ВОЗМОЖНОСТИ УЛЬТРАЗВУКОВОЙ НАВИГАЦИИ ДЛЯ РАДИОЧАСТОТНОЙ ДЕНЕРВАЦИИ МЕЖПОЗВОНКОВЫХ СУСТАВОВ ПОЯСНИЧНОГО ОТДЕЛА ПОЗВОНОЧНИКА

The aim of the study was to evaluate the possibility of US navigation for Radiofrequency denervation (RFD) of the lumbar facets.Material and methods. The authors performed a prospective controlled cohort study which included 50 patients with chronic pain syndrome who underwent RFD LIII-SI facets on both sides. The main group (US) included 25 patients, who underwent US guided navigation with FScontrol of the correct placement of the cannula prior to ablation. In the control group (FS) the RFD was performed only under FS control. Patients were selected after preliminary test block of medial branch with 50% pain reduction from the baseline. Patients with overweight, spinal deformity, pronounced degenerative changes, spinal stenosis and developmental anomalies were not included in the study. For the evaluation of outcomes, the numeric pain scale NRS-11 and the Oswestry index (ODI) were used, the accuracy of the cannula position was assessed and factors determining the accuracy were searched.Results. As a result of the intervention, there was a significant decrease of NRS-11 and ODI criteria in both groups (p0.001), a positive outcome was achieved in 18 (72%) of US patients and 16 (64%) of FS patients, p = 0.564. Of the 200 attempts to position the cannula under the ultrasound control, 169 (84.5%) were successful, in most cases (187 out of 200, 93.5%) at least 3 attempts were required to reposition the cannula. The average time for performing the procedure under the ultrasound control was 47.3±1.13 minutes. The facet angle and procedure level were defined as predictors of the cannula positioning accuracy, odds ratio 0.93 (95% CI 0.894–0.963) and 0.51 (95% CI 0.32–0.805), respectively.Conclusion. RFD of lumbar facet under ultrasound navigation allows to achieve a relatively high accuracy of the cannula position into the zone of passage of the articular branch. The navigation capabilities are reduced at the level of LV and SI vertebrae due to structural features of the joints, namely coronary orientation of the facets with the formation of a narrow space between the transverse and upper articular process, which create difficulties for scanning. The disadvantage of ultrasound control is the lengthy procedure and the need for repeated reinsertion of the cannulae worsening the patient’s tolerance of procedure.Цель исследования — оценить возможности использования УЗ-навигации при выполнении радиочастотной денервации (РЧД) межпозвонковых суставов (МПС) поясничного отдела позвоночника.Материал и методы. Выполнено проспективное контролируемое когортное исследование. В исследование включено 50 пациентов с хроническим болевым синдромом, которым выполнялась РЧД МПС LIII-SI позвонков с двух сторон. Пациенты были поделены на две группы. В основную группу вошло 25 пациентов, которым РЧД проводилась под ультразвуковой навигацией с ФС-контролем правильности установки канюль перед началом абляции. В контрольной группе, состоящей также из 25 пациентов, РЧД проводилась только под ФС-контролем. Отбор пациентов проводился на основании предварительной тестовой блокады МПС при условии снижении боли на 50% от исходного. Для оценки исходов использовалась цифровая шкала боли NRS-11 и индекс Освестри (OID), оценивалась точность попадания канюлей в необходимую зону, проводился поиск факторов, влияющих на точность попадания.Результаты. В результате вмешательства произошло значимое снижение исследуемых показателей в обеих группах (p0,001), положительный исход достигнут у 18 (72%) пациентов основной группы и 16 (64%) контрольной группы, различия не были статистически значимыми (p = 0,564). Из 200 попыток проведения канюль под УЗ-контролем 169 (84, 5%) были успешными при ФС-контроле, в большинстве случаев (187 из 200, 93,5%) требовалось не менее 3 попыток переустановки канюли. Среднее время выполнения вмешательства под УЗ-контролем составило 47,3±1,13 мин. Фасеточный угол и уровень вмешательства определены в качестве предикторов точности попадания, отношение шансов 0,93 при 95% доверительном интервале 0, 894–0,963, и 0,51 при 0,32–0,805 соответственно.Выводы. Выполнение РЧД МПС поясничного отдела позвоночника с использованием УЗ-навигации позволяет достигнуть относительно высокой точности попадания канюлей в зону прохождения артикулярной ветви. Возможности навигации снижаются на уровне LV и SI позвонков, что определяется наличием особенностей строения МПС в виде коронарной ориентации фасеток с формированием узкого пространства между поперечным и верхним суставным отростком, затрудняющим сканирование. Недостатком УЗ-контроля является длительность процедуры и необходимость неоднократной переустановки канюль, ухудшающих переносимость пациентом вмешательства

