Long-Wave Instability of Advective Flows in Inclined Layer with Solid Heat Conductive Boundaries

We investigate the stability of the steady convective flow in a plane tilted layer with ideal thermal conductivity of solid boundaries in the presence of uniform longitudinal temperature gradient. Analytically found the stability boundary with respect to the long-wave perturbations, find the critical Grashof number for the most dangerous among them of even spiral perturbation.Comment: in Russian, 18 pages, 5 figures, submited to Appl. mechanics and physics, RAS Siberian brunch, Novosibirsk, Russia; Key words: advective flow, oblique layer, a longitudinal temperature gradient, long-wave instabilit

Acute Adhesive Small Bowel Obstruction: a Comparative Analysis of Open and Laparoscopic Surgery

Background. Acute adhesive small bowel obstruction (AASBO) is a common surgical emergency requiring immediate interventions. AASBO is a usual indication for both small bowel resection and adhesiolysis. Postoperative adhesions cause 60% of small bowel obstructions.Materials and methods. An analysis of treatment outcomes is presented for 197 acute adhesive small bowel obstruction patients; 63 patients had urgent laparotomy, and 134 were scheduled for laparoscopy. The examination included physical, laboratory, radiological methods (abdominal radiography, ultrasound, CT scan), laparoscopy and intra-abdominal pressure monitoring.Results and discussion. Of 134 patients scheduled for laparoscopic adhesiolysis, only 46.2% had laparoscopy completed, and 53.8% required conversion to laparotomy. The main rationale for conversion were massive adhesions, intraoperative haemodynamic instability, a need for intestinal decompression, as well as rare complications. Laparoscopic operations were reported with the lower vs. laparotomy rates of surgical complications (6.4  vs. 12.69%), mortality (6  vs. 6.3%), shorter hospital stays (6.5 vs. 12 days) and operation times (75 vs. 118 min, respectively).Conclusion. Laparoscopic surgery in acute adhesive small bowel obstruction was feasible in 31.47% patients and in 46.2% — after a diagnostic laparoscopy; however, a thorough patients selection for laparoscopic adhesiolysis is necessary. The first estimated should be the patient’s haemodynamic stability, the severities of condition, adhesions and comorbid cardiorespiratory pathology. Grade I—II adhesions are an indication for laparoscopic surgery

Острая спаечная кишечная непроходимость: сравнительный анализ открытых и лапароскопических операций

Background. Acute adhesive small bowel obstruction (AASBO) is a common surgical emergency requiring immediate interventions. AASBO is a usual indication for both small bowel resection and adhesiolysis. Postoperative adhesions cause 60% of small bowel obstructions.Materials and methods. An analysis of treatment outcomes is presented for 197 acute adhesive small bowel obstruction patients; 63 patients had urgent laparotomy, and 134 were scheduled for laparoscopy. The examination included physical, laboratory, radiological methods (abdominal radiography, ultrasound, CT scan), laparoscopy and intra-abdominal pressure monitoring.Results and discussion. Of 134 patients scheduled for laparoscopic adhesiolysis, only 46.2% had laparoscopy completed, and 53.8% required conversion to laparotomy. The main rationale for conversion were massive adhesions, intraoperative haemodynamic instability, a need for intestinal decompression, as well as rare complications. Laparoscopic operations were reported with the lower vs. laparotomy rates of surgical complications (6.4  vs. 12.69%), mortality (6  vs. 6.3%), shorter hospital stays (6.5 vs. 12 days) and operation times (75 vs. 118 min, respectively).Conclusion. Laparoscopic surgery in acute adhesive small bowel obstruction was feasible in 31.47% patients and in 46.2% — after a diagnostic laparoscopy; however, a thorough patients selection for laparoscopic adhesiolysis is necessary. The first estimated should be the patient’s haemodynamic stability, the severities of condition, adhesions and comorbid cardiorespiratory pathology. Grade I—II adhesions are an indication for laparoscopic surgery. Введение. Острая спаечная кишечная непроходимость (ОСКН) является одной из частых причин в экстренной хирургии, требующих выполнения неотложных оперативных вмешательств. ОСКН — наиболее частое показание как для резекции тонкой кишки, так и для адгезиолизиса. В 60 % причиной обструкции тонкой кишки являются послеоперационные спайки.Материалы и методы. Представлен анализ результатов лечения 197 больных с острой спаечной кишечной непроходимостью, из которых 63 пациентам была выполнена экстренная лапаротомия, 134 — планировали лапароскопические операции. В обследовании применяли физикальные, лабораторные, лучевые методы исследования (обзорная рентгенография живота, УЗИ, КТ), лапароскопию, мониторинг внутрибрюшного давления.Результаты и  обсуждение. Из 134  пациентов, запланированных на лапароскопический адгезиолизис, только у 46,2 % операция завершена лапароскопически, в 53,8 % потребовалась конверсия на лапаротомию. Основными причинами конверсии были массивный спаечный процесс, интраоперационная нестабильность гемодинамики, потребность в декомпрессии кишечника, редко — осложнения. При лапароскопических операциях отметили снижение частоты хирургических осложнений по сравнению с лапаротомией (6,4 и 12,69 %), летальности (6 и 6,3 %), сроков госпитализации (6,5 и 12 дней), сокращение продолжительности операций (75 и 118 минут соответственно).Заключение. Хирургическое лечение лапароскопическим методом больных с острой спаечной кишечной непроходимостью возможно у 31,47 % к их общему числу, в 46,2 % — после диагностической лапароскопии, но требуется тщательный отбор больных на лапароскопический адгезиолизис. Прежде всего необходимо оценить тяжесть состояния больных, стабильность гемодинамики, выраженность спаечного процесса и коморбидной кардиореспираторной патологии. Показанием к лапароскопическим операциям является спаечный процесс I– II степени.

