[HIRSCHSPRUNG'S DISEASE IN TEENAGERS].

Aim - based on the clincal experience of monitoring and treatment of teenagers with Hirschsprung's disease (HD), to study clinical aspects of the disease in older children and to establish an adequate diagnostic and treatment policy. The paper is based on the analysis of the results of examination and treatment of 26 children with Hirschsprung's disease, who were first diagnosed with the disease at the age of 10 years and older. There were 19 (73.08%) boys and 7 (26.92%) girls. The following diagnostic methods were used: X-ray examination of the large intestine, ultrasonography of the abdominal organs and the large intestine, rectosigmoidoscopy, morphological examination of biopsy material, immunohistological examination for acetylcholinesterase (AChE). Nonparametric statistical methods were used due to the small sample and the prevalence of the analysis of qualitative rather than quantitative criteria. Hirschsprung's disease in older children has a latent course with long periods of functional compensation. The rectal form of pathology predominates (57.69%). The main diagnostic methods are anamnesis, features of the clinical course of the pathology, irrigoscopy, morphological examination of full-thickness rectal biopsies and immunohistochemical examination of the rectal mucosa for AChE. 84,62% of teenagers underwent one-stage surgery without postoperative complications; 15,38% of patients had indications for colostomy.

Surgical treatment of chronic colostasis in children: a ten-year experience.

OBJECTIVE: To analyze our ten year experience of surgical treatment of children with chronic colonostasis of different origin. MATERIAL AND METHODS: The study covers 353 children aged from 1 day to 17 years with colonic stasis who undergo treatment at the Department of Children's Surgery, Bukovinian State Medical University, Cernauti, Ukraine. Study design included case history, physical examination, routine clinical and biochemical laboratory tests, endoscopy (sigmoidoscopy, colonoscopy), X-ray (irrigoscopy, irrigography, other radiopaque techniques) methods, and sphincterometry. RESULTS: Non-surgical treatment was effective in 261 (73.94%) patients. The group of the operated patients consisted of 92 (26.06%) children. The outcome of surgical treatment of Hirschsprung's disease (49 children), dolichosigmoid (29 children), Payr's disease (12 children), and Chilaiditi syndrome in all cases is considered to be satisfactory. The optimal methods of surgical operations are offered according to pathology of colon. CONCLUSIONS: One-step Soave-Boley operation is considered to be the method of choice for rectal and rectosigmoid forms of Hirschprung's disease. Transversal colon resection and phrenico-colic ligament dissection in Payr's disease, hepatopexia and right colon fixation in Chilaiditi syndrome are effective treatment approaches.

Determination of reference values for optical properties of liquid phantoms based on Intralipid and India ink.

A multi-center study has been set up to accurately characterize the optical properties of diffusive liquid phantoms based on Intralipid and India ink at near-infrared (NIR) wavelengths. Nine research laboratories from six countries adopting different measurement techniques, instrumental set-ups, and data analysis methods determined at their best the optical properties and relative uncertainties of diffusive dilutions prepared with common samples of the two compounds. By exploiting a suitable statistical model, comprehensive reference values at three NIR wavelengths for the intrinsic absorption coefficient of India ink and the intrinsic reduced scattering coefficient of Intralipid-20% were determined with an uncertainty of about 2% or better, depending on the wavelength considered, and 1%, respectively. Even if in this study we focused on particular batches of India ink and Intralipid, the reference values determined here represent a solid and useful starting point for preparing diffusive liquid phantoms with accurately defined optical properties. Furthermore, due to the ready availability, low cost, long-term stability and batch-to-batch reproducibility of these compounds, they provide a unique fundamental tool for the calibration and performance assessment of diffuse optical spectroscopy instrumentation intended to be used in laboratory or clinical environment. Finally, the collaborative work presented here demonstrates that the accuracy level attained in this work for optical properties of diffusive phantoms is reliable.

[Objective intraoperative estimation of state of the intestinal transplant prepared for placing into the perineum in experiment].

The work is devoted to experimental investigation and practical application of the objective intraoperative diagnosis method for the intestinal transplant state estimation, which is prepared for descendence to perineum, using modified pulsoximetric data analyser in environment of experimental modelling of abdominoanal rectal resection, resulting in determination of objective indices of the intestinal transplant vital capacity. The method of operative intervention in experiment on laboratory animals is adduced. The expediency of application of modified pulsoximetric data analyser in colorectal surgery was established.

[Clinical sequelae of blood remaining in the intestinal inlet after the hemorrhage]. / Naslidny perebuvannia krovi v prosviti kyshechnyku pislia krovotechi.

In experiment there were revealed significant changes of composition of aerobic and anaerobic microorganisms in the jejunum and ileum mucosa after hemorrhage of middle severity. While application of antibiotics these changes were more pronounced, demanding serious substantiation of its application.

[The surgical treatment of perforated bleeding duodenal peptic ulcer in middle-aged and elderly patients]. / Khirurhichne likuvannia penetruiuchoï krovotochyvoï vyrazky dvanadtsiatypaloï kyshky u khvorykh pokhyloho ta starechoho viku.

The surgical hemostasis method was elaborated and introduced in the clinic according to the data of morphological investigation of bleeding penetrating ulcer of the duodenal ampulla posterior wall in elderly and senile patients.

[Classification and selection of treatment of chronic gastroduodenal ulcer complicated by hemorrhage in elderly and senile patients]. / Klasyfikatsiia i vybir taktyky likuvannia khronichnoï hastroduodenal'noï byrazky, uskladnenoï krovotecheiu u khvorykh pokhyloho ta starechoho viku.

The classification of chronical bleeding gastroduodenal ulcer in elderly and senile patients, considering the blood loss severity and concurrent pathology, was proposed. The tactics of treatment--conservative, operative, or actively-waiting one--was determined according to the classification adduced. The proposed classification application and the tactics of treatment also have permitted to reduce mortality from 15.7 to 11.2%.