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The clinical picture and diagnosis of tumors of the brain in infants of the first year of life are analyzed. Supratentorial tumors predominate (60%) at this age; 76% of the tumors were localized on the midline of the brain and grew into the ventricular system. The tumours were large and always induced the development of concomitant hydrocephalus. The disease was most frequently encountered among boys. The syndrome of progressive hydrocephalus comes to the forefront in the clinical picture and does not differ in clinical signs from that encountered in progressive hydrocephalus of nontumorous genesis. That is why every infant under the age of one year with hydrocephalus should be examined for tumor of the brain to exclude it as the cause. The diagnosis of brain tumors in infants of this age is extremely difficult and is possible only with use of a complex of additional radiocontrast methods of examination.

In 11 patients whose ages ranged from 3 months to 5 years occlusive hydrocephalus of nontumorous genesis was treated surgically with the use of endoscopy. Perforation of the floor of the third ventricle, lamina terminalis, and commissures of the fornices and bougienage of the cerebral aqueduct were carried out. One patients died in the postoperative period, in the other 10 patients the immediate result was good. The follow-up of the catamnesis of 9 patients showed that a stable positive effect was produced in 8 of them. The endoscopic method is simple, causes little trauma, and is sufficiently effective as a method of surgical treatment of hydrocephalus of nontumorous genesis in childhood neurosurgery.

Among 319 patients under the age of three years with tumors of the brain verified by means of contrast X-ray examination, during operation, or on autopsy, 215 had undergone surgery (166 with tumor of the posterior cranial fossa and 84 with tumor of supratentotial localization). From analysis of 176 cases in which X-ray contrast methods of examination were applied it was established that the method is safe and yields sufficient information for making the topic diagnosis of the tumor, determining its blood supply, its relation to the system of the cerebrospinal fluid and for judging the degree of the concomitant internal hydrocephalus and occlusion of the cerebrospinal fluid passages. In addition, these methods help to solve problems of the techniques of surgical intervention or the contraindications for operations. Analysis of the results of 250 operations shows that when the child's condition and the localization of the tumor permit, the surgeon should strive to perform single-stage subtotal or total removal of the tumor because this does not increase postoperative mortality.

Shunting of the cerebrospinal fluid by drainage systems of various design was conducted in 64 children aged from 4 months to 14 years with occlusive processes in the posterior cranial fossa. The occlusion was caused by a tumor in 57 cases and by an arachnoid cyst in 7 cases. All children were related to the high risk group, i. e. the prognosis of direct manipulation on the posterior cranial fossa was poor or doubtful. In 26 children surgery was limited to a shunting operation without subsequent intervention on the posterior cranial fossa. The successful implantation of the drainage system was recorded in 45 children (70.2%). In infants and young children as well as in older ones with sharply manifested hypertensive and secondary stem symptomatology the outcome was much better when the shunting operation was conducted before or at the same time as the intervention on the posterior cranial fossa. The prognosis is poorer in infants and adolescents and in primary tumors of the brain stem.

Ventriculoscopy is a simple, safe and informative method of examination of the lateral and third ventricles of the brain in childhood. In hydrocephalus of non-tumorous origin ventriculoscopy makes its possible, as a rule, to determine the origin of the dropsy and its character. The diagnosis of tumor of the brain of intraventricular or paraventricular localization and also of a tumor growing into the lumen of a cerebral ventricle is made on the basis of direct and indirect signs found during a visual examination. The histological nature of the process may be determined by biopsy of the pathological tissue collected during ventriculoscopy.

Cholecystectomy was carried out in 31 patients with acute cholecystitis within 5-7 days after percutaneous transliver microcholecystotomy. During the operation biopsy was taken from bed of gallbladder and liver left lobe for histological studies. In a part of the biopsy material glucocorticoid receptors of the II and III types were studied, simultaneously with detection of some metabolites and cortisol in blood plasma. Glucocorticoid receptors of the II type were estimated in lymphocytes. Content of glucocorticoid receptors of the II type constituted 20.1 fmole.mg-1 of protein and 16.0 fmole.mg-1 of protein in liver cytosol and in liver bed of gallbladder, respectively; content of the receptors of the III type was equal to 268.0 fmole mg-1 and 329.0 fmole.mg-1 of protein in liver tissue and in liver bed of gallbladder, respectively. In lymphocytes 1223 glucocorticoid receptors of the II type were estimated as compared with 4100 receptors in the cells of healthy persons. Distinct increase in the level of cortisol, cholesterol, glucose and urea was observed in the patients, while total protein and protein fractions were similar to control values. Possible role of glucocorticoid receptors in pathogenesis of acute cholecystitis is discussed.