50 research outputs found
Designing a test asset and validating the accuracy of GPS/GNSS speed measurement
Global Navigation Satellite System (GNSS) receivers are now widely used for navigation and speed measurements. The increasing demand for vehicles monitoring in regulatory and non-regulatory environments has led to a growing number of GNSS applications in the automobile industry. In addition, GNSS receivers are commonly used by civilian users for navigation and speed measurements. Manufacturers of GNSS receivers supply speed accuracy parameters in the receiver specification data sheets. However, little information is provided regarding specific conditions when the specified speed accuracy of GNSS receivers might be met. Also, there is limited research available about practical speed accuracy parameters of receivers in a variety of challenging GNSS environments. Finally, to the author’s knowledge, there is no research conducted to understand if adding more satellites from different constellations to GPS, for example, GLONASS provides an improvement in GNSS speed accuracy reporting. This thesis presents the design of a test asset system capable of testing GNSS receivers for speed accuracy and the Uncertainty of Measurements (UOM) analysis for this system. The test asset system utilises a variety of engineering solutions and is capable of maintaining high accuracy benchmarks in speed measurements. The test asset system has an UOM equal 0.4 km/h for the entire range of speeds used for GNSS speed testing. The system was designed, assembled and tested to ensure the system maintains its integrity and capability to test GNSS receivers for speed measurement. Subsequently, several field experiments were performed to collect GNSS speed data records in a variety of driving environments using different receivers. The receivers ranged from geodetic grade to low cost receivers. Test routes were selected specifically to reflect real world and challenging GNSS environments, such as freeways with overpasses and roads with tree canopies. Detailed analyses of outliers and statistical results are presented to demonstrate that GNSS receivers may not measure speed correctly under challenging environments. The results also show that different GNSS receivers perform differently in measuring speed. Methods to filter potentially unreliable speed records were also investigated
THE ADVANTAGES OF USING LINUX IN THE SERVER WORLD
Linux and Windows are two operating systems that are constantly competing for control of the computer market. Both operating systems have shown considerable growth in the server world. Microsoft released its first server operating system (OS) in 1993, just about the time when the Linux OS began surfacing on the Internet. These two operating systems have much in common, but still they are quite different
The importance of the physical culture in formation of future teacherβs personality
The importance of the physical culture in formation of future teacherβs personality as a factor of formation of professional readiness of future specialist for professional activity is consideredΠ Π°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠ»ΡΡΡΡΡ Π² ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠΈ Π»ΠΈΡΠ½ΠΎΡΡΠΈ Π±ΡΠ΄ΡΡΠ΅Π³ΠΎ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Π° ΠΊΠ°ΠΊ ΡΠ°ΠΊΡΠΎΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π³ΠΎΡΠΎΠ²Π½ΠΎΡΡΠΈ Π±ΡΠ΄ΡΡΠ΅Π³ΠΎ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠ° ΠΊ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡ
Rare complications after thoracoplasty in children with congenital pectus excavatum
In this study we presented 4 rare postoperative complications at children after 202 cases of thoracoplasty concerning pectus excavatum deformity of the thorax in the period between 2002 and 2014. The operations were performed by the method proposed by D. Nuss. We revealed following complications: fracture of a body of sternum in the field of its joint with the handle in 1,5 months after operation; massive hemorrhage in a cavity of the fibrous capsule created around a metalwork in 2 years after performance of the thoracoplasty; incarceration of a portion of the latissimus dorsi muscle under "shoulder" of metal construction in 1,5 years after operation; violation of venous outflow at the level of a subclavian vein and a partial compression of a subclavial vein in the early postoperative period. We analyzed possible reasons, clinical symptoms, diagnostics, methods of treatment and offered methods of prevention of these complications
The Use of Multicolor Flow Cytofluorometry in White Blood Cell Differential: HematoFlow Conception
Aim. To develop reference intervals for white blood cell subpopulations in peripheral blood using Cytomics FC500 flow cytometer and CytoDiffTM reagent (Beckman Coulter).
