Immunologic disorders in children with developmental thoracic defects

As the result of immunological examination of 21 children with developmental defects of the chest and analysis of the course of the postoperative period in 136 children, among which 36 had hereditary syndromes of systemic connective-tissue dyshistogenesis, it was found that suppurative complications of thoracoplasty, which are encountered in 15% of children with isolated developmental chest defects and in 33.3% of those with the above mentioned syndromes, were caused to a great measure by disorders of the immune status. The most serious immunological deviations were encountered in the Marfan syndrome due to impaired phagocytic activity of neutrophils and monocytes, decreased number of T, T active, and B lymphocytes, and diminished function of T helpers. In unclassified complexes of developmental defects with Marfaneic ++ phenotypes, the immunological disorders were similar, but less deep. In the Ehlers-Danlos syndrome, a decrease of the number of immunocompetent cells, function of T helpers, and neutrophils was mainly revealed. In isolated forms of funnel chest the function of monocytes and the number of immunoglobulins are mainly decreased.     

Adrenal hemorrhage following the removal of meningiomas of the cerebral hemispheres

Adrenal apoplexy was revealed in 14.6% of the patients, who died after removal of meningiomas of the cerebral hemispheres. This complication more often occurred in basal location of a tumor. Manifestation of acute adrenal apoplexy in the majority of neurooncologic patients are atypical because of their general severe state after removal of a tumor. Adrenal apoplexy usually was associated with hemorrhagic and ischemic disorders in the central nervous system and internal organs and led to the death of patients. A search for the methods of investigation, permitting to prognosticate this complication is necessary.     

Muscarinic cholinergic and alpha 2-adrenergic receptors in the epithelium and muscularis of the human ileum

The aim of this study was to characterize the binding and functional properties of muscarinic cholinergic (MCh) and alpha 2-adrenergic receptors in the human ileum to provide insight into pharmacologic strategies for managing urinary and fecal incontinence after bladder and rectal replacement with intestinal segments. MCh and alpha 2-adrenergic binding sites were characterized in the epithelium and muscularis of eight human ileal segments with 3H-N-methylscopolamine and 3H-rauwolscine, respectively. The dissociation constant for 3H-N-methylscopolamine in the epithelium and muscularis was 0.32 +/- 0.07 nmol/L and 0.45 +/- 0.10 nmol/L, respectively (p = 0.32). The MCh receptor content was approximately eightfold greater in the muscularis compared with the epithelium (p = 0.008). The dissociation constant for 3H-rauwolscine in the muscularis and epithelium was 2.55 +/- 0.42 nmol/L and 2.03 +/- 0.19 nmol/L, respectively (p = 0.29). The alpha 2-adrenoceptor density was twofold greater in the epithelium compared with the muscularis (p = 0.05). Noncumulative concentration-response experiments were performed with carbachol, an MCh agonist, and UK-14304, a selective alpha 2-adrenergic agonist. The epithelium did not contract in the presence of high concentrations of carbachol and UK-14304. The muscularis preparations were responsive only to carbachol. The muscularis contains primarily MCh receptors mediating smooth muscle contraction. The alpha 2-adrenoceptors are localized primarily to the epithelium and may regulate water secretion in the intestine. The distribution and functional properties of ileal MCh and alpha 2-adrenergic receptors provide a theoretic basis for the treatment of incontinence after bladder and rectal replacement with intestinal segments.     

Clinico-roentgenological and physiological evaluation of the spine in patients with juvenile kyphosis

203 patients with juvenile kyphosis, aged 11-16 years, have been subjected to the complex examination, including ++clinico-roentgenologic and physiologic methods. Along with the cardinal signs, common for juvenile kyphosis diagnosis and characteristic of the dystrophic process (wedge distortion, osteoporosis of vertebra bodies and fragmentation of their apophyses, dedifferentiation of the bone structure, height reduction and pathologic restructuring of intervertebral disks following the pattern of fibrosis, presence of discal hernia), the signs of bone ++ dysplasia of spine and skeleton in general should be singled out of the roentgenologic characteristic of disease which determine the variants of pathologic process course and treatment tactics. The presence of dysontogenesis signs in patients with juvenile kyphosis is suggested.     

Relation of the outcome of disk epiphysectomy in dysplastic scoliosis and the biochemical composition of the vertebral body

Pronounced changes in the content of collagen, non-collagen proteins and the activity of a number of lysosomic enzymes have been established in the bone tissue of the vertebral bodies obtained on diskepiphysectomy in the patients with dysplastic scoliosis. Numerous correlation links between the metabolic parameters and the spinal deformation a year after diskepiphysectomy have been determined.     

Microsurgical replantation of the external ear

Cosmetically, the optimal management of the amputated external ear is microsurgical replantation. Although technically demanding, replantation is possible by the experienced surgeon. Success frequently requires the use of vein grafts, heparinization, and the alleviation of venous congestion with medicinal leeches or frequent stab wounds.