Possibilities and features of zero-ischemia nephron-sparing surgery in localized kidney cancer

Kidney cancer (KCa) is one of the greatest challenges in oncological urology due to the increase in morbidity and mortality rates annually. In the treatment of KCa, preservation of renal function is an important objective, in addition to achieving oncological results. The article presents the experience of treatment of 175 KCa-patients of pT1a – T2aN0M0 stages, who underwent nephron-saving surgery (NSS) with preventive hemostatic sutures. Functional outcomes of NSS were studied in the groups without cross-linking (group 1; n = 150) and with cross-linking of the renal pedicle (group 2; n = 25). Kidney resection with prophylactic suturing has been shown to allow removal of a tumour of almost any localisation. By avoiding cross-linking of the renal pedicle during surgery, post-ischemic changes in the renal parenchyma are minimised. Thus, one month after surgery, the perfusion indexes in groups 1 & 2 were 45.2 ± 3.0% vs 35.5 ± 3.3%; renal indexes were 44.8 ± 2.4% vs 39.1 ± 1.4%; areas of the functioning parenchyma were 52.0 ± 10.0% vs 35.0 ± 9.0%, respectively

Synthis and Phisical And Chemical; Properties of SiO[2]-B[2]O[3] and SiO[2]-P[2]O[5] Thin Film Systems and Powders

The SiO[2]-B[2]O[3] and SiO[2]-P[2]O[5] films were synthesized by using film forming solutions having a P[2]O[5] content of up to 30% and B[2]O[3] up to 40%. Properties of the filmforming solutions and binary oxides were examined. The physical and chemical processes occurring in the solution during the heat treatment of films were examined. The conditions for producing films of different thicknesses were determined. The kinetic parameters were calculated

Prognosis of recurrent myocardial infarction based on shortliffe fuzzy models using the electrical characteristics of biologically active points

This report discusses the employment of the electrical characteristics of biologically active points (BAP) in the meridian of the heart to solve the task of prognosticating recurrence of myocardial infarctions during the rehabilitation period using fuzzy decision rule

Wireless power transfer in magnetic resonance imaging at a higher-order mode of a birdcage coil

Magnetic resonance imaging (MRI) is a crucial tool for medical visualization. In many cases, performing a scanning procedure requires the use of additional equipment, which can be powered by wires as well as via wireless power transfer (WPT) or wireless energy harvesting. In this Letter, we propose a novel scheme for WPT that uses a higher-order mode of the MRI scanner's birdcage coil for energy transmission. In contrast to the existing WPT solutions, our approach does not require additional transmitting coils. Compared to the energy harvesting, the proposed method allows supplying significantly more power. We perform numerical simulations demonstrating that one can use the fundamental mode of the birdcage coil to perform a scanning procedure while transmitting the energy to the receiver at a higher-order mode without any interference with the scanning signal or violation of safety constraints, as guaranteed by the mode structure of the birdcage. Also, we evaluate the specific absorption rate along with the energy transfer efficiency and verify our numerical model by a direct comparison with an experimental setup featuring a birdcage coil of a 1.5T MRI scanner.Comment: 6 pages, 5 figures + Supplementary Material 10 pages, 7 figure

Ultra-Mini Percutaneous Nephrolithotripsy and Retrograde Intrarenal Surgery in Treatment of Less than 2 cm Kidney Stones: Comparative Efficacy and Safety

Background. Renal stones of ≤ 2cm size occur most commonly, with several treatment options currently available that include remote shockwave lithotripsy, percutaneous nephrolithotripsy (PCNL) and retrograde intrarenal surgery (RIRS). The choice of treatment for ≤ 2 cm kidney stones remains a relevant and hotly debated issue.Aim. A study of the efficacy, safety, advantages and disadvantages of ultra-mini percutaneous nephrolithotripsy (ultra-mini PCNL) and retrograde intrarenal surgery (RIRS) in treatment of ≤ 2 cm kidney stones.Materials and methods. Treatment outcomes in urology patients of the Botkin Hospital were analysed retrospectively for years 2017–2022. The patients were divided between cohorts: cohort 1 consisted of patients who underwent ultra-mini PCNL; cohort 2 included 41 patients with RIRS.Results and discussion. The incidence of complete stone absence on the day after surgery was significantly higher in cohort 1 (39; 92.8 %) vs. 2 (33; 80.4 %). Mean operation time was significantly less in cohort 1 (55 [30–80] min) vs. 2 (78 [30–125] min). Mean hospital stay did not differ significantly between the cohorts: 3 (1–5) vs. 2.8 (2–4) days in cohorts 1 and 2, respectively. Haematuria was statistically more severe in cohort 1 (7 cases; 16.6 %) vs. 2 (4 cases; 9.7 %); mean postoperative haemoglobin decrease was also significantly higher in cohort 1 (11.6) vs. 2 (6.4 g/L).Conclusion. Both ultra-mini PCNL and RIRS are effective, safe and complementary procedures in treatment for ≤2 cm renal stones. Ultra-mini PCNL is more effective over RIRS in terms of single-intervention complete stone removal and shorter operation time, whereas the overall complications rate did not significantly differ between cohorts

