ОСЛОЖНЕНИЯ ЭКСТРАПЕРИТОНЕОСКОПИЧЕСКИХ РАДИКАЛЬНЫХ ПРОСТАТЭКТОМИЙ

Background. Radical prostatectomy (RPE) is today the gold standard treatment option for locally advanced prostate cancer (PC). These operations are performed both openly and using video-assisted endosurgery. Since 2009, the Research Institute of Urology has been made 70 extraperitoneoscopic RPEs (ERPE).Objective: to assess the complications of ERPE with the validated Clavien complication scale.Materials and methods. The authors retrospectively analyzed the case histories of 70 patients with locally advanced PC who had undergone ERPE. The complications were allocated to 3 groups: intraoperative, early (within 1 month) and late (over 1 month) postoperative ones. All found complications were stratified using Clavien classification scale.Results. The total number of ERPE complications accounted for 35.7%. The most common complications, such as anastomotic incompetence and blood loss that required hemotransfusion, were 9.8 and 11.3%, respectively. Rectal damage was intraoperatively found in 2 cases. Obturator nerve damage was also recognized intraoperatively and did not result in the occurrence of neurological symptoms. The severest complication (Clavien scale grade V) was pulmonary embolism causing death.Conclusion. Postoperative complications of ERPE were observed in a small percentage of the patients and posed no serious threat to their life. The analysis of the complications of ERPE suggests that this treatment for locally advanced PC is a current safe and low-traumatic method.Введение. На сегодняшний день радикальная простатэктомия (РПЭ) является «золотым стандартом» в лечении локализованного рака предстательной железы (РПЖ). Подобные операции выполняются как открыто, так и с применением эндовидеохирургии. В ФГБУ «НИИ урологии» за период с 2009 г. по настоящее время выполнено 70 экстраперитонеоскопических РПЭ (ЭРПЭ).Цель исследования — оценка осложнений ЭРПЭ с точки зрения валидизированной шкалы осложнений Клавиена.Материалы и методы. Нами ретроспективно проанализированы истории болезни 70 пациентов с локализованным РПЖ, которым выполнялась ЭРПЭ. Осложнения распределены на 3 группы: интраоперационные, ранние послеоперационные (в течение 1 мес) и поздние послеоперационные (более 1 мес). Все выявленные осложнения стратифицированы исходя из критериев шкалы Клавиена.Результаты. Общее количество осложнений ЭРПЭ составило 35,7 %. Наиболее частые осложнения: несостоятельность анастомоза и кровопотеря, требующая гемотрансфузии — 9,8 и 11,3 % соответственно. В 2 случаях отмечено повреждение прямой кишки, выявленное интраоперационно. Повреждение обтураторного нерва также было распознано во время вмешательства и не повлекло за собой появление неврологической симптоматики. Наиболее тяжелым осложнением (V степень по шкале Клавиена) была тромбоэмболия легочной артерии, приведшая к смерти пациента.Выводы. Послеоперационные осложнения при проведении ЭРПЭ наблюдались у небольшого процента пациентов и в большинстве случаев не представляли серьезной угрозы для жизни больных. Анализ осложнений ЭРПЭ свидетельствует о том, что данный способ лечения локализованного РПЖ является современным, безопасным и малотравматичным методом

Роль и значение мультипараметрической магнитно-резонансной томографии в диагностике рака предстательной железы

The problem of timely diagnosis and malignancy grade evaluation of prostate cancer is especially urgent considering continuous and progredient increase in morbidity and mortality caused by this nosology, as well as difficulty of diagnostics. The conducted literature review shows that currently magnetic resonance imaging (MRI) is the leading method for diagnostics and grading of primary prostate cancer, as well as evaluation of local metastases, diagnostics of distant metastases, and identification of recurrences in the prostatic fossa after radical prostatectomy. Sensitivity and specificity of MRI are higher than in any of the other safe methods of diagnostic radiology. Active and wide-scale introduction of MRI into routine urological practice provided an impetus for development of complementary modalities and methods including fusion biopsy, targeted prostate biopsy under control of MRI, active observation, focal therapy, and other methods, significance and effectiveness of which will be determined in the future. Проблема своевременной диагностики и оценки степени злокачественности рака предстательной железы на сегодняшний день имеет особую актуальность вследствие неуклонного и прогредиентного роста заболеваемости и смертности от данной нозологии, а также в связи с трудностями диагностики. Проведенный анализ литературы показывает, что в настоящее время магнитно-резонансная томография (МРТ) занимает лидирующие позиции как в диагностике первичного рака предстательной железы, так и в стадировании заболевания, оценке местной распространенности, диагностике отдаленных метастазов, а также в выявлении рецидивов в ложе удаленной предстательной железы после радикальной простатэктомии. По своей чувствительности и специфичности магнитно-резонансное исследование превосходит все другие безопасные методы лучевой диагностики. Активное и массовое внедрение МРТ в рутинную урологическую практику дало импульс для развития смежных модальностей и методик, таких как fusion-биопсия, прицельная биопсия предстательной железы под контролем МРТ, активное наблюдение, фокальная терапия и другие методы, роль и эффективность которых еще только предстоит определить.

