Результаты модульного эндопротезирования параацетабулярной области при опухолевом поражении вертлужной впадины и тазобедренного сустава

Introduction. surgical treatment of patients with pelvic bone tumors, in particular periacetabular tumors, remains challenging. There are many different reconstruction options after resection of these tumors. These include allo- and autografts, megaprosthesis, saddle endoprosthesis, custom-made endoprosthesis, 3D printing endoprosthesis, and femur transposition with the formation of neo-arthrosis. However, all of them are characterized by technical complexity and high risk of postoperative complications. There is still no standard procedure for reconstruction after resection of malignant periacetabular tumors. To date, modular endoprosthesis is a well-established reconstructive device in orthopaedic oncology to manage wide bone resections. Modular systems provide patient-specific endoprostheses that could be modified during surgery. In this article, we present the results of modular acetabular endoprostheses in the treatment of patients with periacetabular tumors.Material and Methods. From 2011 to 2018, 30 patients underwent modular endoprosthetic reconstruction after periacetabular resection. There were 13 (43 %) male and 17 (57 %) female patients aged from 23 to 63 years (median age 45 years). Primary malignant bone tumors were detected in 19 (63 %) patients, giant cell tumor in 5 (17 %), local soft tissue sarcoma in 1 (3 %), solitary metastases of kidney cancer in 2 (7 %) and recurrent sarcoma after previous surgical treatment in 3 (10 %) patients.Results. The average duration of surgery was 310 minutes (range: 145-520 minutes), blood loss was 5520 ml (range: 600-20000 ml). The median follow-up time was 36 months. Histological examination revealed a positive resection margin in 3 (10 %) patients. At a follow-up from 6 to 40 months, disease progression was detected in 10 (33 %) patients. Eight (27 %) patients died on disease progression. Complications of various types were diagnosed in 11 (37 %) patients. Infectious complications were the most common (30 % of patients). The average value of the functional assessment by the MSTS scale was 59 % (15-82%).Conclusion. Modular endoprosthetic replacement for tumors of the acetabulum and hip joint is a promising surgical technique allowing adequate functional results to be achieved.Введение. Хирургическое лечение больных с опухолевым поражением костей таза, в частности параацетабулярной области, является одним из наиболее сложных разделов современной онкоортопедии. Существуют различные методики реконструкции вертлужной впадины: при помощи алло- и аутографтов, мегаэндопротезов, седловидных эндопротезов, индивидуальных эндопротезов, 3Б-принтинга и транспозиции бедренной кости с формированием неоартроза. Однако все они характеризуются технической сложностью выполнения, достаточным риском развития послеоперационных осложнений. Вследствие этого универсальной методики, удовлетворяющей всем поставленным задачам, не существует. Одним из наиболее современных методов реконструкции костей таза является использование модульных эндопротезов на основе конической ножки, преимуществом которых является возможность интра-операционно смоделировать эндопротез, наиболее полно удовлетворяющий конкретной клинической ситуации. В статье представлены результаты использования модульных эндопротезов вертлужной впадины при лечении пациентов с опухолевым поражением параацетабулярной области.Материал и методы. В период с 2011 по 2018 г хирургическое лечение в объеме параацетабулярной резекции с реконструкцией модульным эндопротезом выполнено 30 больным, из них мужчин - 13 (43 %), женщин - 17 (57 %). Средний возраст - 45 лет (23-63 года). Первичные злокачественные опухоли костей были у 19 (63 %) больных, гигантоклеточная опухоль - у 5 (17 %), местнораспространенная саркома мягких тканей - у 1 (3 %), солитарные метастазы рака почки - у 2 (7 %), рецидивы сарком хирургического лечения - у 3 (10 %) пациентов. Результаты. Средняя продолжительность операции - 310 мин (145-520 мин), средний объем интраоперационной кровопотери - 5 520 мл (600-20 000 мл). Положительный край резекции по результатам планового морфологического исследования выявлен у 3 (10 %) больных. Средний срок наблюдения составил 36 мес (4-73 мес). Прогрессирование в сроки от 6 до 40 мес выявлено у 10 (33 %) больных, из них умерло 8 (27 %) пациентов. Осложнения разного типа диагностированы у 11 (37 %) больных, среди которых преобладали инфекционные процессы - 9 (30 %). Среднее значение функционального результата по шкале MSTS составило 59 % (15-82 %).Заключение. Применение модульных систем эндопротезирования вертлужной впадины и тазобедренного сустава при опухолевом поражении является перспективной хирургической методикой, позволяющей добиться адекватных функциональных результатов при сравнимом количестве послеоперационных осложнений

