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The aim of the study was to determine changes in the content of matrix metalloproteinases (MMP) and their tissue inhibitor in children with uncomplicated compression fractures of the spine (UCFS). Materials and methods. Eighty-five children, including 69 patients with UCFS (average age 12.3 ± 2.6 years), were comprehensively examined. The reference group consisted of 16 children (average age 11.8 ± 2.7 years) without spinal pathology. During the diagnostic period for 1-3 days, changes in the MMP content and their tissue inhibitor (TIMP-1) in blood serum were determined by the enzyme immunoassay method in all children after trauma. Results. It was found that in the acute period after spinal injury, the blood levels of gelatinases (MMP-2 and MMP-9), stromelysin (MMP-3), and collagenases (MMP-8) significantly increased compared to their levels in children of the reference group. At the same time, the levels of TIMP-1 and the ratio of MMP/TIMP-1 concentrations in the blood of patients with UCFS significantly decreased compared to the control, which indicates the predominance of the proteolytic effect of MMP. Analysis of changes in the content of MMP in the blood in UCFS boys and girls did not reveal significant differences in the levels of the studied MMP and TIMP-1, except for a significant increase in the concentrations of stromelysin (MMP-3) in the blood serum of boys compared with its level in girls and the control. With different severity of the course of UCFS in children, a significant increase in MMP concentrations associated with an increase in the severity of the injury was revealed, and a substantial decrease in the content of TIMP-1 in the blood of patients compared to its levels in children with 1-2 degrees of severity and control. Conclusion. The established patterns indicate that the determination of the content of MMR and TIMP-1 in the blood in UCFS children allows monitoring the course of the reparative process after injury to the vertebral bodies in children.

Introduction. Hemangiomas in infants at their first weeks of life can quickly progress and lead not only to the disfigurement of appearance, but also to serious complications, like bleeding, ulceration, suppuration and other negative consequences. Purpose. To have good clinical and aesthetic results in children with cavernous hemangiomas using the technique of interstitial selective laser photodestruction. Material and methods. In 2016 - 2018, focal forms of hemangiomas were registered in 140 children aged 1 month-16 years who were consulted in the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma. The technique of interstitial selective laser photodestruction was selected for surgical treatment in all patients (RF Patent №2016110843 dated 04.09.2017). Two-wave laser surgical apparatus LSP IRE-Polyus (Russia) with wavelengths 0.97 μm and 1.56 μm was used. All 140 patients had ultrasound examination of their vascular formations and other preoperative procedures . The surgical intervention was performed in the hospital under general anesthesia. 131 of patients had planned operations and 9 of them had urgent operations because of hemangioma bleeding. Results. Long-term outcomes have shown that in 100% of cases we achieved good clinical result with no residual hemangioma elements; in the majority of cases (69%) the optimal aesthetic result was achieved; and in 31% of cases we had satisfactory outcomes by the criteria of aesthetic effectiveness. Conclusions. Interstitial selective laser photodestruction is the best option to radically treat focal forms of hemangiomas in children.

Introduction. Pyogenic granuloma (PG), a benign vascular tumor of the skin of inflammatory etiology, is often met in children. Complications of this pathology (ulceration and bleeding) are seen in 7.5% of cases. Material and methods. 67 patients were operated on for pyogenic granulomas. 22 patients had bleedings. Before surgery, all patients had sonography with color Doppler mapping of this vascular formation. 57 children had a planned surgery and were operated under topical anesthesia in the outpatient unit. 10 patients on admission had bleedings from pyogenic granulomas. After conservative arresting the bleeding, 7 patients out of these 10 had urgent surgery; in other three children with severe bleeding hemostasis was not achieved conservatively, and they were immediately operated on. All urgent surgical interventions were made under local anesthesia in an outpatient operating room. Patients with emergency cases, were younger than 3 y.o. They were operated in the operation room in the hospital under general anesthesia. Pyogenic granulomas in all 67 patients were removed by the technique of interstitial selective laser photodestruction, the prototype of which was “Method for treating cavernous forms of hemangiomas in children” developed and patented in CRIEPST. For this surgical intervention, two-wave laser surgical device “IRE-Polyus” (Russia), with wavelength of 0.97 mkm and 1.56 mkm was used. Results. Postoperative period in all patients was uneventful, with complete healing of wound defect in 10-12 days; no recurrences of vascular formation or its residual elements were observed in any case. All 67 patients had good clinical and aesthetic results after the applied surgical technique. Conclusion. To prevent complications in children with pyogenic granulomas, surgical treatment with the technique of interstitial selective laser photodestruction adapted for this pathology is recommended. The described interstitial selective laser photodestruction radically removes pathological tissues of pyogenic granulomas and ensures reliable hemostasis, what leads to good clinical and aesthetic results in treating the discussed group of patients both in inpatient and outpatient settings.

