ac Hall Effect and Photon Drag of Superconducting Condensates.

We suggest a theoretical description of the photogalvanic phenomena arising in superconducting condensates in the field of electromagnetic wave. The ac Hall effect and photon drag are shown to originate from the second-order nonlinear response of superconducting carriers caused by the suppression of their concentration due to the combined influence of the electron-hole asymmetry and charge imbalance generated by the incident electromagnetic wave. Starting from the time-dependent Ginzburg-Landau theory with the complex relaxation constant, we develop a phenomenological description of these phenomena and investigate the resulting behavior of the dc supercurrent and second harmonic induced by microwave radiation incident on a superconductor surface.

Surgery of extrahepatic bile duct cancer - current evidence and recommendations.

Extrahepatic cholangiocarcinoma is a rare disease with poor prognosis, requiring comprehensive multidisciplinary management. Only radical resection gives hope for long-term survival. Most patients have either an unresectable disease or their condition does not allow for radical surgery. The method of choice for resectable perihilar cholangiocarcinoma is en-block liver resection including the extrahepatic bile duct, or pancreatoduodenectomy for distal cholangiocarcinoma. Hepatopancreatoduodenectomy can be performed in selected patients if the entire hepato-choledochus is affected. Liver transplantation after neoadjuvant treatment can be also considered in highly selected patients with unresectable perihilar cholangiocarcinoma. These procedures are technically demanding, are associated with high morbidity and relevant mortality, and must be concentrated in tertiary hepatobiliary centers. Preoperative optimization (bile duct drainage, nutrition, portal venous embolization, etc.) plays a crucial role in reducing postoperative morbidity and mortality.

Minimally invasive pancreatic resection in the light of evidence state of the art.

The trend of minimally invasive surgery expands even into the most technically demanding areas, including HPB surgery. Faster recovery and elimination of surgical site infections achieved with a minimally invasive approach provides, in addition to a better quality of life, the possibility of starting adjuvant treatment earlier. However, evidence of non-inferiority of short-term and oncological results compared to open surgery is required. In minimally invasive distal pancreatectomy, there is sufficient evidence to suggest that it as the method of choice for benign tumors and low-grade malignancies. For pancreatic cancer, the long-term results so far appear to be equivalent, although this still needs to be confirmed by ongoing randomized controlled trials (RCT). Enucleation of accessible lesions is also a suitable procedure for the minimally invasive approach. In contrast, in pancreaticoduodenectomy, available evidence does not demonstrate a clear benefit of the minimally invasive approach. Safety concerns still remain, and not even formal training has been successful in eliminating the consequences of the long learning curve for perioperative outcomes. Robotic approach appears to be more promising than laparoscopy for pancreaticoduodenectomy. Key words: pancreaticoduodenectomy distal pancreatectomy minimally invasive - laparoscopic robotic.

Pancreatic head resections in the setting of celiac axis stenosis: Case report and review of literature.

INTRODUCTION: Ischemic complications are a notable cause of morbidity in patients after pancreatic head resections. Stenosis of celiac axis in patients undergoing pancreatoduodenectomy requires further perioperative attention. CASE REPORT: We present a patient with pancreatic head malignancy scheduled for Whipple procedure in the setting of hemodynamically significant celiac axis stenosis. Despite release of the artery from compression by median arcuate ligament, elevation of liver function tests on the first postoperative day was noted. Endovascular stenting was performed on the same day with significant radiological improvement and subsequent normalization of laboratory values. The patient had no further postoperative complications. CONCLUSION: Fast recognition of ischemic complications after pancreatic head resection is crucial. Even postoperatively, endovascular intervention might be a feasible treatment modality of celiac axis stenosis in selected patients who undergo pancreatoduodenectomy.

Inverse Faraday Effect for Superconducting Condensates.