РЕЗУЛЬТАТЫ ТРАНСФОРАМИНАЛЬНОЙ ЭНДОСКОПИЧЕСКОЙ ДИСКЭКТОМИИ ПРИ ГРЫЖАХ МЕЖПОЗВОНКОВЫХ ДИСКОВ ПОЯСНИЧНО-КРЕСТЦОВОГО ОТДЕЛА ПОЗВОНОЧНИКА

Introduction. Lumbar disc herniation is a frequent pathology and surgical target. Endoscopic discectomy becomes more popular due to minimally invasive surgical technique. There is a deficit of scientific papers dedicated to analysis of potential for endoscopic discectomy depending on the specifics of spinal anatomy and degenerative changes.The purpose of the study was to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in comparison with microdiscectomy (MD) and to specify factors determining complications and failures.Materials and methods. The authors performed randomized controlled study where main group of patients included data on prospective examination of 101 patients after TED procedure for lumbar intervertebral disc herniation. Age of patients ranged from 19 to 81 years with average of 41,4±12,6 years. Control group included data of retrospective examination of 153 patients that were operated by the same surgeon in the period from 201 till 2104 with microdiscectomy procedure. Age of patients ranged from 18 to 77 years with average of 47,8±11,3 years. Inclusion criteria were as follows: surgical procedure at the same level of the primary intervertebral herniation. Exclusion criteria were: degenerative spinal canal stenosis, spondylolisthesis, spine deformity.Results. Clinical outcomes after TED demonstrated no difference from MD procedure. No factors of significant influence on outcomes after surgical procedure were observed. The main group was characterized by more cases of revisions and conversions of endoscopic into open procedures (13,9%) which was related to mistakes in transforaminal approach due to features of intervertebral joints and foramina anatomy resulting in impossibility to achieve adequate spinal canal decompression.Conclusion. Transforaminal endoscopic discectomy is an effective and safe method of lumbar intervertebral herniation treatment. Complications and failures during learning curve of endoscopic procedure are associated with technique drawbacks as well as with mistakes in planning and performing the approach. Congenital alignment of lumbar spine with specific patterns of facets and foramina anatomy dictate technical difficulties with transforaminal approach. Актуальность. Эндоскопическая дискэктомия завоевывает все бóльшую популярность в связи с наименьшей травматичностью доступа. Существует дефицит научных работ, анализирующих возможности ее применения в зависимости от особенностей анатомии позвоночника и дегенеративно-дистрофических изменений.Цель исследования — оценить эффективность трансфораминальной эндоскопической дискэктомии в сравнении с открытой дискэктомией, а также определить факторы, влияющие на развитие осложнений и неудовлетворительные результаты.Материал и методы. Выполнено рандомизированное контролируемое когортное исследование. В основную группу были включены данные проспективного исследования 101 пациента, прооперированных по поводу грыж межпозвонковых дисков поясничного отдела позвоночника с использованием трансфораминальной эндоскопической дискэктомии. Возраст пациентов варьировал от 19 до 81 года, в среднем составил 41,4±12,6 лет. В контрольную группу вошли данные ретроспективного обследования 153 пациентов, оперированных тем же хирургом в 2013–2014 гг. в объеме микродискэктомии. Возраст пациентов варьировал от 18 до 77 лет, в среднем — 47,8±11,3 лет. Критерием включения в исследование являлось хирургическое вмешательство на одном уровне по поводу первичной грыжи МПД. Критерии исключения: дегенеративный стеноз позвоночного канала, спондилолистез, деформация позвоночника.Результаты. Клинические результаты эндоскопической дискэктомии не отличались от результатов микродискэктомии. Факторов, значимо влияющих на результаты оперативного лечения в обеих группах, не выявлено. В основной группе было больше повторных операций и конверсий эндоскопических вмешательств в открытые (13,9%). Это связано с ошибками выполнения трансфораминального доступа вследствие конституциональных особенностей анатомии межпозвонковых суставов и отверстий, в результате которого визуализация и адекватная декомпрессия позвоночного канала были невозможны.Выводы. Трансфораминальная эндоскопическая дискэктомия является эффективным и безопасным методом хирургического лечения межпозвонковых грыж поясничного отдела позвоночника. Осложнения и неудачные результаты оперативного лечения во время освоения эндоскопической хирургии определяются недостатками хирургической техники, а также ошибками в планировании и выполнении трансфораминального доступа. Особенности конституции позвоночника в виде гиперили гиполордоза с характерными изменениями анатомии фасеточных суставов и межпозвонковых отверстий оперелеляют технические трудности при трансфораминальном доступе.

