RESUMEN
THE PURPOSE OF THE STUDY: a retrospective analysis of the results of patients treatment with ureteral strictures by evaluating the effectiveness of various methods of laparoscopic operations. MATERIALS AND METHODS: a retrospective analysis of the treatment of 30 patients operated in the Central Hospital of Civil Aviations from 2013 to the present time with strictures of all departments of the ureters, except the pelvic-ureteral segment (LMS), was performed. The study included 18 women and 12 men. The age of patients was 54+/-8.1 years (29-79 years) for men and 51+/-8.5 years (28-74 years) for women. According to the results of x-ray examinations, the length of ureter stricture was determined, after that selected the tactics of surgical treatment. The study included patients who underwent intestinal plastics of the ureter, the operation Boari, ureterocystoanastomosis, ureteroureterostomy. All stages of surgical interventions were performed laparoscopically. RESULTS: 23 patients (76.66%) had a smooth postoperative period. A month after the operation, ureteral stents were removed. Attacks of acute pyelonephritis, relapses of the disease were not observed during the follow-up period from 7 months to 3 years. Possible complications are analyzed. In one case, after intestinal plastic surgery of the ureter in the postoperative period, the phenomena of small bowel obstruction were noted, which required surgical treatment in the volume of applying a bypass eunoascendoanastomosis "side by side". In 7 cases, anastomosis strictures were diagnosed in the postoperative period. In the 5 cases, after examination (CT of the urinary tract with contrast, antegrade ureteropyelography), the anastomosis was recognized compensated. CONCLUSION: It is shown that all the necessary range of operations can be performed by laparoscopic method while preserving all the advantages of low-trauma access.
Asunto(s)
Uréter/cirugía , Obstrucción Ureteral , Anastomosis Quirúrgica , Constricción Patológica , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
This study analyzed the results of bilateral nephrectomy in 14 patients with end-stage renal disease (ESRD) and chronic active pyelonephritis. Seven patients had urosepsis, and 10 patients had a purulent form of pyelonephritis, which was one-sided in 7 of them. In the early postoperative period, on average, after 9.3 days, 9 patients died. Statistically significant risk factors for death were: chronic hemodialysis, long-term antibiotic therapy, and existing sepsis. Intraoperative complications and postoperative morbidity were not significantly associated with death. The study results imply the need of differentiated approach to bilateral nephrectomy in patients with ESRD and risk factors for fatal outcome. It must be performed on the strong indications since the intervention does not lead to eradication of sepsis. It is advisable to perform "preventive, sanation" bilateral nephrectomy in the "cold period" in patients at risk for developing urosepsis.
Asunto(s)
Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/cirugía , Nefrectomía , Pielonefritis/mortalidad , Pielonefritis/cirugía , Adulto , Anciano , Enfermedad Crónica , Femenino , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pielonefritis/complicaciones , Pielonefritis/diagnóstico por imagenRESUMEN
Long term results of treatment of patients with locally advanced breast carcinoma with the use of mixed photon-neutron therapy (PNT) are presented. Among 201 patients with locally advanced breast cancer receiving radiation therapy, in 95 of them it was implemented as a combination of photon and neutron radiation therapy and in 106--in the form of mega-volt photon therapy (PT). Comparative evaluation of the long-term results of treatment proved the superiority of PNT. The immediate effect after PNT in the form of complete and partial response of tumor was registered in 87.4%, and after PT--in 49% of cases. Five-year and ten-year survival rates without signs of disease after PNT were 58.1% and 29.5%, and after PT--36.4% and 7.4% respectively. Substantial differences in toxicity of techniques were not observed.
Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/radioterapia , Neutrones Rápidos/uso terapéutico , Fotones/uso terapéutico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Radioterapia Adyuvante/efectos adversos , Radioterapia Adyuvante/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
We consider the operation of a digital linear ion trap with resonance radial ejection and mass selective instability modes. Periodic wave shape has a positive part with amplitude V+=V0 and duration 0.8T and negative part with amplitude V-=-4V0 and duration 0.2T, where T is the period. The mapping of the stability diagram, calculations of the well's depth and ion oscillations spectra are presented. The process of resonant excitation of ion oscillations by a dipole sinusoidal signal is studied, as well as ion ejection at the stability boundary. The trajectory method is used for this purpose. It is shown that the mass selectivity of dipole excitation is twice as large for rectangular wave shape compared to sinusoidal wave shape. Increasing the diameter of the round rods of the linear trap gives an increase in the resolving power. The possibility of DIT operation in mass-selective instability mode at the boundary point qb=0.39 is discussed.
