Ilaser Submucous Destruction in the Treatment of Hemorrhoids

Aim: to improve the results of treatment in patients with hemorrhoids of the 2nd and 3rd stages.Materials and methods. The prospective study included 60 patients with hemorrhoids of the 2nd and 3rd stages. All patients underwent destruction of internal hemorrhoids with a fiber laser with a diode pump with a wavelength of 1940 nm. The technique is based on the effect of laser energy on the cavernous tissue of the internal hemorrhoidal node and on the terminal branches of the upper rectal artery. The efficiency of the destruction of internal hemorrhoids and the frequency of relapses of the disease were evaluated. The effectiveness of the proposed method was evaluated using anoscopy, measurement of the size of internal hemorrhoidal nodes, transrectal ultrasound with dopplerography. The analysis of the intensity of the pain syndrome, the consumption of nonsteroidal anti-inflammatory drugs and the assessment of the quality of life on the SF-36 scale was carried out. Sphincterometry was performed in all patients to determine the possible effect of laser radiation on the rectal locking apparatus. To assess the possible causes of complications, a single-factor analysis of the amount of energy transferred to each hemorrhoidal node and the total amount of energy spent on the operation was conducted.Results. In all patients, by day 7 after surgery, the pain syndrome in 43 patients (75.4 %) corresponded to 0 points according to VAS. In 3 patients (5 %) intraoperative hemorrhage developed. In the early postoperative period, 5 patients (8.3 %) had 7 complications: 5 cases of thrombosis of the external hemorrhoidal node and 2 — of acute urinary retention. The conducted single-factor analysis showed the dependence of the development of complications on the energy transferred to each hemorrhoidal node and its total amount for the entire operation. In terms of up to 6 months, there were no signs of a return of the disease in any case (hemorrhoidal prolapse and blood discharge). The detected hemorrhoids before the operation, a month after the operation, were not visualized, which persisted after 6 months. The performed transrectal ultrasound examination with spectral-wave dopplerography for up to 6 months allowed to diagnose a persistent decrease in blood flow along the terminal branches of the upper rectal artery compared with preoperative values. When performed sphincterometry, there was no change in the parameters of the anal sphincter function compared to preoperative parameters.Conclusion. The proposed method applying a fiber laser with a diode pump with a wavelength of 1940 nm makes it possible to affect transdermally the internal hemorrhoidal node without damaging the mucosa of the anal canal. The absence of postoperative wounds in the anal canal leads to a decrease in pain syndrome, and by day 7 there are no clinical manifestations of hemorrhoids. The method of laser destruction of internal hemorrhoids can be used in outpatient conditions and can improve the quality of life of patients in the early postoperative period

Effects of Metal-Support Interactions on the Synthesis of Methanol Over Palladium

The synthesis of methanol and other products from CO and H{sub 2} was studied over Pd catalysts prepared by adsorption of Pd({pi}-C{sub 3}H{sub 5}){sub 2} on MgO, ZnO, La{sub 2}O{sub 3}, {gamma}-Al{sub 2}O{sub 3} , SiO{sub 2}, TiO{sub 2}, and ZrO{sub 2} as well as over a SiO{sub 2}-supported Pd catalyst prepared from PdCl{sub 2} and Pd black. Both the activity and selectivity of Pd were affected strongly by the nature of the support and the composition of the Pd precursor. The specific activity for methanol synthesis decreased in the order Pd/La{sub 2}O{sub 3} >> Pd/SiO{sub 2} [derived from PdCl{sub 2}] > Pd/ZrO{sub 2} > Pd/ZnO ~ Pd/MgO > PdTiO{sub 2} > Pd/Al{sub 2}O{sub 3} ~ Pd/SiO{sub 2} [derived from Pd({pi}-C{sub 3}H{sub 5}){sub 2}] >> Pd black while the specific activity for hydrocarbon synthesis decreased in the order Pd/TiO{sub 2} > Pd/ZrO{sub 2} > Pd/La{sub 2}O{sub 3}> Pd/Al{sub 2}O{sub 3} ~ Pd/SiO{sub 2} [derived from PdCl{sub 2}] > Pd/SiO{sub 2} [derived from Pd({pi}-C{sub 3}H{sub 5}){sub 2}] ~ Pd black >> Pd/MgO > Pd/ZnO. Dimethyl ether production was observed over four of the catalysts and the activity for formation of this product decreased in the order Pd/Al{sub 2}O{sub 3} >> Pd/TiO{sub 2} >> Pd/MgO ~ Pd/ZrO{sub 2}. The effects of support composition on the catalytic properties of Pd are discussed in the light of current ideas concerning metal-support interactions and the acid-base properties of the support

