Affine spherical homogeneous spaces with good quotient by a maximal unipotent subgroup

For an affine spherical homogeneous space G/H of a connected semisimple algebraic group G, we consider the factorization morphism by the action on G/H of a maximal unipotent subgroup of G. We prove that this morphism is equidimensional if and only if the weight semigroup of G/H satisfies some simple condition.Comment: v2: title and abstract changed; v3: 16 pages, minor correction

MINIMALLY INVASIVE LUMBAR-PELVIC STABILIZATION FOR UNSTABLE PELVIC RING INJURIES

Reconstructive operations for unstable  pelvic ring injuries  in most cases are performed  at later  date  after  trauma (period  of complete  stabilization of the vital functions). The paper presents  treatment outcomes  of three  patients with vertically unstable  pelvic ring injuries where minimally invasive lumbar-pelvic fixation with pedicle screws was applied. The morphology  of sacrum  injury  determined a configuration of the  lumbar-pelvic transpedicular system. In all cases the final surgery was performed  in the early period of traumatic disease, which made it possible to restore  the anatomy of the pelvic ring and obtain good functional outcomes

Lumbopelvic transpedicular fixation of vertically unstable pelvic ring injuries

Introduction Identification of a proper fixation of the posterior pelvic ring is of paramount importance in treatment of patients with vertically unstable pelvic injuries. Material and methods Outcomes of 29 patients with polytrauma and vertically unstable pelvic injuries treated at Level I Trauma Center between 2013 and 2017 were analyzed. The mean age of the patients was 34.8 ± 99 years. The severity of the injuries and patients’ condition were evaluated using Injury Severity Score (ISS), VPKh-P (MT), VPKh-SP, and Yu. N. Tsibin scales (1975) to determine the sequence of treatment and diagnostic procedures. Classification offered by Pape H. C. (2005) was used to evaluate physiological condition. The ISS score was 27.1 ± 9.9. All patients underwent computed tomography (CT) scan of pelvic for preoperative planning. Lumbopelvic transpedicular fixation (LPTF) was employed as a definitive treatment of vertically unstable pelvic ring fractures in all clinical observations. Posterior half-ring morphology, a need for decompression of the nerve roots of the sacral plexus, timing of surgery were considered to decide on LPTF configuration. Results Three-month-to-six-year follow-ups of 22 patients showed good and excellent results achieved in 72.7 % of the cases that are in line with findings reported in the literature. Discussion Biomechanically adequate method of internal fixation is the method of choice in the definitive treatment of vertical unstable pelvic injuries with the possibility of decompression of compromised neural structures. Lumbopelvic fixation with the possibility of simultaneous access for decompression of neural structures is the most optimal technique for these complicated injuries

The assessment of direct results of drainage operations in the biliary tract in patients with obstructive jaundice

The article presents the results of a clinical examination of 88 patients aged 22 to 91 years who underwent drainage operations for obstructive jaundice in the Gomel Clinical Oncology Center between January 2017 and October 2019. The analysis of drainage interventions on the biliary tract, the duration of jaundice, hospitalization, complications.В статье представлены результаты клинического обследования 88 пациентов в возрасте от 22 до 91 года, перенесших дренирующие операции по поводу механической желтухи в Гомельском клиническом онкологическом диспансере в период с января 2017 по октябрь 2019 года. Проводился анализ дренирующих вмешательств на желчевыводящих путях, длительность желтухи, госпитализации, осложнений

Global analysis by hidden symmetry

Hidden symmetry of a G'-space X is defined by an extension of the G'-action on X to that of a group G containing G' as a subgroup. In this setting, we study the relationship between the three objects: (A) global analysis on X by using representations of G (hidden symmetry); (B) global analysis on X by using representations of G'; (C) branching laws of representations of G when restricted to the subgroup G'. We explain a trick which transfers results for finite-dimensional representations in the compact setting to those for infinite-dimensional representations in the noncompact setting when $X_C$ is $G_C$-spherical. Applications to branching problems of unitary representations, and to spectral analysis on pseudo-Riemannian locally symmetric spaces are also discussed.Comment: Special volume in honor of Roger Howe on the occasion of his 70th birthda

