[Double-tract reconstruction after gastrectomy for gastric cancer in patients with concomitant cardiovascular diseases]. / Rekonstruktsiya double-tract posle gastrektomii po povodu raka zheludka u patsientov s konkuriruyushchimi serdechno-sosudistymi zabolevaniyami.

OBJECTIVE: To demonstrate the capabilities and advantages of double-tract reconstruction after gastrectomy for gastric cancer and simultaneous approach in surgical treatment of patients with cardiovascular diseases and gastric cancer. MATERIAL AND METHODS: We present two cases of double-tract reconstruction after gastrectomy and the gastric stump extirpation as a part of simultaneous surgical approach to patients with gastric cancer and cardiovascular diseases. A 62-year-old patient underwent simultaneous gastrectomy with double-tract reconstruction (for the first time In Russia) and aortofemoral replacement. A 61-year-old patient underwent simultaneous coronary artery bypass surgery, gastric stump extirpation with esophagogastrostomy and double-tract reconstruction. RESULTS: In 1 case, postoperative period was complicated by subcompensated stenosis of the right ureter due to hematoma near the right common iliac artery. This event required endoscopic stenting of the right ureter with positive effect. Both patients were discharged in 16 and 23 days after surgery. CONCLUSION: This method may be alternative to modern reconstructions. Currently, digestive tract reconstruction after gastrectomy is still important and requires further study. Simultaneous procedures in patients with cancer and cardiovascular disease became more widespread. To objectify our statements, further research is needed.

[Minimally invasive interventions for complications associated with intra-abdominal calculi after laparoscopic cholecystectomy]. / Vozmozhnosti minimal'no invazivnykh vmeshatel'stv v lechenii oslozhnenii, svyazannykh s vnutribryushnymi konkrementami posle videolaparoskopicheskoi kholetsistektomii.

OBJECTIVE: To study the possibilities of minimally invasive methods for removing intra-abdominal calculi after laparoscopic cholecystectomy. MATERIAL AND METHODS: There were 5 patients with abdominal abscesses associated with infected calculi after previous laparoscopic cholecystectomy at the Sklifosovsky Research Institute for Emergency Care between 2020 and 2023. Mean age of patients was 55±12 years. There were 3 (60%) women and 2 (40%) men. All patients underwent minimally invasive treatment. RESULTS: Four patients (80%) underwent percutaneous drainage of abscess with subsequent replacement by larger drains and removal of calculi with endoscopic assistance. Event-free period after cholecystectomy was 44±32 months. One patient developed subhepatic abscess in 72 months after laparoscopic cholecystectomy. This patient underwent transluminal removal of calculus through the duodenal wall. There was 1 calculus in 3 (60%) patients, 2 calculi in 1 (20%) patient and 3 calculi in 1 (20%) patient. CONCLUSION: The above-mentioned cases demonstrate successful minimally invasive interventions for symptomatic abdominal calculi after laparoscopic cholecystectomy. Minimally invasive treatment can reduce surgical aggression and accelerate rehabilitation.

[The first experience of small intestinal autotransplantation for advanced digestive cancer]. / Pervyi opyt autotransplantatsii tonkoi kishki pri mestno-rasprostranennykh opukholyakh zheludochno-kishechnogo trakta.

Usually, gastrointestinal tumors (GIT) invading great vessels are acknowledged to be irresectable. Along with that, we can expect positive oncological results only when there is combination treatment with radical surgery (R0 resection). In this article we share the first experience of small intestinal autotransplantation as a method of radical surgery in locally advanced GIT. We conducted the analysis of outcomes of three patients (with pancreas cancer (n=2) and neuroendocrine tumor of caecum (n=1), with neoplastic process involving to superior mesenteric artery and vein. We analyzed intraoperative aspects and algorithm of small intestinal autotransplantation. Long-term outcomes with 1.5-13 months of observing time are presented. On the basis of conducted analysis the authors suggest the possibility of small intestinal autotransplantation in referral centers with strict personalized approach and multidisciplinary surgical team.

