[Diagnostics and thoracoscopic treatment of pleural empyema in younger children].

174 children of all ages with acute destructive pneumonia complicated with pleural empyema were treated during 10 ten years using videothoracoscopic method; among them 74 children were of younger age (43%). General principles of modern diagnostics and videothoracoscopic pleural cavity sanations were formulated. Ultrasonography and computer tomography of the chest carried out in younger children give possibilities for clear differential diagnostics with other diseases. Advantages of endosurgical treatment are proved. Indications for planned recurrent pleural cavity sanations were worked out.

[The diagnosis and surgical treatment of hydatid disease of the liver in children].

An experience with the diagnosis and surgical treatment of hydatid disease of the liver included 191 patients aged from 2 through 15 years, 26 of them had a combined involvement of the liver and lung, in 7 patients there were combined lesions with other organs. Complicated echinococcosis was noted in 25 children. Ultrasonography was given the main role in the diagnosis. Videolaparoscopic hydatidectomy of the liver was performed in 62 patients. Solitary cysts of small and medium sizes located superficially were considered as indications to operation. In patients with large and gigantic cysts of special significance was capitonnage of the residual cavity. Use of albendazole as an antiparasitic agent for the recurrent disease and a prophylactic agent after operation for multiple and combined hydatid disease of the liver was found to be sufficiently effective.

[Use of the ultrasound investigation after operations on the thoracic cavity in children]. / Ispol'zovanie ul'trazvukovogo issledovaniia posle operatsii na grudnoi polosti u detei.

The author describes the experience with using ultrasound investigation (USI) for detection of complications and dynamic control of the state of organs of the thoracic cavity in the postoperative period in 174 children aged from 2 days to 14 years. The findings of USI were used to determine the strategy of treatment in the postoperative period: expedience of pleural puncture, repeated thoracoscopic sanitation for empyema of the pleura etc. In 3 children hematoma was revealed in the bed of the ablated tumor of the mediastinum, in 1 case--pneumothorax after lung hydatidectomy, in 1 infant after operation a recurrent diaphragmatic hernia was revealed by USI. Thus, echography is thought to be an informative harmless method of diagnosis of complications after operations on the thoracic cavity in children allowing to successfully control the state of the pleural cavity, lungs, and mediastinum and to determine the rational strategy of treatment.

[Ultrasonic diagnosis of lung echinococcosis in children]. / Ul'trazvukovaia diagnostika ékinokokkoza legkikh u detei.

Echography was used for diagnosis of pulmonary hydatid cysts in 62 patients aged from 2 to 14 years. Ultrasonic examination was carried out after detection of focal image on chest survey roentgenogram. A hydatid cyst of lung's inferior lobe was diagnosed occasionally during abdominal echography due to abdominal pains in 8 (12.9%) children. Echographic picture of pulmonary hydatid cysts was different depending on Echinococcus stage, presence of complications (cyst suppuration, drainage into bronchial tree). Echography clearly shows location, shape, contours, sizes, internal structure of cysts, width of dehiscence of pleural layers in reactive pleurisy, state of adjacent pulmonary tissue. US-diagnosis is most valuable after surgery for monitoring of cyst bed state, volume of pleural exudate, possible complications.

[Echography in congenital intestinal obstruction in newborn infants]. / Ekhografiia pri vrozhdennoi neprokhodimosti kishechnika u novorozhdennykh.

The authors used echography in order to reveal typical echographic signs of high and low bowel obstruction in 51 newborns. Although the use of echography often fails to establish the real cause of the bowel obstruction, it allows the determination of its level and in general promotes making the proper diagnosis.

[The comprehensive differentiated protection against influenza and acute respiratory diseases of medical workers in industrial enterprises]. / Kompleksnaia differentsirovannaia zashchita ot grippa i ostrykh respiratornykh zabolevanii meditsinskikh rabotnikov promyshlennykh predpriiatii.

Acute diseases of the respiratory organs rank first among temporary invalidity causes (30.5%). For the first time workers of a health center of an industrial enterprise were protected from influenza and ARVI during an epidemic outbreak of influenza A by specific and nonspecific protection means with due consideration for the subject's health status and will. Comprehensive differentiated protection from influenza and ARVI proved highly effective, its index reaching 2.5 and the invalidity periods being shorter by 2.4-4 days.

[Coagulase-negative staphylococci in pyoseptic pathology and methods for their identification]. / Koagulazootritsatel'nye stafilokokki v gnoinosepticheskoi patologii i metody ikh identifikatsii.

Analysis of clinical material from cardiosurgical and cardiotherapeutic patients and that from neonates with pyoseptic infections, hospitalized in Moscow and Gorky, has demonstrated the etiologic significance of coagulase-negative Staphylococci (CNS). Since many strains did not belong to S. aureus, S. epidermidis, or S. saprophyticus, they were species-identified in accordance with the classification by W. Kloos and K. Schleifer (1975). A variety of CNS species was observed, and their role in the development of pyoseptic infections shown, the contribution of S. epidermidis and S. haemolyticus being the greatest here. Besides S. aureus, S. xylosus was often isolated from purulent foci. A certain specificity in CNS spectrum, related to the hospital profile, was revealed. A brief modified scheme of CNS classification was developed, based on analysis of about 700 strains, in accordance with the classification of W. Kloos and K. Schleifer, that included the tests available for practical laboratories.

[Responses of the neuromuscular synapses of chronically desympathized frog muscles to tetanic nerve stimulation]. / Reaktsiia nervno-myshechnogo sinapsa khronicheski desimpatizirovannoi myshtsy liagushki na tetanicheskoe razdrazhenie nerva

7--14 days after unilateral section of the abdominal sympathetic trunk, the quantum content of the end plate potential (e.p.p.) in the m. sartorius of the frog decreased. The facilitation and fluctuations of the e.p.p. amplitude during train of stimuli (20, 50, 100/sec) became more obvious. Noradrenaline (5-10(-6) g/ml) increased the amplitude of a single e.p.p. and the facilitation during repetitive stimulation. The effect of noradrenaline in sympathectomized muscles was more obvious than in the control muscles. After the noradrenaline administration, the fourfold increase of calcium concentration did not change the amplitude of e.p.p.s or the time course of the facilitation. The mechanism of depolarization--secretion coupling in the nerve terminal seems to be impaired by the sympathectomy.