The Cooper pairs in superconducting condensates are shown to acquire a temperature-dependent dc magnetic moment under the effect of the circularly polarized electromagnetic radiation. The mechanisms of this inverse Faraday effect are investigated within the simplest version of the phenomenological dynamic theory for superfluids, namely, the time-dependent Ginzburg-Landau (GL) model. The light-induced magnetic moment is shown to be strongly affected by the nondissipative oscillatory contribution to the superconducting order parameter dynamics, which appears due to the nonzero imaginary part of the GL relaxation time. The relevance of the latter quantity to the Hall effect in the superconducting state allows us to establish the connection between the direct and inverse Faraday phenomena.

[The concept of chronic obstructive pulmonary disease clinical control as a decision - making tool in real clinical practice for optimizing of basic pharmacotherapy].

The main goals of COPD therapy are to achieve clinical stability with minimal clinical manifestations and low risk of relapse. The proposed COPD control concept by analogy with asthma has not been quite well characterized yet. COPD control is defined as "the long - term maintenance of a clinical situation with a low impact of symptoms on the patient's life and absence of exacerbations." The situation of clinical control in COPD is considered desirable and potentially achievable for most patients with COPD. Pharmacotherapeutic options for COPD are constantly expanding. The control concept may be useful when the decision on treatment of COPD is made for dynamic adjustment of the therapy volume.

[Infusion prevention of fat globulaemia during total hip arthroplasty]. / Infuzionnaia profilaktika zhirovoi globulemii pri reéndoprotezirovanii tazobedrennogo sustava.

AIM: To assess the effect of the modified infusion therapy regimen on the frequency of development of laboratory and clinical manifestations of fat embolism syndrome in patients after hip replacement. MATERIAL AND METHODS: The study was conducted in 80 patients (70 men and 10 women) who were admitted for planned revision hip arthroplasty. The criteria for not inclusion in the study were the presence of a traumatic brain injury, episodes of acute disturbance of blood supply (stroke) and diabetes mellitus in history. 40 patients of the main group during the operation were administered Gelofuzin and Sterofundin isotonic, and in the first day after the operation Remaxol and Sterofundin isotonic. Using the copy-steam method, a control group (n=40) out of 197 patients was selected by gender and age. In the control group, infusion therapy was carried out using a 0.9% NaCl solution. All patients underwent assessment of fat globulemia, water-electrolyte balance, acid-base status and oxygenation index - before surgery; 2, 24, 48, and 72 hours after the operation, on the third day, mental disorders were assessed using the Addenburg scale (ACE-R) for evaluating cognitive functions. RESULTS: All patients underwent hip joint endoprosthetics. In the group receiving the modified infusion therapy regimen, the results were significantly better, there were no statistically significant changes in the level of electrolytes (p=0.14), episodes of a decrease in the oxygenation index and cognitive dysfunction. In contrast to patients in the control group, where the level of chlorine and sodium was significantly higher, the number of fat globules with a diameter of more than 8 µm, as well as in two patients, the development of postoperative delirium with a decrease in the oxygenation index below 300 was observed. The causal relationship between the number of fat globules with a diameter of more than 8 microns and clinical manifestations of cerebral and pulmonary forms of fat embolism (r-Pirsen = -0.87 and -0.80, respectively). There were no statistically significant changes in platelet count, potassium concentration with indicators of fat globulemia and a scale of cognitive impairment. CONCLUSION: A high correlation of fatty globulemia with the development of respiratory and pulmonary dysfunction after hip replacement was determined. The inclusion of Gelofuzin, Sterofundin isotonic and Remaxol in intensive therapy provides a pronounced emulsifying effect on fat globules appearing in the bloodstream in the first hours after hip replacement, and effective prevention of potentially dangerous fat embolism.

[Cholangiocellular cancer: the state of the problem and ways to improve the results of surgical treatment]. / Kholangiotselliuliarnyi rak: sostoianie problemy i puti uluchsheniia khirurgicheskogo lecheniia.