[Safety and efficacy of the Relatox in the treatment of patients with cervical dystonia (results of a multicenter simple blind comparative randomized study)]. / Bezopasnost' i effektivnost' preparata Relatoks v lechenii patsientov s tservikal'noi distoniei (rezul'taty mul'titsentrovogo prostogo slepogo sravnitel'nogo randomizirovannogo issledovaniya).

OBJECTIVE: The analysis of evaluation of the efficacy and safety of Relatox in patients with cervical dystonia (CD). MATERIAL AND METHODS: Russian multicenter simple comparative randomized clinical trial. The study involved 180 patients of both sexes aged 18-65 years from 3 research centers of the Russian Federation. All patients had previously established diagnosis of CD and were randomized to one of two groups at 1 visit after the inclusion procedure and signing of informed consent. Patients in group 1 (n=90) got injections of Relatox, in group 2 (n=90) - injections of Botox for the first time or no earlier than 4 months after the previous injection of Dysport 500 units, Botox 200 units or Xeomin 200 units. The assessment of changes in cervical dystonia followed, including of determination of changes in the severity of CD, assessed on the TWSTRS scale by the total score and by the defining values of the blocks, as well as on the scales: the Patient Global Impression of Improvement (PGI-I) and of adverse events (local and systemic reactions). Based on the form of cervical dystonia (torticollis, laterocollis, etc.), the drug was injected under electromyographic control into the target muscles: sternocleidomastoid, belt, trapezoidal, shoulder-lifting muscle. RESULTS: Equal efficacy, good tolerability and safety comparable to the comparison drug Botox was demonstrated in 12 weeks after injection of Relatox. The number of registered local and systemic reactions in both groups was insignificant and did not differ significantly (p>0.05). There were no significant differences in the results of laboratory parameters in patients of both groups (p>0.05). Serious adverse events were also not detected during the study. CONCLUSION: Obtained results indicate the safety, good tolerability and efficacy of Relatox in patients with CD comparable to Botox and can be recomemded for using by practitioners.

[Pancreatic duct stenting in acute severe pancreatitis]. / Stentirovanie pankreaticheskogo protoka pri ostrom tyazhelom pankreatite.

OBJECTIVE: To evaluate the efficacy of endoscopic retrograde stenting of the pancreatic duct for acute severe pancreatitis. MATERIAL AND METHODS: We analyzed 94 patients with acute severe pancreatitis who underwent surgery (n=87, 92.6%) and endoscopic retrograde pancreatic stenting (n=28, 29.8%). The first group included 15 patients (16%) after pancreatic duct stenting in aseptic phase of acute pancreatitis. The second group enrolled 13 patients (13.8%) who underwent pancreatic duct stenting in the phase of sequestration and infection. The third group consisted of 66 patients (70.2%) after open surgery without pancreatic duct stenting. RESULTS: In the 1st group, we recanalized the necrosis zone up to distal pancreas via stenting. Infection was detected in 14 out of 15 patients. Surgical treatment was performed in 13 patients (13.8%). In the second group, pancreatic duct stenting was carried out in the phase of infected pancreatitis. We applied stenting to block the area of duct destruction or restore outflow in case of distal defect. No infection was observed in 1 out of 13 patients. Pancreatic duct stenting was not performed in 66 patients of the third group. Surgical treatment was performed in 59 patients (62.8%). In general, 11 of 94 patients (11.7%) were free from infection. CONCLUSION: Better postoperative outcomes were observed in patients with damage to pancreatic duct, pancreatic drainage through percutaneous drains installed at the first stage of treatment. Early pancreatic duct stenting did not lead to significant improvement in treatment outcomes.

[Endoscopic transluminal drainage for infected pancreatic necrosis]. / Endoskopicheskoe vnutriprosvetnoe drenirovanie zon pankreatogennoi destruktsii pri nekrotiziruyushchem pankreatite.

