[Supraclavicular block during elbow joint surgeries in children].

The regional methods of analgesia are the "golden standard" of choice during trauma surgeries. The supraclavicular block of the bracheal plexus is the method of choice during the cubital joint surgeries. The purpose of the study is to improve the effectiveness of anesthesia and postoperative analgesia for surgical interventions on the cubital joint in children by developing and implementing the clinical practice of peripheral blockade of the brachial plexus by the supraclavicular access. The study included 40 children aged 5 to 12 years. The children rated as ASA I, came to the clinic on an emergency basis with cubital joint bones injuries. All the children were had surgeries on the cubital joint (closed and open repositions with osteosynthesis) with balanced regional anesthesia, the main analgesic component of which was supraclavicular brachial plexus block (by Kulenkampf-Fursaev technique). The supraclavicular block was performed in conditions of psychological comfort of the child. For the means of premedication age appropriate doses of seduxen or midazolam were intravenously administered. Intraoperative sedation was conducted by the re-introduction of benzodiazepines, and ketamine (up to 1 mg/kg/h). During the study period, the effective intraoperative analgesia, provided by supraclavicular blockade of peripheral nerves, was observed in 31 children. In 9 patients the blockade could be found to be incomplete at the second stage of the surgery (reposition). For this reason, it took the additional administration of tramal in a dose of 2 mg/kg and deepening of sedation with ketamine up to the dose of 2 mg/kg/h. The duration of effective postoperative analgesia due to long-acting local anesthetic (0.5% solution of naropin) was 8-9 hours. There were no complications registered as a result of supraclavicular. Thus, this study proves that the supraclavicular brachial plexus block provides effective intra and postoperative analgesia in trauma operations on the cubital joint in children.

[Immunogenicity of Yersinia pestis grown on nutrient media at 28 and 37 degrees C]. / Immunogennost' chumnogo mikroba, vyrashchennogo na nekotorykh pitatel'nykh sredakh pri 28 i 37 gradusov C.

The immunogenicity of Y. pestis strain EV, grown in yeast-casein medium, yeast medium with Hottinger digest and yeast medium with sunflower-seed protein at 28 degrees C and 37 degrees C, for guinea pigs and white mice has been studied. As revealed in this study, these media ensure the formation of highly immunogenic populations of Y. pestis strain EV and, therefore, can be used for growing Y. pestis vaccine strains. Considerable fluctuations in the content of such highly protective antigen as fraction 1 do not affect the immunogenicity of live cultures of Y. pestis strain EV. This is due to the leveling of differences in the content of this antigen in the process of the multiplication of these bacteria in laboratory animals.

[Levels of fraction I and VW antigens in cultures of the plague microbe grown on yeast-casein, yeast-Hottinger broth and yeast-sunflower oil cake media]. / Soderzhanie fraktsii I i VW-antigenov v kul'turakh chumnogo mikroba, vyrashchennykh na sredakh DK, DKh i DP.

The content of fraction 1 and VW-antigens in Y. pestis cultures grown in different media (yeast-casein medium, yeast medium with Hottinger digest, and yeast medium with sunflower-seed protein) was studied over the course of their growth by means of the antibody neutralization and microprecipitation in agar tests. The media under study were not inferior to the casein sulfuric hydrolysate-based medium used for control in their capacity for ensuring the synthesis of VW-antigens. The maximum accumulation of fraction 1 was observed in yeast medium with sunflower-seed protein. In all media the maximum content of fraction 1 was registered on day 3 of cultivation, and the maximum accumulation of VW-antigens on days 8-9 of incubation at 37 degrees C. The data obtained in this study make it possible to regard fraction 1 and VW-antigens as the secondary metabolites of Y. pestis.