39 research outputs found
The correlation of the severity of duodenum injuries and the mechanism of trauma in polytraumatism
Scopul lucrării. Politraumatismul constituie circa 15-20% din totalul leziunilor traumatice cu o mortalitate de 26-50% ,din cauza
leziunilor grave în două sau mai multe regiuni sau organe cu risc vital major, fiind în strânsă și directă legătură cu mecanismul traumei.
Scopul este analiza severității lezionale ale duodenului în raport cu mecanismul traumei.
Materiale și metode. Studiul este bazat pe analiza a 44 pacienți tratați cu leziuni de duoden în perioada anilor 1999 - 2018. B-39,
F-5, vârsta 18-70 ani. Mecanismul traumei: accident rutier 13 (29,54%), corpi străini 2(4,54%), sport 2(4,54%), catatrauma 7(15,9%),
agresiune fizică 8(18,18%), strivire 1(2,27%), armă albă 7(15.9%), armă de foc 5(11,36), explozie 1(2,27%).Toți pacienții au fost
supuși actului chirurgical după indicații. Volumul și metoda de corecție s-a stabilit individual în raport cu condițiile intraoperatoriipneumoperitoneum, peritonită, hematom sau flegmon retroperitoneal.
Rezultate. Intraoperator a fost stabilit gradul de severitate a leziunilor duodenale și a celor asociate.Lezarea duodenului de gradul
I-II a fost stabilita în 30(68%), decedați 13(29%), gradul III-IV 14(31%), decedați 9(20%). După mecanismul traumei au predominat
accidentele rutiere, agresiunea fizică urmată de catatraumă și armă albă.
Concluzii. Analiza corelației severității lezionale și mecanismul traumei nu relevă o diferență semnificativă în lotul de studiu.Mortalitatea
a fost indusă de anemie severă, septicemie.Aim of study. Polytrauma constitutes about 15-20% of all traumatic injuries with a mortality of 26-50%, due to serious injuries in two
or more regions or organs with major vital risk, being in close and direct connection with the trauma mechanism. The goal is analysis
of duodenal lesion severity in relation to trauma mechanism.
Materials and methods. The study is based on the analysis of 44 patients treated with duodenal lesions between 1999 and 2018. M
-39, W-5, age 18-70 years. Trauma mechanism: Road accident – 13 (29.54%), foreign bodies 2(4.54%), sports 2(4.54%), catatrauma
7(15.9%), physical aggression 8(18.18%) ), crushing 1(2.27%), white weapon 7(15.9%), firearm 5(11.36), explosion 1(2.27%). All patients underwent surgery as indicated. The volume and method of correction was established individually in relation to the
intraoperative conditions - pneumoperitoneum, peritonitis, hematoma or retroperitoneal phlegmon.
Results. Intraoperatively, the degree of severity of the duodenal and associated injuries was established. Grade I-II duodenal injury
was established in 30(68%), 13(29%) died, III-IV grade 14(31%), died 9(20%). After the mechanism of trauma, traffic accidents
prevailed, physical aggression followed by catatrauma and white weapons.