OBJECTIVE: To evaluate the effectiveness of intraluminal drainage of acute fluid accumulations for infected pancreatic necrosis. MATERIAL AND METHODS: There were 848 patients with acute pancreatitis between January 2018 and December 2020 at the Sklifosovsky Research Institute for Emergency Care. Necrotizing pancreatitis was detected in 232 (27.4%) patients. Among necrotic forms, pancreatic parenchymal necrosis was detected in 56 (24.1%) patients, its combination with peripancreatic necrosis - in 176 (75.9%) patients. All patients underwent transabdominal ultrasound, CT of the abdomen and retroperitoneal space, esophagogastroduodenoscopy, endo-ultrasonography of pancreatobiliary zone. Dimensions and localization of acute necrotic accumulations were established using ultrasound and CT data. Endoscopic transluminal drainage was performed in 22 patients with necrotizing pancreatitis and fluid accumulations attached to the stomach or duodenum. There were 12 men (55%) and 10 women (45%) aged 48.5 [39; 56] (35; 88) years. Effectiveness of endoscopic treatment was assessed considering clinical, endoscopic data and reduction of fluid accumulations confirmed by ultrasound and CT data. RESULTS: Among 22 patients, connection with pancreatic ductal system was detected in 3 patients (13.6%) that required pancreaticoduodenal stenting. Early postoperative period was complicated by bleeding from the area of pancreatogenic destruction in 4 patients (18.1%). Therefore, angiography and endovascular embolization of a. gastroduodenalis were required in 2 (9.1%) cases. In 1 (4.5%) case, we performed endoscopic hemostasis using Hemoblock hemostatic solution (4 ml). Combination of both methods was used in 1 (4.5%) patient. In 11 (50%) patients, endoscopic drainage was the final method of surgical treatment of necrotizing pancreatitis. Four patients (18.1%) died. Multiple organ failure caused mortality in 3 patients (13.6%). One (4.5%) patient died from severe nosocomial pneumonia developed in 32 days after drainage. Spurs not drained into the stomach with US-confirmed suspension and sequestration were observed in 11 (50%) out of 22 patients. These accumulations required additional ultrasound-assisted percutaneous drainage. CONCLUSION: Endoscopic transluminal drainage is a perspective minimally invasive method for necrotizing pancreatitis.

[Treatment of ischemic penile and scrotum gangrene].

Gangrene of the penis is a rare condition manifesting with purulent necrotization of penile tissues and systemic inflammatory response. In more than 90% of cases, the cause of the development of the penile and scrotal gangrene is rapidly progressive necrotizing fasciitis of polymicrobial etiology, which predominantly affected the external genital organs. Isolated cases of penile gangrene development when using the restraining rings of the penis are described in literature (condom urine collection bag, rings for erection, etc.). Cases of penile and scrotum gangrene, when treatment with bilateral orchiectomy and penectomy is required are quite rare. We present the case of penlie and scrotum gangrene in an 86-year-old patient with mental disorders. The cause of gangrene was long-term forced position of the patient with infringement of the penis and scrotum by the thighs. Active intensive therapy, surgical removal of the penis, scrotum and testicles and urine diversion by the imposition of a trocar cystostomy saved the patients life and he was discharged from the hospital in a satisfactory condition.

Preoperative stereotactic ablative body radiotherapy with postoperative conventional irradiation of soft tissue sarcomas: Protocol overview with a preliminary safety report.

