[Improving renal cancer care].

The article reviews the rates of incidence, late diagnosis and mortality from kidney cancer in Primorsky Krai. The authors address the issues of improving primary and specialized medical care by introducing a three-level health care system and restructuring of hospital beds. They propose a new medical technology for assessing the individual risk of kidney cancer and present a program of measures and organizational modules for prevention, early diagnosis and reduction of mortality from kidney cancer.

[Treatment of closed fractures in children]. / Lechenie zakrytykh perelomov kostei u detei.

The principles of treatment of bone fractures in children differ from those in adults and are determined by the morphofunctional features of the growing and developing child organism: the anatomo-physiological peculiarities of the structure and blood supply of the bone of a child, the high regenerative possibilities, the capability for self-correction of some types of residual displacement during growth. Peculiar types of bone injuries occur in childhood which are not encountered in adults. These are subperiosteal linear and folded fractures, fractures of the green stick type, damage to the growth zones (epiphyseolysis and osteo-epiphyseolysis), etc. The localization of the fracture and the size (degree) of displacement of the fragments are very important in the choice of the therapeutic tactics. Predominantly qualitative appraisal of the displacement suffices in metaphyseal and diaphyseal fracture and in injury to the growth zones (extra-articular fracture). Quantitative appraisal of the size of the displacement is advisable in intra-articular fractures, for which the techniques are suggested. Four degrees of fragment displacement are distinguished. Depending on the localization and character of the fracture and the size of the displacement of the fragments, conservative, active surgical, and operative therapeutic tactics may be chosen according to strictly differentiated indications. Each of them includes various methods of fracture management.

[Congenital and acquired deformities of knee joint menisci in children]. / Vrozhdennye i priobretennye izmeneniia meniskov kolennogo sustava u detei.

Children with congenital and acquired pathology of the menisci account for 7.2% of all patients with internal pathological conditions of the knee joint. The clinical manifestations are due to instability of the joint. In rupture of normally developed menisci the instability is acute or subacute and is displayed by general unspecific reactive symptomatology. The clinical signs of instability are revealed in children with anomalous development of the menisci due to decompensation of the defence-adaptational mechanisms and are evidence of a chronic pathological condition. A precise topical diagnosis of pathology of the menisci may be established only by means of special examination methods among which arthropneumography plays the principal role. The studies made it possible to distinguish and describe a previously unknown pathological condition--abnormal attachment of the menisci to the transverse ligament of the knee. Paracapsular resection of the ruptured or discoid meniscus through a wide parapatellar approach is the optimal surgical policy. Rational postoperative management consisting in early and prolonged kinesitherapy with exclusion of an axial load on the limb and a system of active medical follow-up restore the stability of the knee joint and its full function in 95% of patients and maintain it for postoperative periods of up to 10 years.

Wild measles virus strain: isolation and identification.

Four isolates of measles virus (Gag, Il, Buk and Shed) were obtained from suspensions of mononuclear cells from patients at the active stage of the disease. Vero cells were used for the virus isolation. All the isolates caused in the infected cell culture the appearance of symplasts of differently sized, star- or spindle-shaped multinuclear cells. The specificity of cytopathic effect was proved by the adsorption of monkey erythrocytes on the surface of cells infected by virus. The isolates were identified in virus neutralization (VN) and haemagglutination inhibition (HI) tests with different immune preparations: measles-globulin (standard), hyperimmune sera to rubella and mumps viruses, Sch. Zonne and Sch. Flexneria, as well as with conjugates of sera from measles patients and those vaccinated with live measles vaccine (LMV) L-16.

[The surgeon's procedure in dystrophic bone cysts in children]. / Taktika khirurga pri distroficheskikh kistakh kostei u detei.

The authors set apart childhood dystrophic cyst as a separate nosological unit. The underlying factor of the development of a bone cyst is dysplasia of vessels filling the bone-marrow canal and a concomitant dystrophic process in the surrounding bone tissue. The nonneoplastic nature of the cysts led to the search for sparing methods of treatment, namely, the puncture method. The administration of demineralized bone shavings during therapeutic puncture (after osteoperforation of the wall, scraping off the fibrous membrane) produces good results. The clinical material consists of 46 cases. There were 8 cases of aneurysmal bone cyst, 23 with active and 15 with passive bone cysts. In 44 cases treatment by two or three punctures led to recovery in 2-4 months. In 2 patients with aneurysmal bone cysts three punctures proved ineffective and an operative intervention was undertaken. It is concluded that treatment by puncture is indicated in dystrophic bone cysts. Operation is indicated in poor outcomes of puncture treatment in patients with aneurysmal bone cysts.

[The isolation of measles virus strains and the study of their hemagglutinating activity]. / Vydelenie shtammov virusa kori i izuchenie ikh gemaggliutiniruiushchei aktivnosti.

Three measles strains Gag, Il, and Buk, were isolated from a suspension of mononuclear cells derived from measles patients in the active stage of the disease. Continuous Vero cell cultures were used for virus isolation. In the infected cell culture, all the isolates produced symplasts of different sizes and star-shaped or spindle-shaped multinuclear cells. The specificity of the cytopathic effect was proved by the adsorption of monkey erythrocytes on the surface of virus-affected cells. The isolates were identified in neutralization and HI tests with different immune preparations: measles gamma-globulin (national standard), hyperimmune rabbit sera to measles (Edmonston strain), rubella, and mumps viruses, S. sonnei and S. flexneri, as well as with sera from measles patients and subjects vaccinated with live measles vaccine L-16. The results of identification attest to isolation of 3 measles virus strains, one of which (Buk) possesses particularly high hemagglutinating activity.

