Electron injector based on resonance system with evanescent oscillations

The article presents the design and simulated performances of an electron gun and a bunching system of the Sband injector based on a coupled cavity chain. Amplitude of the on-axis field varies substantially from the cell to the cell in the bunching system. The cell lengths are chosen to get the effective bunching and accelerating of the beam from the initial energy of 25 keV to the energy of about 1 MeV with the current up to 300 mA. The bunching system can be used in electron linacs both for fundamental researches and for radiation technologies.Приведено конструкцію та розрахункові характеристики інжектора 10-см діапазону, основаного на ланцюжку зв’язаних резонаторів. Амплітуда поля суттєво змінюється вздовж осі системи, що дозволяє одержати ефективне групування та прискорення пучка від початкової енергії 25 кеВ до енергії біля 1 МеВ при струмі до 300 мА. Інжектор може бути використаний як в лінійних прискорювачах електронів для фундаментальних досліджень, так і в прискорювачах для радіаційних технологій.Приведены конструкция и расчетные характеристики инжектора 10-cм диапазона, основанного на цепочке связанных резонаторов. Амплитуда поля существенно изменяется вдоль оси системы, что позволяет получить эффективную группировку и ускорение пучка от начальной энергии 25 кэВ до энергии около 1 МэВ с током до 300 мА. Инжектор может использоваться в ускорителях электронов как для фундаментальных исследований, так и для радиационных технологий

Miniinvasive paracentetic drain surgical interventions under ultrasonic control concerning liquid formations of abdominal cavity

Entry. Presently miniinvasive surgical interventions under ultrasonic control became the method of choice in treatment of quite a number of abdominal and retroperitoneal organs diseases, and their complications. These operations have a row of advantages, as compared to open and laparoscopic ones: comparative simplicity, insignificant infecting of abdominal region, least of intra- and postoperative complications. Actuality of problem is conditioned by that indications to the use of paracentetic drain surgical interventions, most optimal methods of preoperative diagnostic, features of postoperative treatment of patients remain not enough studied. Research aim. To study the results of diagnostics and treatment of patients with liquid formations of abdominal cavity that were exposed to miniinvasive surgical interventions under ultrasonic control and, on the basis of it, to work out an optimal curative diagnostic algorithm. Materials and research methods. The results of treatment of 25 patients with liquid formations of abdominal cavity are analyzed. They were submitted to miniinvasive paracentetic drain surgical interventions under ultrasonic control. The pseudocysts of pancreas were in 16 patients, abscesses of abdominal cavity – in 2 patients. Research results. Intraoperative complications were not marked. Postoperative complications were observed in 5 patients. Among them there were inadequate drainage of all cavities of multicamerate abscess of the liver in 2 patients, progress of sacculated uremic peritonitis developing in presence of ascites in one patient, and arrosive hemorrhage in the cavity of pancreas pseudocyst in 2 persons. It is determined that it is necessary to include the spiral computer tomography to the complex of preoperative inspection of patients that allows to diagnose multicamerate abscess of the liver in time and to drain all the additional cavities adequately. 2 patients after paracentetic drain surgical interventions concerning the pseudocyst of pancreas complicated by the arrosive bleeding, were exposed to an open method before operations, related to the internal or external drain of cystic formations. Subsequently pain relapsed in their epigastric area, and the plural cysts of pancreas and retroperitoneum were found out at ultrasonic reexamination and computer tomography. In most patients analysis of liver abscess content showed E.Coli most sensible to carbapenems and cephalosporins of IV generation. Conclusions. The miniinvasive percutaneous paracentetic drain surgical interventions under ultrasonic control are effective enough in treatment of liver abscess and pseudocysts of pancreas, and accompanied by the few complications. Multicamerate liver abscesses are the relative contraindications for these operations. It is not recommended to apply paracentetic drain surgical interventions for patients who had ineffective operations of internal or external drain of pancreatic pseudocyst, in case of plural cysts . These patients have a high risk of the arrosive bleeding. Empiric antibacterial therapy in case of liver abscess before the result of bacterial analysis, must be based on the use of wide spectrum antibiotics, mainly carbapenems and cephalosporin of IV generation

Miniinvasive technologies in surgery of gallstone disease complicated by mechanical jaundice

Abstract Entry. Mechanical jaundice is frequent complication of gallstone disease both in urgent and in planned surgery. In the last few years the increase of amount of patients with mechanical jaundice, especially persons of elderly and senile age, is marked and the results of their treatment don’t satisfy surgeons fully. A similar situation cannot remain regardless and requires the search of new ways of decision of this problem. Research aim. Determination of the most optimal methods of diagnostics and treatment of patients with the gallstone disease complicated by mechanical jaundice and estimation of efficiency of their application. Materials and research methods. The results of laparoscopic cholecystectomy in 3054 patients with gallstone disease and its complications are analyzed. Experience of surgical treatment of 297 (9,7%) patients with gallstone disease complicated by mechanical jaundice is presented. The most frequent complications were: choledocholithiasis, mechanical jaundice - in 290 (9,5%) patients, combination of choledocholithiasis with stenosis of large duodenal papilla - in 218 (7,1%), stricture of choledoch - in 7 (0,2%). Endoscopic papillosphincterotomy and laparoscopic cholecystectomy was performed for 263 (8,6%) patients with mechanical jaundice. Research results. On the I stage of treatment of mechanical jaundice in 263 (8,6%) patients with choledocholithiasis and combination of choledocholithiasis with stenosis of large duodenal papilla endoscopic papillosphincterotomy was performed. On the II stage of treatment of patients laparoscopic cholecystectomy was conducted. It was performed on the 2-7 days after endoscopic papillosphincterotomy and verification of the absence of stones in choledoch. The new method of implementation of laparoscopic cholecystectomy the key moment of which is subserosal coagulation of branches of cystic artery is described. The curatively-diagnostic algorithm of treatment of patients with gallstone disease complicated by mechanical jaundice is offered. Conclusions. The most informative method in diagnostics of choledocholithiasis, complicated by mechanical jaundice, is endoscopic retrograde cholangiopancreatography (85,4% - 95%). Endoscopic papillosphincterotomy is the most effective for patients with the diameter of stones in choledoch less than 10 mm. At a diameter more than 10 mm endoscopic papillosphincterotomy in most cases is ineffective. Such patients must undergo the operative intervention by an open method. Usage of two stage of treatment of the gallstone disease complicated by mechanical jaundice must be priority. We consider the first stage must include combination of endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy, the second stage – laparoscopic cholecystectomy. The method of gall-bladder devascularisation at laparoscopic cholecystectomy with the use of subserosal coagulation of small branches of cystic artery without selection and ligation of her main branch is the effective method of extrahepatic bilious ducts and main (cystic and hepatic) arteries damage prophylaxis

Мініінвазивні технології в хірургії жовчнокам’яної хвороби, ускладненої механічною жовтяницею

Entry. Mechanical jaundice is frequent complication of gallstone disease both in urgent and in planned surgery. In the last few years the increase of amount of patients with mechanical jaundice, especially persons of elderly and senile age, is marked and the results of their treatment don’t satisfy surgeons fully. A similar situation cannot remain regardless and requires the search of new ways of decision of this problem.Research aim. Determination of the most optimal methods of diagnostics and treatment of patients with the gallstone disease complicated by mechanical jaundice and estimation of efficiency of their application.Materials and research methods. The results of laparoscopic cholecystectomy in 3054 patients with gallstone disease and its complications are analyzed. Experience of surgical treatment of 297 (9,7%) patients with gallstone disease complicated by mechanical jaundice is presented. The most frequent complications were: choledocholithiasis, mechanical jaundice - in 290 (9,5%) patients, combination of choledocholithiasis with stenosis of large duodenal papilla - in 218 (7,1%), stricture of choledoch - in 7 (0,2%). Endoscopic papillosphincterotomy and laparoscopic cholecystectomy was performed for 263 (8,6%) patients with mechanical jaundice.Research results. On the I stage of treatment of mechanical jaundice in 263 (8,6%) patients with choledocholithiasis and combination of choledocholithiasis with stenosis of large duodenal papilla endoscopic papillosphincterotomy was performed. On the II stage of treatment of patients laparoscopic cholecystectomy was conducted. It was performed on the 2-7 days after endoscopic papillosphincterotomy and verification of the absence of stones in choledoch. The new method of implementation of laparoscopic cholecystectomy the key moment of which is subserosal coagulation of branches of cystic artery is described. The curatively-diagnostic algorithm of treatment of patients with gallstone disease complicated by mechanical jaundice is offered.Conclusions. The most informative method in diagnostics of choledocholithiasis, complicated by mechanical jaundice, is endoscopic retrograde cholangiopancreatography (85,4% - 95%).Endoscopic papillosphincterotomy is the most effective for patients with the diameter of stones in choledoch less than 10 mm. At a diameter more than 10 mm endoscopic papillosphincterotomy in most cases is ineffective. Such patients must undergo the operative intervention by an open method.Usage of two stage of treatment of the gallstone disease complicated by mechanical jaundice must be priority. We consider the first stage must include combination of endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy, the second stage – laparoscopic cholecystectomy.The method of gall-bladder devascularisation at laparoscopic cholecystectomy with the use of subserosal coagulation of small branches of cystic artery without selection and ligation of her main branch is the effective method of extrahepatic bilious ducts and main (cystic and hepatic) arteries damage prophylaxis.Представлен опыт хирургического лечения 297 пациентов с желчнокаменной болезнью, осложненной механической желтухой. Эндоскопическая папиллосфинктеротомия и лапароскопическая холецистэктомия выполнена у 263 пациентов. Описан новый способ выполнения лапароскопической холецистэктомии, ключевым моментом которого является субсерозная коагуляция ветвей пузырной артерии. Предложен лечебно-диагностический алгоритм лечения пациентов с желчнокаменной болезнью, осложненной механической желтухой. На основе результатов анализа отмечено, что миниинвазивные технологии должны стать приоритетными в выборе метода хирургического лечения этой категории больных.Наведено досвід хірургічного лікування 297 пацієнтів із жовчнокам’яною хворобою, ускладненою механічною жовтяницею. Ендоскопічну папілосфінктеротомію і лапароскопічну холецистектомію виконано у 263 пацієнтів. Описано новий спосіб виконання лапароскопічної холецистектомії, ключовим моментом якого є субсерозна коагуляція гілок міхурової артерії. Запропоновано лікувально-діагностичний алгоритм лікування пацієнтів із жовчнокам’яною хворобою, ускладненою механічною жовтяницею. На основі результатів аналізу визначено, що мініінвазивні технології мають стати пріоритетними у виборі методу хірургічного лікування цієї категорії хворих