Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки

The aim of this study was to compare results of sphincter-sparing operations (SSO) and abdominoperineal resections (APR) in patients  undergoing combined treatment for unresectable locally-advanced rectal cancer.Methods. During September 2007 – January 2011 59 patients were enrolled. Original treatment scheme (RF patent № 2414936) was developed including radiotherapy 40 Gy in 4 Gy fractions, capecitabine 650 mg/m2 bid per os days 1-22, oxaliplatin 50 mg/m2 iv days 3, 10, 17, local hyperthermia on days 8, 12, 15, 17, 2 applications of metronidazole 10 g/m2 per rectum in a polymeric composition. Surgery was carried out following 6–8 weeks. SSO were carried out in 36 patients, APR in 23 patients. Study endpoints included 2-year OS and DFS, local recurrence and distant metastases rate, postoperative complications rate.Results. No significant differences in survival were observed: 2-year OS was 93.2 and 85.6 % (log- rank test p = 0.157) for SSO and APR groups accordingly, 2-year DFS was 88 and 71.9 % (log-rank test p = 0.064). Four (11.1 %) patients in SSO group and 4 (17.4 %) patients in APR group (р = 0.5511) developed local recurrences, 4 (11.1 %) and 7 (30.4 %) (р = 0.1293) developed distant metastases. Postoperative complications rate was 27.8 % (n = 10) and 39.1 % (n = 9) (р = 0.5181) in SSO and APR groups accordingly.Conclusions. Sphincter-sparting surgery is justified for unresectable locally advanced rectal cancer when technically feasible

One-dimensional hydrogen atom with minimal length uncertainty and maximal momentum

We present exact energy eigenvalues and eigenfunctions of the one-dimensional hydrogen atom in the framework of the Generalized (Gravitational) Uncertainty Principle (GUP). This form of GUP is consistent with various theories of quantum gravity such as string theory, loop quantum gravity, black-hole physics, and doubly special relativity and implies a minimal length uncertainty and a maximal momentum. We show that the quantized energy spectrum exactly agrees with the semiclassical results.Comment: 10 pages, 1 figur

A RARE CASE OF TREATMENT POLICY FOR RECURRENT NEUROENDOCRINE CARCINOMA OF THE ANAL CANAL

A rare case of multicomponental treatment of low-differentiated anal neuroendocrine cancer is presented. By using combined treatment involving chemotherapy, local hyperthermia and radiotherapy a complete response of recurrent neuroendocrine cancer has been achieved.A review of modern methods of diagnostics and treatment of rectal neurtoendocrine tumors is presented and possibilities of modern combined treatment are discussed

Connection Conditions and the Spectral Family under Singular Potentials

To describe a quantum system whose potential is divergent at one point, one must provide proper connection conditions for the wave functions at the singularity. Generalizing the scheme used for point interactions in one dimension, we present a set of connection conditions which are well-defined even if the wave functions and/or their derivatives are divergent at the singularity. Our generalized scheme covers the entire U(2) family of quantizations (self-adjoint Hamiltonians) admitted for the singular system. We use this scheme to examine the spectra of the Coulomb potential $V(x) = - e^2 / | x |$ and the harmonic oscillator with square inverse potential $V(x) = (m \omega^2 / 2) x^2 + g/x^2$, and thereby provide a general perspective for these models which have previously been treated with restrictive connection conditions resulting in conflicting spectra. We further show that, for any parity invariant singular potentials $V(-x) = V(x)$, the spectrum is determined solely by the eigenvalues of the characteristic matrix $U \in U(2)$.Comment: TeX, 18 page