Materials & Methods. The trial included the analysis of blood samples of healthy donors (n = 315) using Cytomics FC500 flow cytometer and CytoDiffTM reagent cocktail composed of 6 antibodies in 5 colors (CD36-FITC, CD2-PE, CD294-PE, CD19-ECD, CD16-Cy5, CD45-Cy7) and enabling to count 17 cell populations.
Results. The data obtained by means of multicolor flow cytofluorometry included the reference values of white blood cell populations in peripheral blood. In 1 first-time donor a lymphoproliferative disease was detected. It was subsequently confirmed by immunophenotyping; B-cell chronic lymphocytic leukemia was diagnosed.
Conclusion. Multicolor flow cytofluorometry using CytoDiffTM is considered to be a new step toward an improved WBC differential evaluation aimed mainly at reducing the volume of blood smear analysis using light microscopy at large laboratories, enhancing objectivity, precision and reproducibility of results. WBC differential extended with the count of lymphocyte and monocyte subpopulations can be regarded as modern donor blood screening to detect changes in the pattern of lymphocyte subpopulations as grounds for further examination of donors
FEATURES OF DIAGNOSTIC AND THERAPEUTIC TACTICS FOR BLUNT ABDOMINAL TRAUMA WITH DAMAGE TO THE PANCREAS
Abstract. Injuries of pancreas in the closed abdominal trauma remain the one of most challenging issues in diagnosis and choice of optimal therapy.Objectives. To analyze clinical results of the improved diagnostic and treatment tactics in patients with blunt abdominal trauma and damage to the pancreas.Material and methods. We report the results of treatment for 141 patients with pancreatic trauma treated from 1991 to 2015 at City Hospital No. 3 and City Hospital No. 40. All patients were divided into 2 groups. These groups were formed according to the time factor. The groups were comparable in age, gender, and pancreatic trauma severity. The study group consisted of 59 patients, treated in 2004-2015, and the comparison group consisted of 82 patients (1991β2003). The advanced diagnostic and treatment algorithm for the study group included modern instrumental diagnostic methods, such as ultrasound, computed tomography, diagnostic laparoscopy and improved surgical tactics to lower indications for omental plug, omentobursostomy, suturing capsule of pancreas and cholecystostomy.Results. This algorithm reduced the duration gap between hospitalization and surgery averagely from 10.7 to 4.0 hours, and the modified treatment tactics decreased the incidence of septic complications from 15.8% to 6.8%, and the mortality from 27.6% to 16.9%.Conclusion. As a rule, methods of radiodiagnosis detect only indirect signs of pancreatic injury in blunt abdominal trauma. It is advisable to perform omental plugging only as medical tactics of Β«damage controlΒ»
ΠΠ‘ΠΠΠΠΠΠΠ‘Π’Π ΠΠΠ§ΠΠΠΠ-ΠΠΠΠΠΠΠ‘Π’ΠΠ§ΠΠ‘ΠΠΠ Π’ΠΠΠ’ΠΠΠ ΠΠ Π ΠΠΠΠ Π«Π’ΠΠ Π’Π ΠΠΠΠ ΠΠΠΠΠ’Π Π‘ ΠΠΠΠ ΠΠΠΠΠΠΠΠ ΠΠΠΠΠΠΠ£ΠΠΠ§ΠΠΠ ΠΠΠΠΠΠ«
