Conduction studies of phrenic nerve in healthy children

Background. Unlike parameters of phrenic nerve conduction in healthy adults characterized by stability, in children variations with age are observed. The objective is to investigate the M-wave latency and amplitude in electroneurographic (ENG) examination of the phrenic nerve in healthy children of different ages for development of a normative database of neurophysiological data.Materials and methods. 48 healthy children (28 girls and 20 boys) were examined. Mean age was 9.19 ± 5.43 years (1–18 years). ENG examination of the phrenic nerve was performed with the modified standard procedure of stimulation at the level of the outer margin of the lower third of the sternocleidomastoid muscle with registration of M-wave from standard diaphragm point and parallel registration of the muscle activity from m.deltoideus and m.serratus anterior.Results. Mean values of the M-response latency were 5.64 ± 1.25 ms, amplitude – 0.66 ± 0.34 mV. For age-differentiated subgroups 1–2 years (n = 7), 3–5 years (n = 9), 6–12 years (n = 15), and 13–18 years (n = 17), the latency was 4.96 ± 1.94; 5.01 ± 1.13; 5.42 ± 0.84, and 6.44 ± 1.43 ms, respectively; the amplitude was 1.01 ± 0.37; 0.87 ± 0.31; 0.61 ± 0.24, and 0.45 ± 0.21 mV, respectively. The M-response amplitude values in children aged 1–2 years significantly differed from the values in children aged 6–12 and 13–18 years.Conclusion. ENG examination of the phrenic nerve is a technically uncomplicated procedure, and the obtained data is easy to interpret. During phrenic nerve ENG in children, it is necessary to take age variability of the M-wave latency and amplitude into account. The M-wave amplitude in healthy toddlers (1–2 years old) was significantly lower than in children aged 6–18 years

Электронейрографическое исследование диафрагмального нерва у здоровых детей

Background. Unlike parameters of phrenic nerve conduction in healthy adults characterized by stability, in children variations with age are observed. The objective is to investigate the M-wave latency and amplitude in electroneurographic (ENG) examination of the phrenic nerve in healthy children of different ages for development of a normative database of neurophysiological data.Materials and methods. 48 healthy children (28 girls and 20 boys) were examined. Mean age was 9.19 ± 5.43 years (1–18 years). ENG examination of the phrenic nerve was performed with the modified standard procedure of stimulation at the level of the outer margin of the lower third of the sternocleidomastoid muscle with registration of M-wave from standard diaphragm point and parallel registration of the muscle activity from m.deltoideus and m.serratus anterior.Results. Mean values of the M-response latency were 5.64 ± 1.25 ms, amplitude – 0.66 ± 0.34 mV. For age-differentiated subgroups 1–2 years (n = 7), 3–5 years (n = 9), 6–12 years (n = 15), and 13–18 years (n = 17), the latency was 4.96 ± 1.94; 5.01 ± 1.13; 5.42 ± 0.84, and 6.44 ± 1.43 ms, respectively; the amplitude was 1.01 ± 0.37; 0.87 ± 0.31; 0.61 ± 0.24, and 0.45 ± 0.21 mV, respectively. The M-response amplitude values in children aged 1–2 years significantly differed from the values in children aged 6–12 and 13–18 years.Conclusion. ENG examination of the phrenic nerve is a technically uncomplicated procedure, and the obtained data is easy to interpret. During phrenic nerve ENG in children, it is necessary to take age variability of the M-wave latency and amplitude into account. The M-wave amplitude in healthy toddlers (1–2 years old) was significantly lower than in children aged 6–18 years.Введение. В отличие от параметров проведения по диафрагмальному нерву у здоровых взрослых, которые отличаются устойчивостью, у детей в норме с возрастом наблюдается разброс показателей.Цель исследования – изучение латентности и амплитуды М-ответа при электронейрографическом (ЭНГ) исследовании диафрагмального нерва у здоровых детей разного возраста для создания нормативной базы нейрофизиологических данных.Материалы и методы. Обследованы 48 здоровых детей (28 девочек и 20 мальчиков). Средний возраст составил 9,19 ± 3,43 года (1–18 лет). ЭНГ-исследование диафрагмального нерва проводили с использованием модифицированной 3-канальной регистрации М-ответа с диафрагмы при стимуляции правого диафрагмального нерва в области внешнего края нижней трети грудино-ключично-сосцевидной мышцы при параллельном контролировании наличия вызванных ответов с дельтовидной, передней зубчатой мышц, что позволяет избежать нежелательных артефактов исследования.Результаты. Получены средние значения латентности М-ответа 5,64 ± 1,25 мс и амплитуды – 0,66 ± 0,34 мВ. При разделении группы детей на возрастные подгруппы 1–2 года (n = 7), 3–5 лет (n = 9), 6–12 лет (n = 15) и 13–18 лет (n = 17) латентность составила 4,96 ± 1,94; 5,01 ± 1,13; 5,42 ± 0,84 и 6,44 ± 1,43 мс и амплитуда – 1,01 ± 0,37; 0,87 ± 0,31; 0,61 ± 0,24 и 0,45 ± 0,21 мВ соответственно. Показатели амплитуды М-ответа у детей 1–2 лет достоверно отличались от таковых у детей в возрасте 6–12 и 13–18 лет. Заключение. ЭНГ-исследование диафрагмального нерва является простым в исполнении и интерпретации результатов методом. При проведении ЭНГ диафрагмального нерва у детей необходимо учитывать возрастную вариабельность латентности и амплитуды М-ответа. Показатели амплитуды М-ответа у здоровых детей раннего возраста (1–2 года) достоверно выше таковых у детей 6–18 лет

