The surgical treatment of destructive pulmonary tuberculosis in patients with diabetes

The purpose of the study was to improve quality of surgical treatable of destructive pulmonary tuberculosis in patients with diabetes.Materials and Methods. D.B. Giller and employees of the Department of Phthisiopulmonology and Thoracic Surgery of the First Moscow State Medical University M.I. Sechenov performed operations on 200 patients with diabetes due to tuberculosis. Group 1 was mustered from 78 patients from 2004 to 2009. Group 2 was mustered from 122 patients from 2011 to 2017.Results. An analysis of the results showed that after 31 operations, 27 (13.5%) patients from both groups developed 33 complications. The second group (6.6%) had fewer complications after surgery than the first group (24.4%) 3.7 times. The first group had more vulnerary and bronchopleural complications than the second group. 12 patients (15.4%) of the first group and 6 patients (4.9%) of the second group had bronchopleural complications (empyema, residual cavity, delayed expansion of the lung and intrapleural bleeding). 2 patients died in the hospital (30-day mortality was 0.66%) after 303 surgical intervention in both groups. 1 patient (0.9%) died after 106 surgical interventions in the first group. 1 patient (0.5%) died after 197 surgical interventions in the second group. The full effect was achieved in 75 (96.2%) patients in the first group and 114 (93.4%) in the second group. The survival value of patients of the second group was 100% after 1 year, 98% after 2 years, 98.8% after 3 years, 96.9% after 4 years, 95.2% after 5 years. The surgical treatable affected the occupational rehabilitation of patients from group 2. 61.5% of patients from group 2 became able to work after 1 year. 64.5% of patients from group 2 became able to work after 5 years.Conclusion. If doctors use our tactics in patients with destructive pulmonary tuberculosis and diabetes, the risk of complications after surgery will drop and reactivation of tuberculosis will not occur

The Effectiveness of Laser Vaporization in the Treatment of Intervertebral Hernias of the Lumbar Spine

The purpose of the study: assessment of the use of laser vaporization of the disc with hernial protrusion on the lumbar spine and its effectiveness in the treatment of pain.Material and methods. We analyzed the effectiveness laser vaporization in 230 patients with degenerative-dystrophic diseases of the lumbar spine (protrusions and hernias of the intervertebral discs) treated in the neurosurgical department of the Irkutsk Scientific Centre of Surgery and Traumatology for the period from 2011 to 2018. There were 122 men and 108 women. The average age of the patients was 41 years. The duration of the disease before surgical treatment is 11 ± 3 weeks. Clinical and neurological examination revealed lumbalgia in 102 patients (44.3 %), lumbar ischalgia in 98 (42.6 %) and radiculopathy in 30 patients (13.1 %). Median hernias of the intervertebral discs were revealed in 130 patients (56.4 %), lateral hernias - in 41 (17.8 %) and protrusions - 59 (23.8 %). The leading localization of the pathological process was the LIV-LV segment (138 patients, 60 %). Assessment of the effectiveness of surgical treatment was carried out using VAS and Macnab scales.Results. In 100 % of cases were laser vaporization was applied a decrease in the intensity of the pain syndrome was achieved in terms of up to 3 months. The analysis of the long-term results of this treatment in 124 patients from 3 months to 3 years by Macnab scale revealed excellent results in 25 (20.1 %) patients, good results - in 50 (40.3 %), satisfactory - in 42 (33.8 %), and unsatisfactory results - in 7 (5.6 %) cases.Conclusion. Thus, laser vaporization of hernias of the intervertebral disc is effective in the treatment of pain, which does not stop with conservative treatment for 4-6 weeks; with a hernia of up to 6 mm; with a median localization and with no signs of sequestration

Surgical Treatment of Stenosis of Spinal Canal and Dural Sac at the Craniovertebral Junction

The paper presents the results of surgical treatment of 12 patients with stenosing processes of the vertebral canal at the craniovertebral transition due to chronic, unstable type 2 injuries of the C odontoid process (classification of fractures of odontoid process proposed in 1974 by Anderson and D’Alonzo). Patient examination included clinical-neurologic examination, review spondylograms of the cervical spine in 2 projections, MSCT, MRI. All patients were admitted to the clinic with external fixators (cervical support collar or Philadelphia collar). In the preoperative period, all patients were divided into 2 groups according to indications and contraindications for the application of the HALO-device. The first group consisted of 7 people, with cervical spine still fixed with the cervical support collar or Philadelphia collar, and the second group consisted of 5 patients with CII fracture fixed and corrected in the preoperative period by the HALO-device. All patients underwent surgical intervention – posterior approach decompression of the spinal canal and dural sack in the craniovertebral passage by CI laminectomy, partial resection of the posterior margin of the occipital aperture followed by the implementation of atlanto-axial occipitospondylodesis (a clamp with shape-memory effect for posterior occipitospondylodesis, OOO “MITS SPF”, Novokuznetsk, Russia). A comparative analysis of the results of surgical treatment of posttraumatic stenoses of the vertebral canal with and without the use of the HALO-traction device was performed. The results was better in the second group, which makes it possible to consider the second variant of surgical treatment more pathogenetically justified. Thus, HALO-traction restors anatomo-topographic relationships in the craniovertebral zone creating hard external fixation, helping to avoid intraoperative complications

