Low-coherence dye laser with an intracavity radiation diffuser.

Study of a low-coherence dye laser is reported. A cuvette with a 2 mm gap containing a dense mixture (slurry) of LiF crystal granules (70-140 µm) and an immersion liquid with a dye dissolved in it was installed in a double flat mirror cavity as an active element and simultaneously as a diffuser of radiation. The parallel light beam experiences losses in such a cuvette due to refraction at a set of interfaces between solid particles and a liquid in which different parts of the beam are randomly deflected at small angles. Measurements of the loss coefficients, angles of rays' deflection in the cuvette-diffuser were carried out. When this cuvette was pumped by 25 ns pulses of the 2nd harmonic of a Nd:YAG laser, 20 ns pulses of radiation in the region of 550-650 nm with energy ≈1 mJ at a beam divergence 5-80 mrad, and a degree of spatial coherence γ ≲ 0.1 were obtained in slurry with PM567, Rh101 or DCM dyes. The features of spectra and spatial-angular characteristics of these slurry lasers are discussed, tuning of the spatial coherence of radiation is demonstrated. Possible applications of a dye laser with an intracavity diffuser as a source of low-coherence radiation are considered.

[Appendectomy technique: paradigm shift or a well-forgotten old one? The role of mesoappendectomy in prevention of infectious intra-abdominal complications (announcement of RCT)]. / Metodika appendektomii: smena paradigm ili khorosho zabytoe staroe? Rol' mezoappendiksektomii v profilaktike infektsionnykh intraabdominal'nykh oslozhnenii (anons RKI).

OBJECTIVE: To analyze the role of mesoappendixectomy in the development of intra-abdominal surgical site infection (IAB SSI) after LAE. MATERIAL AND METHODS: A prospective randomized non-blind multiple-center registered (ClinicalTrials.gov NCT03754777) study has been performed for the period from 2016 to 2018. The study was devoted to effectiveness and safety of the modified enhanced recovery protocol in LAE. In the main group, this protocol (n=56) included routine mesoappendixectomy, restrictive strategy for abdominal drainage and postoperative antibiotic prevention. In the control group (n=71), mesoappendixectomy was performed only in case of necrotic changes. Both groups were comparable by demographic parameters and severity of comorbidities. RESULTS: In the main group, significant decrease in the incidence of IAB SSI was found (0% versus 9.8%). Moreover, the main group was characterized by reduced length of hospital-stay (1.43±1.34 d versus 2.94±2, 43 days). CONCLUSION: Mesoappendixectomy should be evaluated in further research as a potential factor in prevention of IAB SSI.

[Comparison of laparoscopic and open suturing of perforated peptic ulcer complicated by advanced peritonitis]. / Sravnitel'naia otsenka rezul'tatov laparoskopicheskogo i otkrytogo ushivaniia perforativnykh gastroduodenal'nykh iazv, oslozhnennykh rasprostranennym peritonitom.

AIM: To compare the results of open and laparoscopic interventions for PGDU complicated by advanced peritonitis. MATERIAL AND METHODS: A retrospective analysis enrolled 172 patients with PGDU who underwent surgery for the period 2014-2016. The research was performed at the bases of the Department of Faculty-Based Surgery No. 1 of the Medical Faculty of the Pirogov Russian National Research Medical University. Further analysis enrolled 138 patients in accordance with inclusion and exclusion criteria (laparoscopic intervention - 116 patients, open surgery - 22). Propensity score matching (pseudorandomization) was applied after comparative analysis of patients' characteristics and treatment outcomes in order to ensure maximum comparability of both groups. RESULTS: Length of hospital-stay (7.1 vs. 9.8 days), incidence of extra-abdominal complications (6.3%. vs. 41.2%) and adverse events Clavien-Dindo grade II (6.3% vs. 35.3%) were significantly lower after minimally invasive surgery (p<0.05). CONCLUSION: Analysis of comparable groups of patients with PGDU complicated by peritonitis revealed that laparoscopic surgery is accompanied by significantly lower incidence of extra-abdominal postoperative complications and shorter hospital-stay compared with open surgery. Mortality and incidence of intra-abdominal postoperative complications were similar in both groups.

The meio- to macrozoobenthos ratio in a lake benthic community: Dynamic aspect.

Multiyear data (2002-2015) on the biomasses of meio- and macrozoobenthic communities have been studied at different depths of a small lake in northern Karelia. A trend towards anti-phase changes in meio- and macrobenthic biomasses was observed and, as a consequence, the ratio between these components varied significantly in different years. Thus, inter-annual dynamics should be taken into account in analysis of hydrobiological data.

[Repeated endoscopic hemostasis as an alternative to surgical treatment of patients with gastroduodenal ulcerative bleeding].