Акустические стволовые вызванные потенциалы в прогнозировании восстановления нарушенных функций после перенесенного острого бактериального менингита у детей

Aim of our work was to evaluate the prognostic value of brainstem auditory evoked potentials (BAEPs) for the recovery period outcomes in children with acute bacterial meningitis.Methods. 65 patients with acute bacterial meningitis (average age 3 years, range 3 months-17 years) and 20 healthy controls of comparable age were evaluated with BAEPs. I-V and III-V intervals, amplitudes of the III and V peaks were registered and analyzed. During the recovery period prolonged neurologic observation was performed for the period of 1-6 years. Severe ataxia, pareses, symptomatic epilepsy, speech disturbances and intellectual impairments were regarded as signs of psycho neurologic deficit. ROC-analysis was performed to evaluate sensitivity and specificity of BAEPs parameters in predicting the occurrence of these signs.Results. There were statistically significant difference between the groups on the parameters of I-V interpeak interval and amplitudes of III and V peaks. ROC-analysis revealed that I-III, I-V interpeak intervals and amplitudes of III and V peaks were sensitive and specific in the predicting of the psycho neurologic deficit in the recovery period. Thus, these parameters may be used as a prognostic tool for predicting of such outcomes in acute meningitis in children.Целью работы явилось изучение значимости акустических стволовых вызванных потенциалов (АСВП) для прогнозирования течения реконвалесценции после перенесенного бактериального гнойного менингита у детей.Материалы и методы. В 2010–2016 гг. в ОРИТ НИИДИ обследованы с помощью акустических стволовых вызванных потенциалов (АСВП) 65 пациентов детского возраста (средний возраст 3 года) на 2–3-е сутки течения острого бактериального менингита и 20 неврологически здоровых детей. АСВП проводилось по стандартной методике с оценкой межпиковых интервалов I–III, III–V, I–V и амплитуды III, V пиков и соотношения I/III и III/V. Впоследствии осуществлялось катамнестическое наблюдение в течение 1–6 лет с оценкой характера течения периода восстановления. Выраженная атаксия, развитие двигательного дефицита (парезы), симптоматическая эпилепсия, интеллектуально-мнестические и речевые нарушения в периоде восстановления расценивались как признаки наличия психоневрологического дефицита.Результаты. Группы достоверно отличались по показателям продолжительности интервала I–V и по амплитуде III и V пиков. По данным ROC-анализа выявлено, что удлинение интервала I–III и интервала I–V, снижение амплитуды III и V пиков обладало достаточной чувствительностью и специфичностью в прогнозировании неблагоприятного течения периода реконвалесценции после перенесенного острого гнойного менингита. Выявление у детей в остром периоде бактериального менингита этих признаков может указывать на развитие психоневрологических нарушений в периоде восстановления