Conclusions. Correlation analysis of lesion severity and trauma mechanism does not reveal a significant difference in the study
group. Mortality was induced by severe anemia, septicemia
The high-redshift gamma-ray burst GRB140515A
High-redshift gamma-ray bursts have several advantages for the study of the
distant universe, providing unique information about the structure and
properties of the galaxies in which they exploded. Spectroscopic identification
with large ground-based telescopes has improved our knowledge of the class of
such distant events. We present the multi-wavelength analysis of the high-
Swift gamma-ray burst GRB140515A (). The best estimate of the
neutral hydrogen fraction of the intergalactic medium (IGM) towards the burst
is . The spectral absorption lines detected for this event
are the weakest lines ever observed in gamma-ray burst afterglows, suggesting
that GRB140515A exploded in a very low density environment. Its circum-burst
medium is characterised by an average extinction (A) that
seems to be typical of events. The observed multi-band light curves
are explained either with a very flat injected spectrum () or with a
multi-component emission (). In the second case a long-lasting central
engine activity is needed in order to explain the late time X-ray emission. The
possible origin of GRB140515A from a Pop III (or from a Pop II stars with local
environment enriched by Pop III) massive star is unlikely.Comment: 10 pages, 8 figures, 5 tables, submitted to Astronomy & Astrophysic
Абдоминосакральная резекция в хирургическом лечении рака прямой кишки
Surgery is the only potentially radical treatment option for locally advanced and recurrent rectal tumors invading the sacral vertebrae. However, the choice of tactics for this patient category remains a difficult task. In spite of the fact that chemoradiation therapy yields good results, it is very difficult to differentiate postradiation changes and residual tumor; the immediate results of combined surgical interventions accompanied by sacral resection remain unsatisfactory, which restricts their use in routine practice and the frequency of unradical operations and local recurrences remains high. Optimization of the results of abdominosacral resection in patients with rectal cancer requires that the definite principles should be adhered to. The chief task of treatment (radical surgery) is fulfilled via resection of the sacrum and, if indicated, other organs even to the extent of performing total pelvic evisceration. In the present view, radiotherapy is a compulsory component of combined treatment that enhances surgical radicalism. However, its impact on the results of this intervention type has been inadequately studied so far. Careful selection of patients to undergo abdominosacral resection determines high requirements for preoperative tumor imaging techniques. Due to their technical complicacy, it is recommended that this operation should be made only by specialized cancer centers having capacities for performing combined treatment for colorectal cancer. Единственным потенциально радикальным методом лечения местно-распространенных и рецидивных опухолей прямой кишки, инвазирующих в крестцовые позвонки, является хирургический. Однако выбор лечебной тактики в отношении данной категории больных остается трудной задачей. Несмотря на то, что химиолучевая терапия приносит хорошие результаты, дифференцировать постлучевые изменения и резидуальную опухоль чрезвычайно сложно; непосредственные результаты комбинированных хирургических вмешательств, сопровождающихся резекцией крестца, остаются неудовлетворительными, что ограничивает их применение в рутинной практике, а количество нерадикальных операций и частота развития местных рецидивов по-прежнему высоки. Оптимизация результатов абдоминосакральной резекции (АСР) у больных раком прямой кишки требует соблюдения определенных принципов. Главная задача лечения – выполнение радикальной операции – решается путем резекции крестца, а также (по показаниям) других органов, вплоть до тотальной эвисцерации таза. Согласно современным представлениям, лучевая терапия является обязательным компонентом комбинированного лечения, повышающим радикализм операции. Однако ее влияние на результаты АСР пока недостаточно изучено. Тщательный отбор пациентов, подлежащих хирургическому вмешательству, обусловливает высокие требования к методам предоперационной визуализации опухоли. В связи с технической сложностью выполнять данную операцию рекомендуется только в специализированных онкологических центрах, располагающих возможностями комбинированного лечения колоректального рака.
ИЗУЧЕНИЕ МЕХАНИЗМОВ ФОТОИНДУЦИРОВАННОЙ ГИБЕЛИ НА МОДЕЛИ КЛЕТОК МЕЛАНОМЫ КОЖИ