Сombined treatment of squamous-cell anal cancer

Since 1974 chemoradiation scheme proposed by Nigro remains the standard of care for squamous-cell anal cancer in most countries. Improvement of treatment results can be achieved by developing new treatment schemes including different radio- and chemosensitizers.Methods. Results of treatment of 157 T1–4N0–2M0 squamous-cell anal cancer patients, which underwent treatment during 1990–2012 were analyzed. Patients were divided into 3 groups: group A received hyperfractionated radiotherapy (RT) single dose 1.2 Gy bid, total dose 40–44 Gy with 3–5 sessions of local hyperthermia (HT) during treatment; group B had similar RT + HT scheme with addition of chemotherapy (CT) with cisplatin 20 mg/m2 in days 1, 3 weeks 1–4 and bleomycin 15 mg in days 2, 4 weeks 1–4; group C had RT with single dose 2 Gy, same total dose, HT and CT as in group B and additionally received metronidazole 10 g/m2 per rectum in a polymeric composition. Two weeks after 1st treatment stage a second course of RT was carried out 20–24 Gy in 2 Gy fractions in all patient groups.Results. Sphincter-sparing treatment was carried out in 11 (50 %), 71 (80.68 %) and 44 (93.62 %) in groups A, B and C accordingly. Three year overall survival (OS) was 60.0; 82.4; 96.4 %; 3-year disease-free survival (DFS) 36.6; 69.8 and 76.3 % accordingly.Conclusions. In our study combined treatment using radiosensitization allow to improve sphincter preservation rate to 93 %, improve OS and DFS for squamous-cell anal cancer patients

Equivalence of Local and Separable Realizations of the Discontinuity-Inducing Contact Interaction and Its Perturbative Renormalizability

We prove that the separable and local approximations of the discontinuity-inducing zero-range interaction in one-dimensional quantum mechanics are equivalent. We further show that the interaction allows the perturbative treatment through the coupling renormalization. Keywords: one-dimensional system, generalized contact interaction, renormalization, perturbative expansion. PACS Nos: 3.65.-w, 11.10.Gh, 31.15.MdComment: ReVTeX 7pgs, doubl column, no figure, See also the website http://www.mech.kochi-tech.ac.jp/cheon

Fermion-Boson Duality of One-dimensional Quantum Particles with Generalized Contact Interaction

For a system of spinless one-dimensional fermions, the non-vanishing short-range limit of two-body interaction is shown to induce the wave-function discontinuity. We prove the equivalence of this fermionic system and the bosonic particle system with two-body $\delta$-function interaction with the reversed role of strong and weak couplings. KEYWORDS: one-dimensional system, $\epsilon$-interaction, solvable many-body problem, exact bosonizationComment: 4 pages ReVTeX 4 epsf figures included, new Ref

Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки

The aim of this study was to compare results of sphincter-sparing operations (SSO) and abdominoperineal resections (APR) in patients  undergoing combined treatment for unresectable locally-advanced rectal cancer.Methods. During September 2007 – January 2011 59 patients were enrolled. Original treatment scheme (RF patent № 2414936) was developed including radiotherapy 40 Gy in 4 Gy fractions, capecitabine 650 mg/m2 bid per os days 1-22, oxaliplatin 50 mg/m2 iv days 3, 10, 17, local hyperthermia on days 8, 12, 15, 17, 2 applications of metronidazole 10 g/m2 per rectum in a polymeric composition. Surgery was carried out following 6–8 weeks. SSO were carried out in 36 patients, APR in 23 patients. Study endpoints included 2-year OS and DFS, local recurrence and distant metastases rate, postoperative complications rate.Results. No significant differences in survival were observed: 2-year OS was 93.2 and 85.6 % (log- rank test p = 0.157) for SSO and APR groups accordingly, 2-year DFS was 88 and 71.9 % (log-rank test p = 0.064). Four (11.1 %) patients in SSO group and 4 (17.4 %) patients in APR group (р = 0.5511) developed local recurrences, 4 (11.1 %) and 7 (30.4 %) (р = 0.1293) developed distant metastases. Postoperative complications rate was 27.8 % (n = 10) and 39.1 % (n = 9) (р = 0.5181) in SSO and APR groups accordingly.Conclusions. Sphincter-sparting surgery is justified for unresectable locally advanced rectal cancer when technically feasible.  Целью данного исследования было провести сравнительный анализ результатов сфинктеросохраняющих операций (CCО) и брюшно-промежностных экстирпаций (БПЭ) прямой кишки в рамках комплексного лечения больных местно-распространенным первично-неоперабельным раком прямой кишки (РПК).Методы. С сентября 2007 г. по январь 2011 г. в исследование включено 59 пациентов. Создана оригинальная схема лечения (патент РФ № 2414936), включающая лучевую терапию с разовой очаговой дозой 4 Гр, суммарной очаговой дозой 40 Гр, химиотерапию капецитабином 650 мг/м2 per os 2 р/сут дни 1–22-й, оксалиплатином 50 мг/м2 в/в дни 3, 10, 17-й, локальную гипертермию в дни 8, 12, 15, 17-й, два введения метронидазола 10 г/м2 per rectum в составе полимерной композиции в дни 12-й, 17-й; операция выполнялась через 6–8 нед. ССО были выполнены 36 пациентам, БПЭ – 23 пациентам. Критериями оценки были общая и безрецидивная 2-летняя выживаемость, частота рецидивов и метастазов, частота послеоперационных осложнений.Результаты. Достоверных различий в показателях выживаемости не отмечено. Двухлетняя общая выживаемость в группах ССО и БПЭ составила 93,2 и 85,6 % (log-rank test, p = 0,157), 2-летняя безрецидивная выживаемость – 88 и 71,9 % (log-rank test, p = 0,064) соответственно. Рецидив РПК развился у 4 (11,1 %) пациентов в группе ССО и у 4 (17,4 %) пациентов в группе БПЭ (р = 0,5511), метастазы – у 4 (11,1 %) и 7 (30,4 %) пациентов соответственно (р = 0,1293). Частота послеоперационных  осложнений составила 27,8 % (n = 10) и 39,1 % (n = 9) (р = 0,5181) в группе ССО и БПЭ соответственно.Выводы. Проведение сфинктеросохраняющих операций оправданно с онкологической точки зрения у больных местно-распространенным первично-неоперабельным РПК

ОРГАНОСОХРАНЯЮЩАЯ ХИРУРГИЯ РАКА ПРЯМОЙ КИШКИ – ЭВОЛЮЦИЯ, СОВРЕМЕННЫЕ ТЕНДЕНЦИИ И ПЕРСПЕКТИВЫ

The article describes the main stages of the development of sphincter-saving surgery for rectal cancer. An historical look at this issue from the standpoint of research of past years in our country and abroad, as well as analysis of current sphincter-preserving surgery and future directions in this area.В статье отражены основные этапы развития органосохраняющей хирургии рака прямой кишки. Приведен исторический взгляд на данную проблему с позиций исследований прошлых лет в нашей стране и за рубежом, а также анализ современного представления сфинктеросохраняющих операций и перспективные направления в этой области

Semiclassical energy formulas for power-law and log potentials in quantum mechanics

We study a single particle which obeys non-relativistic quantum mechanics in R^N and has Hamiltonian H = -Delta + V(r), where V(r) = sgn(q)r^q. If N \geq 2, then q > -2, and if N = 1, then q > -1. The discrete eigenvalues E_{n\ell} may be represented exactly by the semiclassical expression E_{n\ell}(q) = min_{r>0}\{P_{n\ell}(q)^2/r^2+ V(r)}. The case q = 0 corresponds to V(r) = ln(r). By writing one power as a smooth transformation of another, and using envelope theory, it has earlier been proved that the P_{n\ell}(q) functions are monotone increasing. Recent refinements to the comparison theorem of QM in which comparison potentials can cross over, allow us to prove for n = 1 that Q(q)=Z(q)P(q) is monotone increasing, even though the factor Z(q)=(1+q/N)^{1/q} is monotone decreasing. Thus P(q) cannot increase too slowly. This result yields some sharper estimates for power-potential eigenvlaues at the bottom of each angular-momentum subspace.Comment: 20 pages, 5 figure