21 research outputs found
Charged particle dynamics in multiple colliding electromagnetic waves. Survey of random walk, Levy flights, limit circles, attractors and structurally determinate patterns
No full textThe multiple colliding laser pulse concept formulated by Bulanov et al. (Phys. Rev. Lett., vol. 104, 2010b, 220404) is beneficial for achieving an extremely high amplitude of coherent electromagnetic field. Since the topology of electric and magnetic fields of multiple colliding laser pulses oscillating in time is far from trivial and the radiation friction effects are significant in the high field limit, the dynamics of charged particles interacting with the multiple colliding laser pulses demonstrates remarkable features corresponding to random walk trajectories, limit circles, attractors, regular patterns and Levy flights. Under extremely high intensity conditions the nonlinear dissipation mechanism stabilizes the particle motion resulting in the charged particle trajectory being located within narrow regions and in the occurrence of a new class of regular patterns made by the particle ensembles.Office of Science of the US DOE [DE-AC02-05CH11231]; National Basic Research Program of China [2013CBA01502]; NSFC [11535001]; National Grand Instrument Project [2012YQ030142]SCI(E)ARTICLE8
Prognostic factors affecting survival of patients after liver resection due to colorectal liver metastases
No full textIntroduction: Colorectal liver metastases have a poor prognosis and only 2% have an average 5 - year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%.
Aim: To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients.
Methods: A retrospective study was conducted at the Clinic of General and Hepato - pancreatic Surgery at the University Hospital "Aleksandrovska" - Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS- 19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT).
Results: Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni- or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients.
Conclusion: In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival.
Keywords: colorectal metastases, radical resections, prognostic factors, survival, stage of the diseas
THE TRAILER AS A PHENOMENON OF CONTEMPORARY SCREEN CULTURE / ТРЕЙЛЕР КАК ФЕНОМЕН СОВРЕМЕННОЙ ЭКРАННОЙ КУЛЬТУРЫ
No full textThe author considers a special kind of movie advertising, —the trailers of the films, preparing for the release. This format has its own characteristics, the genre, the style and the uniqueness of the individual phenomenon of contemporary screen culture. It is a rapidly growing format, which is, increasingly, separated from its source and lives its own life, becoming for most culturally significant event due to the special structure, dynamics, clipvote, saturation of emotions and events, archetypal characters that are relevant to the viewer.
Автор рассматривает особый вид рекламы фильмов, готовящихся к прокату, – трейлеров. Такой формат имеет свои особенности, жанровость, стилистику и своеобразие отдельного феномена современной экранной культуры. Это стремительно развивающийся видеоформат, который все больше отделяется от его первоисточника и живет своей собственной жизнью, становясь для многих культурно значимым событием благодаря особой структуре, динамике, клиповости, насыщенности эмоциями и событиями, архетипическими символами, актуальными для зрителя
Methods for Vascular Control in Liver Resections Due to Colorectal Metastases - Impact on Residual Parenchyma
No full textAbstract
Introduction. Massive blood loss while performing resections of the liver continues to be a serious problem with potentially lethal outcome. Therefore in the last 2-3 decades there has been a significant developement of techniques for vascular control during liver resections. Methods. In the period from 01.01.2006 to 31.12.2015 in KOCPH UMBAL "Aleksnadrovska" a total of 239 patients with colorectal liver metastases underwent surgery of whom: 179 patients were radicaly operated on and 57 patients were subjected to Pringle maneuver. Using the statistical software SPSS-19 we analyzed various factors that may affect the early postoperative results. Results. In resections of colorectal liver metastases there was a significant difference in the postoperative functional parameters (AST, ALT), which correlated with the degree of liver damage, in patients with Pringle and without Pringle maneuver 265.32 vs. 448 (p=0.001), and 300.53 vs. 481.91 (p=0.002),-respectively. There was no significant difference in the postoperative results in comparisson of resections <15 minutes, performed without Pringle and with Pringle maneuver. The blood loss is another factor that affects the postoperative complications (p = 0.048), and it was lowest in the Pringle group <15 min. Conclusion. Pringle maneuver is a simple and effecttive method for vascular control. As a result of its use we can observe the damage of the residual liver volume from the continuous ischemia to the reperfusion period. Thus, in liver resections, due to colorectal metastasis, vascular control strategy should be individual and corresponding to the extent of the procedure and associated diseases of the liver-fatty liver, cirrhosis, chronic hepatitis and others.</jats:p
Methods for vascular control in liver resection due to colorectal metastases - impact on residual parenchima
No full textIntroduction. Massive blood loss while performing resections of the liver continues to be a serious problem with potentially lethal outcome. Therefore in the last 2-3 decades there has been a significant developement of techniques for vascular control during liver resections.