Хирургический гемостаз при тяжелых сочетанных травмах таза

For the treatment of patients with severe multysistem pelvic trauma accompanied by pelvic bleeding, many algorithms have been proposed that have different procedures for the use of various methods of surgical hemostasis, but none of them may guarantee the complete arrest of pelvic bleeding. The purpose of this study was to estimate clinical efficacy and developed algorithm, aimed at timely diagnosis of intrapelvic bleeding and its complete arrest with the help of different methods of surgical hemostasis in patients with severe concomitant injury of the pelvis. The article analyzes the results of treatment of 168 patients with unstable pelvic ring injuries and signs of intrapelvic bleeding, who were treated in two trauma centers of the first level in St. Petersburg: I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine and Military Surgery Clinic of S.M. Kirov Military Medical Academy in 2010-2018. The victims were divided into two statistically homogeneous groups. In the comparison group (75 people), the pelvic ring was mechanically stabilized with the Ganz C-clamp or the anterior part of the pelvis was fixed with an external fixation device (EFD), and the arrest of the ongoing pelvic bleeding was expected due to occur due to the effect of biological tamponade. In the main group (93 people), after mechanical stabilization of the pelvic ring, various methods of surgical hemostasis were used: balloon occlusion of the aorta, pelvic tamponade, angiography with embolization. The choice of method for surgical haemostasis after trauma depended on the severity of the affected condition of hemodynamic parameters, availability of life-threatening consequences of damage to other areas of the body and the efficacy of previously applied method for intrapelvic bleeding arrest. The introduction of modern diagnostic and treatment algorithm, aimed at complete hemostasis in patients with ongoing intrapelvic bleeding reduced the overall mortality rate by 1.7 times, mortality within 24 hours of admission by 2.3 times, as well as the duration and the volume of blood transfusion therapy by 3 and 1.8 times.Authors declare lack of the conflicts of interests.ВВЕДЕНИЕ. Для лечения пострадавших с тяжелой сочетанной травмой таза, сопровождающейся внутритазовым кровотечением, предложено множество алгоритмов, имеющих разный порядок применения тех или иных способов хирургического гемостаза, но не один из них не может гарантированно обеспечить окончательную остановку внутритазового кровотечения.ЦЕЛЬ ИССЛЕДОВАНИЯ. Оценить клиническую эффективность разработанного алгоритма, направленного на своевременную диагностику внутритазового кровотечения и его окончательную остановку с помощью различных способов хирургического гемостаза у пострадавших с тяжелой сочетанной травмой таза.МАТЕРИАЛ И МЕТОДЫ. В статье проанализированы результаты лечения 168 пострадавших с нестабильными повреждениями тазового кольца и признаками внутритазового кровотечения, находившихся на лечении в двух травматологических центрах первого уровня Санкт-Петербурга: в СПб НИИ СП им. И.И.Джанелидзе и в клинике военно-полевой хирургии Военно-медицинской академии им. С.М. Кирова в период с 2010 по 2018 г. Пострадавшие были разделены на две статистически однородные группы. В группе сравнения (75 больных) для остановки внутритазового кровотечения выполняли механическую стабилизацию тазового кольца изолированно рамой Ганца или одновременно фиксировали передний отдел таза аппаратом внешней фиксации, а остановка продолжающегося внутритазового кровотечения происходила за счет эффекта биологической тампонады. В основной группе (93 пациента) после механической стабилизации тазового кольца применяли различные способы хирургического гемостаза: баллонную окклюзию аорты, тампонаду таза, ангиографию с эмболизацией. Выбор способа хирургического гемостаза при травме таза зависел от тяжести состояния пострадавшего, показателей гемодинамики, наличия жизнеугрожающих последствий повреждений других областей тела, эффективности ранее примененного способа остановки внутритазового кровотечения.ВЫВОДЫ. Внедрение современного лечебно-диагностического алгоритма, направленного на достижение окончательного хирургического гемостаза у пострадавших с продолжающимся внутритазовым кровотечением, позволило снизить общую летальность в 1,7 раза, досуточную — в 2,3 раза, а также в 1,8 раза сократить длительность и объем заместительной гемотрансфузионной терапии.Авторы заявляют об отсутствии конфликта интересов

