A New Method and Mass-Spectrometric Instrument for Extraterrestrial Microbial Life Detection Using the Elemental Composition Analyses of Martian Regolith and Permafrost/Ice.

We propose a new technique for the detection of microorganisms by elemental composition analyses of a sample extracted from regolith, permafrost, and ice of extraterrestrial bodies. We also describe the design of the ABIMAS instrument, which consists of the onboard time-of-flight laser mass-reflectron (TOF LMR) and the sample preparation unit (SPU) for biomass extraction. This instrument was initially approved to fly on board the ExoMars 2020 lander mission. The instrument can be used to analyze the elemental composition of possible extraterrestrial microbial communities and compare it to that of terrestrial microorganisms. We have conducted numerous laboratory studies to confirm the possibility of biomass identification via the following biomarkers: P/S and Ca/K ratios, and C and N abundances. We underline that only the combination of these factors will allow one to discriminate microbial samples from geological ones. Our technique has been tested experimentally in numerous laboratory trials on cultures of microorganisms and polar permafrost samples as terrestrial analogues for martian polar soils. We discuss various methods of extracting microorganisms and sample preparation. The developed technique can be used to search for and identify microorganisms in different martian samples and in the subsurface of other planets, satellites, comets, and asteroids-in particular, Europa, Ganymede, and Enceladus. Key Words: Mass spectrometry-Life-detection instruments-Biomarkers-Earth Mars-Biomass spectra. Astrobiology 17, 448-458.

THE FIRST REPORT OF LAPAROSCOPIC RADICAL CYSTECTOMY IN GEORGIA.

Bladder cancer is the ninth most commonly diagnosed malignant tumor worldwide. Radical cystectomy is the standard surgical treatment for non-metastatic, muscle-invasive bladder cancer and a recommended treatment of choice in a subset of highest-risk patients with non-muscle invasive disease. Recently, laparoscopic radical cystectomy has become an attractive alternative to an open counterpart and many centers worldwide have reported their early experiences with the technique. Laparoscopic radical cystectomy is a technically challenging procedure and current recommendations still consider it, with or without robotic assistance, to be experimental due to absence of long-term data on oncological and functional outcomes and possible selection bias in the reported series. In this paper, we report the case of a 61 year-old male with a muscle-invasive recurrence of bladder cancer, who underwent laparoscopic radical cystectomy at the National Centre of Urology in Tbilisi, Georgia. This is the first such procedure performed in Georgia and most of the former Soviet countries, with the exception, to our knowledge, of only the Russian Federation. The technique of laparoscopic radical cystectomy with simultaneous prepubic urethrectomy, extended pelvic lymph node dissection, and extracorporeal urinary diversion in the form of an ileal conduit is described. Laparoscopic radical cystectomy is a feasible minimally-invasive alternative to the standard open surgery when performed by experienced surgeons in selected patients. We deem the introduction of the technique a step forward in the field of minimally invasive urology in Georgia.

Results of radical cystectomy with Mainz pouch II diversion (single institution experience).

Evaluation of the peri- and postoperative morbidity in patients who underwent radical cystectomy and sigma-rectum pouch (Mainz pouch II) diversion with curative intent for invasive bladder cancer. We've reviewed 320 patients with invasive bladder cancer who underwnt radical cystectomy with lymphadenectomy and urinary diversion in our clinic from 1988 to 2011. In 134 (41.9%) patients Mainz pouch II diversion was performed. The results and complication rates have been analyzed in these patients. Intraoperaive injury of the rectum occurred in 2 (1.5%) patient, early complications were found in 40 (29.9%) and late complications in - 5 (3.7%) patients. Oral alkalization was necessary in 30 (22.4%) cases. 9 (6.7%) patients were hospitalized because of severe acidosis. Acute pyelonephritis developed in 8 (5.9%) patients. Hydronephrosis developed in 15 (11.2%) cases. In 7 (5.2%) patients dilatation of upper urinary tract was bilateral and in 8 (5.9%) - unilateral. In 4 (2.9%) patients stricture of the ureteral anastomosis was diagnosed. All patients were dry at day time. Only three (2.2%) patients (2 male and 1 female) needed pads at night time. All of these three patients were above 70 years old. Two patients underwent surgical intervention for interintestinal abscess. One patient was operated because of mechanical bowel obstruction 2 month after surgery. Perioperative mortality was 3.7%. Mainz Pouch II has a low morbidity and mortality rates. This form of diversion is method of choice for patients in whom the urethra cannot be used. In selected cases Mainz Pouch II is alternative to other types of continent diversion.

[Some aspects of transurethral resection of large benign prostatic hyperplasia].

