“A Part of Speech” by Joseph Brodsky: Bilingualism as a Creative Method in Poetry

This article is an attempt of textological conceptualization of an interlingual transfer (doubling) of a literary text. This transfer, in case it has been done by the author him/herself, is traditionally called self-translation, yet it can also by qualified as an adaptation of the “old” text to the perceptive abilities of the “new” recipient, i.e. a collective reader representing a different national and cultural medium and bearing its values as a prevalent aesthetic waymark. Special importance in the above process is attached to such a significant feature of any literary text of high quality as its elasticity. The textological approach to the scientific understanding of the differentlanguage text binary is often complemented by the bilinguological categorization of the subject, i.e. a text of poetry and, at the same time, a poetic cycle. From this standpoint, the mode of primary/secondary character of the two interconnected texts might lose its substantial preciseness. Further on, the article scrutinizes a landmark (for the Russian culture) literary text and its self-translation: the poetic cycle “A Part of Speech” by Joseph Brodsky. Four conceptual dominants of the cycle, with regard to their axiological hierarchy, are distinguished: 1) space/distance – location – oblivion; 2) time (epoch) – history – event – oblivion; 3) love – breakup – oblivion; 4) speech – art – extension – immortality. Further, a comparative analysis of their different-language verbalization is carried out. It is stated that Brodsky’s creation of this bilingual cycle reflects his striving for a cultural adaptation of each version to the background knowledge, historical experience, principles, traditions, aesthetic attitudes and, generally, sentiments of different groups of readers. In some cases this is done by means of the national language only, in other cases by the general complication of the poems’ figurative fabric.

Early Warning Value of ASL-MRI to Estimate Premorbid Variations in Patients With Early Postoperative Cognitive Dysfunctions

Background: Postoperative cognitive dysfunction (POCD) is a general complication following cardiac and major non-cardiac surgery amongst the elderly, yet its causes and mechanisms are still unknown. The present study aimed to detect whether regional cerebral blood flow (CBF) is altered in the brain before surgery in POCD patients compared with non-POCD (NPOCD) patients, thus, CBF variation may potentially predict the occurrence of early POCD.Methods: Fifty patients scheduled for spinal stenosis surgery were enrolled in the study. All study participants completed a battery of neuropsychological tests (NPTs) by a well-trained neuropsychologist before the surgery and 1 week after the surgery. POCD was defined when the preoperative to postoperative difference of at least two of the NPTs’ |Z|-scores with reference to a control group exceeded 1.96. Pulsed arterial spin-labeling (ASL) MRI was scanned at least 1 day before surgery. The ASLtbx toolkit and SPM12 were applied to preprocess and correct the images, which were then normalized to the MNI brain template space to obtain standardized cerebral perfusion images.Results: POCD was identified in 11 out of 50 patients (22%). The CBF of the right superior temporal lobe, right and left middle cingulate gyrus, and the right hippocampus, and parahippocampal gyrus in POCD group was lower than that in NPOCD group (P < 0.001). The CBF of the pars triangularis of inferior frontal gyrus in POCD group was higher than that in NPOCD group (P < 0.001).Conclusions: These preliminary findings suggest that CBF premorbid alterations may happen in cognitively intact elderly patients that develop early POCD. Alterations of preoperative CBF might be a bio-marker for early POCD that can be detected by noninvasive MRI scans.

Freeze-dried Carboxymethyl Chitosan/starch Foam for Use as Hemostatic Wound Dressing

Prolonged bleeding is a general complication that occurs after tooth extraction or oral surgery. Thus, patients must apply pressure and use absorbable wound dressings to stop bleeding and prevent blood loss. This method can stop bleeding and create blood clotting. However, some people have bleeding disorders or cannot stop bleeding with applied pressure after oral surgery. Therefore, hemostatic foam dressing has been an interesting material that can be used to stop bleeding and not damage blood clotting in the wound site. In this study, foam was prepared using a blend of starch with carboxymethyl chitosan and glyoxal as a crosslinking agent. The foam was formed by freeze-drying. Carboxymethyl chitosan/starch foam can absorb and hold water rapidly as analyzed by blood clotting assay and maximum swelling. Thus, carboxymethyl chitosan/starch foam (CM/starch foam) in a 1:4 ratio with 1% glyoxal can also absorb blood very well with suitable properties. It is non-cytotoxic to human dermal fibroblast cells by MTT assay and has good mechanical properties in a wet environment.