Geodesic flows on Riemannian g.o. spaces

We prove the integrability of geodesic flows on the Riemannian g.o. spaces of compact Lie groups, as well as on a related class of Riemannian homogeneous spaces having an additional principal bundle structure.Comment: 12 pages, minor corrections, final versio

Iliosacral Screw Fixation in Patients with Polytrauma

The need to perform iliosacral fixation in patients with polytrauma and unstable pelvic injuries in the acute period of injury is still an unresolved issue. Minimally invasive techniques of pelvis internal fixation allow to perform single step reconstructive surgery in the acute period of the trauma.Purpose — to evaluate the results of minimally invasive acute iliosacral fixation in patients with polytrauma and unstable pelvic injuries.Materials and methods. The authors analyzed treatment outcomes in 105 patients with polytrauma and unstable pelvic injuries after iliosacral screw fixation in acute period. 69 (65.7%) patients had B-type and 36 (34.3%) patients had c-type of unstable pelvic injuries by AO/ASIF classification. Mean age was 35.5±11.7 years. The severity of injury on the ISS scale was 22.5±12.9 points. Ап patients underwent minimally invasive iliosacral fixation with screws in the acute period of the trauma.Results. Patients classified according to the severity of their status as «stable» (n = 50) and «borderline» (n = 26) with stable hemodynamics (SAD >90 mm Hg) underwent minimally invasive iliosacral screw fixation of posterior pelvic ring straight in the anti-shock surgery. Injured classified as «unstable» (n = 15) and «borderline» (n = 14) with unstable hemodynamic parameters (SAD <90 mm Hg), who needed urgent large surgical procedures (laparotomy, thoracotomy et al.), underwent temporary pelvis stabilization by external fixation and/or c-frame, and as the hemodynamic parameters were stabilized iliosacral screw fixation within 48 hours from the moment of injury. The functional pelvis state in 58 patients by S.A. Majeed scale rated 90.7±11.2 points. The quality of life was assessed using the SF-36 questionnaire.Conclusion. Restoration of the anatomical shape of the pelvic ring and its fixation, primarily posterior aspects, in the acute period of trauma allowed to obtain good anatomical and functional treatment outcomes in 94.9% of the patients with polytrauma

Magnetic Susceptibility and Charge State of Gd Impurity in Pb1−x\text{}_{1-x}Snx\text{}_{x}Te⟨Gd⟩ Crystals

The effective magnetic momentum p$\text{}_{eff}$ of Gd-impurities in the Pb$\text{}_{1-x}$Sn$\text{}_{x}$Te⟨Gd⟩ crystals as a function of crystal composition x with 0 ≤ x ≤ 0.25 is studied. It is shown that with the increase in tin content in the crystals from 0 to 0.15, p$\text{}_{eff}^{2}$(Gd) increases slowly from 37 to 43. Then p$\text{}_{eff}^{2}$(Gd) increases abruptly to 63 value when x = 0.16±0.01. For subsequent increase x ≥ 0.17 p$\text{}_{eff}^{2}$(Gd) remains constant at 63. Possible reasons of observed changes of p$\text{}_{eff}$(Gd) and possible mechanisms of influence of the Pb$\text{}_{1-x}$Sn$\text{}_{x}$Te crystal field on the effective magnetic momentum value of Gd-impurities in the crystals under study are analysed

FORMATION OF VASCULARIZED BONE GRAFTS AND THEIR USE FOR TREATMENT OF PSEUDOARTHROSES AND BONE DEFECTS

An analysis of 135 transplant surgeries of vascularised bone grafts in treatment of pseudoarthroses and defects of the clavicle, humerous, ulnar, radial, metacarpal,wrist and fingers bones was made. The fusion was noticed in 130 operated patients. The earlier removal of immobilization (in 2), the repeated trauma (in 2) and osteomyelitis of the transplanted graft, which required its removal in 1 patient, were the causes of failure in 5 (3.7%) patients