Определение полисорбата 80 в биофармацевтических препаратах с помощью оптимизированной колориметрической методики

Objectives. We hereby describe an improvement of a previously developed quantification technique for polysorbate 80 in biopharmaceutical formulations (darbepoetin alfa and eculizumab) and report the validation of the new approach.Methods. Polysorbate was isolated from analyte samples by protein precipitation using an organic solvent, followed by supernatant evaporation in vacuum. Polysorbate was derivatized using a ferric thiocyanate reagent and extracted into an organic phase; the relevant optical density measurements were performed.Results. We established the optimal conditions for each step of the analysis procedure. The accuracy was 97–102% in the tested analytical range, the relative standard deviation did not exceed 5%, and the limit of quantification was 0.01 mg/mL.Conclusions. The reported approach is highly sensitive; polysorbate isolation and quantification do not depend on the matrix or, most importantly, the protein.Цели. В данной работе была усовершенствована ранее разработанная методика определения полисорбата 80 в биотехнологических препаратах (дарбэпоэтин альфа, экулизумаб), а также проведена ее валидация.Методы. Полисорбат извлекали из пробы осаждением белка органическим растворителем, затем выпаривали супернатант в вакууме. Полисорбат дериватизировали оптимизированным железо–тиоцианатным реагентом; дериват экстрагировали в слой органического растворителя и измеряли оптическую плотность.Результаты. Были установлены оптимальные условия для каждой стадии методики. Правильность находится в диапазоне степени извлечения 97–102%, относительное стандартное отклонение составляет не более 5%, предел количественного определения методики 0.01 мг/мл.Выводы. Представленная методика имеет высокую чувствительность. Извлечение и определение полисорбата не зависят от матрикса пробы – прежде всего, от присутствующего белка

Превентивный шов при лапароскопической резекции почки без ишемии. Описание методики ГКБ им. С.П. Боткина

Background. Radical removal of the tumor while maximizing sparing of the renal function are the main goals of the partial nephrectomy. Shortening of the warm ischemia time is one of the best ways to achieve good functional results of the surgery. Aim. To present our technique of non-ischemic laparoscopic kidney resection with preventive suturing around the tumor.Materials and methods. Before tumor resection, sutures are placed around tumor spaced by 1 cm with moderate tension. Enucleoresection is performed between tumor and preplaced sutures in visually healthy plane. 30 patients underwent this technique.Results. Median tumor size was 3.6 (1.5–7.2) cm. All patients had negative surgical margin. Warm ischemia was needed in 8 (26.7 %) patients with a median time of 9 minutes. Median operative time was 115 (65–185) minutes. There were no intra or postoperative complications. Trifecta was achieved in all patients (100 %).Conclusion. This technique allows to perform the surgery in non-ischemic fashion, decrease bleeding and improve visualization of the resection field and achieve superior oncologic and functional results.Введение. Основные цели выполнения резекции почки с опухолью – радикальное удаление новообразования и максимально возможное сохранение функции почки. Уменьшение времени тепловой ишемии является одним из способов достижения лучшего функционального результата операции.Цель исследования – представить описание лапароскопической резекции почки без ишемии с применением превентивных гемостатических швов.Материалы и методы. Перед резекцией непосредственно вокруг опухоли через каждый сантиметр накладывают превентивные швы, создавая умеренное натяжение. Выполняют энуклеорезекцию опухоли между опухолью и наложенными швами в слое визуально неизмененной почечной ткани. Представленная методика выполнена 30 пациентам.Результаты. Средний размер опухоли составил 3,6 (1,5–7,2) см. У всех пациентов был констатирован отрицательный хирургический край. Пережатие почечной ножки потребовалось 8 (26,7 %) пациентам при среднем времени тепловой ишемии 9 мин. Средняя длительность операции – 115 (65–185) мин. Интраи послеоперационных осложнений не отмечено. Трифекта достигнута у всех 30 (100 %) пациентов.Заключение. Данная методика позволяет снизить вероятность тепловой ишемии, улучшить визуализацию во время резекции и достичь лучших онкологических и функциональных результатов

