Summary and analysis of Russian and international requirements for the safe management of very low level radioactive waste and production waste containing very low active radionuclides.

This article gives an overview of Russian legislation and international recommendations on the safe management regulation of the accumulated very low level radioactive waste (RW), provides the comparison of Russian and international criteria for RW attribution to this or that class and also the existing radiation safety requirements. This article also deals with the difficulties in management of production waste containing radionuclides. Criteria and standards were selected from international (ICRP and IAEA publications) and Russian (Federal Law on Management of Radioactive Waste, Government Decree on Radioactive Waste Classification, The Basic Sanitary Rules of Radiation Safety) documents for comparative analysis. International and Russian criteria for the radioactive materials attribution to RW and production waste containing radionuclides were compared during the analysis. A number of radionuclides for which it is necessary to establish such criteria have been identified. It was found that Russian classification of radioactive materials is generally consistent with IAEA classification. Practices of managing production waste containing radionuclides (protection from contact with the environment, the placement in the long-term storage facilities or disposal) depend on the period of potential hazard of radionuclides. The management of production waste containing radionuclides requires a separate system which should be developed in accordance with the RW management system.

Loss of lamin A function increases chromatin dynamics in the nuclear interior.

Chromatin is organized in a highly ordered yet dynamic manner in the cell nucleus, but the principles governing this organization remain unclear. Similarly, it is unknown whether, and how, various proteins regulate chromatin motion and as a result influence nuclear organization. Here by studying the dynamics of different genomic regions in the nucleus of live cells, we show that the genome has highly constrained dynamics. Interestingly, depletion of lamin A strikingly alters genome dynamics, inducing a dramatic transition from slow anomalous diffusion to fast and normal diffusion. In contrast, depletion of LAP2α, a protein that interacts with lamin A and chromatin, has no such effect on genome dynamics. We speculate that chromosomal inter-chain interactions formed by lamin A throughout the nucleus contribute to chromatin dynamics, and suggest that the molecular regulation of chromatin diffusion by lamin A in the nuclear interior is critical for the maintenance of genome organization.

[Current possibilities of radiodiagnosis in liver tumors].

The report deals with potential of present-day techniques for radiological imaging, differential diagnosis and working out of modalities of treatment for primary and metastatic hepatic tumors. Results of complex examination (ultrasound, CT, MRI, PET using fluorine -18 FDG) of patients with benign and malignant tumors are discussed. Sensitivity and specificity of each procedure have been identified to be used in diagnosis of large-size tumors.

[Role of current MRI technology in the diagnosis of pancreatic tumors]. / Rol' sovremenykh tekhnologii MRT v diagnostike opukholei podzheludochnoi zhelezy.

The Magnetom Vision unit (Siemens) with 1.5 T magnetic field and a Body surface coil was used to examine 87 patients with pancreatic tumors, adenocarcinoma--56, cystadenoma--3, and chronic pancreatitis--28. Magnetic resonance cholangiopancreatography (87), dynamic contrast-enhanced MRI (56) and MR angiography of the abdominal cavity (21) were used in conjunction with the paramagnetic drugs Magnevist (Shearing) or Omniscan (Nikomed). All necessary data for diagnosis and planning of surgical treatment of pancreatic tumors were obtained during a single examination due to complex use of present-day MRI techniques.

Corticosteroid treatment of severe, non-responsive Clostridium difficile induced colitis.

Clostridium difficile can cause inflammatory diarrhoea and colitis by disrupting normal colonic flora. Corticosteroids are effective against diarrhoea associated with inflammatory bowel disease, but their effectiveness in treating inflammatory diarrhoea of C difficile has not been reported. In this preliminary report, we describe the use of corticosteroids in a child with severe C difficile diarrhoea and colitis refractory to standard treatments.

[Use of magnetic resonance imaging in surgical hepatology]. / Primenenie magnitno-rezonansnoi tomografii v khirurgicheskoi gepatologii.

Three hundred and ninety eight patients with different diseases of the liver and biliary tract were examined on the basis of the complex use of latest technologies of magnetic resonance imaging (dynamic contrast MRI, MR-arterio- and venoportography, MR-cholangiopancreatography), which yield all necessary information during one study to design surgical treatment. The study was conducted by using a Magnetom Vision 1.5T apparatus (Siemens). The advantages of the technique over invasive X-ray studies are shown. Different MRI procedures have been ascertained to be highly diagnostically effective in evaluating hepatic and biliary diseases.

Celiac disease presenting with microcephaly.