[Restoration of movement in the joints with the aid of a hinge-distraction apparatus]. / Vosstanovlenie dvizhenii v sustavakh s pomoshch'iu sharnirno-distraktsionnykh apparatov.

The device described presents an external hinge which is fixed by transosseous wires and reproduces as far as possible the normal kinematics of the joint. By removing all load from the joint surfaces and maintaining a constant predetermined space between them, the apparatus eliminates friction, prevents pain and muscle spasm, and minimizes abnormal mobility (or instability). It also permits gradual and controlled reduction of old traumatic or congenital dislocations or contractures. Once the bones are in proper relationship, the apparatus permits graduated, controlled, nearly frictionless motion about the correct axis so that a good range of motion is restored and joint surfaces of the proper shape are formed. Finally, ununited fractures close to the joint surface may be immobilized while joint motion is permitted. Experience gained with the apparatus has shown that the method described is physiological and not difficult, complications associated with its use being rare and not serious. The good results obtained with the use of the apparatus warrant its wider application.

[Treatment of fractures of long tubular bones in children using a compression-distraction rod device]. / Lechenie perelomov dlinnykh trubchatykh kostei u detei s pomoshch'iu kompressionno-distraktsionnykh sterzhnevykh apparatov.

The article deals with the treatment of fractures of the long tubular bones in children by means of a rod device produced by the M. I. Sitenko Kharkov Research Institute of Traumatology and Orthopedics. It analyses some experience in the use of a compression-distraction rod device in 40 children (25 with fracture of the femur, 10 with fractures of the leg bones, 5 with fracture of the humerus). The advantages of rod devices over the other methods of treatment (pin apparatus, skeletal traction, intramedullary osteosynthesis) are shown, in the management of femoral fractures in particular. The authors consider the simplicity and easiness of the design and the possibility of rapid and bloodless installation and subsequent activation of the patient to be the main advantages of the rod device. The indications for application of the rod device were as follows: fractures which were difficult for reduction, open fractures, neglected fractures with the callus forming in improper position of the fragments, the need to perform an emergency operation on the viscera in polytrauma, delayed consolidation. Examples are given of successful treatment of patients 3 to 14 years of age. The method for applying the rod device is described as well as the possibility of expanding the volume of the reduction by using a reducing unit from the Volkov-Oganesyan apparatus together with a reducing unit from the apparatus. The possible complications which may occur in application of the apparatus and the means for overcoming them are discussed.

[Non-ossifying fibroma of the bone in children]. / Neossifitsiruiushchaiasia fibroma kosti u detei.

The article discusses problems dealing with the diagnosis of a benign tumor of the skeleton, "non-ossifying++ tumor of bone", encountered quite often in children. Observations over 68 patients of 7 to 15 years of age show that the tumor develops from foci of fibrous osteodysplasia (Lichtenstein-Braitsev disease) and its solitary from--fibrous metaphyseal defect. The latter usually ossifies spontaneously by the end of the child's growth and follows an asymptomatic course, but cases with growth of the focus occur. Magnified radiographs (the reisgraphy method) make it possible to detect the transformation of a dysplastic process into a true tumor. All of the 68 patients were operated on by means of ultrasonic bone resection and repair of the defect with a cortico-demineralized allograft by the "faggot" method suggested by the author.

[Changes in water balance and its correction in patients with stomach cancer]. / Izmenenie vodnogo balansa i ego korrektsiia u bol'nykh rakom zheludka.

Blood volume and its components as well as total, extra- and intracellular fluid were measured in 58 gastric cancer patients (including those with concomitant pathology) on admission, preoperatively and in postoperative period. The parameters were compared with those of 17 healthy controls. On admission, water imbalance was relatively more pronounced in cancer patients with concomitant pyloric stenosis. Correction was effected by preoperative infusions of 10.9 l of liquid in uncomplicated cancer for 9.8 days +/- 2.1 and 25.5 l in cases of concomitant pyloric stenosis for 12.1 days +/- 2.4. As a result of these infusions and drug treatment carried out in preoperative period and during the first five postoperative days, water metabolism returned to normal and postoperative clinical course improved.

Treatment of fractures in tubular bones by the Volkov-Oganesyan repositioning-compression apparatus.

The hinged compression external fixation device of Volkov and Oganesyan is widely used in Eastern Europe. The device facilitates repositioning, provides stable fixation, and permits early ambulation and weight-bearing.

[Principles of the treatment of dystrophic bone cysts in children]. / Printsipy lecheniia distroficheskikh kist kostei u detei.

The experience with the treatment of 328 children and juveniles with dystrophic bone cysts is analyzed. Nine patients were cured by conservative methods. The others were operated upon (excohleation--in 4 patients; marginal resection--in 244 patients, segmentary resection in 66 patients etc.). The advantages of the marginal resection and alloplasty by the method of "faggot" are shown.