Runoff variations in Lake Balkhash Basin, Central Asia, 1779-2015, inferred from tree rings

Long highly-resolved proxies for runoff are in high demand for hydrological forecasts and water management in arid Central Asia. An accurate (R2 = 0.53) reconstruction of October-September discharge of the Ili River in Kazakhstan, 1779–2015, is developed from moisture-sensitive tree rings of spruce sampled in the Tian Shan Mountains. The fivefold extension of the gauged discharge record represents the variability of runoff in the Lake Balkhash Basin for the last 235 years. The reconstruction shows a 40 year long interval of low discharge preceded a recent high peak in the first decade of the 2000s followed by a decline to more recent levels of discharge not seen since the start of the gauged record. Most reconstructed flow extremes (± 2σ) occur outside the instrumental record (1936–2015) and predate the start of large dam construction (1969). Decadal variability of the Ili discharge corresponds well with hydrological records of other Eurasian internal drainages modeled with tree rings. Spectral analysis identifies variance peaks (highest near 42 year) consistent with main hemispheric oscillations of the Eurasian climatic system. Seasonal comparison of the Ili discharge with sea-level-pressure and geopotential height data suggests periods of high flow likely result from the increased contribution of snow to runoff associated with the interaction of Arctic air circulation with the Siberian High-Pressure System and North Atlantic Oscillation

ETIO-PATHOGENETIC ASPECTS AND TREATMENT POLICY OF INTRA-ABDOMINAL HYPERTENSION

The examination results  of 296 patients suffering from  severe  abdominal pathology in combination with intra-abdominal hypertension are analyzed  in the article. Physical parameters of the  abdominal space  of 30 patients during  video-laparoscopic operations are studied. 3 volume  characteristics of the  abdominal space  are given by the  article writers: reserve volume, maximal volume and physiologic volume, all of them being individual marks depending on sex, age  and  body  type.  The package of measures directed on the  3 main abdominal space components is proposed

CHOICE OF SURGICAL METHOD OF TREATMENT OF CHOLELITHIASIS

This article presents results of surgical treatment of 2963 patients with cholelithiasis. The majority of them (71,8%) had an elective surgery, though 28,2% of patients underwent an emergency operation. A comparative assessment of obligate treatment criteria was made in 2 groups. A first group consisted of 803 patients and it was before introduction of Roman selection criteria used for surgical treatment of patients. A second group included 2963 patients in the period after introduction of selection criteria. Preoperative planning of surgery with evaluation of technical complexity of all stages of intervention with prognosis for possible complications should be the base of reasonable choice of surgical method of treatment of cholelithiasis and safety protection of surgery. The study completed and results obtained allowed decrease of the rate of postoperative complications to 1,4% and lethality - to 0,3%, respectively

ЭТИОПАТОГЕНЕТИЧЕСКИЕ АСПЕКТЫ И ЛЕЧЕБНАЯ ТАКТИКА ПРИ СИНДРОМЕ ИНТРААБДОМИНАЛЬНОЙ ГИПЕРТЕНЗИИ

The examination results  of 296 patients suffering from  severe  abdominal pathology in combination with intra-abdominal hypertension are analyzed  in the article. Physical parameters of the  abdominal space  of 30 patients during  video-laparoscopic operations are studied. 3 volume  characteristics of the  abdominal space  are given by the  article writers: reserve volume, maximal volume and physiologic volume, all of them being individual marks depending on sex, age  and  body  type.  The package of measures directed on the  3 main abdominal space components is proposed.Представлен анализ результатов обследования 296 больных с тяжёлой абдоминальной патологией в сочетании с синдромом интраабдоминальной гипертензии и изучения физических параметров брюшной полости у 30 больных при выполнении видеолапароскопических операций. Авторами выделены три характеристики объёма брюшной полости: резервный, максимальный и физиологический, являющиеся индивидуальными показателями и зависящими от пола, возраста, конституции.  Предложен комплекс  лечебных мероприятий, связанный с тремя основными компонентами объёма брюшной полости