Correlation Time-of-flight Spectrometry of Ultracold Neutrons

The fearures of the correlation method used in time-of-flight spectrometry of ultracold neutrons are analyzed. The time-of-flight spectrometer for the energy range of ultracold neutrons is described, and results of its testing by measuring spectra of neutrons passing through interference filters are presented.Comment: 16 pages, 5 figure

Microlaparoscopic pyeloplasty. 120 cases experience

The aim of the study was to evaluate functional results of microlaparoscopy compared with standard laparoscopy in pyeloplasty in adults. Patients and methods. The study included 120 patients who underwent microlaparoscopic pyeloplasty (MlP) - and 101 standard laparoscopic pyeloplasty (SlP). MlP was performed with two or three 2.5-3 mm trocars (Storz) and one 5 mm trocar for the Hd-laparoscope installed through the navel. In all cases Hynes- Anderson procedure was performed with antegrade insertion of stent. Two continuous 5-0 biosyn sutures were used for anastomosis. Stent was removed after 6 weeks and evaluation of renal function was performed in 3-6 months. Results. All options of laparoscopic pyeloplasty provide good postoperative results: 100% - MlP and 98% - SlP (defined as absense of pain and/or T1/2 improvement). There was no conversion. There were no statistically significant differences in complications, duration of hospital stay. After 3-4 months postoperative scars were almost invisible in the navel, and the sites from 3 mm trocars were like little moles, at the same time SlP postoperative scars were more noticeable. Conclusion. In our study MlP showed the same functional outcome and safety in comparison with the SlP. MlP with Hd-vision allows the use of thin filaments № 5-0 for anastomosis to provide greater operative precision that made it a standard method of pyeloplasty in our clinic with regard to a better cosmetic result achieved.Введение: Лапароскопическая пиелопластика является золотым стандартом лечения гидронефроза. Улучшение микролапароскопического инструментария позволило его применить для сложной диссекции и реконструкции, которые требуются в ходе лапароскопической пиелопластики. Целью работы являлась оценка функциональных результатов микролапароскопии в сравнении со стандартной лапароскопией при пластике гидронефроза у взрослых. Методы: Нами были проанализированы результаты хирургического лечения 120 пациентов, которым была проведена микролапароскопическая пиелопластика (МЛП) с 2010 по 2017 гг. и 101 больного, которым выполнена операция пиелопластики по стандартной лапароскопической методике (СЛП). Применялась методика гибридной микролапароскопии с использованием одного 5мм троакара для HD -лапароскопа, устанавливаемого скрыто в пупочном разрезе и 2,5 или 3 мм рабочих инструментов, в сравнении со стандартной лапароскопией. Во всех случаях выполнена операция Hynes-Anderson c антеградной установкой стента. результаты: все варианты лапароскопической пиелопластики обеспечили хорошие послеоперационные результаты: 100% - МЛП и 98% - СЛП (оценивался как исчезновение болевого симптома и/или улучшение при ДНСГ). Не наблюдалось статистически значимых различий в уровне интраоперационных и послеоперационных осложнений, времени операции, нахождения дренажа, уретрального катетера, мочеточникового стента и пребывания в стационаре. Через 3-4 месяца места разрезов были практически невидимы в области пупка, а места от 3мм троакаров напоминали маленькие родинки, в то время как места от разрезов после СЛП были более заметны. Выводы: в нашем исследовании микролапароскопия продемонстрировала одинаковый функциональный результат и безопасность выполнения в сравнении со стандартной при пластике гидронефроза у взрослых. МЛП с HD-видением позволяет использовать при анастомозе тонкие нити № 5-0, что обеспечивает большую прецизионность выполнения операции, что, с учетом лучшего косметического результата, достигаемого при минилапароскопии, сделало эту методику стандартной при пиелопластике в нашей клинике

Ангиомиолипома почки: описание клинического случая

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