Architecture of an object-oriented software implementation of algorithms for a full cycle of optical images of an unknown object processing

Formulation of the problem. In the process of software processing of highly distorted optical images (OI) of distant objects formed in ground-based telescopes, it becomes necessary to solve the problems of estimating the parameters of background radiation, filtering images of information objects, isolating them on the original OIs, and classifying them. This situation is typical when processing images of both a single object and moving space objects in images of the starry sky. In this regard, the authors, within the framework of the object-oriented approach, have developed a universal design pattern that makes it possible to implement the necessary processing from a single point of view.Objective. Development of a prototype for software implementation of algorithms for solving the aforementioned problems within the framework of the design pattern proposed by the authors. Examining the possibility of its use in the development of software architecture, with examples of OI processing obtained in natural conditions.Results. The article presents the results of the development of the software implementation algorithms architecture for processing distorted OIs of remote space objects formed in ground-based telescopes. Within the framework of the objectoriented programming paradigm using the Universal Modeling Language (UML), a description of the main components of static and dynamic architecture models is provided. For the static model, a new representation of the OI is proposed using a set of Boolean matrices. Within the framework of the dynamic model, a universal template (interface) has been developed for the implementation of algorithms for processing distorted OIs using UML activity diagrams. Its particularization is given when solving the problems of highlighting individual structural elements in the image of a single object and highlighting the tracks of moving objects in the image of the starry sky.Practical significance. The developed software implementations of low-quality optical image processing algorithms can be used in the modernization of software systems for ground-based telescopes

Профилактика бронхолегочной дисплазии у новорожденных с низкой и экстремально низкой массой тела при рождении путем «позднего» введения сурфактанта

Цель исследования: оценка возможности профилактики развития бронхолегочной дисплазии с помощью «поздних» ингаляций легочного сурфактанта (сурфактант-БЛ, Россия). Наблюдали 50 новорожденных с массой тела от 690 до 1620 г, в том числе 34 ребенка в основной группе и 16 - в контрольной группе. У19 детей инагаляции сурфактанта начинали с 3-го по 8-й день нахождения на кислородной поддержке (подгруппа А), а у 15 - позже 8-го дня (подгруппа Б). Установлено, что раннее начало сурфактант-терапии (3,6+0,24 дня) позволило переводить детей на второй этап выхаживания через 19,4+3,06 дня, а позднее (16,4+2,09 дня) — через 31,0+3,37 дня (/КО,05). Катамнез в течение первого года жизни показал, что только 6,7+6,68% детей основной группы болели ОРВИ 3 раза и более в течение года (в контроле — 63,2+11,37%; /КО,001). Бронхообструктивный синдромом (не более 2 эпизодов в год) наблюдался у 26,3+10,38% детей основной группы против 66,7+12,59% в контроле (более 3-5 раз в год; /КО,05). Отсутствие нарушений зрения бьио выявлено у 61,5+14,05% пациентов против 14,3+9,71% в контроле (/КО,01). Выводы. Оптимальным сроком начала «поздней» сурфактант-терапии для профилактики бронхолегочной дисплазии является 3—8-й день нахождения ребенка на кислородной поддержке. Раннее начало «поздних» ингаляций сурфактанта снижает длительность пребывания в ОРИТ и приводит к профилактике бронхолегочной дисплазии