RESUMEN
We consider the operation of a digital linear ion trap with resonant radial ejection. A sequence of rectangular voltage pulses with a dipole resonance signal is applied to the trap electrodes. The periodic waveform is piecewise constant, has zero mean, and is determined by an asymmetry parameter d $$ d $$ : one value is taken on interval 0 dT $$ \left(0, dT\right) $$ and another on dT T $$ \left( dT,T\right) $$ , where T $$ T $$ is the RF period. Ion mass scanning is performed by varying the asymmetry parameter d $$ d $$ and amplitude of the negative pulse part with time. The ion oscillation frequencies and acceptance of the linear trap are calculated. The dependence of the ion mass to charge ratio m / z $$ m/z $$ on the parameter d $$ d $$ is m / z ~ d 2 $$ m/z\sim {d}^2 $$ . The maximum value is about m / z = 30 $$ m/z=30 $$ kDa for typical parameters of the linear trap: frequency 0.5 MHz, rod radius 4 mm, and negative pulse amplitude 1 kV. The dipolar excitation frequency is 0.125 MHz at which the LIT acceptance is maximal.
RESUMEN
The results of modeling AC and DC dipole excitation of ion oscillations in a quadrupole mass filter are presented. The simulation is done by numerical integration of the ion motion equations, ions' initial coordinates and velocities are distributed normally. For AC dipole excitation the instability bands on the (a, q) stability diagram follow along the isolines ßx/2 and ßy/2, creating regular dips on the transmission contour. We show that AC excitation at frequency Ω/2 makes it possible to control the resolution of the mass filter by either changing the AC amplitude or phase. Instability bands can be used for mass selective excitation in a linear ion trap. Options for the joint use of DC and AC dipole excitation to form the mass peak shape are considered.
RESUMEN
Peculiarities of the course of metabolic processes in tissues of the bivalve mollusc Anadara inaequivalvis Br. were studied under conditions of experimental anoxia. In the absence of oxygen, in gill and foot the protein catabolism processes were found to be enhanced; this led to a decrease of the protein content and to an increase of the free amino acid and urea levels. Predominantly hydrolyzed were low molecular peptides, which was indicated by a decrease of the cathepsin D activity on the background of a rise of the gamma-glutamyltranspeptidase activity. Anoxia was accompanied by enhancement of the succinate thiokinase and fumarate reductase reactions controlled by alanine and aspartate aminotransferases. They prevented accumulation of toxic lactate in tissues and allowed obtaining an additional macroerg resource. Metabolic processes in the mollusc hepatopancreas were oriented to production of amino acids.
Asunto(s)
Arcidae/metabolismo , Hipoxia/metabolismo , Adaptación Fisiológica , Aminoácidos/metabolismo , Animales , Arcidae/enzimología , Metabolismo de los Hidratos de Carbono , Hipoxia/fisiopatología , Especificidad de Órganos , Proteínas/metabolismo , Urea/metabolismoRESUMEN
A modeling investigation was performed to choose moderator material and size for creating optimal epithermal neutron beams for BNCT based on a proton accelerator and the (7)Li(p,n)(7)Be reaction as a neutrons source. An optimal configuration is suggested for the beam shaping assembly made from polytetrafluoroethylene and magnesium fluorine to be placed on high current IPPE proton accelerator KG-2.5. Results of calculation were experimentally tested and are in good agreement with measurements.
Asunto(s)
Terapia por Captura de Neutrón de Boro/instrumentación , Neutrones Rápidos/uso terapéutico , Aceleradores de Partículas , Terapia por Captura de Neutrón de Boro/estadística & datos numéricos , Simulación por Computador , Arquitectura y Construcción de Instituciones de Salud , Humanos , Método de Montecarlo , Neoplasias/radioterapia , Fantasmas de Imagen , Dosificación RadioterapéuticaRESUMEN
The results of multimodality treatment are analyzed in 56 patients with local breast cancer. Combined gamma-neutron therapy with the use of fast reactor neutrons enhances the efficiency of breast cancer treatment and does not increase the number of radiation reactions and complications. The three-year survival increased from 44 +/- 12 to 75 +/- 9%. The test reactors specifically adjusted may be useful for the radiation therapy of patients with various malignant neoplasms. Combined gamma-neutron therapy is more promising for this purpose than neutron therapy alone.
Asunto(s)
Neoplasias de la Mama/radioterapia , Neutrones/uso terapéutico , Adulto , Anciano , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/cirugía , Terapia Combinada , Neutrones Rápidos/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Radioterapia/efectos adversos , Dosificación Radioterapéutica , Piel/efectos de la radiación , Enfermedades de la Piel/etiología , Factores de TiempoRESUMEN
The proteins characteristic of the whole period of differentiation constitute the main bulk of soluble proteins in the spermatogenic cells. Their content and enzymatic activity are subject to marked changes during spermatogenesis. The activity of glycolysis and pentose cycle enzymes is jointly changed; the fluctuations of enzymes of pyruvate oxidation and Krebs-cycle are in antiphase. Sorbitol dehydrogenase suffers marked activation in the late spermiogenesis. This process is facultative and is not expressed in the cells of young animals. It is suggested that the level of sorbitol dehydrogenase may serve as an index of biochemical maturity of late spermatids.