Abstract. Injuries of pancreas in the closed abdominal trauma remain the one of most challenging issues in diagnosis and choice of optimal therapy.Objectives. To analyze clinical results of the improved diagnostic and treatment tactics in patients with blunt abdominal trauma and damage to the pancreas.Material and methods. We report the results of treatment for 141 patients with pancreatic trauma treated from 1991 to 2015 at City Hospital No. 3 and City Hospital No. 40. All patients were divided into 2 groups. These groups were formed according to the time factor. The groups were comparable in age, gender, and pancreatic trauma severity. The study group consisted of 59 patients, treated in 2004-2015, and the comparison group consisted of 82 patients (1991β2003). The advanced diagnostic and treatment algorithm for the study group included modern instrumental diagnostic methods, such as ultrasound, computed tomography, diagnostic laparoscopy and improved surgical tactics to lower indications for omental plug, omentobursostomy, suturing capsule of pancreas and cholecystostomy.Results. This algorithm reduced the duration gap between hospitalization and surgery averagely from 10.7 to 4.0 hours, and the modified treatment tactics decreased the incidence of septic complications from 15.8% to 6.8%, and the mortality from 27.6% to 16.9%.Conclusion. As a rule, methods of radiodiagnosis detect only indirect signs of pancreatic injury in blunt abdominal trauma. It is advisable to perform omental plugging only as medical tactics of Β«damage controlΒ».Π Π΅Π·ΡΠΌΠ΅. Π’ΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΠΎΠ΄ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ (ΠΠ) ΠΏΡΠΈ Π·Π°ΠΊΡΡΡΠΎΠΉ ΡΡΠ°Π²ΠΌΠ΅ ΠΆΠΈΠ²ΠΎΡΠ° ΠΏΠΎ ΡΡΡΠ΄Π½ΠΎΡΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π²ΡΠ±ΠΎΡΠ° ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ ΠΎΡΡΠ°ΡΡΡΡ ΠΎΠ΄Π½ΠΈΠΌΠΈ ΠΈΠ· ΡΠ°ΠΌΡΡ
ΡΠ»ΠΎΠΆΠ½ΡΡ
ΡΡΠ΅Π΄ΠΈ ΡΡΠ°Π²ΠΌ ΠΎΡΠ³Π°Π½ΠΎΠ² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ.Π¦Π΅Π»Ρ. ΠΠ½Π°Π»ΠΈΠ· ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π»Π΅ΡΠ΅Π±Π½ΠΎ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Ρ ΠΏΠΎΡΡΡΠ°Π΄Π°Π²ΡΠΈΡ
Ρ Π·Π°ΠΊΡΡΡΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ ΠΆΠΈΠ²ΠΎΡΠ° Ρ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ ΠΠ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ 141 ΠΏΠΎΡΡΡΠ°Π΄Π°Π²ΡΠ΅Π³ΠΎ Ρ Π·Π°ΠΊΡΡΡΠΎΠΉ ΡΡΠ°Π²ΠΌΠΎΠΉ ΠΠ, Π½Π°Ρ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² Π³ΠΎΡΠΎΠ΄ΡΠΊΠΈΡ
Π±ΠΎΠ»ΡΠ½ΠΈΡΠ°Ρ
β 3 ΠΈ β 40 Π³ΠΎΡΠΎΠ΄Π° Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π° Ρ 1991 ΠΏΠΎ 2015 Π³. ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° 2 Π³ΡΡΠΏΠΏΡ. ΠΡΡΠΏΠΏΡ ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½Ρ ΠΏΠΎ Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌΡ ΡΠ°ΠΊΡΠΎΡΡ ΠΈ Π±ΡΠ»ΠΈ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡ ΠΏΠΎ ΠΏΠΎΠ»ΠΎΠ²ΠΎΠΌΡ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΌΡ ΠΏΡΠΈΠ·Π½Π°ΠΊΠ°ΠΌ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎ ΡΡΠΆΠ΅ΡΡΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠΠ. ΠΡΡΠΏΠΏΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 59 ΠΏΠΎΡΡΡΠ°Π΄Π°Π²ΡΠΈΡ
, ΠΏΡΠΎΠ»Π΅ΡΠ΅Π½Π½ΡΡ
Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2004 ΠΏΠΎ 2015 Π³., Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²- Π½Π΅Π½ΠΈΡ β 82 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (1991β2003 Π³Π³.). Π ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π»Π³ΠΎΡΠΈΡΠΌ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΡΠ°ΠΊΠΈΠ΅ ΠΊΠ°ΠΊ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΡ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½Π° Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ°ΠΊΡΠΈΠΊΠ° β ΡΠΎΠΊΡΠ°ΡΠ΅Π½Ρ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΊ ΡΠ°ΠΌΠΏΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ, ΠΎΠΌΠ΅Π½ΡΠΎΠ±ΡΡΡΠΎΡΡΠΎΠΌΠΈΠΈ, ΠΎΡΠΊΠ°Π· ΠΎΡ ΡΡΠΈΠ²Π°Π½ΠΈΡ ΠΊΠ°ΠΏΡΡΠ»Ρ ΠΆΠ΅Π»Π΅Π·Ρ, Ρ
ΠΎΠ»Π΅ΡΠΈΡΡΠΎΡΡΠΎΠΌΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π»Π³ΠΎΡΠΈΡΠΌΠ° ΡΠΌΠ΅Π½ΡΡΠΈΠ»ΠΎ Π²ΡΠ΅ΠΌΡ, ΠΏΡΠΎΡ
ΠΎΠ΄ΡΡΠ΅Π΅ ΠΎΡ ΠΌΠΎΠΌΠ΅Π½ΡΠ° Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π΄ΠΎ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΏΠΎΡΡΡΠ°Π΄Π°Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΠΎΠ±ΠΈΡ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Ρ 10,7 Π΄ΠΎ 4,0 Ρ, Π° ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅ Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ ΡΠ½ΠΈΠ·ΠΈΠ»ΠΎ ΡΠ°ΡΡΠΎΡΡ Π³Π½ΠΎΠΉΠ½ΠΎ-ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Ρ 15,8 Π΄ΠΎ 6,8%, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎΠ±ΡΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ Ρ 27,6 Π΄ΠΎ 16,9%.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΠΎΠ΄Ρ Π»ΡΡΠ΅Π²ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΊΠ°ΠΊ ΠΏΡΠ°Π²ΠΈΠ»ΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ Π²ΡΡΠ²ΠΈΡΡ Π»ΠΈΡΡ ΠΊΠΎΡΠ²Π΅Π½Π½ΡΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΠ ΠΏΡΠΈ Π·Π°ΠΊΡΡΡΠΎΠΉ ΡΡΠ°Π²ΠΌΠ΅ ΠΆΠΈΠ²ΠΎΡΠ°. Π‘ ΡΠ΅Π»ΡΡ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π³Π½ΠΎΠΉΠ½ΠΎ-ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ ΠΎΠ³ΡΠ°Π½ΠΈΡΠΈΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ°ΠΌΠΏΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π»ΡΠ½ΠΈΠΊΠΎΠ²ΠΎΠΉ ΡΡΠΌΠΊΠΈ Π»ΠΈΡΡ ΡΠ°ΠΌΠΊΠ°ΠΌΠΈ Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Β«damage controlΒ»
Spreading the Experience of Preschool Educational Establishments
The paper observes the issue of spreading the innovative experience of municipal preschool educational establishments (MPEE). The author outlines the ways of spreading the ideas of Β«Development Program of MPEEΒ» and Β« Educational Program of MPEEΒ» worked out according to the federal state requirements. Theoretical methodological basis of the research combines the fundamental studies of the last centuryβs Russian teachers and psychologists: L. S.Β Vygodsky, A. N. Leontyev, L. I. Bozhovitch, A. V. Zaporozhets, V. V. Davydov, etc. Based on their studies, a series of teaching methodical manuals was developed in the Institute of Reflexive Psychology of Creativity and Humanizing the Education at the International Academy of Humanizing the Education, SotchiβMagdeburg: Β«Russian Education 2020 β the Model of Preschool EducationΒ» and Β«Pedagogic Innovations in MPEE of Innovative TypeΒ».In authorβs opinion, the outcome of the research can promote the modernization efficiency in preschool education
ΠΠΠΠΠ ΠΠΠ ΠΠΠΠ ΠΠΠΠΠΠΠ ΠΠ Π ΠΠ ΠΠΠ‘Π’ΠΠΠΠ-ΠΠΠΠΠΠΠΠ’ΠΠΠΠΠ ΠΠΠΠ¬Π€ΠΠ ΠΠΠ¦ΠΠ
