Resection interventions in the treatment of hepatocellular cancer in a specialized surgery center

Background. The relevance of the treatment of hepatocellular cancer (HCC) is determined by a significant increase in the incidence rate and its high prevalence among primary malignant hepatic tumors.The aim of the study. To summarize the experience of providing specialized medical care to patients with hepatocellular cancer.Methods. We studied the direct results of treatment of patients with primary hepatic cancer treated at the Kuzbass Regional Hepatological Center for the period from January 2015 to August 2022. The materials for the study were medical records of patients with an established diagnosis of primary hepatic cancer, surgical records, results of pathohistologic examination. The exclusion criterion was diagnosed cholangiocellular carcinoma.Results. During the period from 2015 to 2022, 59 patients with primary hepatic cancer were treated at the Kuzbass Regional Hepatological Center. Among them, hepatocellular cancer was diagnosed in 48 cases, cholangiocellular cancer – in 11 cases; radical surgery was performed in 12 patients with hepatocellular cancer; fatal outcome was noted in 1 (2.1 %) patient, complications in the postoperative period developed in 5 (41.7 %) cases and were ranked as I-3, IIIb-1 and IVb-1 according to Clavien – Dindo classification.Conclusion. The degree of risk of severe post-resection hepatic failure should be considered one of the main criteria in choosing a strategy for radical surgical treatment. New surgical approaches (laparoscopic vascular isolation of the portal blood flow, using temporary hemostasis in laparoscopic hepatic resections and the device for its implementation) in resection surgery of primary hepatic cancer can improve the immediate results of treatment

Poloidal inhomogeneity of the particle fluctuation induced fluxes near of the LCFS at lower hybrid heating and improved confinement transition at the FT-2 tokamak

This paper deals with the new spectral and microturbulence experimental data and their analysis, which show, that the radial electric field Er generated at the LH heating (LHH) in the FT-2 is high enough to form the transport barriers. The ETB is formed when LHH is switched off. The radial fluctuation-induced EB drift flux densities near LCFS in SOL are measured at two different poloidal angles. For this purpose two Langmuir probes located at low and high field sides of the torus are used. Registration of the poloidal and radial components of the electric field and density fluctuations at the same time during one discharge permits to measure the poloidal asymmetry of the transport reduction mechanism of the radial and poloidal particle fluxes in the SOL. The absolute E(~) fluctuation levels show dependence on the sign of Er shear. The modification of the microscale turbulence by the poloidal Er x B rotation shear EB at the L - H transition near LCFS is also studied by X-mode fluctuation Reflectometry. The new data were obtained by spatial spectroscopic technique.Comment: 12th International Congress on Plasma Physics, 25-29 October 2004, Nice (France

Acute cerebellar ataxia in a young woman: Wernicke’s encephalopathy?

Wernicke’s encephalopathy (WE) is a rare but severe neurological syndrome caused by thiamine deficiency. According to the data of autopsy studies, the prevalence of WE in the general population varies from 0.4 to 2.8 per 100,000 population; the disease occurs many times more frequently in alcohol abusers than in people who lead a healthy lifestyle. These studies also showed that most cases of WE were diagnosed postmortem; less than 20% of patients with the disease were diagnosed in life. A healthy adult requires 1–2 mg of thiamine daily, depending on the carbohydrate intake. Body’s reserves of thiamine are only 30–50 mg so any malnutrition condition lasting more than 3–4 weeks can cause complete depletion of the vitamin’s stores. Classically, WE is characterized by the sudden onset of a typical triad of symptoms: an altered mental state, ophthalmoplegia, and ataxia. However, this clinical picture can be seen in only one-third of patients. The onset of the disease may sometimes look completely different: heart failure with hypotension and tachycardia; gastrointestinal symptoms (abdominal pain and nausea); hypothermia due to the involvement of the posterior hypothalamus; deafness affecting the thalamus; epileptic seizures in case of enhanced activity of the glutamatergic system.The paper describes a clinical case of acute cerebellar ataxia that is apparently caused by Wernicke’s encephalopathy in a young woman

