[ICG angiography in prevention of colorectal anastomotic leakage]. / Rol' ICG-angiografii v profilaktike nesostoyatel'nosti kolorektal'nykh anastomozov.

OBJECTIVE: To evaluate the effectiveness of indocyanine green fluorescence angiography in assessment of colorectal anastomosis perfusion. MATERIAL AND METHODS: A prospective single-center non-randomized comparative study included 85 patients with rectum and sigmoid colon cancer between September 2019 and March 2023. In the main group (n=41), we intraoperatively injected indocyanine green (ICG) IV to assess perfusion in the near infrared spectrum. In the control group (n=44), the same interventions were performed without ICG. RESULTS: In the main group, anterior resection of the rectum was performed in 23 (56.1%) patients with neoplasms of distal sigmoid colon and rectosigmoid tumors. Low anterior resection was performed in 18 (43.9%) cases. In the control group, the same procedures were carried out in 24 (54.5%) and 20 (45.5%) patients, respectively. After mobilization of the colon and ICG injection, we corrected resection line in 4 cases. As soon as anastomosis was formed and blood supply was controlled by ICG fluorescence angiography, we performed a water-bubble test to detect anastomotic leakage. Positive tests were detected in 4 (9.8%) and 5 (11.4%) patients of both groups, respectively. Postoperative complications occurred in 10 (24.4%) and 11 (27.3%) patients, respectively (p=0.94). Anastomosis failure was found in 1 and 7 patients, respectively. Anastomotic leakage grade «B¼ was significantly more common in the control group (2.4 and 13.6%, respectively, p=0.06). Anastomotic leaks were absent in all 4 patients who underwent resection level adjustment after intraoperative ICG angiography. CONCLUSION: Fluorescent luminescence will qualitatively improve intraoperative diagnosis of hypoperfusion of resection edges. Undoubtedly, this will reduce the incidence of colorectal anastomotic leaks caused by ischemia of large bowel wall.

[Magnetotherapy in patients with malignant tumors receiving immunotherapy]. / Opyt primeneniya reabilitatsionnoi magnitoterapii u patsientov so zlokachestvennymi opukholyami, poluchayushchikh immunoterapiyu.

OBJECTIVE: To analyze the quality of life in patients receiving immunotherapy and overall response rate in case of additional magnetotherapy. MATERIAL AND METHODS: The study included 3 cohorts of patients (n=48) with various disseminated malignancies (melanoma, lung cancer, kidney cancer) who received immunotherapy. In the study groups, all patients additionally took courses of rehabilitation based on magnetotherapy. In the control cohorts, patients underwent courses of immunotherapy without additional magnetic therapy. Treatment efficacy was assessed according to iRECIST 1.1 criteria. The Russian version of the EORTC QLQ-C30 questionnaire was used to study the quality of life. We analyzed adverse events using the CTCAE 5.0 criteria. RESULTS: In patients with melanoma, the most common response to systemic treatment was stabilization (41.7% in the study group and 30.8% in the control group). The objective response rate was higher in the study group (33.3% vs. 23.1%). There was also significant improvement in the quality of life after treatment in the study group (by 23.5%). In the control group, the indicator worsened by 4.8%. Overall health improved by 12.8% in the study group and 10.3% in the control group. In patients with lung cancer, response to systemic treatment with stabilization was achieved in 33.3% of patients in the study group and 20% of patients in the control group. The objective response rate was 33.3% and 20%, respectively. Analysis of the study group revealed improvement of overall health by 9.6% and overall quality of life by 38.6%. In the control group, overall health improved by 4.8% and quality of life remained the same. In patients with kidney cancer, the objective response rate was 40% and 42.9%, respectively. Disease stabilization was achieved in 40% and 28.6% of patients, respectively. Overall health improved by 16.7% and 6.3%, overall quality of life - by 19% and 9.1%, respectively. CONCLUSION: Magnetic therapy during the course of immunotherapy improved the overall quality of life and reduced severity of adverse events. Further study of magnetotherapy as an accompanying rehabilitation technique is required.

Critical onset of layering in sedimenting suspensions of nanoparticles.

We quantitatively study the critical onset of layering in suspensions of nanoparticles in a solvent, where an initially homogeneous suspension, subject to an effective gravity a in a centrifuge, spontaneously forms well-defined layers of constant particle density, so that the density changes in a staircaselike manner along the axis of gravity. This phenomenon is well known; yet, it has never been quantitatively studied under reproducible conditions: therefore, its physical mechanism remained controversial and the role of thermal diffusion in this phenomenon was never explored. We demonstrate that the number of layers forming in the sample exhibits a critical scaling as a function of a; a critical dependence on sample height and transverse temperature gradient is established as well. We reproduce our experiments by theoretical calculations, which attribute the layering to a diffusion-limited convective instability, fully elucidating the physical mechanism of layering.

[Surgical and combined treatment of recurrent colon cancer].

Colon cancer recurrence is considered to be the main reason of unsatisfactory results of surgical treatment. The goal of the study was to assess the possibilities of the combined and surgical treatment of the recurrent colon cancer. The retrospective analysis of 265 cases with stage I-III primary colon cancer, treated during 2004-2008 yy. Cumulative tumor-specific survival of patients with locoregional recurrence of colon cancer in the first year was 71.9±7.5%. The two-year tumor-specific survival rate was 42.5±8.4%, three year - 26.2±7.7% and, four-year survival rate was 22.9±7.4%. Thus, surgery and combination of surgical treatment with chemo- and radiation therapy can alleviate or relieve patients from symptoms of the disease, prolong life and improve its quality.