Benign prostatic hyperplasia (BPH) is a progressive disease that affects the quality rather than the quantity of life of men. There are two methods of surgical treatment of BPH: transurethral resection of the prostate (TURP) and open prostatectomy. In this study we investigated the safety and efficacy of TURP for large prostate glands. To analyze our clinical data we can conclude introduction of technological innovations, especially of "low pressure" TURP, have made it possible to perform TURP for large prostates so safely as for recommended volumes. Also our trial has demonstrated that complications after TURP were within admissible limits of standard TURP. Therefore, TURP can be considered as an effective and safe procedure for patients with large prostate glands.

[Radical perineal prostatectomy--surgical technique, first results].

Prostate cancer is the most common malignancy in men and the second leading cause of cancer death. Radical prostatectomy is the most effective treatment for localized prostate cancer. With increasing use of minimally invasive treatment methods, clinical outcomes are becoming important assessment tools to compare one option to another. Perineal prostatectomy is modified to incorporate contemporary surgical ideas, including preservation of cavernosal nerve bundles, sphincteric urethra at the prostatic apex, and the bladder neck. During 2001-2004 in National Centre of Urology radical perineal prostatectomy was performed in 9 patients. The mean age of the patients was 64 years (range: 53-71 years). All operations were carried out with curative purpose for the treatment of localized prostate cancer. In all cases prostate specific antigen (PSA) was <10 ng/ml, Gleason score<7. There were analyzed operative time, volume of blood transfusions, duration of hospital stay, peri-operative complications, pre and postoperative potency and urinary continence. The distribution of pT categories was: pT2a-2 (22.2%); pT2b-5 (55.6%); pT3a-1 (11.1%); pT3b-1 (11.1%). The mean operative time was 130 minutes (range 95-180 minutes). The middling volume of blood transfusion per patient was 427 ml. At 12 months incontinence was manifested in 1 (11.1%) patient. Postoperative potency was reached in one case. Margins were positive in 2 (22.2%) cases. In both cases was manifested biochemical relapse. One of these patients died after 32 month from surgery. According our results 3-year tumor specific survival was in 7 (77.8%) patients. Radical perineal prostatectomy is an excellent alternative approach for radical surgery in the treatment of early prostate cancer. This method of prostatectomy is able to achieve complete cancer resection while preserving urinary and sexual function in the majority of men presenting with clinically localized prostate cancer. The simplicity and minimally invasive nature of this procedure contribute to a short recovery and low overall cost of therapy. The radical perineal prostatectomy is a cost-efficient, outcome-effective minimally invasive method of treating men with localized prostate cancer.

[The efficacy of extracorporal shock wave lithotrypsy in urinary stone disease].

Extracorporal Shock Wave Lithotrypsy (ESWL) is "golden" standard therapy among the various methods of treatment of urinary stone disease. We have evaluated 1645 patients with urinary stone disease who underwent ESWL from 2003 to 2006, with third generation Dornier Compact Delta lythotriptor. 932 (56.7%) of them were male and 713 (43.3%) were female, 55 (3.3%) of all were children. Patients' age varied from 1 to 93 years. The total amount of sessions performed were 3391 (mean 2.1). In case of renal calculi the amount of shocks was 2000-3500 and the duration of session varied from 20 to 35 minutes. In case of urethral calculi--3000-4500 shocks, duration of session varied from 30 to 45 minutes. From 1719 stones 1452 (84.5%) were X-Ray positive and 267 (15.5%) were X-Ray negative. ESWL was successful (stone free) in 1211 (73.6%) and semi successful in 91 (5.5%) cases; Semi successful group included patients, which became disobstructed after ESWL, but the some of the stone fragments were dislocated into lower calyx and were not eliminated. Unfinished treatment (Patient disappeared after the initial sessions) were in 262 (15.9%) cases. 81 cases were not successful. 31 patients from this group underwent urethrorenoscopy, 49 patients--open surgery and 7--PNL. In conclusion, ESWL is the "golden" standard treatment of Urinary stone disease in cases of carefully performed examination and management. Careful study of every single case, gives as the possibility to avoid expensive and invasive procedures and reduce the risk of complications.

[Extended lymphadenectomy in radical cystectomy: margins, scope, methodology].

