Редкие виды перфораций желудочно-кишечного тракта — диагностика, тактика, лечение

RATIONALE Hollow organ perforation is an urgent problem in abdominal surgery. According to the literature, the incidence of perforation is from 0.37% to 2.3% of cases among various acute surgical pathologies of the abdominal organs. The greatest attention in the literature is paid to the problem of perforated gastroduodenal ulcers. At the same time, a much smaller number of publications, both Russia and foreign, are devoted to other, more rare types of perforations. This situation is most likely explained by the low prevalence of other types of perforations, which, in turn, does not make them a less urgent problem in emergency surgery, which requires a modern approach to the treatment of this group of patients.PURPOSE OF THE STUDY Analysis of domestic and foreign literature on the diagnosis and treatment of rare types of benign intestinal perforations.MATERIAL AND METHODS A literature review was performed for the period from 1994 to 2020 in Russian and in English, available on Pubmed, Medline, Springer, Scopus, E-library, on topics such as perforated diverticula of the small intestine, perforation of Meckel’s diverticulum, perforated ulcers of the small intestine, perforation of the intestine by a foreign body. RESUltS With all the variety of surgical techniques for various types of perforation of the gastrointestinal tract, currently in the literature there are no specific criteria for choosing a particular method of intervention with regard to the cause, level, and duration of perforation.CONCLUSION The lack of unified approaches in the diagnosis and treatment of patients with rare GIT perforations dictates the need for a more in-depth study of this issue in order to apply and optimize the technique of videolaparoscopic approach, develop a treatment and diagnostic algorithm for patients with suspected perforations of the gastrointestinal tract using the video laparoscopic method.Перфорация полого органа — актуальная проблема в абдоминальной хирургии. По данным литературы частота развития перфораций составляет от 0,37 до 2,3% случаев среди различной острой хирургической патологии органов брюшной полости.Наибольшее внимание в литературе уделено проблеме перфоративных гастродуоденальных язв. В то же время другим, более редким, видам перфораций посвящено гораздо меньшее количество публикаций, как отечественных, так и зарубежных. Такая ситуация, вероятнее всего, объясняется небольшой распространенностью других видов перфораций, что в свою очередь не делает их менее актуальной проблемой в экстренной хирургии, требующей современного подхода к лечению данной группы пациентов.ЦЕЛЬ ИССЛЕДОВАНИЯ Анализ отечественной и зарубежной литературы, посвященной диагностике и лечению редких видов доброкачественных перфораций кишечника.МАТЕРИАЛ И МЕТОДЫ Выполнен обзор литературы за период с 1994 по 2020 г. на русском и английском языках, доступной на базах Pubmed, Medline, Springer, Scopus, E-library, по таким темам, как перфоративные дивертикулы тонкой кишки, перфорация дивертикула Меккеля, перфоративные язвы тонкой кишки, перфорация кишки инородным телом.РЕЗУЛЬТАТЫ При всем разнообразии оперативных методик при различных видах перфораций желудочно-кишечного тракта (ЖКТ), в настоящее время в литературе не определены конкретные критерии выбора того или иного способа вмешательства операции в зависимости от причины, уровня, срока перфорации.ЗАКЛЮЧЕНИЕ Отсутствие единых подходов в диагностике и лечении пациентов с редкими перфорациями ЖКТ диктует необходимость более углубленного изучения данного вопроса с целью применения и оптимизации техники видеолапароскопического пособия, разработки лечебно-диагностического алгоритма у больных с подозрением на перфорацию органов ЖКТ с использованием видеолапароскопического метода

Interpolation in variable exponent spaces

In this paper we study both real and complex interpolation in the recently introduced scales of variable exponent Besov and Triebel–Lizorkin spaces. We also take advantage of some interpolation results to study a trace property and some pseudodifferential operators acting in the variable index Besov scale

On some structural properties of Banach function spaces and boundedness of certain integral operators

summary:In this paper the notions of uniformly upper and uniformly lower $\ell$-estimates for Banach function spaces are introduced. Further, the pair $(X,Y)$ of Banach function spaces is characterized, where $X$ and $Y$ satisfy uniformly a lower $\ell$-estimate and uniformly an upper $\ell$-estimate, respectively. The integral operator from $X$ into $Y$ of the form $$K f(x)=\varphi (x) \int _0^x k(x,y)f(y)\psi (y)\mathrm{d}y$$ is studied, where $k$, $\varphi$, $\psi$ are prescribed functions under some local integrability conditions, the kernel $k$ is non-negative and is assumed to satisfy certain additional conditions, notably one of monotone type