ACTIVATIONAL SYSTEM BASED ON POLYMER COMPOSITIONAL MATERIAL FOR USE IN SMALL SPACECRAFTS, NANO- AND PICOSATELLITES

Работа связана с поиском, анализом научно-технической информации о внешних условиях в открытом космосе и работоспособности конструкции в заданных условия; созданием модели распространения тепла в системе; проектированием – расчетами, подтверждающими работоспособность конструкции и эскизным проектированием конструкции.The work is connected with search and analysis of scientific and technical documentation on environmental conditions in outer space and structure working capacities in those conditions; creation of heat transmission model in the system; designing – calculations to confirm working capacities of the structure and schematic design of the structure

MODERNIZATION OF ACTIVATED SYSTEM ON THE BASIS PKM WITH EFFECT OF SHAPE MEMORY FOR DISCLOSURE OF SOLAR PANELS IN SMALL SPACECRAFTS

Work is connected with search, the analysis of scientific and technical information on external conditions in an outer space and operability of a design in set conditions; analysis of research works on this subject; development of a way of modernization of activated system on the basis of PKM with effect of shape memory.Работа связана с поиском, анализом научно-технической информации о внешних условиях в открытом космосе и работоспособности конструкции в заданных условия; анализом научно-исследовательских работ по данной тематике; разработкой способа модернизации активаторной системы на основе полимерного композиционного материала (ПКМ) с эффектом памяти формы

БИОЛОГИЧЕСКИЕ РЕСУРСЫ ОЗЕРА ГУСИНОЕ СЕЛЕНГИНСКОГО РАЙОНА РЕСПУБЛИКИ БУРЯТИЯ

The research is conducted on Gusinoe lake in Selenginskiy district of theRepublicofByryatiya. The lake is one of the biggest in the Gusino-Ubukinskaya system and it suffers from anthropogenic impact. The wastewaters of Hydro Power Plant and wastewaters of the settlement flow into the lake where the water is used for drinking. The authors explored thelakebioresourcesand registered 4 main cropping. The main part of biomass contains perch – Perca fluviatilis (L.), roach – Rutillus rutilus L.) and pike – Esoxlucius (L.). The authors explored the dimensionally species variation based on the analysis of research skinning and application of heterobrochate nets. The research explores the data on the age distribution in the population. The authors observed perch, roach and pike in the fish fauna of Gusinoe lake where perch dominated 93.1% on the number and 77.1% on biomass. The roach can be referred to the species of common occurrence when its share in controlling yields was 6.4% on the number and 16.4% on the mass. The proportion of pike in the biomass was 6.3%. The perch population is characterized by dominating species aged 2+ to 4+. The researchers observed insufficient number of the fish aged 6+ to 11+ in the population. The roach is characterized by the fish aged 1+ to 12+ where the species aged 3+, 8+ and 10+ dominate. The linear growth of perch is steady during 20 years. The perch growth indicator was 11% higher than average in Gusinoe lake that that in the basins of Baikal region.Исследования проведены на оз. Гусиное, расположенном вСеленгинском районе Республики Бурятия. Озеро является одним из крупнейших в Гусино-Убукунской системе озер и в настоящее время подвергается сильнейшему антропогенному воздействию. В озеро поступают сточные воды ГРЭС и непосредственно стоки самого населенного пункта, воду используют для питьевых целей. Нами были проведены исследования по изучению биоресурсов озера. В ихтиофауне зарегистрированы четыре основных промысловых вида. Основу численности биомассы составляли окунь – Perca fluviatilis (L.), плотва – Rutillus rutilus (L.), щука – Esoxlucius (L.). Нами была изучена размерно-видовая изменчивость на основе анализов научных съемок с использованием разноячеистых сетей. Были получены также данные по возрастному распределению в популяции. В период 2013–2016 гг. в ихтиофауне оз. Гусиное отмечены окунь, плотва, щука. Доминировал в уловах окунь – 93,1% по численности и 77,1% по массе. Плотву сибирскую можно отнести к обычно встречающимся видам, ее доля в контрольных уловах по численности составила 6,4, по массе – 16,4%. Удельный вес щуки по биомассе – 6,3%. У окуня в популяции преобладают особи от 2+ до 4+. Рыбы в возрасте от 6+ до 11+ составляют незначительное количество популяции. Плотва представлена рыбами в возрасте от 1+ до 12+, преобладают особи 3+, 8+ и 10+. Линейный рост окуня остается стабильным в течение 20 лет. Показатель роста окуня в оз. Гусиное был на 11% выше средних для водоемов Забайкалья значений и находился на уровне предыдущих лет