AIM: To improve the outcomes in patients with resectable biliary cancer. MATERIAL AND METHODS: There were 263 procedures for cholangiocellular carcinoma (CCC) for the period 1998­2017. Adjuvant chemotherapy was performed in 102 (38.8%) patients. Extensiveliver resections (78.9%) prevailed for intrahepatic cholangiocellular carcinoma (n=128), 6 (4.7%) patients required vascular resection. Seventy-seven pancreatoduodenectomies were performed for common bile duct cancer, portal vein resection was done in 8 (10.4%) patients. In case of Klatskin tumor (n=58) liver resection combined with bile duct resection (n=52) prevailed. Portal vein resection was done in 16 (27.6%) patients. RESULTS: Postoperative morbidity in patients with intrahepatic CCC was revealed in 68 (53.1%) cases, mortality ­ in 5 (3.9%) cases. Among patients with Klatskin tumor morbidity was revealed in 51 (87.9%) cases, mortality ­ in 6 (10.3%) cases. In patients with common bile duct cancer morbidity was revealed in 53 (68.8%) cases, mortality ­ in 4 (5.2%) cases. In whole cohort median overall survival was 30 months. R0-resection was associated with better long-term results (median 37 months) compared with R1­R2 resection (20 months; p=0.01). Lymph node involvement is associated with significantly worse prognosis (p=0.016), however 5-year survival is observed (25.6%). Adjuvant chemotherapy in R0-resection significantly improved long-term results: median was 46 months (vs. 30 in group without chemotherapy; p=0.02). In intrahepatic CCC patients multiple lesions or mechanical jaundice did not aggravate long-term results. CONCLUSION: R0-resection including lymphadenectomy, resection of adjacent organs and vessels is advisable for CCC. Isolated bile duct resection should be used as an exception. Adjuvant therapy improved long-term results. Multiple lymph node lesion or bile duct infiltration are not contraindications to surgery in intrahepatic CCC patients.

Temperature Controlled Fulde-Ferrell-Larkin-Ovchinnikov Instability in Superconductor-Ferromagnet Hybrids.

We show that a wide class of layered superconductor-ferromagnet (S/F) hybrids demonstrates the emergence of the Fulde-Ferrell-Larkin-Ovchinnikov (FFLO) phase well below the superconducting transition temperature. By decreasing the temperature, one can switch the system from uniform to the FFLO state which is accompanied by the damping of the diamagnetic Meissner response down to zero and also by the sign change in the curvature of the current-velocity dependence. Our estimates show that an additional layer of the normal metal (N) covering the ferromagnet substantially softens the conditions required for the predicted FFLO instability, and for existing S/F/N systems, the temperature of the transition into the FFLO phase can reach several kelvins.

Effects of Fullerene Derivatives on Activity of Ca2+-ATPase of the Sarcoplasmic Reticulum and cGMP Phosphodiesterase.

We studied the effects of new water-soluble polysubstituted fullerene C60 (PFD) derivatives on activity of Ca2+-Mg2+ ATPase of the sarcoplasmic reticulum and cGMP phosphodiesterase. All examined fullerene derivatives inhibited activity of both enzymes. For instance, PFD-I, PFD-II, PFD-III, PFD-V, PFD-IX, PFD-X, and PFD-XI in a concentration of 5×10-5 M completely inhibited hydrolytic and transport functions of Ca2+-ATPase. These compounds in a concentration of 5×10-6 suppressed active transport of calcium ions by 51±5, 77±8, 52±5, 52±5, 100±10, 80±8, and 100±10%, respectively, and inhibited ATP hydrolysis by 31±3, 78±8, 18±2, 29±3, 78±8, 63±7, and 73±9%, respectively, uncoupling the hydrolytic and transport functions of the enzyme. PFD-I noncompetitive and reversibly reduced activity of Ca2+-ATPase (Ki=2.3×10-6 M). All the studied fullerene derivatives (except for PFD-VII) inhibited cGMP phosphodiesterase by more than 80% in concentration of 10-4 M and higher and by more than 50% in concentration of 10-5 M. PFD-I is a non-competitive reversible inhibitor of cGMP phosphodiesterase (Ki=7×10-6 M). These results allow us to expect antimetastatic, antiaggregatory, antihypertensive and vasodilative activity of the studied compounds.

