Early onset of ground-state deformation in the neutron-deficient polonium isotopes

In-source resonant ionization laser spectroscopy of the even-$A$ polonium isotopes $^{192-210,216,218}$Po has been performed using the $6p^37s$ $^5S_2$ to $6p^37p$ $^5P_2$ ($\lambda=843.38$ nm) transition in the polonium atom (Po-I) at the CERN ISOLDE facility. The comparison of the measured isotope shifts in $^{200-210}$Po with a previous data set allows to test for the first time recent large-scale atomic calculations that are essential to extract the changes in the mean-square charge radius of the atomic nucleus. When going to lighter masses, a surprisingly large and early departure from sphericity is observed, which is only partly reproduced by Beyond Mean Field calculations.Comment: As submitted to PR

Coulomb excitation of 68^{68}Ni at safe energies

The $B(E2;0^+\to2^+)$ value in $^{68}$Ni has been measured using Coulomb excitation at safe energies. The $^{68}$Ni radioactive beam was post-accelerated at the ISOLDE facility (CERN) to 2.9 MeV/u. The emitted $\gamma$ rays were detected by the MINIBALL detector array. A kinematic particle reconstruction was performed in order to increase the measured c.m. angular range of the excitation cross section. The obtained value of 2.8$^{+1.2}_{-1.0}$ 10$^2$ e$^2$fm$^4$ is in good agreement with the value measured at intermediate energy Coulomb excitation, confirming the low $0^+\to2^+$ transition probability.Comment: 4 pages, 5 figure

ВНЕДРЕНИЕ ЛАПАРОСКОПИЧЕСКИХ ТЕХНОЛОГИЙ В ХИРУРГИЮ КОЛОРЕКТАЛЬНОГО РАКА

Background. Although minimally invasive surgery has undoubted advantages, the proportion of endovideosurgical interventions in the treatment of patients with colorectal cancer (CRC) remains insignificant and indications for their application have not been defined until the present time. The authors describe their experience with laparoscopic CRC surgery.Objective and methods. 132 endovideosurgical interventions and 143 open surgeries for рТ2–4N0–2М0–1а CRC were performed for 25 months of surgical practice. The above patient groups were assessed for body index, patient age, comorbidity severity (CR-ROSSUM scale), T index, number of lymph nodes removed, blood loss, operation time, and complication rate and pattern. The learning curve was studied from the duration of each type of laparoscopic surgery.Results. No significant differences were found between the groups in the ratio of surgery types, the number of lymph nodes removed, and the rate of complications. More significant blood loss and a larger number of postoperative wound infections were seen in the patients who had been operated on through open access with the significantly shorter duration of open surgery. All the types of laparoscopic surgery for CRC are characterized by a marked learning curve, except for those for rectal resection with total mesorectumectomy.Conclusion. Laparoscopic surgery for CRC compares well with routine surgery. The principles of laparoscopic resections should be employed in CRC and open surgery. It is possible and necessary to more extensively use endovideosurgical techniques.Введение. При несомненных преимуществах малоинвазивной хирургии доля эндовидеохирургических вмешательств в лечении больных колоректальным раком (КРР) остается незначительной и показания к их применению до сих пор не определены. В работе представлен собственный опыт внедрения лапароскопических технологий в хирургию КРР.Материалы и методы. За 25 мес хирургической деятельности было выполнено 132 эндовидеохирургических вмешательства и 143 открытых операций по поводу рака прямой и ободочной кишки рТ2–4N0–2М0–1а. Для указанных групп пациентов оценивались индекс массы тела, возраст, тяжесть сопутствующей патологии (шкала CR-POSSUM), индекс Т, количество удаленных лимфатических узлов, кровопотеря, время операции, частота и структура осложнений. Изучалась кривая обучения по продолжительности каждого типа лапароскопической операции.Результаты. По соотношению типов операций, качеству мезоректумэктомии, количеству удаленных лимфатических узлов, частоте осложнений достоверных различий между группами не было выявлено. Более существенная кровопотеря и большее число нагноений послеоперационной раны были у пациентов, прооперированных открыто при достоверно меньшей продолжительности открытой операции. Для всех видов лапароскопических операций при КРР характерна выраженная кривая обучения, за исключением резекции прямой кишки с тотальной мезоректумэктомией.Выводы. Лапароскопические операции при КРР не уступают традиционным. Целесообразно использовать принципы лапароскопических резекций при КРР и в открытой хирургии. Более широкое применение эндовидеохирургических методик возможно и необходимо

