[Voice disturbances in young children with gastroesophageal reflux disease].

The objective of the present work was to study voice disturbances in young children with gastroesophageal reflux disease. Diagnostic algorithm included direct transnasal examination of the larynx using an Olympus fibroscope (Japan), fibrogastroduodenoscopy, 24-hour potentiometry, biopsy of oesophageal mucosa, and acoustic analysis of the voice. A total of 26 children at the age from 8 months to 3 years with voice disturbances were examined, including 12 children below one year, 5 between 1 and 2 years, and 9 between 2 and 3 years. The main signs of laryngoesophageal reflux were dysphonia, oedema, hyperemia, and altered light reflex of mucous membrane of arytenoid cartilages, interarytenoid space, and vocal cords. It is concluded that voice disturbances are the most common symptoms of laryngoesophageal reflux in young children which necessitates the earliest possible endoscopic study of the larynx in all cases of dysphonia.

[Indications for surgery and methods of surgical correction of infundibuliform abnormality of the chest in children]. / Pokazaniia k operatsii i metody khirurgicheskoi korrektsii voronkoobraznoi deformatsii grudnoi kletki u detei.

Based on the survey of 104 patients, a method has been developed for early diagnosis of progression of infundibuliform chest deformity (ICD), which defines indications for thoracoplasty in children over 2 years. A differential approach has been applied to the stabilization of the sternocostal complex, taking into account various ICD types. Experience in surgical management of 247 patients with simple and complex ICD types has been generalized. A procedure has been improved to stabilize the sternocostal complex with a metallic plate in critical ICD types. The sparing thoracoplasty variants have been developed for simple ICD types and Degree I progressive ICD ones, stabilizing the sternocostal complex with a niticolic brace and a CPK-22 apparatus in the modified resistant case.

[Analysis of hydroxypyridine cross-links of collagen from human rib cartilage]. / Analiz gidroksipiridinovykh sshivok kollagena rebernogo khriashcha cheloveka.

Ion-paired reversed-phase high performance liquid chromatography (HPLC) has been used for the analysis of the content of mature collagen crosslinks--hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in biopsy specimens of human rib cartilage from healthy donors (n = 14) and patients with inherited diseases of the connective tissue complicated with funnel chest (n = 17). Analysis of normal tissues reveal the presence of LP (alongside with HP) in embryonal rib cartilage. LP has been found in the rib cartilage of 4 out of 6 patients with funnel chest (FC) associated with Ehlers-Danlos syndrome (EDS); with no signs of this pathology detected in individuals with isolated FC. In rib cartilage of 2 patients with recurrent isolated FC LP has been discovered alongside with the presence of type I collagen. A significant increase of LP content in rib cartilage in a child with clinical phenotype of EDS type VI has been discovered.

[Differentiated approach to the method of sternum stabilization in surgical treatment of funnel chest in children]. / Differentsirovannyi podkhod k metodu stabilizatsii grudiny pri khirurgicheskom lechenii voronkoobraznoi deformatsii grudnoi kletki u detei.

Experience in surgical treatment of 186 patients with funnel chest deformity (FCD) is generalized. With consideration for the great variety of the forms of deformity of the plastron, simple and complicated forms of FCD are distinguished. The simple forms include isolated, symmetrical, low (beginning from the level of the fourth rib) II-III degree deformities, the complicated forms include wide, II-III degree deformities beginning from the level of the second rib, and flat asymmetrical deformities. The use of a metal plate as a stabilizer in complicated forms of FCD is suggested. The optimal method of treatment in simple forms of the deformity is thoracoplasty with fixation of the sternum in the corrected position by means of a nitinol clip.