Boundedness of Stein’s spherical maximal function in variable Lebesgue spaces and application to the wave equation

We prove the boundedness of the Stein's spherical maximal operator in variable Lebesgue spaces. The result is then interpreted as the preservation of the integrability properties of the initial velocity of propagation to the solution of the initial-value problem for the wave equatio

IS THE RELATIONSHIP OF OSTEOPOROSIS AND ATHEROSCLEROSIS IN PROGRESS?

The majority of scientific research data promote the idea that OP and Atherosclerosis are inter-connected via OPG system. Scientists have speculation that OPG is the molecular bond between artery hardening and bone resorbtion. Thus the mechanism explained above makes obvious the co-existence of two: Artery hardening and Osteoporosis. There are number of ongoing Clinical trials on Denosumab therapy in patients with diagnosis of Osteoporosis and Atherosclerosis. The increase of Bone mineral density is associated with less intensive hardening of arteries. This fact inspired us to study bone mass in patients with cardiovascular events and atherosclerosis. Materials and methods: 1675 men, age range 38-78 years, mean age 59±4.3 Disease duration 6,4±1,75 with the diagnosis of Atherosclerosis (revealed on coronarography, assessed lipid profile). At the moment of research Stabile Angina Pectoris (Stable Angina) found in 20% (335); unstable angina non S-T elevation in 48% (804) ; Myocardial Infarction 32% (536). Bone Mass was assessed by DXA Absorbtiometry technique (Hologic 1000) using T and Z Scores (WHO 1994). As a control group 680 healthy Georgian men 40-70 age range were assessed. Results: Men having atherosclerosis are rather predisposed to Osteoporosis than health individuals. In Atherosclerosis subgroup normal bone mass was measured in 23% (385.25 patients) of patients; Osteopenia was diagnosed in 19% (315.25 patients), Osteoporosis was detected in 58% (971.5%) according to T-Score SD. BMD records are shown in table 1: Conclusion: 1. According to our research, more than 50% of men with verified Atherosclerosis are diagnosed to have osteoporosis. 2. The lowest BMD values were observed in Lumbar Spine L1-L4, indicating that trabecular bone is more deteriorated than cortical. 3. Correlation between T-Score values and clinical forms of Atherosclerosis were not observed. 4. The best understanding of interrelations of mechanisms could point out the right direction for the simultaneous therapy against both targets - Osteoporosis and Atherosclerosis. 5. Therefore the expectation of establishing novelty direction among other subtypes of the Medical Specialties as a Preventive Gerontology can be realistic. Stable Angina n=335 Unstable angina nont S-T n=804 Myocardial Infarction n= 536 Healthy N=680 L2- L4 -2.6 ±11 * -2.9±1.4 ** -3.1 ±1.1 ** -0.6±0.2 Prox. Femur Neck -1.8±0.5* -2.6±1.4** -2.5±1.6** -1.14±0.26 Prox. Femur Total -2.7±1.48** -2.7±0.2** -2.7±1.25** -1.05±0.5 *p<0.01,**p<0.00

New automatic quantification method of immunofluorescence and histochemistry in whole histological sections.

Immunofluorescent staining is a widespread tool in basic science to understand organ morphology and (patho-) physiology. The analysis of imaging data is often performed manually, limiting throughput and introducing human bias. Quantitative analysis is particularly challenging for organs with complex structure such as the kidney. In this study we present an approach for automatic quantification of fluorescent markers and histochemical stainings in whole organ sections using open source software. We validate our novel method in multiple typical challenges of basic kidney research and demonstrate its general relevance and applicability to other complex solid organs for a variety of different markers and stainings. Our newly developed software tool "AQUISTO", applied as a standard in primary data analysis, facilitates efficient large scale evaluation of cellular populations in various types of histological samples. Thereby it contributes to the characterization and understanding of (patho-) physiological processes