Comparative growth and biomass allocation of two varieties of cat's claw creeper, Dolichandra unguis-cati (Bignoniaceae) in Australia

Introduced as an ornamental vine, cat's claw creeper Dolichandra unguis-cati (syn. Macfadyena unguis-cati) has invaded coastal and subcoastal areas of subtropical eastern Australia. Two varieties have been indentified, one of which ('short-pod') is found throughout south-eastern Australia, while the other ('long-pod') appears to be restricted to several sites in south-eastern Queensland. We compared the growth and biomass allocation patterns of the two varieties in the field over a 22-month period to determine if a higher growth rate and/or more efficient allocation of biomass may contribute to this disparity in distribution. The long-pod variety produced greater aboveground and total biomass than the short-pod variety in both riparian and non-riparian zones. Belowground the two varieties produced a similar number of tubers and overall biomass, though the long-pod variety allocated a smaller portion of its carbon belowground. High growth rates and greater biomass allocation aboveground are characteristic of invasive species, allowing them to outcompete and crowd out existing vegetation. There was no significant site by variety interaction, an indication of consistency in variety performance across riparian and non-riparian sites. Results from our study suggest that differences in growth and biomass allocations are unlikely to have contributed to the disparity in distribution of the two varieties. Despite currently occupying a relatively small range, the long-pod variety may be a more adept invader than the short-pod variety, and could become more prevalent in the future. © 2012 CSIRO

Mode-locked operation of a pulsed Nd :YAG laser with polarization switching in SHG crystal

International audienc

Об инновационной структуре университетских комплексов

In the article the authors appealing to their experience raise the questions connected with the problems of the University complexes forming. The readers are proposed the variants of solution of the problems for their consideration and probable discussion on journal’s pagesВ статье авторы на основе своего опыта поднимают вопросы, связанные с проблемами создания инновационных университетских комплексов, и предлагают варианты решения этих проблем

Results of modular endoprosthetic reconstruction of periacetabular bone defects in patients with tumors of the acetabulum and hip joint

Introduction. surgical treatment of patients with pelvic bone tumors, in particular periacetabular tumors, remains challenging. There are many different reconstruction options after resection of these tumors. These include allo- and autografts, megaprosthesis, saddle endoprosthesis, custom-made endoprosthesis, 3D printing endoprosthesis, and femur transposition with the formation of neo-arthrosis. However, all of them are characterized by technical complexity and high risk of postoperative complications. There is still no standard procedure for reconstruction after resection of malignant periacetabular tumors. To date, modular endoprosthesis is a well-established reconstructive device in orthopaedic oncology to manage wide bone resections. Modular systems provide patient-specific endoprostheses that could be modified during surgery. In this article, we present the results of modular acetabular endoprostheses in the treatment of patients with periacetabular tumors.Material and Methods. From 2011 to 2018, 30 patients underwent modular endoprosthetic reconstruction after periacetabular resection. There were 13 (43 %) male and 17 (57 %) female patients aged from 23 to 63 years (median age 45 years). Primary malignant bone tumors were detected in 19 (63 %) patients, giant cell tumor in 5 (17 %), local soft tissue sarcoma in 1 (3 %), solitary metastases of kidney cancer in 2 (7 %) and recurrent sarcoma after previous surgical treatment in 3 (10 %) patients.Results. The average duration of surgery was 310 minutes (range: 145-520 minutes), blood loss was 5520 ml (range: 600-20000 ml). The median follow-up time was 36 months. Histological examination revealed a positive resection margin in 3 (10 %) patients. At a follow-up from 6 to 40 months, disease progression was detected in 10 (33 %) patients. Eight (27 %) patients died on disease progression. Complications of various types were diagnosed in 11 (37 %) patients. Infectious complications were the most common (30 % of patients). The average value of the functional assessment by the MSTS scale was 59 % (15-82%).Conclusion. Modular endoprosthetic replacement for tumors of the acetabulum and hip joint is a promising surgical technique allowing adequate functional results to be achieved