Identification of Novel Candidate Markers of Type 2 Diabetes and Obesity in Russia by Exome Sequencing with a Limited Sample Size

Type 2 diabetes (T2D) and obesity are common chronic disorders with multifactorial etiology. In our study, we performed an exome sequencing analysis of 110 patients of Russian ethnicity together with a multi-perspective approach based on biologically meaningful filtering criteria to detect novel candidate variants and loci for T2D and obesity. We have identified several known single nucleotide polymorphisms (SNPs) as markers for obesity (rs11960429), T2D (rs9379084, rs1126930), and body mass index (BMI) (rs11553746, rs1956549 and rs7195386) (p < 0.05). We show that a method based on scoring of case-specific variants together with selection of protein-altering variants can allow for the interrogation of novel and known candidate markers of T2D and obesity in small samples. Using this method, we identified rs328 in LPL (p = 0.023), rs11863726 in HBQ1 (p = 8 × 10−5), rs112984085 in VAV3 (p = 4.8 × 10−4) for T2D and obesity, rs6271 in DBH (p = 0.043), rs62618693 in QSER1 (p = 0.021), rs61758785 in RAD51B (p = 1.7 × 10−4), rs34042554 in PCDHA1 (p = 1 × 10−4), and rs144183813 in PLEKHA5 (p = 1.7 × 10−4) for obesity; and rs9379084 in RREB1 (p = 0.042), rs2233984 in C6orf15 (p = 0.030), rs61737764 in ITGB6 (p = 0.035), rs17801742 in COL2A1 (p = 8.5 × 10−5), and rs685523 in ADAMTS13 (p = 1 × 10−6) for T2D as important susceptibility loci in Russian population. Our results demonstrate the effectiveness of whole exome sequencing (WES) technologies for searching for novel markers of multifactorial diseases in cohorts of limited size in poorly studied populations

Effect of low temperature RF plasma treatment on electrical properties of junctionless InGaAs MOSFETs

In this paper, we study the effect of low-temperature RF plasma treatment in forming gas (10%H2+90%N2) on the electrical characteristics of junctionless MOSFETs with n-In0.53Ga0.47As channel and an Al2O3 gate dielectric. The impact of plasma power density on the device parameters is investigated. It is found that RF plasma annealing with a low power density (0.5 W/cm2) at 150°C for 10 min provides substantial improvement of source/drain contacts resistance and the carrier mobility resulting in a considerable increase of the on-state current and transconductance. It also improves the subthreshold slope and reduces the fixed positive charge in Al2O3 under the gate, shifting the threshold voltage toward positive values. It is demonstrated that non-thermal factors play a principle role in modification of electrical properties of the JL MOSFETs under RF plasma treatment. Such treatment may be an efficient tool for the improvement of the performance of the advanced MOSFETs with III-V channel materials

Prediction of inter-particle adhesion force from surface energy and surface roughness

Fine powder flow is a topic of great interest to industry, in particular for the pharmaceutical industry; a major concern being their poor flow behavior due to high cohesion. In this study, cohesion reduction, produced via surface modification, at the particle scale as well as bulk scale is addressed. The adhesion force model of Derjaguin-Muller-Toporov (DMT) was utilized to quantify the inter-particle adhesion force of both pure and surface modified fine aluminum powders (∼8 μm in size). Inverse Gas Chromatography was utilized for the determination of surface energy of the samples, and Atomic Force Microscopy was utilized to evaluate surface roughness of the powders. Surface modification of the original aluminum powders was done for the purpose of reduction in cohesiveness and improvement in flowability, employing either silane surface treatment or dry mechanical coating of nano-particles on the surface of original powders. For selected samples, the AFM was utilized for direct evaluation of the particle pull-off force. The results indicated that surface modification reduced the surface energy and altered the surface nano-roughness, resulting in drastic reduction of the inter-particle adhesion force. The particle bond number values were computed based on either the inter-particle adhesion force from the DMT model or the inter-particle pull-off force obtained from direct AFM measurements. Surface modification resulted in two to three fold reductions in the Bond number. In order to examine the influence of the particle scale property such as the Bond number on the bulk-scale flow characterization, Angle of Repose measurements were done and showed good qualitative agreements with the Bond number and acid/base surface characteristics of the powders. The results indicate a promising method that may be used to predict flow behavior of original (cohesive) and surface modified (previously cohesive) powders utilizing very small samples

Multiscale molecular dynamics/hydrodynamics implementation of two dimensional “Mercedes Benz” water model

A multiscale Molecular Dynamics/Hydrodynamics implementation of the 2D Mercedes Benz (MB or BN2D) [1] water model is developed and investigated. The concept and the governing equations of multiscale coupling together with the results of the two-way coupling implementation are reported. The sensitivity of the multiscale model for obtaining macroscopic and microscopic parameters of the system, such as macroscopic density and velocity fluctuations, radial distribution and velocity autocorrelation functions of MB particles, is evaluated. Critical issues for extending the current model to large systems are discussed