Asunto(s)
Proteínas/metabolismo , Espermatogénesis , Espermatogonias/enzimología , Espermatozoides/enzimología , Animales , Diferenciación Celular , Ciclo del Ácido Cítrico , Electroforesis en Gel de Poliacrilamida , Glucólisis , Masculino , Ratones , Pentosafosfatos/metabolismo , Proteínas/análisis , Solubilidad , Espermátides/enzimologíaRESUMEN
Clinical and biochemical investigation was performed in 49 patients with epilepsy of different etiology and clinical course, 10 patients with nonepileptic forms of neurologic and psychic disorders and 50 normal subjects. An additional blood serum protein fraction was found in epileptic patients as compared with the normals using the electrophoretic investigation on the acetate-cellulose plates and devices produced by Hélène France company. Additional biochemical study is suggested as a diagnostic tool in epilepsy.
Asunto(s)
Epilepsia/diagnóstico , Adolescente , Adulto , Electroforesis de las Proteínas Sanguíneas/instrumentación , Electroforesis de las Proteínas Sanguíneas/métodos , Epilepsia/sangre , Epilepsia/etiología , Femenino , Humanos , Masculino , Trastornos Neuróticos/sangreRESUMEN
Studies of tumours and adjacent tissue were carried out in 29 patients with carcinoma of the larynx after preoperative irradiation with fast neurons at a total focal dose 5.6 Gy alone or in combination with gamma therapy. Pronounced pathomorphosis was established in all the cases, up to a full disappearance of the tumor in 2 patients, the degree of pathomorphosis did not depend on location, macroscopic form of growth, degree of dissemination. No changes were found in the wall of the larynx outside the tumor.
Asunto(s)
Neutrones Rápidos , Neoplasias Laríngeas/patología , Cuidados Preoperatorios/métodos , Terapia Combinada , Rayos gamma , Humanos , Neoplasias Laríngeas/radioterapia , Necrosis , Inducción de Remisión/métodosRESUMEN
In anesthetized rats, concentrations of adrenaline and noradrenaline in sequential 20-min microdialysis samples were measured. Central activation of adrenal secretory function induced by controlled bleeding, increased catecholamine levels in dialysate but the maximal levels were reached after hemorrhage when a decrease in the blood pressure had been stabilized. The results of parallel measurements of catecholamine concentration in dialysate and blood samples suggest that reflex endocrine response of the adrenal gland during hypovolemic hypotension significantly exceeds sympathetic neural response.
Asunto(s)
Médula Suprarrenal/metabolismo , Volumen Sanguíneo/fisiología , Catecolaminas/fisiología , Hipotensión/fisiopatología , Animales , Presión Sanguínea/fisiología , Diálisis/instrumentación , Diálisis/métodos , Epinefrina/análisis , Epinefrina/fisiología , Hemorragia/fisiopatología , Masculino , Norepinefrina/análisis , Norepinefrina/metabolismo , Prótesis e Implantes , Ratas , Ratas EndogámicasRESUMEN
More than 250 patients, mainly with locally advanced tumors of the head, neck and breast were treated with a I MeV beam of fast neutrons emitted from a BR-10 reactor. The fast neutron contribution to the total dose of the radical component of complex gamma-neutron therapy was 20-40%. Said modality was shown to improve the results of treatment for laryngeal and breast tumors. The 5-year actuarial survival following complex gamma-neutron therapy for laryngeal cancer was 89.25, while in controls--65.2% (p < 0.005). The 5-year actuarial overall survival in breast cancer patients treated with fast neutrons was 66.5%: gamma-neutron therapy alone--46.0% (p < 0.05).
Asunto(s)
Neoplasias de la Mama/radioterapia , Neutrones Rápidos , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de la Mama/patología , Femenino , Rayos gamma , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Radioterapia/efectos adversos , Radioterapia/métodos , Dosificación Radioterapéutica , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Microdialysis technique has been developed to study secretory function of the adrenal gland in anesthesized rats. Concentration of adrenaline and noradrenaline in sequential 20 min microdialysis samples was measured by HPLC with electrochemical detection. The suitability of method was tested by local and central stimulation of catecholamine secretion. In the first case 100 mmol of KCl or 1 mmol of carbachol were added to perfusion medium, in the second one hypovolemic hypotension was applied. All the stimuli used increased catecholamine levels in the adrenal gland dialysates. Institute of Experimental Cardiology of the All-Union.
Asunto(s)
Médula Suprarrenal/metabolismo , Epinefrina/metabolismo , Norepinefrina/metabolismo , Animales , Cromatografía Líquida de Alta Presión/métodos , Diálisis/métodos , Epinefrina/biosíntesis , Masculino , Norepinefrina/análisis , Perfusión/métodos , Ratas , Ratas EndogámicasRESUMEN
Basing on roentgenological and morphological investigations the causes of the iliac veins passability disorder were studied up. In 45.1% of observations the stenosis was revealed of the left and in 1.2% of the right common iliac vein. Among the stenosis causes were osteal or cartilagenous prominences of vertebral column, intravascular structures (webs, membranes) in the left common iliac vein, the external iliac vein squeeze by internal iliac artery, retroperitoneal fibrosis, the right common iliac artery aneurysm, anomalous branching of parietal pelvic artery.