AIM: To define the role of endoscopic hemostasis in treatment of gastroduodenal ulcers complicated by bleeding. MATERIAL AND METHODS: The results of endoscopic hemostasis in 770 patients with peptic ulcers were analyzed. RESULTS: Injection hemostasis had the highest efficacy in case of recurrent bleeding. No other method showed significant advantage in its efficiency. The efficacy of injection method was 52%, argon-plasma coagulation - 83.3%, radiowave technique - 78%, combined endoscopic method  - 96%. In case of recurrent bleeding endoscopic hemostasis is effective alternative to surgery especially in high-risk patients. Repeated endoscopic hemostasis significantly decreases mortality from 45% to 23% in case of recurrent bleeding.

[Effectiveness of panzytrat--modern physiological enzyme preparation in complex therapy of pancreatic exocrine secretory insufficiency in cholelithiasis].

In the article the analysis of the survey with 102 patients with gallstone disease involved, 68 of whom underwent cholecystectomy and 34 were treated conservatively, is made. The content of fecal elastase 1 in stool was estimated for diagnostics of exocrine enzyme insufficiency of pancreas by immune-enzyme analysis. It was stated that 90% of patients possess secondary exocrine insufficiency of pancreas in case of gallstone disease. It is the result of complex metabolic liver abnormalities, portal and mesenterial haemodynamics, dysbiosis of large intestine which are the components of a syndrom of maldigestion and appear during gallstone disease progressing long time before hospitalization. Cholecystectomy doesn't eliminate enzyme insufficiency of pancreas. The effectiveness of using new physiological enzymatic drug Panzytrat in a complex therapy of a syndrom of maldigestion in case of gallstone disease is shown.

Submicrosecond regular and chaotic nonlinear dynamics in a pulsed picosecond Nd:YAG laser with millisecond pumping.

We propose and study both numerically and experimentally a feedback-controlled laser system capable of generating regular bursts with a submicrosecond period. Bursting is obtained in a laser that is controlled by a combination of feedbacks in which the negative feedback loop action is delayed by one cavity round trip with respect to the positive one, and the period is adjusted by relative feedback sensitivity. The proper combination of feedbacks is realized in a Nd:YAG laser with millisecond pumping by means of a single optoelectronic negative feedback unit that utilizes the signal reflected from an intracavity Pockels cell polarizer. Regular bursting (microgroups of picosecond pulses) with controlled periods from 25 to 75 cavity round trips is obtained experimentally. The development of chaotic dynamics displayed by the system at a higher pumping level differs from the Feigenbaum scenario.

[Disturbance of liver functions and dysbiosis in patients with lipid distress syndrome and its treatment with lactulose preparation "Duphalac" (lactulose)]. / Narushenie funktsii pecheni i disbioz pri lipidnom distress-sindrome i ikh lechenie preparatom "Dufalak" (Laktuloza).

Disturbances of liver's functions and its connection with microflora pathology of large intestine were examined in the patients with lipid dysstress-syndrome. Severe dysbiosis (reduce of light fatty acids level and increase of anaerobe index) was revealed. Efficiency of "Dufalak" (lactulose disaccharide) on liver's functions was estimated.

Changes in pancreahepatoduodenal organs during experimental acute lipogenic pancreatitis.

Experiments on animals with experimental lipogenic pancreatitis showed that disturbances in lipid metabolism stimulate destructive processes in the pancreas, liver, and spleen. Acute experimental lipogenic pancreatitis is characterized by extensive destructive changes in the pancreatic parenchyma accompanied with fatty necrobiosis of hepatocytes, fatty transformation of the gallbladder wall, and pronounced reaction of the reticuloendothelial stroma in the spleen.

Morphofunctional changes in hepatopancreatobiliary organs in experimental dyslipoproteinemia.

Dyslipoproteinemia was induced and corrected in 40 Chinchilla rabbits. Lipid metabolism disorders were corrected by Fishant vaseline-pectin emulsion and partial ileoshunting. Experimental dyslipoproteinemia initiated destructive dystrophic processes in the hepatopancreatobiliary organs manifesting by liver stenosis, gallbladder cholesterosis, and focal structural and functional disorders in pancreatic parenchyma. Correction of dyslipoproteinemia normalized the status of hepatopancreatobiliary organs, decreased the severity of destructive processes, and prevented their further development.

[Radionuclide hepatobiliscintigraphy in prediction of the Buchwald's operation effect]. / Radionuklidnaia hepatobilistsintigrafiia v prognozirovanii éffekta operatsii Bukhval'da.

The authors have proposed a method for predicting the effect of Buchwald's operation (partial iliac bypass surgery) and successfully tested it in 32 patients with hyperlipidemia. The method is based on pharmacological simulation of major pathophysiological intervention points verified by radionuclide hepatobiliscintigraphy. Evaluating lipid metabolic changes before and after simulation serves as a basis for predicting the effect of the operation.