A 15-month-old girl with celiac disease presented with microcephaly and developmental delay. Head growth resumed during a gluten-free diet. Subsequent gluten ingestion resulted in no head growth, areflexia, and increased celiac antibodies. All resolved with gluten elimination. Poor head growth may precede other clinical manifestations of celiac disease.

Laparoscopy in the management of children with chronic recurrent abdominal pain.

BACKGROUND AND OBJECTIVES: The purpose of the present study was to evaluate the results of diagnostic laparoscopy in children with chronic recurrent abdominal pain. PATIENTS AND METHODS: Thirteen children with chronic recurrent abdominal pain were subjected to diagnostic laparoscopy. Ages varied from 10 to 17 years. There were six males and seven females. Abdominal pain was present from 3 weeks to 12 months (mean, 2 months). Extensive laboratory and imaging studies did not contribute to the diagnosis. In all patients, the pain was disabling and severe enough to warrant repeated visits to the pediatrician, emergency room visits, or hospital admissions, as well as absence from school. RESULTS: All children recovered uneventfully. Laparoscopic findings that identified the cause of abdominal pain were obtained in 12 of 13 patients. Laparoscopic appendectomy was done in all patients. There were no operative complications. One child presented three months later with incomplete small bowel obstruction, which resolved with conservative management. There were no other postoperative complications. Follow-up varied from six months to three years. Abdominal pain resolved in ten patients. One patient presented eight months later with biliary dyskinesia. She improved following laparoscopic cholecystectomy and later on sphincterotomy, but her pain has not yet completely resolved. One patient presented six months later with abdominal pain secondary to intestinal adhesions. Her pain completely resolved after laparoscopic lysis of adhesions. A third patient who developed lower abdominal pain six months after laparoscopy improved with conservative management and antibiotics for pelvic inflammatory disease. CONCLUSIONS: Diagnostic laparoscopy is a valuable procedure in the management of children with chronic recurrent abdominal pain. In the present study, laparoscopic examination revealed the cause of abdominal pain in most patients, and this pain resolved in most cases. Based on our experience, we recommend diagnostic laparoscopy early in the course of debilitating chronic recurrent abdominal pain in children. Appendectomy should be done when no other significant cause of abdominal pain has been identified, even if the appendix looks normal.

Nonspecific esophageal motility disorders in children without gastroesophageal reflux.

BACKGROUND: Nonspecific esophageal motility disorders (NEMDs) have been identified in up to 50% of adults with noncardiac chest pain or dysphagia. This study sought to determine the incidence of NEMDs in children with upper gastrointestinal tract symptoms and to evaluate the clinical course of pediatric patients with these manometric abnormalities. METHODS: The study involved 154 children aged 4 to 18 years (mean age, 11.6+/-2.6 years [SE]) who had upper gastrointestinal, swallowing-related symptoms. The children were evaluated by 24-hour intraesophageal pH monitoring, esophageal manometry, and esophagogastroduodenoscopy. RESULTS: Gastroesophageal reflux (GER) was diagnosed by pH study in 109 (71%) of 154 patients, and examination of biopsy specimens demonstrated esophagitis in 70 children with GER. Results of esophageal manometry were abnormal in 30 (67%) of 45 children without GER. A variety of motility disorders were diagnosed in 17 of the patients without GER, whereas NEMDs were diagnosed in the remaining 13 children (mean age, 10.6+/-2.7 years; 10 boys, 3 girls). Patients with GER showed normal esophageal wave propagation; however, mean lower esophageal sphincter pressure was significantly lower in patients with GER than in children with NEMDs. The children with NEMDs exhibited a diverse array of symptoms, including esophageal food impaction in 4 of the 13 patients. During a 36.2+/-4.3-month follow-up period, no correlation was found between therapeutic intervention and clinical course in the 13 patients with NEMDs. Symptomatic improvement occurred in 6 of 13 patients, including 3 children for whom no pharmacologic therapy was prescribed. CONCLUSIONS: These data indicate that NEMDs represent a common group of esophageal manometric abnormalities in children with upper gastrointestinal tract symptoms and without GER. Food impaction appears to be a relatively frequent complication, and NEMDs should be considered in children who have this finding.

[Diagnostic possibilities of magnetic resonance cholangiopancreatography]. / Diagnosticheskie vozmozhnosti magnitno-rezonansnoi kholangiopankreatografii.

