UPBF.