[Dyslipoproteinemia in pancreonecrosis: cause-effect interrelationships]. / Dislipoproteidemiia pri pankreonekroze: prichinno-sledstvennye vzaimosviazi.

The work analyzes the results of study of lipid metabolism in 53 patients who underwent operation for pancreatogenic peritonitis. The blood for the test was collected from the portal vein, the hepatic vein, and the aorta which made it possible to appraise metabolism in the liver according to the "entry-exit" blood flow system. It is shown that due to pancreatogenic toxemia, toxemic hepatocytic dyslipoproteinemia develops in patients with pancreonecrosis and persists in the late period. As a consequence of such a condition of lipid metabolism, early atherosclerotic damages to the arteries of the heart and brain and the peripheral arteries occur in patients after pancreonecrosis. The fate of patients was studied 8-10 years after the operation. The nature of atherosclerotic manifestations of toxemic hepatocytic dyslipoproteinemia in the late period after recovery from destructive pancreatitis was determined on the basis of study of central and peripheral hemodynamics.

[The role of hyperlipidemia in the pathogenesis of acute thrombophlebitis of the surface veins of the lower extremities]. / Rol' giperlipidemii v patogeneze ostrogo tromboflebita poverkhnostnykh ven nizhnikh konechnostei.

Biochemical investigations carried out in patients with acute thrombophlebitis of the lower limb superficial veins showed that 70% of such patients develop marked changes in blood plasma lipid spectrum, hyperlipidemia. Blood serum lipid spectrum was examined in 19 patients with various forms of acute thrombophlebitis of the lower limb superficial veins and in 17 with varicose disease. Histologic material for morphologic examination (a fragment of the great subcutaneous vein near saphenofemoral anastomosis and of the wall near the thrombus) was collected during surgery. Venous wall fragments were examined under a light microscope for lipid content. The findings did not confirm the expected changes in venous wall in hyperlipidemia analogous with arterial wall changes in atherosclerosis. That is why we may propose that hyperlipidemia, though not directly changing venous wall structure, contributes to thrombogenesis process via other mechanisms.

[Age and dyslipidemia as risk factors in transcutaneous transluminal angioplasty]. / Vozrast i dislipidemiia kak faktory riska pri chreskozhnoi transliuminal'noi angioplastike.

The paper outlines the analysis of immediate and late outcomes of transcutaneous transluminal angioplasty (TTA) in 147 patients with atherosclerosis obliterans of the lower extremities. The study has revealed that age and dyslipidemia as TTA risk factors fail to affect the immediate outcomes in the early postoperative period. There is a positive correlation of the reocclusion time after TTA and the age and lipid metabolic disturbances in patients with atherosclerosis obliterans of the lower extremities in long-term periods. The paper provides strong evidence for that it is essential to correct dyslipidemias in order to make TTA results better in these patients.

[Buchwald's operation in the surgery of atherosclerosis obliterans]. / Operatsiia Bukhval'da v khirurgii obliteriruiushchego ateroskleroza.

Analyzing the world's experience in the surgical management of hyperlipidemias and their own results, the authors make an assessment of Buchwald's operation used in the surgery for atherosclerosis obliterans. The major disadvantage of partial ileac bypass is that there is no prognosis of the operation and its complication. Based on the pathophysiological mechanisms of implementation of Buchwald's operation, the authors have developed a mode of pharmacological simulation of a partial bypass which allows one to predict the effect of the impending intervention and to avoid unjustified operations. The unique procedure also enables the indications for simultaneous interventions to be defined. Ten partial ileac bypass surgeries made by the authors are comprehensively analyzed. Taking into account, the authors propose to choose a treatment of patients with hyperlipidemia and atherosclerosis on an individual basis and to do away with the routine indications for partial ileac bypass surgery.

[Correction of dyslipidemia in patients with arteriosclerosis obliterans as a method for improving the results of endovascular angioplasty]. / Korrektsiia dislipidemii u bol'nykh obliteriruiushchim aterosklerozom kak sposob uluchsheniia rezul'tatov éndovaskuliarnoi angioplastiki.

The authors analyse the results of endovascular angioplasty of the pelvic and lower limb arteries in 147 patients of various age suffering from arteriosclerosis obliterans. It was found that the results of endovascular angioplasty depended on the state of the lipid balance. The necessity for correcting the shifts in the lipid metabolism is shown. The article evaluates the results of dyslipidemia correction by dietotherapy, pharmacotherapy, and operation for partial ilio-shunting in patients with arteriosclerosis obliterans of the pelvic and lower limb arteries. The efficacy of the listed methods of treatment are analysed according to the severity of dyslipidemia.