[Chest injuries treated in the town hospital of Sabha, Libya]. / Grudni travmi, lekuvani v bolnitsata na gr. Sebkha--Libiia.

This is a report on 113 patients with chest injuries subjected to treatment over the period 1991 through 1993. Of them 72.5 per cent are with ages ranging from 11 to 30 years, and 94.7 per cent are men. The series includes cases presenting incised penetrating wounds (49.6 per cent), involvement in motor-vehicle road accidents (26.5 per cent) and gunshot wounds (15.9 per cent). Of the total number 23 per cent are polytraumatized. Most of the patients (56.7 per cent) have hemopneumothorax with pleural drainage being the only treatment applied. In 15.9 per cent thoracotomy, laparotomy or thoracotomy plus laparotomy are used. Complications are recorded in 7.1 per cent, with deaths amounting to 2.7 per cent.

[The pathomorphological changes in the pleura of rabbits with artificial pneumothorax and uropolin pleurography]. / Patomorfologichni promeni v plevrite na zaitsi pri artifitsialen pnevmotoraks i plevrografiia s uropolin.

The results from artificial pneumothorax in 25 rabbits with intrapleural administration of Uropolin (10 rabbits) as well as of 10% solution of NACl (7 rabbits) were described. Thoracotomy was made on 7th, 14th and 12 21st day and the parietal, diaphragmatic and visceral pleura with underlaying tissues were examined. Proliferation of the mesothelium [correction of mesother] and growth of the connective tissue, which were more manifested in rabbits treated with Uropolin, were established histologically. The authors think that pathohistological examinations confirm the clinical observed favourable effect of intrapleural administration of Uropolin for obliteration of the pleural cavity.

[Surgical results in secondary nonspecific pleural empyema]. / Rezultati ot khirurgichnoto lechenie na vtorichnite nespetsifichni plevralni empiemi.

During a 12-year period (1975-1987) 448 patients with secondary nonspecific pleural empyema have been treated--84.8 per cent males and 15.2 per cent females. In 78.1 per cent of the patients the empyema was complication of pneumonia and acute suppurative-destructive diseases of the lungs, in 9.6 per cent--of blunt chest trauma and in 6.3 per cent occurred after abdominal operations. Subtotal and total empyema had 46.7 per cent of the patients with acute empyema and 35.6 per cent of those with chronic empyema. It is pointed out that largely for subjective reasons the diagnosis and early adequate treatment of empyema was delayed which led to subsequent chronification. In 257 patients with acute empyema covered aspiration drainage was applied (89.9 per cent of the patients): 81.4 per cent were cured, 13.8 per cent experienced improvement and 4.8 per cent died. The most common surgical intervention in the 191 patients with chronic empyema was pleurectomy with decortication of the lung (57.6 per cent of the cases); 97.3 per cent of the operated patients were cured, 1.8 per cent improved and 0.9 per cent died.

Immunoreactivity in pulmonary echinococcosis. A comparative study of immunodiagnostic tests.

A comparison was made of the diagnostic value of five immunological tests-complement fixation (CF), latex agglutination (LA), bentonite flocculation (BF), passive haemagglutination (PHA), and intradermal (ID)-in patients operated on for pulmonary echinococcosis. The sensitivity of all five tests was significantly lower in the patients with pulmonary echinococcosis than in a comparable group with liver echinococcosis. Some 252 patients with miscellaneous nonhydatid diseases and parasitic infections were also tested; nonspecific reactions were highest in the ID and CF tests and lowest in the LA and BF tests. None of the serological tests was significantly more sensitive than the others, although the CF test was somewhat less sensitive and therefore probably has the least diagnostic value in pulmonary echinococcosis. The ID test showed a significantly higher sensitivity than any of the serological tests. The difficulties encountered in the immunodiagnosis of pulmonary hydatid disease are discussed and it is recommended that at least two serological methods (PHA and either LA or BF) and the ID test should be used in each case.

Immunoreactivity in pulmonary echinococcosis. 2. Evaluation of antibody response.

The part played by certain factors in determining the antibody response in pulmonary echinococcosis has been studied. Five immunodiagnostic procedures were used-complement fixation, latex agglutination, bentonite flocculation, passive haemagglutination, and intradermal tests-and parasitological and pathological examinations were carried out. The number of hydatid cysts had only a small influence on the qualitative nature of the immune response while the quantitative effect was considerable. The immune response did not vary significantly in relation to the size of hydatid cysts but it was affected by changes within the cysts and the surrounding lung tissue. In patients with cysts full of clear hydatid fluid the proportions with negative results and relatively low antibody titres were highest. In these patients the size of hydatid cyst appeared to be significant-the smaller the size, the lower the antibody level. The immune response is weak or completely absent when the hydatid cyst has a thick fibrous capsule. When suppurative changes are present in the hydatid fluid and/or in the fibrous capsule, and when there is inflammatory involvement of the surrounding lung tissue an easily detectable immune response may be seen at an early stage, sometimes even with a high antibody level, but later it usually decreases and may disappear completely. A hypothesis for the explanation of immunological reactivity in pulmonary hydatid disease is discussed.