Radical cystectomy with pelvic lymphadenectomy is a gold standard for treatment of muscle-invasive urinary bladder cancer. However, therapeutic and prognostic value of pelvic lymphadenectomy is still controversial. Recent studies have demonstrated a better prognosis after extended lymphadenectomy. A multicenter study was made to standardize an extended lymphadenectomy procedure. We examined prospectively the total number of lymph nodes removed from various sites, number and location of positive nodes and its relation to location of primary tumors in the urinary bladder. Thirty five radical cystectomies with extended lymphadenectomy were performed for the treatment of invasive bladder cancer in National Urology Center in 1999-2004. The margins of extended lymphadenectomy were: cranial level of a.mesenterica inferior; lateral--n.n. genitofemoralis; caudal-fossa obturatoria. A total amount of removed lymph nodes comprised 1081, mean 34.2 +/- 8.1 lymph node per patient (range from 10 to 58). Fourteen patients (40.0%) were node positive (69 nodes). According to N category: N1--6 patients; N2--7 patients. Six patients had lymph node metastases up to the aortic bifurcation. In 6 cases a positive node was found on the contralateral side. Thus, we recommend extended radical lymphadenectomy for all patients undergoing radical cystectomy for bladder cancer.

Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of a prospective multicenter study.

PURPOSE: Previous studies demonstrate a positive correlation between postoperative survival and the extent of pelvic lymphadenectomies in patients with bladder cancer. However, the distribution of nodal metastases has not been examined in sufficient detail. Therefore, we conducted a comprehensive prospective analysis of lymph node metastases to obtain precise knowledge about the pattern of lymphatic tumor spread. MATERIALS AND METHODS: Between 1999 and 2002 we performed 290 radical cystectomies and extended lymphadenectomies. Cranial border of the lymphadenectomy was the level of the inferior mesenteric artery, lateral border was the genitofemoral nerve and caudal border was the pelvic floor. We made every effort to excise and examine microscopically all lymph nodes from 12 well-defined anatomical locations. RESULTS: Mean total number and standard deviation of lymph nodes removed was 43.1 +/- 16.1. Nodal metastases were present in 27.9% of patients. The percentage of metastases at different sites ranged from 14.1% (right obturator nodes) to 2.9% (right paracaval nodes above the aortic bifurcation). By studying cases of unilateral primary tumors or with only 1 metastasis we observed a preferred pattern of metastatic spread. However, there were many exceptions to the rule and we did not identify a well-defined sentinel lymph node. CONCLUSIONS: We strongly recommend extended radical lymphadenectomy to all patients undergoing radical cystectomy for bladder cancer to remove all metastatic tumor deposits completely. The operation can be conducted in routine clinical practice and our data may serve as a guideline for future standardization and quality control of the procedure.

MEP (Mars Environment Package): toward a package for studying environmental conditions at the surface of Mars from future lander/rover missions.

In view to prepare Mars human exploration, it is necessary to promote and lead, at the international level, a highly interdisciplinary program, involving specialists of geochemistry, geophysics, atmospheric science, space weather, and biology. The goal of this program will be to elaborate concepts of individual instruments, then of integrated instrumental packages, able to collect exhaustive data sets of environmental parameters from future landers and rovers of Mars, and to favour the conditions of their implementation. Such a program is one of the most urgent need for preparing human exploration, in order to develop mitigation strategies aimed at ensuring the safety of human explorers, and minimizing risk for surface operations. A few main areas of investigation may be listed: particle and radiation environment, chemical composition of atmosphere, meteorology, chemical composition of dust, surface and subsurface material, water in the subsurface, physical properties of the soil, search for an hypothesized microbial activity, characterization of radio-electric properties of the Martian ionosphere. Scientists at the origin of the present paper, already involved at a high degree of responsibility in several Mars missions, and actively preparing in situ instrumentation for future landed platforms (Netlander--now cancelled, MSL-09), express their readiness to participate in both ESA/AURORA and NASA programs of Mars human exploration. They think that the formation of a Mars Environment working group at ESA, in the course of the AURORA definition phase, could act positively in favour of the program, by increasing its scientific cross-section and making it still more focused on human exploration.

Right colonic reservoir with submucosally embedded tapered ileum--'Tiflis pouch'.

Seventeen patients with invasive bladder cancer aged between 44 and 67 years underwent radical cystectomy and construction of the continent urinary reservoir from 20 to 25 cm cecoascendum reconfigurated a.m. Heineke-Mikulicz. and submucosally embedded tapered ileum as a continence mechanism--'Tiflis pouch'. There were no perioperative mortalities and only minor complication but abdominal wound dehiscence occurred with a subsequent hernia in 1 obese patient. One patient died of urethral recurrence and malignancy progression 14 months after surgery. During the follow-up period of 9-37 months, all renal units remained unobstructed. Eleven of 15 preoperatively dilated units improved. No case of pouch stone formation, stomal stenosis or difficulties with catheterization was observed. All patients are continent but 4 need catheterization at 3-hour intervals. The functional capacity is in the range of 310-560 ml. The Tiflis pouch is a capacious reservoir in which the continence state is satisfactory, perioperative complication rate is low and quality of life is high.