Putative ammonia-oxidizing Crenarchaeota in suboxic waters of the Black Sea : a basin-wide ecological study using 16S ribosomal and functional genes and membrane lipids

Author Posting. © Blackwell, 2007. This is the author's version of the work. It is posted here by permission of Blackwell for personal use, not for redistribution. The definitive version was published in Environmental Microbiology 9 (2007): 1001-1016, doi:10.1111/j.1462-2920.2006.01227.x.Within the upper 400 m at western, central, and eastern stations in the world’s largest stratified basin, the Black Sea, we studied the qualitative and quantitative distribution of putative nitrifying Archaea based on their genetic markers (16S rDNA, amoA encoding for the alfa-subunit of archaeal ammonia monooxygenase), and crenarchaeol, the specific glycerol diphytanyl glycerol tetraether (GDGT) of pelagic Crenarchaeota within the Group I.1a. Marine Crenarchaeota were the most abundant Archaea (up to 98% of the total archaeal 16S rDNA copies) in the suboxic layers with oxygen levels as low as 1 μM including layers where previously anammox bacteria were described (Kuypers et al., 2003). Different marine crenarchaeotal phylotypes (both 16S rDNA and amoA) were found at the upper part of the suboxic zone as compared to the base of the suboxic zone and the upper 15-30 m of the anoxic waters with prevailing sulfide concentrations of up to 30 μM. Crenarchaeol concentrations were higher in the sulfidic chemocline as compared to the suboxic zone. These results indicate an abundance of putative nitrifying Archaea at very low oxygen levels within the Black Sea and might form an important source of nitrite for the anammox reaction.This work was supported by a grant from the Netherlands Organization for Scientific Research (VENI Innovational Research Grant nr. 813.13.001 to MJLC), an U. S. National Science Foundation grant OCE0117824 to SGW and the Spinoza award to JSSD, which we greatly acknowledge

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio

Observation of a new chi_b state in radiative transitions to Upsilon(1S) and Upsilon(2S) at ATLAS

The chi_b(nP) quarkonium states are produced in proton-proton collisions at the Large Hadron Collider (LHC) at sqrt(s) = 7 TeV and recorded by the ATLAS detector. Using a data sample corresponding to an integrated luminosity of 4.4 fb^-1, these states are reconstructed through their radiative decays to Upsilon(1S,2S) with Upsilon->mu+mu-. In addition to the mass peaks corresponding to the decay modes chi_b(1P,2P)->Upsilon(1S)gamma, a new structure centered at a mass of 10.530+/-0.005 (stat.)+/-0.009 (syst.) GeV is also observed, in both the Upsilon(1S)gamma and Upsilon(2S)gamma decay modes. This is interpreted as the chi_b(3P) system.Comment: 5 pages plus author list (18 pages total), 2 figures, 1 table, corrected author list, matches final version in Physical Review Letter

