Endoscopic and surgical treatment of the Mirizzi syndrome

Academia Medicală de Studii Postuniversitare, Harkov, Ucraina, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Sindromul Mirizzi se caracterizează prin compresia căii biliare de către colecist sau formarea unei fistule între acestea, care corespunde tipului Mirizzi I şi II (McSherry, 1984). Diagnosticul se confirmă prin ERCP. Corecţia chirurgicală este complexă şi adesea în cazurile de Mirizzi II este necesară aplicarea hepaticojejunostomiei. Scop: Evaluarea oportunităţilor tratamentului endoscopic şi chirurgical al sindromului Mirizzi pentru păstrarea pasajului bilei spre duoden. Material şi metode: Dintre 2144 pacienţi cu litiază biliară, obstrucţia căilor biliare a fost evidențiată la 328 (15,3%). Sindromul Mirizzi a fost diagnosticat în 21 (6,4%) cazuri: de tip I – la 6 (28,6%) pacienţi, de tip II – la 15 (71,4%). Rezultate: În două cazuri de Mirizzi I iniţial a fost practicat drenajul biliar transnazal, într-un caz – stentarea ductului biliar comun. Colecistectomia laparoscopică s-a efectuat la 5 pacienţi şi deschisă – la unul. La 2 din 15 (13,3%) pacienţi cu Mirizzi II s-a reuşit litotripsia, la un bolnav a fost realizată stentarea biliară. Pentru a reduce icterul în 12 cazuri a fost aplicat drenajul biliar transnazal. Ulterior, 9 pacienţi au suportat colecistectomie cu plastia defectului ductului biliar comun, la 2 bolnavi s-a efectuat colecistectomie laparoscopică cu extragerea calculilor biliari, şi într-un caz s-a practicat hepaticojejunostomia. Astfel, la 14 din 15 (93,3%) bolnavi cu Mirizzi II pasajul biliar fiziologic a fost restabilit cu succes. Mortalitatea postoperatorie a constituit 0, morbiditatea – 19% (4 pacienţi). Concluzie: Aplicarea tratamentului endoscopic şi chirurgical la pacienţii cu Mirizzi II a permis restabilirea pasajul biliar fiziologic în 93% din cazurile noastre.Introduction: The Mirizzi syndrome is characterized by compression of bile duct by gallbladder or fistula formation between them, that corresponds to the Mirizzi type I and type II (McSherry, 1984). The diagnosis confirms by ERCP. Surgical correction is complex and often needs hepaticojejunostomy in cases of Mirizzi II. Aim: Evaluate opportunities of the endoscopic and surgical treatment of Mirizzi syndrome in the preservation of bile passage to the duodenum. Material and methods: Among 2144 patients with cholelithiasis, biliary tract obstruction occurred in 328 (15.3%). Mirizzi syndrome was diagnosed in 21 (6.4%): type I – in 6 (28.6%) patients, type II – in 15 (71.4%). Results: In two cases of Mirizzi I initially transnasal biliary drainage was performed and in one – the common bile duct stenting. In 5 patients laparoscopic and in one open cholecystectomy was performed. In 2 of 15 (13.3%) patients with Mirizzi II lithotr ipsy was successful; in one bile duct stenting was performed. To reduce jaundice in 12 cases transnasal biliary drainage was introduced. Thereafter, 9 patients underwent cholecystectomy with the common bile duct defect plasty, 2 patients underwent laparoscopic cholecystolitotomy with bile duct stones extraction, and in one case hepaticojejunostomy was formed. Thus, in 14 of 15 (93.3%) of Mirizzi II physiological bile passage was successfully restored. Postoperative mortality was 0, morbidity was 19% (4 patients). Conclusion: The use of endoscopic and surgical treatment in cases of Mirizzi II allowed restoring the physiological bile passage in 93% of cases

Використання ентропійного аналізу для оцінки розвитку ознак молочної худоби голштинської породи