Comparative study of laparoscopic and open surgery in management of 50 cases of liver hydatid cyst

Background: Echinococcosis is caused by parasite called Echinococcus granulosus and Echinococcus multilocularis. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy.Methods: This clinical study was done on 50 patients who had liver hydatid disease admitted in Sir T Hospital, Bhavnagar from August 2013 to February 2016. Patients were divided into two groups consisting of 25 cases in each. Group A: managed by open surgery. Group B: managed by laparoscopic surgery. All patients followed up for 6 months after surgery.Results: The mean operative time in Group A was 65.2 minutes (range 35-100 minutes) while in Group B it was 76.32 minutes (range 50-100 minutes). Group B patients were mobilised early and resumed duty very fast then Group A. The mean duration of stay in hospital was 12.4 days (range 4-20 days) in Group A and 6.2 days (range 4-12 days) in Group B. Wound infection seen in 16% in Group A and 0% in Group B. General complication rate was 32% in Group A and 8% in Group B. No recurrence noticed in either group during follow up.Conclusions: Overall laparoscopic management of liver hydatid cyst is cost effective in terms of early mobilization, early discharge and early resumption of work along with cosmetic benefit.

The short-term result of distal pancreatectomy with splenic preservation

Introduction: The tumor of pancreatic body and tail are relatively rare compared to those of head of pancreas. Splenic preservation in pancreatic carcinoma’s surgery should be decided on every case. This study to determine the feasibility of distal pancreatectomy with splenic preservation, the rate of early complications of splenectomy surgery to preserve the spleen and the factors: tumor size, tumor location, tumor characteristic to help assess the possibility of preserving the splenic vessels in distal pancreatectomy with splenic preservation. Methods: retrospective study, case series description for all patients aged 16 years and older with distal pancreatectomy and splenic preservation from 01/01/2012 to 31/12/2017. Result: We had 47 case of distal pancreatectomy with splenic preservation. There were 26 cases of splenic preservation with preserving the splenic vessels (Kimura technique), 13 cases of splenectomy but not preserving the splenic vessels (Warshaw technique). There were 16 cases of laparoscopic surgery, 31 cases open surgery, general complication in surgery 11 cases. The mean age was 41.13 (17-76 years old). The mean hospital stay was 7.7 days (3 days - 21 days). General complication after surgery in 7 cases, pancreatic fistula in 5 cases, no cases need re-operation, no mortality. Conclusion: The rate of intraopertative incidence was 23.4%; complications after surgery 14.9%. No case of re-operation or mortality in the study. Factors such as tumor size, tumor location, tumor characteristic did not help assess the possibility of preserving the splenic vessels in of distal pancreatectomy with splenic preservation.

MANAGEMENT OF POSTOPERATIVE PERITONITIS IN LOW-RESOURCES SERVICES

Background. Postoperative peritonitis (PP) reminds one of the most difficult complications in abdominal surgery with mortality rate 22.3 – 90 %. Methods. In Ivano-Frankivsk Regional (tertiary level) Clinical Hospital (Ivano-Frankivsk, Ukraine) during 2010–2017 were operated 8762 patients with acute and chronic diseases of digestive system (appendicitis, pancreatitis, cholecystitis, bowel obstruction, complicated ulcer of upper gastrointestinal truck, mesenteric vessels thrombosis, abdominal adhesion diseases, hernia, Chron’s diseases, abdominal trauma), among them in 209 (2.4 %) patients developed PP. Local PP (abscess of abdominal cavity) had 142 (67.9 %), diffuse PP – 67 (42.1 %) patients. Results. Clear local symptoms of peritonitis were absent in 178 (85.1 %) of 209 patients. General complication, such as acute respiratory failure had 95 (45.5 %), cardiovascular insufficiency – 68 (32.5 %), hepato-renal dysfunction - 46 (22 %) patients with PP. 129 (61.7 %) patients were treated by minimally invasive approach: 24 patients had laparoscopic lavage with drain of abdominal cavity abscess and 105 - ultrasound guided drain of abscess with catheter. 80 (38.3 %) patients had re-laparotomy (RL): 61 (91 %) from 67 with diffuse PP, 19 (13.4 %) from 142 patients – with local PP. 46 (57.5 %) patients underwent one RL, 26 (32.5 %) – two, 8 (10 %) patients – three RL. With increasing numbers of RL, increase mortality rate: after first RL died 7 (15.2 %) of 46 patients, after second RL – 12 (63.2 %) of 19, after third RL 6 (75 %) of 8 patients. Conclusions. Together with standard surgical methods and precise technique were used lavage of abdominal cavity with 8 – 12 litres of antiseptic solutions, solution for peritoneal dialysis intraabdominally, nasointestinal drain tube, what was favourable for faster treatment of abdominal sepsis, reducing number of RL and postoperative mortality.