Effects of Nitrosyl Iron Complexes with Thiocarbamide and Its Aliphatic Derivatives on Activities of Ca2+-ATPase of Sarcoplasmic Reticulum and cGMP Phosphodiesterase.

We studied the effects of water-soluble cationic dinitrosyl iron complexes with thiocarbamide and its aliphatic derivatives, new synthetic analogs of natural NO donors, active centers of nitrosyl [1Fe-2S]proteins, on activities of Ca2+-ATPase of sarcoplasmic reticulum and cGMP phosphodiesterase. Nitrosyl iron complexes [Fe(C3N2H8S)Cl(NO)2]0[Fe(NO)2(C3N2H8S)2]+Cl- (I), [Fe(SC(N(CH3)2)2(NO)2]Cl (II), [Fe(SC(NH2)2)2(NO)2Cl×H2O (III), and [Fe(SC(NH2)2)2(NO)2]2SO4×H2O (IV) in a concentration of 10-4 M completely inhibited the transporting and hydrolytic functions of Ca2+-ATPase. In a concentration of 10-5 M, they inhibited active Ca2+ transport by 57±6, 75±8, 80±8, and 85±9% and ATP hydrolysis by 0, 40±4, 48±5, and 38±4%, respectively. Complex II reversibly and noncompetitively inhibited the hydrolytic function of Ca2+-ATPase (Ki=1.7×10-6 M). All the studied iron-sulphur complexes in a concentration of 10-4 M inhibited cGMP phosphodiesterase function. These data suggest that the studied complexes can exhibit antimetastatic, antiaggregation, vasodilatatory, and antihypertensive activities.

[Placement of a ventricular catheter into narrow lateral ventricles. Popular navigation]. / Ustanovka ventrikuliarnogo katetera v uzkie bokovye zheludochki. Navigatsiia dlia vsekh.

Placement of a ventricular catheter is the most common and easiest procedure in neurosurgery. Usually, the procedure is performed using anatomical landmarks. However, despite the apparent ease of this manipulation, its results are not always satisfactory. According to the literature data, the rate of improperly placed ventricular catheters amounts to 10-40%, which is directly correlated with the risk of shunt dysfunction. The use of special equipment, such as ultrasound scanners, endoscopes, stereotactic devices, and neuronavigation systems, significantly increases success of surgery. However, the high cost and complexity of equipment confine its use at neurosurgical centers, and increased surgery time limits routine use of the equipment. A Thomale guide provides the accuracy comparable to that of modern navigation systems and, at the same time, is a cheap and easy-to-use device. AIM: To determine capabilities and master a technique of using the Thomale guide during placement of ventricular catheters. MATERIAL AND METHODS: Twenty seven surgeries wich Thomale guide were performed at the Rogachev Federal Research Center of Pediatric Hematology, Oncology, and Immunology in the period from April 2015 to November 2016. The Ommaya reservoir was placed in 23 cases; there were 2 ventriculoperitoneal shunting procedures; external ventricular drainage was placed in 2 cases. In 19 cases, the catheter was placed into narrow lateral ventricles. RESULTS: In all 27 cases, the ventricular catheter was successfully placed, at the first attempt, into the anterior horn of the lateral ventricle. CONCLUSION: The Thomale guide is a simple but reliable device for accurate and quick placement of a ventricular catheter into the lateral ventricles, regardless of their size.

[Surgical strategy for locally-advanced right-sided colonic cancer]. / Strategiia khirurgicheskogo lecheniia mestno-rasprostranennogo raka pravoi poloviny obodochnoi kishki.

