[Endoscopic electroexcision of benign urethral tumors in children].

Endoscopic treatment was performed in 17 boys aged 4 months-16 years with benign new growths of the posterior urethra: false polyps (n = 11), fibroepithelial polyps (congenital--4, acquired--1), fetal rabdomyoma of the urethra and urinary bladder (n = 1). Acquired fibroepithelial polyp was detected in a patient who previously had resection and urethral anastomosis for posttraumatic stricture and long-term preventive catheterization. A leading symptom of the disease in 8 patients was infravesical obstruction. Most complete diagnostic information was provided by urethroscopy. All the patients were treated with endoscopic electroexcision of the tumors with coagulation of their bases. In a child with fetal rabdomyoma a vesicular part of the tumor was removed transvesically. Histological examination of the false polyps identified epithelium-covered granulation tissue. Fibroepithelial polyps were represented with mature connective tissue covered with urothelium. Recovery was achieved in all the patients. Benign urethral tumors should be considered in differential diagnosis in children as one of rare causes of infravesical obstruction. Most of the neoplasms are represented by congenital and acquired polyps of connective tissue of various maturity covered with transitory epithelium. False polyps may be an initial stage of the development of fibroepithelial acquired polyp. Factors of a higher risk of acquired urethral polyps are secondary trauma of urethral mucosa in device investigations and manipulations as well as chronic inflammation. A method of choice in the treatment of benign urethral neoplasms is endoscopic electroexcision which in some cases can be made with transvesicular approach.

[Pefloxacin in the treatment of patients with mucoviscidosis]. / Mesto pefloksatsina v lechenii bol'nykh mukovistsidozom.

It was shown that microbial flora isolated from the bronchial secretion of 39 patients with mucoviscidosis in 1999-2001 consisted in one third (32.8%) of S. aureus strains. Evaluation of pefloxacin efficacy in the case of monoinfection and pathogens association revealed potent antistaphylococcal effect of the drug. Positive result was demonstrated in 82.3% cases by the 7th day. Among the side effects dominated arthropathy which disappeared at the period from 3 days to 3 months after drug administration was stopped.

[On fluoroquinolones treatment safety in children (clinical, morphological and catamnesis data)]. / O bezopasnosti primeneniia ftorkhinolonov u detei (kliniko-morfologicheskie i katamnesticheskie dannye).

Results of prospective comparative investigation of monofluoroquinolones (ciprofloxacin, ofloxacin, pefloxacin) arthropathy are presented. The trial was performed at 144 children with mucoviscidosis (aged 0.5-16) and at 37 children with aplastic anemia (aged 1.75-15). Two groups differ by necessary antibacterials regimes and hence by different abilities for arthropathy development: patients with mucoviscidosis were treated with fluoroquinolones followed by repeated short courses in combination with other antibacterials; patients with aplastic anemia--were treated permanently for a long time with low doses as monotherapy for autoinfection prophylaxis. Analysis was performed on the base of catamnesis, year growth rate, postmortal morphological investigation of the right knee joint. It was shown that quinolone arthropathy development didn't depend on treatment duration, as it developed during the first three weeks of the fluoroquinolone use, but depended on the drug, patient age and nosology. Arthropathy has favourable prognosis and was fully resolved at the period from 7 days to 3 month according to the arthropathy form (arthrologic, arthritic). Quinolones arthropathy at the children has specific features, the main one is absence of cartilage damage confirmed by morphological analysis.

[Comparative yearly growth rate of children with mucoviscidosis treated and not treated with ciprofloxacin:clinicomorphological comparisons]. / Cravnitel'naiia godovaia skorost' rosta u detei s mukovistsidozom, poluchavshikh i nepolychavshikh tsiprofloksatsin:klinicomorfologicheskie copostavleniia.

The results of the prospective and comparative investigation of the linear growth of children at the age of 4 to 16 years with mucoviscidosis treated with ciprofloxacin in combination with a cephalosporin or an aminoglycoside in the main group and a cephalosporin or an aminoglycoside alone in the control group are presented. The children were observed for 3 and 5 years. It was shown that in spite of the treatment term with ciprofloxacin the yearly growth rate in the children in the main and control groups did not significantly differ. The morphological investigation did not reveal any injury of the armicular cartilage and growth zone. The hyperplastic reaction in the tegmental cartilage was states and considered as a physiological one in response to the presence of ciprofloxacin and therefore reversible. No chondrotoxicity of the fluoroquinolones and ciprofloxacin, particularly in the children, is explained.

[Comparative morphological analysis of the articular cartilage, epiphyseal plate, spongy bone, and synovial membrane of the knee joint in children treated and not treated with ciprofloxacin]. / Sravnitel'nyi morfologicheskii analiz sostoianiia sustavnogo khriashcha, épifizarnoi plastinki, gubchatoi kosti i sinovial'noi obolochki kolennogo sustava u detei, poluchavshikh i ne poluchavshikh tsiprofloksatsin.

Comparative data on he postmortem morphological examination of the knee joint in children treated and not treated with ciprofloxacin while alive are presented. Nine children were ill with mucoviscidosis and 8 children were ill with aplastic anemia. The patients were ill with mucoviscidosis and 8 children were ill with aplastic anemia. The patients were treated with ciprofloxacin in a daily dose of 20 to 40 mg/kg body weight at the average for 148 days. The condition of the articular cartilage, growth area, spongy bone and synovial membrane of the knee joint was examined visually, histologically and morphologically. It was revealed that ciprofloxacin had no chondrotoxic effect. The structure affected in some cases by the ciprofloxacin treatment was the synovial membrane which developed subacute synovitis not clinically manifested (latent) in life. The phenomenon is explained.