Introduction. Testicular torsion is an emergency condition requiring emergency medical care. Polymorphism of symptoms in testicular torsion makes diagnostics not easy and leads to late treatment what can results in irreversible damages to the testicle. Early diagnostics is a key point to organ preservation. Material and methods. The authors describe two clinical cases of testicular torsion in adolescents with errors in diagnostics. Clinical, laboratory findings and instrumental examination (MRI, ultrasound) were used for diagnostics. Results. A diagnostic error resulted in orchectomy which was made to one patient. In the other patient - despite a diagnostic error- testiclular detorsion and urgent surgical intervention resulted in patient’s complete recovery. Discussion. These examples illustrate how important is to carefully study the patient’s case-history - onset and nature of pain, associated vegetative symptoms - nausea and vomiting - which are not characteristic for other acute testicular diseases. Conventional tactics of urgent surgical intervention for all acute testicular diseases in children does not insure against diagnostic errors in case of testicular torsion with atypical symptoms. Ultrasound examination is of irreplaceable value, but one cannot be guided only by its findings in excluding testicular torsion. Conclusion. Any of the symptoms of testicular torsion - whether it is acute onset or severe pain, or a combination with vomiting, or severe pain on palpation, or ultrasound findings - is a reason to suspect testicular torsion and, it is an absolute indication for urgent surgery. The protocol for diagnostics and treatment of acute testicular diseases developed by us includes these diagnostic peculiarities and allows to choose an effective treatment modality.

Introduction. Despite the modern development of surgery complications and relapses after the surgical treatment of children with a pathology of the vaginal process of the peritoneum continue to occur in the practice of the pediatric surgeon. The aim is to determine the causes of complications and relapses after the surgical treatment of children with the pathology of obliteration of the vaginal process of the peritoneum. Material and methods. The article presents the results of surgical treatment of 1818 children with the pathology of the vaginal process of the peritoneum, including 32 children with complications and relapses occurred after surgical interventions. Two clinical observations of children of 10 and 14 years were operated on for recurrence of an inguinal hernia and hydrocele are described. Results. The frequency of relapses or complications in the Research Institute of Emergency Pediatric Surgery and Traumatology after surgical treatment of children with inguinal hernias, hydrocele and cryptorchidism ranged from 1.5% to 2.3%. Conclusions. Non-adherence to surgical treatment causes recurrences and complications.

Capillary angiodysplasia of the skin presents by itself pathologically dilated capillaries located under the basal zone of the growth of the epidermis. There are many options for the correction of this vascular pathology of the skin, including general and local methods. In recent years, laser treatments for capillary angiodysplasia have become widespread. According to many authors, the most effective and promising method is laser photodestruction by radiation of the yellow-green spectral range. Unfortunately, the optimal ranges of the parameters of exposure to laser radiation in the treatment of specific forms of capillary angiodysplasia of the skin, taking into account nature and age characteristics of the skin in children, have not yet been determined.

A renal calyceal diverticulum is a cystic cavity within the renal parenchyma, which is lined by transitional epithelium and communicates with the calyx or, more rarely, the renal pelvis. In children, this anomaly is extremely rare. The article describes the resection of the middle calyceal diverticulum in an 8-year-old child using retroperitoneoscopic access.

It is well known that aging is the natural growing multisection biological process inevitably leading to limitation of body adaptive capabilities. The body ageing is the result of self-regulation mechanism limitation, reduction of their potential capabilities at molecular-genetic, energetic, cellular and general-regulatory levels. It should be noted that due to lack of the unified theory of aging the importance of nutrition factor has been acknowladged particularly initiation and intensity of the process, and the role of antioxidants is discussed much in detail. As the result of long term investigations at model and natural objects the technologies of powder and condensed sterilized gerodietetic milk based preserved foods have been developed. The multicomponent receipts modules balanced by fatty-acid and amino-acid composition as well as enriched with lycopene have been theoretically substantiated and realized. The new gerodietetic products are characterized by the following coefficients of RL3/RL6 not less than for the products: powdered - 0.871/0.615 and condensed sterilized - 0.883/0.648. The following amino-acid balance of Rp/σ protein for the products: powdered - 0.46/15.00, condensed -0.44/15.76 has been obtained. The obtained velues of the balanced criteria of the protein-lipid composition of the product are higher comparing to similar values for milk fat and protein. Two lycopene dosages in the products are provided: prophylactic - 5 mg and antioxidant - 1.5 mg in 400 ml of the reconstituted milk. On the basis of the carried out studies two technologies of the manufacture of condensed milk gerodietetic products adapted to actual conditions of concentrated milk factories have been developed.