Search for displaced vertices arising from decays of new heavy particles in 7 TeV pp collisions at ATLAS

We present the results of a search for new, heavy particles that decay at a significant distance from their production point into a final state containing charged hadrons in association with a high-momentum muon. The search is conducted in a pp-collision data sample with a center-of-mass energy of 7 TeV and an integrated luminosity of 33 pb^-1 collected in 2010 by the ATLAS detector operating at the Large Hadron Collider. Production of such particles is expected in various scenarios of physics beyond the standard model. We observe no signal and place limits on the production cross-section of supersymmetric particles in an R-parity-violating scenario as a function of the neutralino lifetime. Limits are presented for different squark and neutralino masses, enabling extension of the limits to a variety of other models.Comment: 8 pages plus author list (20 pages total), 8 figures, 1 table, final version to appear in Physics Letters

Measurement of the inclusive isolated prompt photon cross-section in pp collisions at sqrt(s)= 7 TeV using 35 pb-1 of ATLAS data

A measurement of the differential cross-section for the inclusive production of isolated prompt photons in pp collisions at a center-of-mass energy sqrt(s) = 7 TeV is presented. The measurement covers the pseudorapidity ranges |eta|<1.37 and 1.52<=|eta|<2.37 in the transverse energy range 45<=E_T<400GeV. The results are based on an integrated luminosity of 35 pb-1, collected with the ATLAS detector at the LHC. The yields of the signal photons are measured using a data-driven technique, based on the observed distribution of the hadronic energy in a narrow cone around the photon candidate and the photon selection criteria. The results are compared with next-to-leading order perturbative QCD calculations and found to be in good agreement over four orders of magnitude in cross-section.Comment: 7 pages plus author list (18 pages total), 2 figures, 4 tables, final version published in Physics Letters

Measurement of the production cross section of prompt j/psi mesons in association with a W (+/-) boson in pp collisions root s=7 TeV with the ATLAS detector

The process pp → W±J/ψ provides a powerful probe of the production mechanism of charmonium in hadronic collisions, and is also sensitive to multiple parton interactions in the colliding protons. Using the 2011 ATLAS dataset of 4.5 fb-1 of p s = 7TeV pp collisions at the LHC, the first observation is made of the production of W± + prompt J/ events in hadronic collisions, using W± → μ and J/ψ → μ+μ-. A yield of 27.4±7.5 -6.5 W± + prompt J/ψ events is observed, with a statistical significance of 5.1. The production rate as a ratio to the inclusive W± boson production rate is measured, and the double parton scattering contribution to the cross section is estimated. Copyright CERN, for the benefit of the ATLAS Collaboration

Measurement of D*+/- meson production in jets from pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

This paper reports a measurement of D*+/- meson production in jets from proton-proton collisions at a center-of-mass energy of sqrt(s) = 7 TeV at the CERN Large Hadron Collider. The measurement is based on a data sample recorded with the ATLAS detector with an integrated luminosity of 0.30 pb^-1 for jets with transverse momentum between 25 and 70 GeV in the pseudorapidity range |eta| < 2.5. D*+/- mesons found in jets are fully reconstructed in the decay chain: D*+ -> D0pi+, D0 -> K-pi+, and its charge conjugate. The production rate is found to be N(D*+/-)/N(jet) = 0.025 +/- 0.001(stat.) +/- 0.004(syst.) for D*+/- mesons that carry a fraction z of the jet momentum in the range 0.3 < z < 1. Monte Carlo predictions fail to describe the data at small values of z, and this is most marked at low jet transverse momentum.Comment: 10 pages plus author list (22 pages total), 5 figures, 1 table, matches published version in Physical Review