[The mechanoreceptor tactile diagnostics of thoracic diseases].

The novel system of tactile analysis was used in the mechanoreceptor device. The local pressure measurement is carried out in in cameras, divided by the elastic membrane from the analyzed organ. The devise allows fast and adequate real-time measurement of tissue density and elasticity. The results, acquired with the use of the mechanoreceptor device were checked microscopically. The study showed high compatibility and adequacy of the novel mechanoreceptor.

[Total mesorectumectomy in surgical treatment of rectal cancer].

561 patients with rectal cancer were included in the study. The main group consisted of 119 patients, operated on during 2006-2009 years. They received total mesorectumectomy with the following pathomorphological control of the radicality. The group of control consisted of 442 patients, who had the rectum mobilized in a "standard" blunt fashion, without using principles of interfascial separation. The operation of total mesorectumectomy proved to take more time, though, it allowed to decrease the intraoperative blood loss, frequency of postoperative urogenital complications and did not increase rates of colorectal anastomosis insufficiency.

[Laparoscopic peritoneoanal resection of rectum with coloanal anastomosis].

65 laparoscopic peritoneoanal resections were performed. 80 patients, who underwent the traditional open surgery, comprised the control group. The mean operative time for the laparoscopic procedure was 202+/-47.7 min. Conversion was performed in 2 cases. A delayed transversostomy was performed in 10 cases because of the coloanal anastomosis ischemia. Lethality rate was 3%. 5-year survival was 76.9% after the radical laparoscopic procedure.

[Prognostic factors for the definition of the extent of lymphadenectomy by the early gastric cancer].

The predictive role of submucosal invasion and metastatic spread to local lymph nodes at early gastric cancer was analyzed. Material from 32 patients was morphologically and immunohistochemically analyzed. The prognostic value of the depth of invasion, tenascin and positive MMP2 and MMP9 staining, proliferative activity and microvascular solidity in the lesion were studied. Watch lymph nodes were detected in 22 patients with the diagnosed early gastric cancer. The method is appropriate only by early cancer and in combination with other macro- and microscopic factors. Its' efficacy was 100% in the group of the early cancer (n=15), whereas in the group with the locally spread cancer the sensitivity, accuracy and specificity were 76, 71 and 100%, respectively. Though larger series are necessary to make definite conclusions about the predictive value of watch nodes in gastric cancer.

Pyroelectric effect induced by the built-in field of the p-n junction in the quantum paraelectric PbTe: experimental study.

We report here the first observation of a pyroelectric effect in a nonpolar semiconductor. This effect originates in the temperature-dependent electric dipole of the PbTe p-n junction. The junction was illuminated by a chopped CO(2) laser beam, and periodic and single-pulse pyroelectric signals were observed and measured as a function of temperature, reverse bias voltage, and chopper frequency. The measured pyroelectric coefficient is approximately 10(-3) microC/cm(2) K in the region of 40-80 K. The theoretical model describes quantitatively all experimental features. The time evolution of the temperature inside the junction region was reconstructed.

[Complications of fibrinolytic therapy in thromboses of the major arteries of the lower extremities]. / Oslozhneniia fibrinoliticheskoi terapii trombozov magistral'nykh arterii nizhnikh konechnostei.

Fibrinolytic therapy with streptokinase preparations was administered to 79 patients. Hemorrhagic, embolic, thrombotic, and allergic complications were observed over the course of therapy. Massive bleedings occurred in 3 (4%) patients, two of them died. Negligible hematomas at the site of vessel puncture were seen in 11 (14.4%) cases. Distal arteries embolization developed in 6 (7.6%) patients. Nine patients (11.4%) developed early re-thromboses soon after therapy was over. Allergic reactions presenting as hyperthermia and short-term chill were observed in one third of the patients. Measures to prevent possible complications of fibrinolytic therapy are strict adherence to thrombolysis methods and a dynamic laboratory monitoring over the course of therapy.

[Regional thrombolytic therapy of thrombosis of arteries of the pelvis and lower extremities]. / Regionarnaia tromboliticheskaia terapiia v lechenii trombozov arterii taza i nizhnikh konechnostei.

Regional thrombolysis was performed in 62 patients with thrombosis of the aorta and arteries of the pelvis and lower extremities. The thrombolytics used were avelysin (20 patients) and celiase (42 patients). Complete lysis of the thrombi was recorded in 49 cases. After successful thrombolytic therapy balloon angioplasty of the revealed stenoses was carried out in 39 patients. After thrombolysis was completed 15 patients underwent various reconstructive operations which failed to produce an effect in 4 patients and the extremity was amputated. The complications of thrombolysis included hematomas at the site of catheterization of the arteries in 5 patients, distal embolism in 7, and an allergic reaction in one patient. The authors appraise the dependence of thrombolysis efficacy on the level, extent, and duration of the thrombotic occlusion.

[Thrombolytic therapy of acute thrombosis of the major arteries in the legs with streptokinase preparations]. / Tromboliticheskaia terapiia ostrogo tromboza magistral'nykh arterii nizhnikh konechnostei preparatami streptokinazy.

Thrombolytic therapy was used in treatment of 40 patients with acute thromboses of the aorta, major arteries of the pelvis and lower extremities. Complete lysis of the thrombus was achieved in 21 patients, partial lysis in 13 patients, 6 patients had no effect. The authors consider that the effectiveness of the treatment of acute thrombosis of major arteries is dependent on duration of the disease, character, level and distance of the occlusion, degree of ischemia of the extremity. It is stressed that the method of choice is the selective administration of streptokinase drugs (Awelysin, Celiase).