Methods. In the period from 01.01.2006 to 31.12.2015 in KOCPH UMBAL "Aleksnadrovska" a total of 239 patients with colorectal liver metastases underwent surgery of whom: 179 patients were radicaly operated on and 57 patients were subjected to Pringle maneuver. Using the statistical software SPSS-19 we analyzed various factors that may affect the early postoperative results.
Results. In resections of colorectal liver metastases there was a significant difference in the postoperative functional parameters (AST, ALT), which correlated with the degree of liver damage, in patients with Pringle and without Pringle maneuver 265.32 vs. 448 (p = 0.001), and 300.53 vs. 481.91 (p = 0.002),- respectively. There was no significant difference in the postoperative results in comparisson of resections < 15 minutes, performed without Pringle and with Pringle maneuver. The blood loss is another factor that affects the postoperative complications (p = 0.048), and it was lowest in the Pringle group <15 min.
Conclusion. Pringle maneuver is a simple and effective method for vascular control. As a result of its use we can observe the damage of the residual liver volume from the continuous ischemia to the reperfusion period. Thus, in liver resections, due to colorectal metastasis, vascular control strategy should be individual and corresponding to the extent of the procedure and associated diseases of the liver - fatty liver, cirrhosis, chronic hepatitis and others.
Keywords: colorectal liver metastases, liver resection, vascular occlusion of hepato-duodenal ligament, ischemia, residual parenchyma
A rare case of IgG4-related disease: a gastric mass, associated with regional lymphadenopathy
No full textPrognostic Factors Affecting Survival of Patients after Liver Resection Due to Colorectal Liver Metastases
No full textAbstract
Introduction. Colorectal liver metastases have a poor prognosis and only 2% have an average 5-year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%.
Aim. To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients.
Methods. A retrospective study was conducted at the Clinic of General and Hepato-pancreatic Surgery at the University Hospital “Aleksandrovska”-Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS-19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT).
Results. Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni-or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients.
Conclusion. In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival.</jats:p
A rare combination between familial multiple lipomatosis and extragastrointestinal stromal tumor
No full textAbstractIntroductionGastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Rarely, GISTs can be located in mesentery, retroperitoneal space, omentum or pancreas. In these cases, the neoplasm is defined as “extra-gastrointestinal stromal tumors” (EGISTs).Presentation of caseWe reported a case of a 63-year-old male patient diagnosed by computer tomography with large intraabdominal tumor with vague origin, postoperatively determined as an EGIST. The diagnosis was confirmed by immunohistochemical study. The patient had multiple, subcutaneous, painless lipomas localized in the arms, forearms, thighs, abdomen and thorax. Because of the family history and the clinical presentation the disease was determined as familial multiple lipomatosis (FML). We performed radical tumor resection with distal pancreatectomy and splenectomy, and abdominoplasty, removing redundant skin and underlying subcutaneous fat tissue with multiple lipomas.DiscussionFML is a rare hereditary benign disease. On the other hand, only few cases with familial GIST have been reported. In cases with extensive abdominal involvement, the primary origin of EGIST may be impossible to determine so the differential diagnosis is very difficult.ConclusionAlthough we could not prove correlation between the observed diseases, they are extremely rare and their combination is unusual which makes the presented case valuable and interesting
