4 research outputs found
ΠΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΡΠΉ ΡΠΎΠ² ΠΏΡΠΈ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΠΎΡΠΊΠΈ Π±Π΅Π· ΠΈΡΠ΅ΠΌΠΈΠΈ. ΠΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ ΠΠΠ ΠΈΠΌ. Π‘.Π. ΠΠΎΡΠΊΠΈΠ½Π°
Background. Radical removal of the tumor while maximizing sparing of the renal function are the main goals of the partial nephrectomy. Shortening of the warm ischemia time is one of the best ways to achieve good functional results of the surgery. Aim. To present our technique of non-ischemic laparoscopic kidney resection with preventive suturing around the tumor.Materials and methods. Before tumor resection, sutures are placed around tumor spaced by 1 cm with moderate tension. Enucleoresection is performed between tumor and preplaced sutures in visually healthy plane. 30 patients underwent this technique.Results. Median tumor size was 3.6 (1.5β7.2) cm. All patients had negative surgical margin. Warm ischemia was needed in 8 (26.7 %) patients with a median time of 9 minutes. Median operative time was 115 (65β185) minutes. There were no intra or postoperative complications. Trifecta was achieved in all patients (100 %).Conclusion. This technique allows to perform the surgery in non-ischemic fashion, decrease bleeding and improve visualization of the resection field and achieve superior oncologic and functional results.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ ΡΠ΅Π»ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΠΎΡΠΊΠΈ Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ β ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ΅ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠ΅ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠΎΡΠΊΠΈ. Π£ΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΡΠ΅ΠΏΠ»ΠΎΠ²ΠΎΠΉ ΠΈΡΠ΅ΠΌΠΈΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠΏΠΎΡΠΎΠ±ΠΎΠ² Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ Π»ΡΡΡΠ΅Π³ΠΎ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΠΎΡΠΊΠΈ Π±Π΅Π· ΠΈΡΠ΅ΠΌΠΈΠΈ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΡΡ
Π³Π΅ΠΌΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ²ΠΎΠ².ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ΅ΡΠ΅Π΄ ΡΠ΅Π·Π΅ΠΊΡΠΈΠ΅ΠΉ Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎ Π²ΠΎΠΊΡΡΠ³ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΡΠ΅ΡΠ΅Π· ΠΊΠ°ΠΆΠ΄ΡΠΉ ΡΠ°Π½ΡΠΈΠΌΠ΅ΡΡ Π½Π°ΠΊΠ»Π°Π΄ΡΠ²Π°ΡΡ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΡΠ΅ ΡΠ²Ρ, ΡΠΎΠ·Π΄Π°Π²Π°Ρ ΡΠΌΠ΅ΡΠ΅Π½Π½ΠΎΠ΅ Π½Π°ΡΡΠΆΠ΅Π½ΠΈΠ΅. ΠΡΠΏΠΎΠ»Π½ΡΡΡ ΡΠ½ΡΠΊΠ»Π΅ΠΎΡΠ΅Π·Π΅ΠΊΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΡΡ ΠΈ Π½Π°Π»ΠΎΠΆΠ΅Π½Π½ΡΠΌΠΈ ΡΠ²Π°ΠΌΠΈ Π² ΡΠ»ΠΎΠ΅ Π²ΠΈΠ·ΡΠ°Π»ΡΠ½ΠΎ Π½Π΅ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Π½ΠΎΠΉ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° 30 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ ΡΠ°Π·ΠΌΠ΅Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ» 3,6 (1,5β7,2) ΡΠΌ. Π£ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ» ΠΊΠΎΠ½ΡΡΠ°ΡΠΈΡΠΎΠ²Π°Π½ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΡΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΊΡΠ°ΠΉ. ΠΠ΅ΡΠ΅ΠΆΠ°ΡΠΈΠ΅ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π½ΠΎΠΆΠΊΠΈ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π»ΠΎΡΡ 8 (26,7 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΈ ΡΡΠ΅Π΄Π½Π΅ΠΌ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΡΠ΅ΠΏΠ»ΠΎΠ²ΠΎΠΉ ΠΈΡΠ΅ΠΌΠΈΠΈ 9 ΠΌΠΈΠ½. Π‘ΡΠ΅Π΄Π½ΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ β 115 (65β185) ΠΌΠΈΠ½. ΠΠ½ΡΡΠ°ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ. Π’ΡΠΈΡΠ΅ΠΊΡΠ° Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΠ° Ρ Π²ΡΠ΅Ρ
30 (100 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ².ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ°Π½Π½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΠ΅ΠΏΠ»ΠΎΠ²ΠΎΠΉ ΠΈΡΠ΅ΠΌΠΈΠΈ, ΡΠ»ΡΡΡΠΈΡΡ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΈ Π΄ΠΎΡΡΠΈΡΡ Π»ΡΡΡΠΈΡ
ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ²
Dry and Humid Periods Reconstructed from Tree Rings in the Former Territory of Sogdiana (Central Asia) and Their Socio-economic Consequences over the Last Millennium
One of the richest societies along the Silk Road developed in Sogdiana,
located in present-day Tajikistan, Uzbekistan, and Kyrgyzstan. This urban civilisation
reached its greatest prosperity during the golden age of the Silk Road (sixth to
ninth century ce). Rapid political and economic changes, accelerated by climatic
variations, were observed during last millennium in this region. The newly developed
tree-ring-based reconstruction of precipitation for the pastmillennium revealed
a series of dry and wet stages. During the Medieval Climate Anomaly (MCA), two
dry periods occurred (900β1000 and 1200β1250), interrupted by a phase of wetter
conditions. Distinct dry periods occurred around 1510β1650, 1750β1850, and
1920β1970, respectively. The juniper tree-ring record of moisture changes revealed
that major dry and pluvial episodes were consistent with those indicated by hydroclimatic
proxy data from adjacent areas. These climate fluctuations have had longand
short term consequences for human history in the territory of former Sogdiana