ЛУЧЕВЫЕ МЕТОДЫ ДИАГНОСТИКИ ПРИ ОБСЛЕДОВАНИИ ПАЦИЕНТОВ ПЕРЕД ОПЕРАТИВНЫМИ ВМЕШАТЕЛЬСТВАМИ В БОКОВОМ ОТДЕЛЕ ЛИЦА

The work testifies to the possibilities of ultrasound, magnetic resonance imaging (MRI) and multispiral computed tomography (MSCT) in revealing the formation of parotid salivary glands. Evaluation of the results of MRI and MSCT facilitates preoperative planning and minimizes postoperative complications in operations in the side of the face. Modern methods of radiation diagnosis are indispensable for the dynamic control of possible recurrences of tumors of the parotid salivary glands. The purpose of this study was to improve radiation methods of examination in the complex preoperative preparation and intraoperative management of patients with pathology of the side facial.Работа свидетельствует о возможностях ультразвукового исследования (УЗИ), магнитно-резонансной томографии (МРТ) и мультиспиральной компьютерной томографии (МСКТ) в выявлении образований околоушных слюнных желез. Клиническая оценка результатов МРТ и МСКТ облегчает предоперационное планирование и минимизирует послеоперационные осложнения при операциях в боковом отделе лица. Современные методы лучевой диагностики незаменимы для динамического контроля возможных рецидивов опухолей околоушных слюнных желез. Целью данного исследования явилось совершенствование лучевых методов обследования в составе комплексной предоперационной подготовки и интраоперационного ведения пациентов с патологией бокового отдела лица

Brainstem auditory evoked potentials as the prognostic tool of the functional recovery in children after acute bacterial meningitis

Aim of our work was to evaluate the prognostic value of brainstem auditory evoked potentials (BAEPs) for the recovery period outcomes in children with acute bacterial meningitis.Methods. 65 patients with acute bacterial meningitis (average age 3 years, range 3 months-17 years) and 20 healthy controls of comparable age were evaluated with BAEPs. I-V and III-V intervals, amplitudes of the III and V peaks were registered and analyzed. During the recovery period prolonged neurologic observation was performed for the period of 1-6 years. Severe ataxia, pareses, symptomatic epilepsy, speech disturbances and intellectual impairments were regarded as signs of psycho neurologic deficit. ROC-analysis was performed to evaluate sensitivity and specificity of BAEPs parameters in predicting the occurrence of these signs.Results. There were statistically significant difference between the groups on the parameters of I-V interpeak interval and amplitudes of III and V peaks. ROC-analysis revealed that I-III, I-V interpeak intervals and amplitudes of III and V peaks were sensitive and specific in the predicting of the psycho neurologic deficit in the recovery period. Thus, these parameters may be used as a prognostic tool for predicting of such outcomes in acute meningitis in children

Spinal muscular atrophy in a child with manifestations of acute flaccid paralysis

The article presents the state of the problem of acute flaccid paralysis (AFP) in the world and Russia. It emphasizes the relevance of clinical and epidemiological surveillance of all diseases accompanied by AFP syndrome in children under 15 years of age. A clinical observation of a child diagnosed with spinal muscular atrophy is used as an example to consider the differential diagnosis of AFP and hereditary neuromuscular diseases

The Phobos information system

We have developed a Geo-information system (GIS) for Phobos, based on data from the Mars Express and Viking Orbiter missions, which includes orthoimages, global maps, terrain- and gravity field models, all referenced to the Phobos coordinate system. The data are conveniently stored in the ArcGIS software system, which provides an environment for mapping and which allows us to carry out joint data analysis and miscellaneous data cross-comparisons. We have compiled catalogs of Phobos craters using manual and automated techniques, which includes about 5500 and 6400 craters correspondingly. While crater numbers are biased by available image data resolution and illumination, we estimate that our catalog of manually detected craters contains all Phobos craters with diameters D>250 m which is a total of 1072 and catalog of automated detected craters are complete for craters D>400 m (360 craters). Statistical analysis of these large craters reveals a surplus of craters on the anti-Mars hemisphere, whereas differences in crater abundance between leading and trailing hemisphere cannot be confirmed. This in contrast to previous papers, where no such asymmetry was found ( Schmedemann et al., 2014). But we cannot rule out remaining biases due to resolution, viewing angles or illumination effects. Using digital terrain model (DTM) derived from photogrammetry image processing we estimate depths of 25 craters larger than 2 km using geometric and dynamic heights (for discussion of Phobos crater morphometry see Kokhanov et al., 2014). We also have compiled catalogs of lineaments, and boulders. In particular, we mapped 546 individual grooves or crater chains, which extend in length from 0.3 km to 16.2 km. We identified and determined the sizes and locations of 1379 boulders near crater Stickney. Cross-comparisons of gravity field models against distribution patterns of grooves and boulders are currently under way and may shed light on their possible origins. Finally, we have developed a Geo-portal, which allows the science community to conveniently search for, analyze, and download data of interest from our system. Additionally we provide access to color electronic maps (e-maps) with support for layers based on Phobos geodatabase and ArcGIS tools