The article presents the results of research on the evaluation of the development of dairy cattle characteristics in Holstein breed of different selection using entropy-information analysis (EIA). According to the studied indicators of dairy productivity their determinism is low, because there are many factors which influence the development of the signs. The degree of organization and informative content for Holstein breed cows of German and Ukrainian selection in adjacent generations has been established according to the basis characteristics of productivity, reproductive and adaptive ability of animals. The highest level of prevalence was characterized by signs of fat and protein content in milk as in the firstborn Holstein cows of German and Ukrainian breeding. Comparing to mothers, daughters have not only the highest level of informative content, but also have a bigger number of determinism. The probable influence of the «generation» factor was established only on the content of fat in milk. The smallest values of absolute organization the system were characterized by signs, the development of which is largely due to factors of environment. Signs which characterize reproductive and adaptive abilities of cows generally have lower entropy evaluations. This indicates their higher determinism and, consequently, biological importance. Especially it is true for the duration of the dry period in cows of the Holstein breed of German breeding. It is known that it causes physiological processes in the transitional period between two lactations and, accordingly to this, it influences the milk productivity of cows, especially, in the next lactation. Typically, according to the two signs (the duration of the first lactation and the duration of the given-birth period), we determined the probable effect of background (breeding) on the degree of their determinism (in both cases: P < 0.05). At the same time, according to these features in animals of German breeding the level of organization was higher than for Ukrainian selection of cows, regardless of generation. Thus, the use of EIA allows determining the effect of selection on the development of signs in dairy cattle.У статті викладено результати дослідження щодо оцінки розвитку ознак молочної худоби голштинської породи різної селекції з використанням ентропійно-інформаційного аналізу (ЕІА). За оцінюваними показниками молочної продуктивності їхня детермінованість невисока, оскільки на розвиток ознак впливають багато факторів. Встановлено ступінь організованості та інформативності для корів голштинської породи німецької та української селекції суміжних поколінь за ознаками продуктивності, відтворювальної та адаптаційної здатності тварин. Вищим рівнем детермінованості характеризувалися ознаки: вміст жиру і білка в молоці як голштинських корів-перівсток німецької, так й української селекції. Порівняно з матерями у дочок не лише вищий рівень інформативності, а й більша детермінованість цих ознак. Вірогідний вплив фактору «генерація» було встановлено лише для вмісту жиру в молоці. Найменшими значеннями абсолютної організованості системи характеризувалися ознаки, розвиток яких у значній мірі обумовлено факторами середовища. Ознаки, що характеризують відтворювальні та адаптаційні здатності корів, загалом мають нижчі оцінки ентропії, що свідчить про їх вищу детермінованість і відповідно біологічну важливість. Особливо це стосується тривалості сухостійного періоду в корів голштинської породи німецької селекції. Як відомо, він обумовлює фізіологічні процеси у перехідний період між двома лактаціями й відповідно в значній мірі впливає на молочну продуктивність корів, особливо в наступну лактацію.  Характерно, що відносно двох ознак (тривалість першої лактації та тривалість міжотельного періоду) нами було відмічено вірогідний вплив походження (селекції) на ступінь їхньої детермінованості (в обох випадках: Р < 0,05). При цьому, у тварин німецької селекції рівень організованості за цими ознаками був вищим, ніж для корів української селекції, незалежно від генерації. Таким чином, використання ЕІА дозволяє визначити вплив селекції на розвиток ознак молочної худоби

Synchronous and Non-Synchronous Semelparity in Sibling Species of Pulmonates

Diverse life histories have been documented in terrestrial pulmonates, which inhabit different regions in climate. Life history traits are often phenotypically plastic and vary depending on the environment. Thus, surveys using designs that control for the confounding effects of environment are needed to evaluate the evolutionary differences between populations of closely related species in the wild. We examined the life histories of sibling species of terrestrial pulmonate within two regions of similar climates. Bradybaena pellucida (BP) is endemic to Japanese islands, and has recently been expanding its distribution northeastward, whereas B. similaris (BS) has been introduced by humans into temperate and tropical regions worldwide. We found that these species exhibit discrete differences in population dynamics and life cycle, despite their close relatedness. The annual life cycle of BP is synchronized among individuals in a population. Thus, BP is univoltine with discontinuous generation. In contrast, BS individuals do not synchronize their growth or reproduction, and thus exhibit overlapping generations. Our results indicate that synchronized and non-synchronized population dynamics diverge relatively rapidly in semelparous pulmonates. This type of difference has not been documented in pulmonate life history, and may have been overlooked because only a few studies have explicitly compared life cycles of closely related species within the same climate. Our results provide a basis for further studies of life history evolution in pulmonates.ArticleZOOLOGICAL SCIENCE. 32(4):372-377 (2015)journal articl

Determination of water content in clay and organic soil using microwave oven

The article deals with the techniques of soil water content determination using microwave radiation. Its practical application would allow solving the problems of resource efficiency in geotechnical survey due to reduction of energy and resource intensity of laboratory analysis as well as its acceleration by means of decreasing labour intensity and, as a result, cost reduction. The article presents a detail analysis of approaches to soil water content determination and soil drying, considers its features and application. The study in soil of different composition, typical for Western Siberia including organic and organic-mineral ones, is a peculiarity of the given article, which makes it rather topical. The article compares and analyzes the results of the investigation into soil water content, which are obtained via conventional techniques and the original one developed by the authors, consisting in microwave drying. The authors also give recommendation on microwave technique application to dry soil

A case report of cardiogenic syncope in the adolescent.