РЕДКИЙ СЛУЧАЙ КРОВОТЕЧЕНИЯ ИЗ ОСТРЫХ ЯЗВ КУЛЬТИ ТОНКОЙ КИШКИ

The diagnosis and management of gastrointestinal bleeding from unknown sources is one of the most difficult problems in emergency surgery as it is associated with a high level of morbidity and mortality, which may reach 80%. Available methods of endoscopic diagnostic in 10-15% cases of these disease don’t identify the source of bleeding. We report the clinical observation of a patient with intestinal bleeding of a high severity from acute ulcers of small intestinal stump.Проблема диагностики и лечения желудочно-кишечных кровотечений из неустановленных источников остается одной из сложнейших в ургентной хирургии за счет высокой частоты осложнений и уровня летальности, достигающей 80%. Доступные методы эндоскопической диагностики в 10−15% наблюдений не позволяют уточнить источник кровотечения. Представлено клиническое наблюдение пациента с кишечным кровотечением тяжелой степени кровопотери из острых язв культи тонкой кишки

ХИРУРГИЧЕСКАЯ ТАКТИКА ПРИ СИНДРОМЕ ДЬЕЛАФУА РЕДКОЙ ЛОКАЛИЗАЦИИ

Abstract The given clinical example demonstrates the possibility of diagnosis and surgical treatment of Dieulafoy’s lesion with rare location (cecum in this case) when endoscopic hemostasis cannot be adequately performed. The manifestation of the disease is caused by the use of dual antiplatelet therapy after installation of stents into coronary arteries for unstable angina.Приведенный клинический пример демонстрирует возможность диагностики и хирургического лечения синдрома Дьелафуа редкой локализации, в нашем наблюдении в слепой кишке, при невозможности выполнения адекватного эндоскопического гемостаза. Манифестация заболевания вызвана использованием двойной дезагрегантной терапии после стентирования коронарных артерий по поводу нестабильной стенокардии.  

Methods of improvement of treatment results in patients with strangulated inguinal hernias

OBJECTIVE. The authors investigated the ways of improvement the results of treatment and diagnostics of patients with strangulated inguinal hernias. MATERIAL AND METHODS. An analysis of diagnostic and treatment results was made in 136 patients. The main group included 52 patients who underwent treatment at the period from 2015 till 2016. An individual treatment and diagnostic strategy was applied for these patients, where diagnostic and therapeutic laparoscopy was actively used. The control group consisted of 84 patients who were treated at the period from 2011 till 2014. There was a common diagnostic and treatment strategy. That management led to late diagnostics and unsatisfactory treatment results. RESULTS. The research showed that the rate of common complications decreased from 25 to 1,9 % and the rate of local complications reduced from 29,8 to 5,7 % (p < 0,05). The lethality dropped from 8,3 to 0 %. CONCLUSIONS. The application of individual diagnostic and treatment approach allowed doctors to reduce levels of common and local complications and morbidity rate in patients with strangulated inguinal hernias

EXPERIENCE IN INTRODUCING LAPAROSCOPIC TECHNOLOGIES INTO COLORECTAL CANCER SURGERY

Background. Although minimally invasive surgery has undoubted advantages, the proportion of endovideosurgical interventions in the treatment of patients with colorectal cancer (CRC) remains insignificant and indications for their application have not been defined until the present time. The authors describe their experience with laparoscopic CRC surgery.Objective and methods. 132 endovideosurgical interventions and 143 open surgeries for рТ2–4N0–2М0–1а CRC were performed for 25 months of surgical practice. The above patient groups were assessed for body index, patient age, comorbidity severity (CR-ROSSUM scale), T index, number of lymph nodes removed, blood loss, operation time, and complication rate and pattern. The learning curve was studied from the duration of each type of laparoscopic surgery.Results. No significant differences were found between the groups in the ratio of surgery types, the number of lymph nodes removed, and the rate of complications. More significant blood loss and a larger number of postoperative wound infections were seen in the patients who had been operated on through open access with the significantly shorter duration of open surgery. All the types of laparoscopic surgery for CRC are characterized by a marked learning curve, except for those for rectal resection with total mesorectumectomy.Conclusion. Laparoscopic surgery for CRC compares well with routine surgery. The principles of laparoscopic resections should be employed in CRC and open surgery. It is possible and necessary to more extensively use endovideosurgical techniques

RARE CASE OF BLEEDING FROM ACUTE ULCERS OF THE SMALL INTESTINAL STUMP

The diagnosis and management of gastrointestinal bleeding from unknown sources is one of the most difficult problems in emergency surgery as it is associated with a high level of morbidity and mortality, which may reach 80%. Available methods of endoscopic diagnostic in 10-15% cases of these disease don’t identify the source of bleeding. We report the clinical observation of a patient with intestinal bleeding of a high severity from acute ulcers of small intestinal stump