The article describes a case of successful treatment of a child not elder than 1 year old with a gangrene in the right upper lobe of the lung against the background of its cystic adenomatoid malformation. The disease manifested as pneumonia. The diagnosis was confirmed following multispiral computed tomography. The first stage of surgery was drainage of the pleural cavity. Thoracotomy and upper lobe lobectomy were done after a childβs condition had stabilized. Gangrene in the cystic and adenomatoid piece of the lobe was confirmed macroscopically and histologically.Β Π ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΠΈΡΠ°Π½ ΡΠ»ΡΡΠ°ΠΉ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π³ΠΎΠ΄Π° Ρ Π³Π°Π½Π³ΡΠ΅Π½ΠΎΠΉ Π²Π΅ΡΡ
Π½Π΅ΠΉ Π΄ΠΎΠ»ΠΈ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π½Π° ΡΠΎΠ½Π΅ Π΅Π΅ ΠΊΠΈΡΡΠΎΠ·Π½ΠΎ-Π°Π΄Π΅Π½ΠΎΠΌΠ°ΡΠΎΠ·Π½ΠΎΠΉ ΠΌΠ°Π»ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π½Π°ΡΠ°Π»ΠΎΡΡ Ρ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ. ΠΠΈΠ°Π³Π½ΠΎΠ· ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ ΠΏΠΎΡΠ»Π΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΌΡΠ»ΡΡΠΈΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ. ΠΠ΅ΡΠ²ΡΠΌ ΡΡΠ°ΠΏΠΎΠΌ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΡΠ»ΠΎ Π΄ΡΠ΅Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ ΠΈ ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° ΡΠΎΡΠ°ΠΊΠΎΡΠΎΠΌΠΈΡ, Π²Π΅ΡΡ
Π½Π΅Π΄ΠΎΠ»Π΅Π²Π°Ρ Π»ΠΎΠ±ΡΠΊΡΠΎΠΌΠΈΡ. ΠΠ°ΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈ ΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π° Π³Π°Π½Π³ΡΠ΅Π½Π° ΠΊΠΈΡΡΠΎΠ·Π½ΠΎ-Π°Π΄Π΅Π½ΠΎΠΌΠ°ΡΠΎΠ·Π½ΠΎ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Π½ΠΎΠΉ Π΄ΠΎΠ»ΠΈ.
ΠΠ½ΠΎΠΉΠ½ΠΎ-Π½Π΅ΠΊΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠ°ΡΠ°ΠΏΡΠΎΠΊΡΠΈΡ Ρ ΡΠ΅Π±Π΅Π½ΠΊΠ° 5 Π»Π΅Ρ: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅
Authors present a rare clinical case of successful treatment of a 5-year-old child with purulent-necrotic paraproctitis, which developed against the background of a primary immune deficiency state.
Clinical case. A 5-year-old boy became acutely ill, against the background of diarrhea with hyperthermia. An area of hyperemia, edema, and tissue infiltration appeared in the perianal region. In anamnesis, with frequent respiratory infections and dysfunction of the intestinal tract in the form of diarrhea. He was admitted to the Regional Childrens Hospital on the 10th day of illness from the regional hospital, where antibiotic treatment was started. Upon admission, the condition was serious in the perianal region with an extensive wound necrotic tissues and a plaque of fibrin. To create favorable conditions for wound healing, a preventive sigmostomy operation was performed. Multidrug-resistant Pseudomonas aeruginosa was found in the wound culture. Thus, courses of antibiotics treatment, infusion therapy, and surgical debridement of the perianal wound and its local treatment were performed. Upon immunological status examination, a primary immunodeficiency was revealed, for which drugs with immunoglobulin G were administered. As a result of the treatment, the wound healed by secondary intention, thus, an operation was performed to close the sigmostoma. The child was discharged in satisfactory condition under the supervision of an immunologist and a surgeon.