Preoperative radiotherapy in patients with soft tissue sarcomas is characterized by important advantages: high precision of dose delivery, reduction of tumor volume and implantation potential, induction of immunologic response. Postoperative irradiation is associated with a reduced risk of complication, and a comprehensive radiotherapy planning in accordance with the pathologic report. Combination of pre- and postoperative irradiation gives the opportunity to use the best of both methods. OBJECTIVE: To analyze feasibility and safety of radiotherapy protocol that combined pre- and postoperative radiotherapy in patients with soft tissues sarcomas of extremities. MATERIALS AND METHODS: From 06.2018 to 01.2021, 23 patients with soft tissue sarcomas of extremities were included in the protocol (NCT04330456) and 14 cases with at least 12 months follow-up were eligible for analysis. Preoperative stereotactic ablative body radiotherapy (SBRT) was performed as 5 fraction of 7 Gy with dose reduction (5 fractions of 5 Gy) on the margins of the tumor. Postoperative radiotherapy started 5-8 weeks after the surgery and was performed as standard compartmental irradiation in 25 fractions of 2 Gy. Complications were determined according to CTCAE and wound complication scales. RESULTS: Preoperative SBRT and subsequent radical resection with tumor free surgical margins were performed in all 14 cases. Primary wound closure was mentioned in all patients. Postoperative radiotherapy started 51.8 days (range 33-99 days) days after the surgery. With a relatively short follow-up of 21.5 (13-30) months, we recorded 2 cases (14%) of severe complications (Canadian sarcoma group criteria), and there were no local recurrences. CONCLUSION: Our preliminary results demonstrate that the combination of preoperative SBRT and postoperative conventional radiotherapy is feasible and does not increase the risk of postoperative complications.

Density of states in locally ordered amorphous organic semiconductors: Emergence of the exponential tails.

We present a simple model of the local order in amorphous organic semiconductors, which naturally produces a spatially correlated exponential density of states (DOS). The dominant contribution to the random energy landscape is provided by electrostatic contributions from dipoles or quadrupoles. An assumption of the preferable parallel orientation of neighbor quadrupoles or antiparallel orientation of dipoles directly leads to the formation of the exponential tails of the DOS even for a moderate size of the ordered domains. The insensitivity of the exponential tail formation to the details of the microstructure of the material suggests that this mechanism is rather common in amorphous organic semiconductors.

[Intraocular pressure with miniscleral contact lenses]. / Oftal'motonus v usloviyakh nosheniya miniskleral'nykh kontaktnykh linz.

According to literature data, some experts do not exclude the possibility that scleral lens wear could influence intraocular pressure. PURPOSE: To evaluate the influence of rigid gas permeable miniscleral contact lenses on intraocular pressure (IOP), keratometry readings and corneal thickness, and to study the correlation between scleral (IOPs) and corneal (IOPc) intraocular pressure using the Icare ic100 tonometer (model TAO11, Icare Finland Oy). MATERIAL AND METHODS: The study included 99 volunteers without history of ocular diseases. The first group consisted of 66 participants (122 eyes) aged 22.3±2.2 years - IOPc and IOPs were measured by the Icare ic100 tonometer in order to determine the correlation. The second group (33 participants, aged 22.7±1.7 years) - day 1, diurnal IOPc and IOPs fluctuations were measured; on day 2, a miniscleral lens (diameter 14.9 mm) was placed on the study eye and was worn for 6 hours, the paired eye served as control. IOP was measured before, after lens placement, after 2 hours of lens wear, and before and after lens removal. Corneal topography was evaluated before and after lens removal. RESULTS: In the first group, there was a weak but significant correlation between IOPc and IOPs (Spearman correlation coefficient 0.285, p=0.001). In the second group, IOPc in the study eye before lens placement (14.8±3.8 mm Hg) and IOPc after its removal (13.6±3.9 mm Hg) were not different from those in the control eye. There were also no statistically significant changes in IOPs before, during lens wear, and after lens removal. The central corneal thickness increased by 2.9% (p<0.001) after 6 hours of lens wear. CONCLUSION: In young individuals without history of ocular diseases, wearing the miniscleral lens for 6 hours does not have significant influence on IOP and does not cause clinically significant corneal edema.

[Endoscopic transluminal drainage of infected pancreatic necrosis]. / Endoskopicheskoe translyuminal'noe drenirovanie ostrogo zhidkostnogo skopleniya pri infitsirovannom pankreonekroze.