The results of the experimental study of immune response of human skin malignant melanoma cells Mel 226 on photodynamic exposure are represented in the article. Photoinduced apoptosis of skin malignant melanoma was studied in vitro. The study showed that irradiation with the agent fotoditazin at dose of 0.5–2.5 µg/ml (6 and 10 min exposure 30 min before irradiation; irradiation parameters: wavelength of 662 nm, total light dose from 40 to 60 J/cm2) induced early apoptosis. The increase of the time of laser irradiation significantly accelerates the conversion of photosensitized tumor cells from early to late apoptosis.В статье представлены результаты экспериментального исследования иммунного ответа клеток меланомы кожи человека Mel 226 на фотодинамическое воздействие. Изучен фотоиндуцированный апоптоз клеток меланомы кожи in vitro. Исследования показали, что облучение с препаратом фотодитазин в концентрациях 0,5-2,5 мкг/мл (экспозиция в течение 6 и 10 мин за 30 мин до облучения; параметры облучения: длина волны 662 нм, суммарная доза облучения от 40 до 60 Дж/см2) индуцирует ранний апоптоз. Увеличение времени лазерного облучения достоверно ускоряет переход фотосенсибилизированных опухолевых клеток из ранней фазы апоп-тоза в позднюю
ВЛИЯНИЕ ЗАДЕРЖКИ ДИАГНОСТИКИ НА ДОГОСПИТАЛЬНОМ ЭТАПЕ НА РЕЗУЛЬТАТЫ ЛЕЧЕНИЯ БОЛЬНЫХ С ГЕРМИНОГЕННЫМИ ОПУХОЛЯМИ ЯИЧКА В САНКТ-ПЕТЕРБУРГЕ
Over the past quarter-century germ cell tumors are one of the few cancers for which highly effective treatment is found. However there is a lack of awareness of young men and general practitioners about germ cell tumors which is often cause of late medical aid appealability and potential diagnostic errors. Reducing the time between patient's medical aid appealability and final diagnosis may contribute to the diagnostics of germ cell tumors in the early stages, reducing the amount of treatment and improving survival rates.За последние четверть века герминогенные опухоли (ГО) стали одним из немногих онкологических заболеваний, при которых возможно высокоэффективное лечение. Однако сохраняется недостаточная осведомленность молодых мужчин и врачей общей практики о герминогенных опухолях, что часто является причиной поздней обращаемости и возможных диагностических ошибок. Сокращение времени от обращения пациента до окончательной постановки диагноза может способствовать диагностике ГО яичка на ранних стадиях, уменьшению объема необходимых лечебных мероприятий и улучшению показателей выживаемости больных
Authenticating the Presence of a Relativistic Massive Black Hole Binary in OJ 287 Using Its General Relativity Centenary Flare : Improved Orbital Parameters
Results from regular monitoring of relativistic compact binaries like PSR 1913+16 are consistent with the dominant (quadrupole) order emission of gravitational waves (GWs). We show that observations associated with the binary black hole (BBH) central engine of blazar OJ 287 demand the inclusion of gravitational radiation reaction effects beyond the quadrupolar order. It turns out that even the effects of certain hereditary contributions to GW emission are required to predict impact flare timings of OJ 287. We develop an approach that incorporates this effect into the BBH model for OJ 287. This allows us to demonstrate an excellent agreement between the observed impact flare timings and those predicted from ten orbital cycles of the BBH central engine model. The deduced rate of orbital period decay is nine orders of magnitude higher than the observed rate in PSR 1913+16, demonstrating again the relativistic nature of OJ 287's central engine. Finally, we argue that precise timing of the predicted 2019 impact flare should allow a test of the celebrated black hole "no-hair theorem" at the 10% level.Peer reviewe
Primary Black Hole Spin in OJ 287 as Determined by the General Relativity Centenary Flare
OJ 287 is a quasi-periodic quasar with roughly 12 year optical cycles. It displays prominent outbursts that are predictable in a binary black hole model. The model predicted a major optical outburst in 2015 December. We found that the outburst did occur within the expected time range, peaking on 2015 December 5 at magnitude 12.9 in the optical R -band. Based on Swift /XRT satellite measurements and optical polarization data, we find that it included a major thermal component. Its timing provides an accurate estimate for the spin of the primary black hole, ##IMG## [http://ej.iop.org/images/2041-8205/819/2/L37/apjl523055ieqn1.gif] . The present outburst also confirms the established general relativistic properties of the system such as the loss of orbital energy to gravitational radiation at the 2% accuracy level, and it opens up the possibility of testing the black hole no-hair theorem with 10% accuracy during the present decade.Peer reviewe
Меланома полового члена и уретры: обзор литературы и наблюдения из практики
One of clinical and anatomical types of melanoblastoma is melanoma of the glans penis appearing on the skin or mucosa of the penis (external opening of the urethra or ureter, internal or external layer of the foreskin). It’s a rare disease, and most of specialists are unfamiliar with it, including oncologists and urologists. Thus, the conducted research has practical importance as it may improve diagnostics and treatment of patients with this oncological pathology. Одной из клинико-анатомических разновидностей меланобластомы является меланома головки полового члена, возникающая на коже полового члена или на слизистой оболочке (наружном отверстии мочеиспускательного канала или уретры, внутреннем или наружном листке крайней плоти). Это редкое заболевание, малоизвестное широкому кругу специалистов, в том числе онкологам и урологам, поэтому выполненная работа имеет большое практическое значение, так как позволит улучшить диагностику и лечение больных данной онкопатологией