Discussion. In this case, preventive sigmostomy is justified; however, authors limit themselves to surgical intervention on the perineum in other cases. Pseudomonas aeruginosa shows its pathogenicity in patients with impaired immunity. Therefore, courses of antibiotics, infusion therapy, and immunomodulatory therapy along with surgical treatment, favorable result were achieved.
Conclusion. Children with purulent-necrotic paraproctitis, which developed against the background of a primary immune deficiency should be hospitalized as early as possible in a specialized hospital.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΡΠ΅Π΄ΠΊΠΎΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π±Π΅Π½ΠΊΠ° 5 Π»Π΅Ρ Ρ Π³Π½ΠΎΠΉΠ½ΠΎ-Π½Π΅ΠΊΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°ΡΠ°ΠΏΡΠΎΠΊΡΠΈΡΠΎΠΌ, ΡΠ°Π·Π²ΠΈΠ²ΡΠΈΠΌΡΡ Π½Π° ΡΠΎΠ½Π΅ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΈΠΌΠΌΡΠ½ΠΎΠ΄Π΅ΡΠΈΡΠΈΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ.
ΠΠΏΠΈΡΠ°Π½ΠΈΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ. ΠΠ°Π»ΡΡΠΈΠΊ, 5 Π»Π΅Ρ, Π·Π°Π±ΠΎΠ»Π΅Π» ΠΎΡΡΡΠΎ, ΠΊΠΎΠ³Π΄Π° Π½Π° ΡΠΎΠ½Π΅ Π΄ΠΈΠ°ΡΠ΅ΠΈ Ρ Π³ΠΈΠΏΠ΅ΡΡΠ΅ΡΠΌΠΈΠ΅ΠΉ Π² ΠΏΠ΅ΡΠΈΠ°Π½Π°Π»ΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΏΠΎΡΠ²ΠΈΠ»ΡΡ ΡΡΠ°ΡΡΠΎΠΊ Π³ΠΈΠΏΠ΅ΡΠ΅ΠΌΠΈΠΈ, ΠΎΡΠ΅ΠΊΠ° ΠΈ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ ΡΠΊΠ°Π½Π΅ΠΉ. Π Π°Π½Π°ΠΌΠ½Π΅Π·Π΅: ΡΠ°ΡΡΡΠ΅ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠ΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΈ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ° Π² Π²ΠΈΠ΄Π΅ Π΄ΠΈΠ°ΡΠ΅ΠΈ. ΠΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ Π² ΠΠ±Π»Π°ΡΡΠ½ΡΡ Π΄Π΅ΡΡΠΊΡΡ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ Π½Π° 10-Π΅ ΡΡΡΠΊΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈΠ· ΡΠ°ΠΉΠΎΠ½Π½ΠΎΠΉ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ, Π³Π΄Π΅ Π±ΡΠ»ΠΎ Π½Π°ΡΠ°ΡΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠ°ΠΌΠΈ. ΠΡΠΈ ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΡΡΠΆΠ΅Π»ΠΎΠ΅, Π² ΠΏΠ΅ΡΠΈΠ°Π½Π°Π»ΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΎΠ±ΡΠΈΡΠ½Π°Ρ ΡΠ°Π½Π° Ρ Π½Π΅ΠΊΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠΊΠ°Π½ΡΠΌΠΈ ΠΈ Π½Π°Π»Π΅ΡΠΎΠΌ ΡΠΈΠ±ΡΠΈΠ½Π°. ΠΠ»Ρ ΡΠΎΠ·Π΄Π°Π½ΠΈΡ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ Π΄Π»Ρ Π·Π°ΠΆΠΈΠ²Π»Π΅Π½ΠΈΡ ΡΠ°Π½Ρ Π±ΡΠ»Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠΈΠ³ΠΌΠΎΡΡΠΎΠΌΠΈΠΈ. Π ΠΏΠΎΡΠ΅Π²Π΅ ΠΈΠ· ΡΠ°Π½Ρ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° ΠΏΠΎΠ»ΠΈΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½Π°Ρ Pseudomonas aeruginosa. ΠΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΊΡΡΡΠ°ΠΌΠΈ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ², ΠΈΠ½ΡΡΠ·ΠΈΠΎΠ½Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ° ΡΠ°Π½Ρ ΠΏΠ΅ΡΠΈΠ°Π½Π°Π»ΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΈ ΠΌΠ΅ΡΡΠ½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ΅ ΠΈΠΌΠΌΡΠ½ΠΎΠ΄Π΅ΡΠΈΡΠΈΡΠ½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅, ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ Π²Π²ΠΎΠ΄ΠΈΠ»ΠΈΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ Ρ ΠΈΠΌΠΌΡΠ½ΠΎΠ³Π»ΠΎΠ±ΡΠ»ΠΈΠ½ΠΎΠΌ G. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ°Π½Π° Π·Π°ΠΆΠΈΠ»Π° Π²ΡΠΎΡΠΈΡΠ½ΡΠΌ Π½Π°ΡΡΠΆΠ΅Π½ΠΈΠ΅ΠΌ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡ Π·Π°ΠΊΡΡΡΠΈΡ ΡΠΈΠ³ΠΌΠΎΡΡΠΎΠΌΡ. Π Π΅Π±Π΅Π½ΠΎΠΊ Π²ΡΠΏΠΈΡΠ°Π½ Π² ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ ΠΏΠΎΠ΄ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³Π° ΠΈ Ρ
ΠΈΡΡΡΠ³Π°.
ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. Π Π΄Π°Π½Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΠΎΠΏΡΠ°Π²Π΄Π°Π½ΠΎ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΠΎΠ΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΡΠΈΠ³ΠΌΠΎΡΡΠΎΠΌΠΈΠΈ, Ρ
ΠΎΡΡ Π² Π΄ΡΡΠ³ΠΈΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
Π°Π²ΡΠΎΡΡ ΠΎΠ³ΡΠ°Π½ΠΈΡΠΈΠ²Π°Π»ΠΈΡΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎΠΌ Π½Π° ΠΏΡΠΎΠΌΠ΅ΠΆΠ½ΠΎΡΡΠΈ. Pseudomonas aeruginosa ΠΏΡΠΎΡΠ²Π»ΡΠ΅Ρ ΡΠ²ΠΎΡ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΠΎΡΡΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ°. ΠΠΎΡΡΠΎΠΌΡ, Π½Π°ΡΡΠ΄Ρ Ρ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ, ΠΊΡΡΡΠ°ΠΌΠΈ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ², ΠΈΠ½ΡΡΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ, ΡΠΎΠ»ΡΠΊΠΎ ΠΏΡΠΈ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠΌΠΎΠ΄ΡΠ»ΠΈΡΡΡΡΠ΅ΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±ΡΠ» Π΄ΠΎΡΡΠΈΠ³Π½ΡΡ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΡΠ΅Π·ΡΠ»ΡΡΠ°Ρ.
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΠ΅ΠΉ Ρ Π³Π½ΠΎΠΉΠ½ΠΎ-Π½Π΅ΠΊΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°ΡΠ°ΠΏΡΠΎΠΊΡΠΈΡΠΎΠΌ, ΡΠ°Π·Π²ΠΈΠ²ΡΠΈΠΌΡΡ Π½Π° ΡΠΎΠ½Π΅ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΈΠΌΠΌΡΠ½ΠΎΠ΄Π΅ΡΠΈΡΠΈΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΊΠ°ΠΊ ΠΌΠΎΠΆΠ½ΠΎ ΡΠ°Π½ΡΡΠ΅ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π² ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