Studies for 39 patients have been done with the use of a new non-invasive method of observation--MR cholangiopancreatography,--that enables to get a high contrast-enhanced image of the intrahepatic, extrahepatic and pancreatic ducts without administration of the contrast agents and invasive interventions. High diagnostic efficiency of the method has been proved in patients with diseases of bile ducts and pancreas. The observation technique has been optimized and semiotics has been clarified in cases of various diseases that cause on obstruction of the biliferous tracts. The advantages of this method has been showed as compared to invasive roentgenologic methods of examinations.

[The role of dynamic contrast magnetic resonance tomography in the complex radiation diagnosis of focal hepatic lesions]. / Rol' dinamicheskoi kontrastnoi magnitno-rezonansnoi tomografii v kompleksnoi luchevoi diagnostike ochagovykh porazhenii pecheni.

The results of complex radiation study of 269 patients with various focal hepatic diseases were analyzed. Present day methods of radiation study were used. Dynamic contrast magnetic resonance imaging (DCMRI) was made in 62 patients. It is concluded that DCMRI is higher sensitive in detecting focal hepatic diseases than other techniques. The time course of changes in signal intensity in different abnormalities greatly differs in quantitative and qualitative parameters, which differentiates the nosological nature of the revealed changes to a high accuracy.

Gastrointestinal problems in a child with dyskeratosis congenita.

We describe a pediatric patient with dyskeratosis congenita, whose symptoms included abdominal pain, vomiting, dysphagia, and hematochezia. Gastrointestinal symptom are prominent in this rare genetic disorder.

[Magnetic resonance tomography using the contrast preparation Magnevist]. / Magnitnaia rezonansnaia tomografiia s ispol'zovaniem kontrastnogo preparata magnevist.

The diagnostic possibilities of magnetic resonance tomography (MRT) using the contrasting agent magnevist were assessed by the examination of 282 patients with diseases of various organs and systems. The findings suggest that the contrasting agent magnevist shows its highly diagnostic efficiency particularly in central nervous diseases, among them there are tumors, multiple sclerosis, some vascular abnormalities and cerebral circulatory disorders. The agent used in MPT is also highly effective in identifying diseases of the liver (tumors, cysts), uterine (tumors), prostate (tumors). The valuable diagnostic information was obtained while detecting skeletal and soft tissue tumors and aseptic necrosis of the head of the femur.

Esophageal dysmotility elicited by acid perfusion in children with esophagitis.

OBJECTIVE: To determine the importance of acid reflux-induced dysmotility in the genesis of noncardiac chest pain in children. METHOD: We performed esophageal manometries during intraesophageal perfusion with 0.9% NaCl or 0.1 N HCl in 19 children (age, 14.5 +/- 0.5 yr) with gastroesophageal reflux, biopsy-proven esophagitis, and complaints of at least one episode of chest pain per day. RESULTS: Baseline esophageal motilities were normal in all patients. Eight of 19 children (42%) complained of chest pain during intraesophageal acid perfusion. In three of these eight patients, complaints of chest pain during acid perfusion were temporally associated with "conversion" of previously normal motility patterns to manometric tracings, indicating esophageal dysmotility. Compared with findings during saline perfusion, esophageal acid exposure in these three children resulted in significant increases in both the duration (13.6 +/- 4.0 vs 3.2 +/- 0.2 s, p < 0.05) and amplitude (105.2 +/- 7.8 vs 61.2 +/- 2.1 mm Hg, p < 0.05) of esophageal contractions during wet swallows. Symptoms of chest pain resolved in all patients after therapy with H2-receptor antagonists. CONCLUSIONS: These data represent the first demonstration of acid-induced esophageal dysmotility in children with chest pain and suggest that reflux-induced motor abnormalities contribute to the onset and/or exacerbation of chest pain in pediatric patients with gastroesophageal reflux and esophagitis.

Recurrent benign intracranial hypertension due to iron deficiency anemia. Case report and review of the literature.

PURPOSE: Iron deficiency anemia (IDA) causes benign intracranial hypertension (BIH). PATIENTS AND METHODS: A case of an 11-year-old girl with severe IDA and benign intracranial hypertension is presented. RESULTS: Treatment of iron deficiency resulted in the resolution of BIH. Recurrence of BIH is observed with the recurrence of IDA. Chronic intermittent blood loss from the intestinal polyps was the etiology of recurrent IDA. CONCLUSIONS: A thorough search to determine the etiology of IDA is essential for proper treatment. Although BIH is a rare complication of IDA, its association with IDA should be recognized for prompt treatment before an extensive and costly workup for BIH is done.