[Fluorine level in the bone and cartilage in children treated with ciprofloxacin (data obtained from the femur distal part]. / Soderzhanie ftora v kosti i khriashche u detei, poluchavshikh tsiprofloksatsin (na modeli distal'nogo otdela bedrennoi kosti)

Comparative data on the content of fluorine in various sections of the left femur distal part, i.e. spongy bone, process zone and articular cartilage are presented. The examination was performed on postmortem sections from 10 pediatric cases (the average age of 9.5 years) with mucoviscidosis or aplastic anemia treated before the death for up to 12 months with ciprofloxacin in a dose of 20 to 40 mg/kg body weight. The control postmortem sections were from 10 practically healthy children (the average age of 10.4 years) killed in a car accident. The sections were subjected to 2-stage dry ashing with ionometric determination of the fluorine ions. The results were treated according to the V.Yu. Urbach procedure. It was shown that the content of fluorine in the sponge bone and process zone in both the groups did not significantly differ. A comparatively high content of fluorine was detected only in the postmortem sections of the articular cartilage from the children of the main group who however had no chondrotoxic symptoms while alive. That means that the difference is statistically and clinically insignificant.

[Pathomorphology of extrarenal alterations in hemolytic-uremic syndrome in children]. / Patomorfologiia vnepochechnykh izmenenii pri gemolitiko-uremicheskom sindrome u detei.

Extrarenal alterations were studied in 64 cases of hemolytic-uremic syndrome (HUS) in children aged from 17 days to 4 years. Three groups are distinguished depending on the presence of acute renal failure (ARF) or induced by its treatment. Thrombotic microangiopathy which was present in the acute stage of the disease in the colon, pancreas, brain, spleen, liver represented the first group. The second group included extrarenal alterations associated with ARF-hyperhydration of organs and tissues with accumulation of the liquid in the serous cavities, dilatation of the heart cavities and myocardial hypertrophy, brain hemorrhages, hemorrhagic diathesis, immunodepression of immunogenesis organs. The third group of the extrarenal alterations induced by the ARF treatment was characterized by infectious and iatrogenic complications.

[Pathomorphology of the kidneys in hemolytic-uremic syndrome in children]. / Patomorfologiia pochek pri gemolitiko-uremicheskom sindrome u detei.

The kidneys were studied morphologically in 64 cases of hemolytic-uremic syndrome (HUS) in children aged from 17 days to 4 years. Three variants of the kidney alterations are distinguished depending on the duration of acute renal failure (ARF): early, late and delayed alterations. Early alterations were observed if ARF lasted for 1-10 days and were characterized by glomerular thrombotic microangiopathy with disturbance of the nephron proximal part function resultant from microcirculatory damage. Late kidney alterations (11-20 days of ARF) consisted of glomerular thrombi fibrinolysis, development of mesangial cell proliferation and mesangiolysis, proximal tubular epithelium regeneration and the appearance of nephrohydrosis resulting from the distal nephron part obstruction by hyalin cylinders. Delayed alterations (21-62 days of ARF) manifested with predominant atrophic and sclerotic processes. The first variant corresponded to the acute course of HUS while the two last variants to the subacute one.

[Thrombotic thrombocytopenic purpura in children]. / Tromboticheskaia trombotsitopenicheskaia purpura u detei.

An analysis of 4 cases of the thrombotic thrombocytopenia in children of 4 to 10 years of age is performed. The disease was characterized by fever, purpura, headache and abdominal pains, arterial hypertension, microangiopathic haemolytic anemia, thrombocytopenia, increase of blood urea and serum creatinine, micro-haematuria and proteinuria. The duration of the disease was from 4 days to 7 months. Anuria, gangrene of the ears, scrotum, penis and soft tissues of legs and feet were registered in a 5-year-old patient with a fulminant disease. The cause of death of other patients was heart failure with acute lung oedema, brain haemorrhages and haemorrhagic pancreonecrosis. The diagnosis of the thrombotic thrombocytopenia was confirmed by the finding in the autopsy material of thrombotic microangiopathy of small arteries, veins, arterioles, venules and capillaries in kidneys and other organs and tissues. Kidney damage in fulminant disease is complicated by segmentary cortical necrosis, in a more prolonged disease--by glomerulosclerosis or mesangio-capillary glomerulonephritis.

[A method for obtaining a long-lived intestinal tissue culture]. / K metodike polucheniia dolgozhivushchei intestinal'noi kul'tury tkani.

The interest in the studies of the intestines using the method of tissue organ culture has considerably grown in recent years. It can be explained by the great possibilities of obtaining unique data about the state of intestines in normal and pathological condition, e.g. malabsorption syndrome. The paper deals with the method modified by the authors to obtain long-living (24 hours) intestinal tissue organ culture. The investigations used bioptic sections which were obtained by jejunoscopy with spot biopsy of children suffering from intestinal malabsorption. The viability of the explants was proved by histological and histochemical tests. The promise held by the methods is emphasized.

[Morphology of Chediak-Higashi syndrome]. / Morfologiia sindroma Chediaka-Khigasi.

The authors observed two boys born to cousin sib parents. The boys presented with a variant of primary immunodeficiency--Chediak-Higashi syndrome. The diagnosis was based mainly on the presence of giant azurophil granulations in proband phagocytes. The disease studied morphologically ran a specific course with development of reactive generalized histiocytosis and erythrophagia. The latter are thought to arise in response to defective phagocytosis. The patients suffered recurrent infections from which they died.