AIM: To present early and remote surgical outcomes in patients with locally-advanced right-sided colonic cancer, invasion of pancreatic head and/or duodenal wall. MATERIAL AND METHODS: Early and remote surgical outcomes were analyzed in 27 patients who underwent gastropancreatoduodenectomy combined with right-sided hemicolectomy (ileotransversostomy extirpation) for locally-advanced right-sided colonic cancer. RESULTS: Mean time of surgery was 300 (240-460) minutes, intraoperative blood loss - 2000 (500-7200) ml. Postoperative complications were observed in 15 (55.6%) patients. 3 (11.1%) patients died in early postoperative period. Overall 1-, 3- and 5-year survival was 92.7%, 48% and 36,5% respectively. Median was 33 months. CONCLUSION: Advanced combined surgery for locally-advanced right-sided colonic cancer, invasion of pancreatic head and/or duodenal wall is associated with acceptable incidence of postoperative complications, early and long-term mortality.

[The value of volatile fatty acids, citrulline and malondialdehyde for diagnosis of suppurative cholangitis in obstructive jaundice and choosing of optimal surgical approach (with commentary)]. / Otsenka informativnosti pokazatelei letuchikh zhirnykh kislot, tsitrullina i malonovogo dial'degida dlya diagnostiki gnoinogo kholangita pri mekhanicheskoi zheltukhe i vybora optimal'noi khirurgicheskoi taktiki (s kommentariem).

AIM: To define the role of volatile fatty acids, citrulline and malondialdehyde for diagnosis of suppurative cholangitis in obstructive jaundice and to define optimal surgical approach. MATERIAL AND METHODS: We studied the results of examination and treatment of 87 patients with different hepatopancreatobiliary pathology complicated by obstructive jaundice. It was determined blood concentration and range of volatile fatty acids which are metabolites of facultative anaerobic and obligate anaerobic bacterial pathogens. RESULTS: In 39 patients the defined levels of acetic, propionic, butyric and isovaleric acids contributed to accurate diagnosis of suppurative cholangitis. Statistically significant threshold concentrations of volatile fatty acids were revealed. These values facilitate detection of anaerobic microflora in suppurative cholangitis. CONCLUSION: Research of contents of volatile fatty acids, citrulline and malondialdehyde contributes to early diagnosis of suppurative cholangitis in patients with obstructive jaundice and further objectifies an algorithm of surgical tactics.

[Total pancreatectomy for pancreatic cancer]. / Total'naya pankreatektomiya pri opukholevom porazhenii podzheludochnoi zhelezy.

AIM: to determine the indications and to evaluate early and long-term outcomes of total pancreatectomy for pancreatic cancer. MATERIAL AND METHODS: Treatment of 29 patients who underwent one- and two-stage pancreatectomy for different malignancies was analyzed. RESULTS: Median of surgery duration and intraoperative blood loss was 280 min and 2200 ml respectively. Postoperative complications were observed in 9 (31%) patients. There were 2 (6.9%) deaths. 1- and 3-year overall actual survival was 61% and 16% respectively in case of ductal adenocarcinoma. Median was 18 months. Patients after surgery for primary multiple lesion (cancer of pancreatic body-tail and major duodenal papilla), pancreatic metastases of renal cancer, mucinous cystadenoma and neuroendocrine cancer are still alive. Follow-up periods are 4, 49, 49 and 65 months respectively. CONCLUSION: Total pancreatectomy is difficult intervention followed by severe metabolic disorders. However it can improve long-term survival with acceptable incidence of postoperative complications and quality of life if clear indications for surgery are present.

[Treatment of acute appendicitis: Retrospective analysis]. / Lécba akutní apendicitidy: retrospektivní analýza vlastního souboru.

