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Objective. The primary tuberculosis infection in childhood is manifested as a common disease. The diagnostics of liver tuberculosis is still a little-studied problem due to the absence of clinical manifestations.Purpose. To study clinical course, diagnostics and management of liver tuberculosis in children.Material and methods. 5 children, aged from 5 days to 16 years, with liver tuberculosis were under the observation. To put diagnosis, the researchers used the following parameters: anamnesis, examination, laboratory and specific tests, ultrasound, radiological methods including CT, biopsy of the surgical material.Results and discussion. Out of 5 children with liver tuberculosis, 3 had disseminated miliary pulmonary tuberculosis with liver damage; one had liver tuberculosis of the tuberculoma type and one had tumor-like liver tuberculosis. These three observations are described the article. In the diagnostics, basic indexes are CT of the abdominal organs, histological examination of the surgical material and positive Diaskin test.Conclusion. An isolated tuberculous liver damage is a rare case. More often, several anatomical regions are simultaneously involved in the specific process.

Рязанский государственный медицинский университет им. акад. И.П. Павлова, ул. Высоковольтная, 9, 390026, г. Рязань, Российская Федерация В статье приводятся результаты наблюдения (максимальный период -5 лет) 249 детей с костными кистами и опухолями костей, из них у 20,1% детей были диаг-ностированы аневризматические кисты, у 74,3% -доброкачественные и у 5,6% -злокачественные опухоли. Было показано, что дифференцированный подход в лече-нии детей с костными кистами и доброкачественными опухолями костей, вклю-чающий консервативные мероприятия и радикальную хирургическую тактику с применением биоимплантанта «Тутопласт R» и аллотрансплантатов, позволяет по-лучить хорошие и удовлетворительные результаты в 64,0% случаев. Однако, ре-зультаты лечения детей с остеосаркомой до настоящего времени остаются неудовле-творительными: 5-летняя выживаемость без рецидивов зарегистрирована только в 6 из 14 случаев, рецидив заболевания -в 5 случаях, летальный исход -в 8 случаях. По мнению авторов, для улучшения результатов лечения данной группы пациентов не-обходимо повышение онконастороженности врачей общей практики и использова-ние у всех таких пациентов современных комбинированных программ лечения в ус-ловиях специализированных медицинских учреждений. Ключевые слова: кисты костей, доброкачественные опухоли костей, остеосарко-ма, диагностика, лечение, дети. _____________________________________________________________________________ THE RESULTS OF TREATMENT OF BONE CYSTS AND BONE TUMORS IN CHILDREN A.E. Solovyov, O.V. LarichevaRyazan State Medical University, Vysokovoltnaya str., 9, 390026, Ryazan, Russian Federation This article presents the results of observation (maximum period 5 years) of 249 children with bone cysts and bone tumors, of these, 20,1% of children were diagnosed with aneurysmal cysts, 74,3% -of benign tumors and 5,6% -of malignant tumors. It was shown that a differentiated approach in the treatment of children with bone cysts and benign bone tumors, including conservative events and radical surgical tactics with the use of bioimpendance «Tutoplast R» and allografts, allows to obtain good and satisfactory results in 64,0% of the cases. However, the results of treatment of children with osteosarcoma at the present time remain unsatisfactory: the 5-year relapse-free survival was only 6 of 14 cases, recurrence of the disease in 5 cases, fatal in 8 cases. According to the authors, to im-

MATERIALS AND METHODS: Within 20 yrs, 76 children aged 28 yrs with kidney trauma were under observation, and 35 of them had associated trauma. Clinical, instrumental, and radiological methods were used in the diagnosis. RESULTS: Of the 76 children with closed kidney trauma, 23 were diagnosed with kidney contusion, 14 with kidney injury with subcapsular hematoma, 16 with kidney injury with rupture of the capsule and perirenal urohematoma, 21 with kidney rupture and damage to the calyxpelvic system, and 2 with traumatic hydronephrotic kidney. Conservative treatment was carried out in 49 (64.4%) children and surgical treatment in 28 (25.6%). In the long term, 28 children with kidney injuries and treated conservatively were examined. Complications were found in nine children: pyeloectasia, deformation of the calyxpelvic system, pyelonephritis, and renal hypertension. Organ-preserving surgery was performed in 22 (28.9%) children and nephrectomy in 5 (6.6%) children. As long-term results: the function of the operated kidneys was satisfactory, some changes occurred in the calyxpelvic systems, and no data for pyelonephritis was found. CONCLUSION: Renal injuries with subcapsular rupture and perirenal urohematoma should be surgically treated to prevent severe long-term complications. In unclear cases, the choice can be a two-stage organ-preserving operation for the so-called crushing of the kidney.