The Role of GDC Embolization as a Second Choice in the Treatment of Ruptured Cerebral Aneurysm

We investigated the role of GDC embolization as a second choice for the treatment of ruptured cerebral aneurysm. From september 1997 to may 2001, 139 ruptured aneurysms out of 151 consecutive ruptured aneurysms transferred to our hospital were treated by clipping (first choice) or GDC embolization (second choice). Patient selection was decided by more than two neurosurgeons under the policy that GDC embolization is the second choice of treatment. The mid-term (longer than three months) outcome of both group was examined. One hundred and nineteen Ans (BA two, IC-paraclinoid one, IC-PC or IC-Ach 36, IC-ant. Wall two, ACoA34, ACA six, MCA38) were treated by clipping (clipping group), 20 Ans (surgical difficulty; BA three, IC-paraclinoid three, VA dissection six, general complications; IC-PC two, IC-dissection one, ACoA four, VAPICA one) by GDC embolization (GDC group) within 24 hours after admission. SAH grade and GOS of each group were Gr1: 35&4, Gr2: 41&5, Gr3: 23&5, Gr4: 11&4, Gr5: 9&2, respectively, and GR: 79&14, MD: 8&3, SD: 11&0, VS: 8&0, D: 13&3 respectively. Good prognosis (better than MD) was gained in 73% of clipping group and 85% of GDC group. No rebleeding was seen in GDC group. GDC embolization for the cases with surgical difficulty or general complication raised the overall outcome. GDC embolization would be suitable for IC-paraclinoid Ans, BA-VA Ans, and ruptured VA dissections. Because of the good clinical outcome gained in the GDC group, GDC treatment would be the first choice of treatment for such aneurysms as geometrically suitable for coiling.

Quantitative Review of Operative and Nonoperative Management of Achilles Tendon Ruptures

Background There is no consensus on the best method for management of acute Achilles tendon ruptures. Individual preferences, drawn from experience and study, determine whether treatment is operative or nonoperative. Purpose Our goal was to review the literature to try to determine what management method was the most popular and effective. We wanted to ascertain the best results in terms of complication rates and patient outcomes. Study Design Retrospective review of retrospectively and prospectively collected data. Methods We analyzed 125 articles in peer-reviewed journals for year of publication, patient numbers, sex, management method, follow-up complications, and patient satisfaction. Each article was graded using a validated methods score. Methods, patient satisfaction, and complication rates were correlated with the year each article was published. Results Skin-healing complications were lowest in conservatively managed patients (3 of 578, 0.5%) and highest in open repair and immobilized patients (543 of 3718, 14.6%). General complication rates were lowest in open repair and early-mobilization groups (16 of 238, 6.7%) and highest in percutaneous and early-mobilization groups (19 of 122, 15.6%). Rerupture rates were highest in immobilized conservative management groups (62 of 578, 10.7%) and lowest in groups with external fixation (0%). Conclusions In general, the number of publications reporting Achilles tendon ruptures is increasing, the quality of articles is increasing, and the trend for the number of reported complications is decreasing. The published articles had a low methods score (mean, 50.9; range, 25 to 77) and showed a trend toward earlier mobilization. Open repair and early mobilization give the best functional recovery and an acceptable complication rate.

Intraoperativne i postoperativne komplikacije splenektomije

Spleen is being surgically removed because of trauma, in diagnostic and-or therapeutical purposes because of the benignant and malignant diseases. The percentage of morbidity during and after splenectomy is relatively low. During surgery might occur bleeding, trauma of the pancreatic tail, stomach, lineal flexure of the colon, left hemidiafragm, left suprarenal gland and upper pole of the left kidney, which must be correspondingly reclaimed during the same intervention. In the early postoperative period, postoperative bleeding, subfrenic abscess, pulmonal atelectasis, bronchopneumonia and left pleural extravasations might occur. Especially is important notification of these events in due time and adequate conservative and surgical treatment. After splenectomy, there is an increase of the number of trombocytes, which might lead to the tromboembolic complications. In the prevention of these complications in the postoperative period prolonged antiagregation therapy is suggested. Postsplenectomy sepsis is very late, general complication of splenectomy, which occurs because of the lower immunity in the child age. To prevent these complications, partial splenectomies, reimplantations of the spleen, prolonged application of the penicillin medicines after splenectomy and antipneumococcal vaccine are performed.