OBJECTIVE: To report initial experience of endoscopic transluminal drainage of infected pancreatic necrosis. MATERIAL AND METHODS: There were 8 patients with acute severe pancreatitis and large-focal pancreatic necrosis who underwent transluminal drainage of destruction zones for the period from December 2018 to October 2019. RESULTS: Transluminal drainage of pancreatogenic destruction zones in acute severe pancreatitis can be considered as the only surgical approach in 50% of cases that is comparable with literature data.

Giant optical anisotropy in transition metal dichalcogenides for next-generation photonics.

Large optical anisotropy observed in a broad spectral range is of paramount importance for efficient light manipulation in countless devices. Although a giant anisotropy has been recently observed in the mid-infrared wavelength range, for visible and near-infrared spectral intervals, the problem remains acute with the highest reported birefringence values of 0.8 in BaTiS3 and h-BN crystals. This issue inspired an intensive search for giant optical anisotropy among natural and artificial materials. Here, we demonstrate that layered transition metal dichalcogenides (TMDCs) provide an answer to this quest owing to their fundamental differences between intralayer strong covalent bonding and weak interlayer van der Waals interaction. To do this, we made correlative far- and near-field characterizations validated by first-principle calculations that reveal a huge birefringence of 1.5 in the infrared and 3 in the visible light for MoS2. Our findings demonstrate that this remarkable anisotropy allows for tackling the diffraction limit enabling an avenue for on-chip next-generation photonics.

[Modern options for non-surgical correction of keratoconus]. / Sovremennye vozmozhnosti «nekhirurgicheskoi¼ korrektsii keratokonusa.

The article reviews data on the so called non-surgical methods of keratoconus (KC) correction. The combined approach to KC treatment entails three main tasks: prevention of progression, optical correction of induced refractive disorders, and structural repair. Measures taken to accomplish the first two tasks should be regarded as symptomatic treatment, while addressing the last task requires pathogenetically oriented solutions. Corneal cross-linking and optical correction of refractive disorders with rigid gas permeable (RGP) scleral contact lenses should be regarded as the first choice for symptomatic non-surgical correction of keratoconus.

Simultaneous Enhancement of Thermopower and Electrical Conductivity through Isovalent Substitution of Cerium in Bismuth Selenide Thermoelectric Materials.

It is challenging to achieve highly efficient thermoelectric materials due to the conflicts between thermopower (Seebeck coefficient) and electrical conductivity. These parameters are the core factors defining the thermoelectric property of any material. Here, we report the use of isovalent substitution as a tool to decouple the interdependency of the Seebeck coefficient and the electrical properties of cerium-doped bismuth selenide thermoelectric material. With this strategy, we can achieve a simultaneous increase in both the electrical conductivity and the Seebeck coefficient of the material by tuning the concentration of cerium doping, due to formation of neutral impurities and consequently the improvement of carrier mobility. Our theoretical calculation reveals a downward shift of the valence band with cerium concentration, which influences the thermoelectric enhancement of the synthesized materials. Finally, an order of magnitude enhancement of the figure of merit is obtained due to isovalent substitution, thus providing a new avenue for enhancing the thermoelectric performance of materials.

Direct band-gap crossover in epitaxial monolayer boron nitride.

Hexagonal boron nitride is a large band-gap insulating material which complements the electronic and optical properties of graphene and the transition metal dichalcogenides. However, the intrinsic optical properties of monolayer boron nitride remain largely unexplored. In particular, the theoretically expected crossover to a direct-gap in the limit of the single monolayer is presently not confirmed experimentally. Here, in contrast to the technique of exfoliating few-layer 2D hexagonal boron nitride, we exploit the scalable approach of high-temperature molecular beam epitaxy to grow high-quality monolayer boron nitride on graphite substrates. We combine deep-ultraviolet photoluminescence and reflectance spectroscopy with atomic force microscopy to reveal the presence of a direct gap of energy 6.1 eV in the single atomic layers, thus confirming a crossover to direct gap in the monolayer limit.

Diffusion of a particle in the Gaussian random-energy landscape: Einstein relation and analytical properties of average velocity and diffusivity as functions of driving force.

We demonstrate that the Einstein relation for the diffusion of a particle in the random-energy landscape with the Gaussian density of states is an exclusive one-dimensional property and does not hold in higher dimensions. We also consider the analytical properties of the particle velocity and diffusivity for the limit of weak driving force and establish a connection between these properties and dimensionality and spatial correlation of the random-energy landscape.

Composition and strain relaxation of In x Ga1-x N graded core-shell nanorods.

Two In x Ga1-x N nanorod samples with graded In compositions of x = 0.5-0 (Ga-rich) and x = 0.5-1 (In-rich) grown by molecular beam epitaxy were studied using transmission electron microscopy. The nanorods had a wurtzite crystal structure with growth along [Formula: see text] and core-shell structures with an In-rich core and Ga-rich shell. Energy-dispersive x-ray analysis confirmed grading over the entire compositional range and showed that the axial growth rate was primarily determined by the In flux, and the radial growth rate by the Ga flux. There was no evidence of misfit dislocations due to grading, but the strain due to the lattice mismatch between the In-rich core and Ga-rich shell was relaxed by edge dislocations at the core-shell interface with Burgers vectors [Formula: see text] and [Formula: see text].

[Choice of surgical tactics in patients with acute cholecystitis complicated by cholelithiasis]. / Vybor taktiki khirurgicheskogo lecheniia bol'nykh s ostrym kholetsistitom, oslozhnennym kholedokholitiazom.

PURPOSE OF THE STUDY: Comparison of the methods of surgical treatment of cholelithiasis. MATERIAL AND METHODS: The work is based on the experience of treating 139 patients with acute cholecystitis complicated by choledocholithiasis from 2008 to 2016, who were on treatment of the department of acute surgical diseases of the liver and pancreas, N.V. Sklifosovsky. RESULTS: The use of percutaneous drainage of the gallbladder in an acute period can reduce complications and reduce the number of urgent video-laparoscopic cholecystectomies to 1%.

Diffusion of a particle in the spatially correlated exponential random energy landscape: Transition from normal to anomalous diffusion.

Diffusive transport of a particle in a spatially correlated random energy landscape having exponential density of states has been considered. We exactly calculate the diffusivity in the nondispersive quasi-equilibrium transport regime for the 1D transport model and found that for slow decaying correlation functions the diffusivity becomes singular at some particular temperature higher than the temperature of the transition to the true non-equilibrium dispersive transport regime. It means that the diffusion becomes anomalous and does not follow the usual ∝ t1/2 law. In such situation, the fully developed non-equilibrium regime emerges in two stages: first, at some temperature there is the transition from the normal to anomalous diffusion, and then at lower temperature the average velocity for the infinite medium goes to zero, thus indicating the development of the true dispersive regime. Validity of the Einstein relation is discussed for the situation where the diffusivity does exist. We provide also some arguments in favor of conservation of the major features of the new transition scenario in higher dimensions.

Comparative Monte-Carlo simulations of charge carrier transport in amorphous molecular solids as given by three most common models of disorder: The dipolar glass, the Gaussian disorder, and their mix.

We have performed Monte-Carlo simulations of the charge carrier transport in a model molecularly doped polymer using three most popular hopping theories (the dipolar glass model, the Gaussian disorder model, and an intermediate between them) in a wide range of applied electric fields and temperatures. Time of flight transients have been computed and analyzed in logarithmic coordinates to study the Poole-Frenkel field dependence, the non-Arrhenius mobility temperature dependence, and the nondispersive versus dispersive current shapes. We also have made an attempt to estimate the total disorder energy directly from simulation data at the lowest electric field thus checking the consistency of the model fitting. Computational results have been compared with the analytical and experimental information available in the literature.