Spatial transformation as an institutional factor of the public management of macroeconomic systems

Purpose: The article analyzes the issue of substantiating the impact of the spatial organization of the territory of the Russian Federation on the public management at the level of macroeconomic systems. Design/Methodology/Approach: The federal districts were chosen as the object of the study as macro-regional socio-economic systems, the Southern Federal District and its constituent regions (subjects of the Russian Federation). The article investigates the main transformational processes taking place in the RF spatial development, concerning the development of the regional systems of the public management and the necessity of their consistency at the supra-regional (macro-regional) level. Findings: The authors propose a set of measures to form supra-regional system to coordinate the regional development priorities considering the peculiarities of the spatial transformation of Russia's territory and the position of the Southern macro-region in the spatial system of the country. This system formation allows involving as many interested parties as possible. Practical Implications: The results may be implemented into macro-region public administration to maximize the advantages of the geo-economic and strategic position, natural and climatic conditions of Russian regions' development. Originality/Value: The main contribution of this study is a tailored approach to the public administration of the social and economic development of the macro-regions in the context of the spatial transformation.peer-reviewe

The priority choice in the process of strategy working-out of the social economic micro region development

The development of the social economic strategies progress of the micro region namely the choice of priority industries which progress is to be supported by the authorities. The given article provides detailed description of a special authors’ approach how to analyze of perceptivity investment level into different sectors in frames of strategies working-out of the social economic development of the micro region. This approach is based on the creation of a special scale within its formation special attention is paid to the identification of the life cycle stage of the industry under analyses besides the potential development possibility of industries available for resources usage.peer-reviewe

Лечение стриктур билиодигестивного анастомоза после трансплантации левого латерального сектора печени

Many studies have shown that biliary complications after transplantation of the left lateral segment (LLS) of the liver reduce graft and recipient survival. Thus, timely correction of biliary complications, and strictures in particular, improves long-term outcomes in transplantation. Objective: to analyze our own experience in correcting biliary strictures in LLS graft transplantation. Materials and methods. From February 2014 to April 2020, 425 LLS grafts were transplanted in children. 19 (4.5%) patients were diagnosed with biliary strictures at different times after transplantation (from 0.2 to 97 months). Results. Biliary strictures were more often formed a year after transplantation (17.8 ± 23.9 months). In 14 out of the 19 patients, internal-external biliary drainage was successfully performed with phased replacement of the catheter with one that was larger in diameter (from 8.5 Fr to 14 Fr). The catheters were removed in 8 patients after completion of the treatment cycle. Restenosis was not observed during follow-up (13 ± 8.7 months) after the internal-external biliary drainage catheter had been removed. In 5 cases, antegrade passage of a guide wire through the stricture was unsuccessful. As a result, biliary reconstruction was performed in 4 (21.1%) patients and retransplantation was required in 1 (5.3%) patient. Conclusion. An antegrade minimally invasive approach can successfully eliminate biliary strictures in most children after liver LLS graft transplantation. The proposed technique is effective and safe.Введение. Билиарные осложнения после трансплантации левого латерального сектора (ЛЛС) печени, согласно многим исследованиям, негативно влияют на выживаемость трансплантатов и реципиентов. Таким образом, своевременная коррекция билиарных осложнений, и в частности стриктур, позволяет улучшить отдаленные результаты трансплантации. Цель. Проанализировать собственный опыт лечения билиарных стриктур при трансплантации ЛЛС печени. Материалы и методы. С февраля 2014-го по апрель 2020 года проведено 425 трансплантаций ЛЛС печени детям. У 19 (4,5%) пациентов диагностированы стриктуры желчных протоков в разные сроки после трансплантации (от 0,2 до 97 мес.). Результаты. Билиарные стриктуры чаще формировались через год после трансплантации (17,8 ± 23,9 мес.). У 14 из 19 было успешно проведено наружно-внутреннее дренирование желчных протоков с этапной заменой дренажа на больший диаметр (с 8,5 до 14 Fr). Дренажи удалены у 8 пациентов после завершения цикла лечения. За период наблюдения (13 ± 8,7 мес.) после удаления дренажа рестенозов не отмечалось. В 5 случаях антеградное прохождение стриктуры не удалось, в связи с чем в 4 (21,1%) случаях выполнена билиарная реконструкция и в 1 (5,3%) случае потребовалась ретрансплантация. Выводы. Антеградный мини-инвазивный подход позволяет успешно устранить билиарные стриктуры у большинства детей после трансплантации ЛЛС печени. Предложенный алгоритм лечения является эффективным и безопасным

Treatment of biliodigestive anastomotic strictures after transplantation of left lateral segment of the liver

Many studies have shown that biliary complications after transplantation of the left lateral segment (LLS) of the liver reduce graft and recipient survival. Thus, timely correction of biliary complications, and strictures in particular, improves long-term outcomes in transplantation. Objective: to analyze our own experience in correcting biliary strictures in LLS graft transplantation. Materials and methods. From February 2014 to April 2020, 425 LLS grafts were transplanted in children. 19 (4.5%) patients were diagnosed with biliary strictures at different times after transplantation (from 0.2 to 97 months). Results. Biliary strictures were more often formed a year after transplantation (17.8 ± 23.9 months). In 14 out of the 19 patients, internal-external biliary drainage was successfully performed with phased replacement of the catheter with one that was larger in diameter (from 8.5 Fr to 14 Fr). The catheters were removed in 8 patients after completion of the treatment cycle. Restenosis was not observed during follow-up (13 ± 8.7 months) after the internal-external biliary drainage catheter had been removed. In 5 cases, antegrade passage of a guide wire through the stricture was unsuccessful. As a result, biliary reconstruction was performed in 4 (21.1%) patients and retransplantation was required in 1 (5.3%) patient. Conclusion. An antegrade minimally invasive approach can successfully eliminate biliary strictures in most children after liver LLS graft transplantation. The proposed technique is effective and safe