The article presents authors’ observation of a clinical case of the girl aged 15 years old with cardiogenic syncope due to sick sinus syndrome, which progressed from normocardia sinus rhythm to pauses of the cardiac rhythm lasting 10.2-second during 3 years’ period

The results of treatment of patients with an acute cholecystitis and perivesical complications

Objective. To improve the quality of diagnosis and results of treatment in patients, suffering an acute cholecystitis, complicated by formation of perivesicular infiltrate, abscess and Mirizzi’s syndrome. Materials and methods. Results of diagnosis and surgical treatment of 694 patients, suffering an acute cholecystitis, ageing 38 - 87 yrs old, admitted to the clinic in 2010 - 2019 yrs, were analyzed. The examination have included general clinical investigation, biochemical investigations of the blood, ultrasonographic investigation of a gallbladder and extrahepatic biliary ducts, and in accordance to certain indications – computer tomography, papilloscopy and endoscopic retrograde cholangiopancreaticography. Results. Of 694 patients, suffering an acute cholecystitis in 541 (78.0%) perivesical complications were revealed. In 215 (31.0%) patients perivesical infiltrate was formed, while in 76 (11.0%) – perivesical abscess. In 250 (36.0%) patients an acute cholecystitis have developed on background of obturation jaundice, caused by choledocholithiasis in 138 patients, while in 98 patients Mirizzi’s syndrome Type I was diagnosed, and in 14 - Mirizzi’s syndrome Type II. Of 215 patients with an acute cholecystitis and perivesical infiltrate in 84 laparoscopic cholecystectomy was performed after course of antibacterial therapy, while in 131 patients – open cholecystectomy. In all 76 patients with perivesical abscess open cholecystectomy was performed. Of 138 patients, suffering obturation jaundice on background of choledocholithiasis in 82 endoscopic retrograde cholangiopancreaticography with simultaneous lithoextraction and subsequent laparoscopic cholecystectomy was conducted. In 56 patients naso-biliary drainage was installed and was held in place till calculi from common biliary duct have gone away and subsequent laparoscopic cholecystectomy performed. Of 98 patients with an acute cholecystitis and confirmed Mirizzi’s syndrome Type I in 95 laparoscopic cholecystectomy was performed, while in 3 – the open one. Of 14 patients, suffering Mirizzi’s syndrome Type II, in 10 open operation was done with sanation of biliary ducts and plasty of a common biliary duct defect, while in 4 – laparoscopic cholecystocholedocholithotomy with restoration of the bile physiological passage. Conclusion. In 78.0% patients with an acute cholecystitis perivesical complications were diagnosed. Of 531 patients with perivesical infiltrate, choledocholithiasis and Mirizzi’s syndrome in 321 (60.5%) laparoscopic operations on biliary ducts were accomplished. Open laparotomy was performed in 210 (39.5%) patients. In all the patients, suffering Mirizzi’s syndrome of both Types, physiologic passage of bile was preserved

Observation of narrow baryon resonance decaying into pKs0pK^0_s in pA-interactions at 70GeV/c70 GeV/c with SVD-2 setup

SVD-2 experiment data have been analyzed to search for an exotic baryon state, the $\Theta^+$-baryon, in a $pK^0_s$ decay mode at $70 GeV/c$ on IHEP accelerator. The reaction $pA \to pK^0_s+X$ with a limited multiplicity was used in the analysis. The $pK^0_s$ invariant mass spectrum shows a resonant structure with $M=1526\pm3(stat.)\pm 3(syst.) MeV/c^2$ and $\Gamma < 24 MeV/c^2$. The statistical significance of this peak was estimated to be of $5.6 \sigma$. The mass and width of the resonance is compatible with the recently reported $\Theta^+$- baryon with positive strangeness which was predicted as an exotic pentaquark ($uudd\bar{s}$) baryon state. The total cross section for $\Theta^+$ production in pN-interactions for $X_F\ge 0$ was estimated to be $(30\div120) \mu b$ and no essential deviation from A-dependence for inelastic events $(\sim A^{0.7})$ was found.Comment: 8 pages, 7 figures, To be submitted to Yadernaya Fizika. v3-v5 - Some references added, minor typos correcte

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13