INTRODUCTION: Acute appendicitis is the most common cause of intra-abdominal emergency surgery worldwide. The approach to its treatment keeps changing. The number of acute appendectomies has been decreasing. Many patients are treated conservatively with success. Our study compares conservative and surgical treatment of acute appendicitis, including its complications in our department. METHODS: We retrospectively analyzed the group of 117 patients hospitalized with the clinical diagnosis of acute appendicitis. We distinguished patients with complicated and uncomplicated appendicitis, and patients operated and treated conservatively. We evaluated complication rates and recurrences of the disease, respectively, in 1-year follow-up. The Student t test and Fishers exact test were used for the statistical analysis. RESULTS: In 2012 we hospitalized 117 patients with acute appendicitis: 83 patients (71%) for uncomplicated and 34 (29%) for complicated appendicitis. 41% of patients with complicated and 13% with uncomplicated appendicitis (p=0.02) were treated conservatively. Conservative treatment or laparoscopic surgery, respectively, were used more often in women ( p0.001). There was no failure of conservative treatment. Perioperative morbidity was 13%. No patient died. 6 patients (24%) of the conservatively treated group were hospitalized in the subsequent year for recurrent problems. 4 (16%) were reoperated. The rate of negative appendectomy (negative pathological findings) was 11%. The hospitalization time was shorter in patients treated conservatively or using laparoscopy, respectively, compared to the group of patients undergoing appendectomy. CONCLUSION: In the modern era of available complementary examinations and a broad spectrum of antibiotics the conservative approach is favoured as a treatment of complicated appendicitis. Conservative treatment of uncomplicated appendicitis is an option, but not the method of choice. Routine elective appendectomy after successful conservative treatment is groundless. Laparoscopic appendectomy is associated with lower morbidity than open appendectomy. Despite the available tests and scoring systems the negative appendectomy rate remains high. KEY WORDS: appendicitis - appendectomy - laparoscopy - antibiotic treatment.

Giant Mesoscopic Fluctuations and Long-Range Superconducting Correlations in Superconductor-Ferromagnet Structures.

The fluctuating superconducting correlations emerging in dirty hybrid structures under the conditions of the strong proximity effect are demonstrated to affect the validity range of the widely used formalism of Usadel equations at mesoscopic scales. In superconductor-ferromagnet structures these giant mesoscopic fluctuations originating from the interference effects for the Cooper pair wave function in the presence of the exchange field can be responsible for an anomalously slow decay of superconducting correlations in a ferromagnet even when the noncollinear and spin-orbit effects are negligible. The resulting sample-to-sample fluctuations of the Josephson current in superconductor-ferromagnetic-superconductor junctions and the local density of states in superconductor-ferromagnetic hybrid structures can provide an explanation of the long-range proximity phenomena observed in mesoscopic samples with collinear magnetization.

[CLINICAL ASPECTS OF SEPTIC ENCEPHALOPATHY].

Septic encephalopathy is a form of general cerebral dysfunction caused by a systemic inflammatory reaction. Its investigation encounters enormous difficulties for the lack of reliable biological markers of neuronal lesions and methods for the evaluation of consciousness in severely ill patients. Hence, the importance of correct clinical interpretation of the character and magnitude of CNS activity. Examples are presented demonstrating the difficulty of interpreting disorders in CNS activity associated with evere community-acquired pneumonia.

[Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position].

Paradoxical air embolism (PAE) is a rare life-threatening complication when air emboli enter arteries of the systemic circulation and cause their occlusion. Here, we describe a clinical case of PAE developed during neurosurgery in a patient in the sitting position. PAE led to injuries to the cerebral blood vessels, coronary arteries, and lungs, which caused death of the patient. An effective measure for preventing PAE is abandoning surgery in the sitting position in favor of surgery in the prone position.

Tunable quasiparticle trapping in Meissner and vortex states of mesoscopic superconductors.

Nowadays, superconductors serve in numerous applications, from high-field magnets to ultrasensitive detectors of radiation. Mesoscopic superconducting devices, referring to those with nanoscale dimensions, are in a special position as they are easily driven out of equilibrium under typical operating conditions. The out-of-equilibrium superconductors are characterized by non-equilibrium quasiparticles. These extra excitations can compromise the performance of mesoscopic devices by introducing, for example, leakage currents or decreased coherence time in quantum devices. By applying an external magnetic field, one can conveniently suppress or redistribute the population of excess quasiparticles. In this article, we present an experimental demonstration and a theoretical analysis of such effective control of quasiparticles, resulting in electron cooling both in the Meissner and vortex states of a mesoscopic superconductor. We introduce a theoretical model of quasiparticle dynamics, which is in quantitative agreement with the experimental data.