Основные аспекты межгоспитальной транспортировки пациентов с политравмой, находящихся в критическом состоянии

Polytrauma is one of the main causes of death in modern medicine. It is characterized by the particular severity of clinical manifestations and attended by significant impairments of the body’s vital functions, by diagnostic difficulties, and treatment complexity. In Kuzbass, as many as 8 thousand victims annually die from severe injuries. Death rates amount 21—22% in specialized hospitals and up to 60% or more in unspecialized hospitals. On the basis of multidisciplinary medical centers, an effective network of health care facilities (HCF) is being set up to render a specialized medical aid to patients with polytrauma. The application of expensive medical diagnostic and therapeutic technologies reduces the rates of morbidity and disability among patients with polytrauma. A specialized medical aid cannot be rendered to all victims without solving the problems of their transportation to a specialized center. Of the greatest difficulty is the transportation of critically ill patients with polytrauma and unstable hemodynamics when artificial ventilation is used during transportation. The transportation service set up in the Center of Miners’ Health Care in the specialized polytrauma center is engaged in the development of the problems of safe transport of this category of victims. Organizational problems are to collect information on victims, to form a specialized team and to supply the latter with equipment. Therapeutic-and-diagnostic problems are to additionally evaluate the status of victims at the scene (in an unspecialized HCF, if required, in and around the area of an accident), to prepare a patient before transportation; to provide a complete set of intensive therapy during interhospital transportation of patients with polytrauma in relation to the predominant component of a damage. In the authors’ opinion, solution of this group of problems can enhance the efficiency of intensive care during transportation and reduce mortality rates in this category of patients. Политравма является одной из основных причин смертности в современной медицине. Она отличается особой тяжестью клинических проявлений, сопровождается значительными нарушениями жизненно важных функций организма, трудностью диагностики, сложностью лечения. В Кузбассе ежегодно погибает до 8 тыс пострадавших от тяжелых травм. В условиях специализированных стационаров летальность составляет 21—22%, не специализированных ЛПУ — она достигает 60% и более. На базе многопрофильных медицинских центров создается действенная сеть лечебных учреждений для оказания специализированной медицинской помощи пациентам с политравмой. Использование дорогостоящих медицинских диагностических и лечебных технологий позволяет снизить уровень летальности, инвалидности среди пациентов с политравмой. Оказание специализированной медицинской помощи всем пострадавшим невозможно без решения вопросов транспортировки в специализированный центр. Наибольшую сложность представляет транспортировка пациентов с политравмой, находящихся в критическом состоянии, с нестабильной гемодинамикой, с применением во время транспортировки ИВЛ. Созданная в «Центре охраны здоровья шахтеров» при специализированном центре политравмы служба транспортировки занимается разработкой вопросов безопасного транспорта этой категории пострадавших. Организационными: информация о пострадавших, формирование специализированной бригады и её оснащения. Лечебно-диагностическими: дополнительная оценка состояния пострадавших на месте (в неспециализированном ЛПУ, при необходимости — в зоне чрезвычайных происшествий); подготовка пациента перед транспортировкой; обеспечение полного комплекса интенсивной терапии во время межгоспитальной транспортировки у пациентов с политравмой в зависимости от доминирующего компонента повреждения. Решение этих вопросов позволит повысить эффективность интенсивной терапии при проведении транспортировки и снизить летальность у данной категории пациентов.