Combined search for the quarks of a sequential fourth generation

Results are presented from a search for a fourth generation of quarks produced singly or in pairs in a data set corresponding to an integrated luminosity of 5 inverse femtobarns recorded by the CMS experiment at the LHC in 2011. A novel strategy has been developed for a combined search for quarks of the up and down type in decay channels with at least one isolated muon or electron. Limits on the mass of the fourth-generation quarks and the relevant Cabibbo-Kobayashi-Maskawa matrix elements are derived in the context of a simple extension of the standard model with a sequential fourth generation of fermions. The existence of mass-degenerate fourth-generation quarks with masses below 685 GeV is excluded at 95% confidence level for minimal off-diagonal mixing between the third- and the fourth-generation quarks. With a mass difference of 25 GeV between the quark masses, the obtained limit on the masses of the fourth-generation quarks shifts by about +/- 20 GeV. These results significantly reduce the allowed parameter space for a fourth generation of fermions.Comment: Replaced with published version. Added journal reference and DO

Measurement of the t t-bar production cross section in the dilepton channel in pp collisions at sqrt(s) = 7 TeV

The t t-bar production cross section (sigma[t t-bar]) is measured in proton-proton collisions at sqrt(s) = 7 TeV in data collected by the CMS experiment, corresponding to an integrated luminosity of 2.3 inverse femtobarns. The measurement is performed in events with two leptons (electrons or muons) in the final state, at least two jets identified as jets originating from b quarks, and the presence of an imbalance in transverse momentum. The measured value of sigma[t t-bar] for a top-quark mass of 172.5 GeV is 161.9 +/- 2.5 (stat.) +5.1/-5.0 (syst.) +/- 3.6(lumi.) pb, consistent with the prediction of the standard model.Comment: Replaced with published version. Included journal reference and DO

Measurement of the Forward-Backward Asymmetry in the B -> K(*) mu+ mu- Decay and First Observation of the Bs -> phi mu+ mu- Decay

We reconstruct the rare decays $B^+ \to K^+\mu^+\mu^-$, $B^0 \to K^{*}(892)^0\mu^+\mu^-$, and $B^0_s \to \phi(1020)\mu^+\mu^-$ in a data sample corresponding to $4.4 {\rm fb^{-1}}$ collected in $p\bar{p}$ collisions at $\sqrt{s}=1.96 {\rm TeV}$ by the CDF II detector at the Fermilab Tevatron Collider. Using $121 \pm 16$ $B^+ \to K^+\mu^+\mu^-$ and $101 \pm 12$ $B^0 \to K^{*0}\mu^+\mu^-$ decays we report the branching ratios. In addition, we report the measurement of the differential branching ratio and the muon forward-backward asymmetry in the $B^+$ and $B^0$ decay modes, and the $K^{*0}$ longitudinal polarization in the $B^0$ decay mode with respect to the squared dimuon mass. These are consistent with the theoretical prediction from the standard model, and most recent determinations from other experiments and of comparable accuracy. We also report the first observation of the $B^0_s \to \phi\mu^+\mu^- decay and measure its branching ratio${\mathcal{B}}(B^0_s \to \phi\mu^+\mu^-) = [1.44 \pm 0.33 \pm 0.46] \times 10^{-6}$using$27 \pm 6$signal events. This is currently the most rare$B^0_s$ decay observed.Comment: 7 pages, 2 figures, 3 tables. Submitted to Phys. Rev. Let

Search for a New Heavy Gauge Boson Wprime with Electron + missing ET Event Signature in ppbar collisions at sqrt(s)=1.96 TeV

We present a search for a new heavy charged vector boson $W^\prime$ decaying to an electron-neutrino pair in $p\bar{p}$ collisions at a center-of-mass energy of 1.96\unit{TeV}. The data were collected with the CDF II detector and correspond to an integrated luminosity of 5.3\unit{fb}^{-1}. No significant excess above the standard model expectation is observed and we set upper limits on $\sigma\cdot{\cal B}(W^\prime\to e\nu)$. Assuming standard model couplings to fermions and the neutrino from the $W^\prime$ boson decay to be light, we exclude a $W^\prime$ boson with mass less than 1.12\unit{TeV/}c^2 at the 95\unit{%} confidence level.Comment: 7 pages, 2 figures Submitted to PR

Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum