Amelanotic melanoma of the skin – detailed review of the problem

BackgroundMalignant melanoma (MM) of the skin accounts for about one per cent of all malignancies in humans. Amelanotic melanoma is a rare tumour, diagnosed in eight per cent of all melanomas.AimsThe study aimed to analyse our clinical experience with amelanotic MM of the skin and the statistical data from a retrospective five year analysis of pigmented and amelanotic types of skin melanoma. Furthermore, we compare our results to those from other teams' studies. To reach the corresponding in-depth conclusions.MethodsThe study included 151 patients with malignant melanoma of the skin, diagnosed and treated at Dr. Georgi Stranski University in Pleven, Bulgaria, between 2012 and 2016. All the patients signed informed consent forms.ResultsOf the 151 patients we studied, 14 (9.3 per cent) were diagnosed with amelanotic melanoma. The average Breslow thickness in patients with amelanotic MM was 4.2mm, while in pigmented MM patients it 2.1mm. Local recurrence rates (35.7 per cent) were higher in patients with amelanotic melanoma. Distant metastases were found in 39 of all tested patients with melanoma. Of the 14 patients with amelanotic MM, eight had such metastases.ConclusionAmelanotic melanoma was diagnosed too late. Local recurrences were six times as many as the ones diagnosed in pigment melanoma. Distant metastases were twice as many, and mortality rates were three times higher

Definitive treatment of a basal cell carcinoma on the upper lip through the oral administration of Vismodegib

Basal cell carcinoma is the most common malignant neoplasm of the skin of the face in old, caucasian humans. The tumour growth slow and rarely has metastases. The clinical presentation is different. The main method for treating is radical surgical excision, but if the tumour is very big or there are metastases, there is a very effective target therapy with the peroral capsules Vismodegib 150mg. In this case we introduce a patient whit cancer of upper lip of preoperative target therapy whit Vismodegib 150mg, which destroy the tumour cells and help us to make cosmetic surgical excision

BIOCENOTIC HETEROGENEITY IN ANTHROPOZOONOSIS FOR EGGS - TRIMODULATE ECOTECHNICAL AGROCENOSIS FOR EFFECTIVE USE OF MANURE

There are three models of detritus chains that reproduce the technology for processing manure applied in practice for utilization of fertilizer from hens that were raised with floor adherence to the technological standards: biotechnological chain for anaerobic degradation of fertilizer (AR); for controlled aerobic degradation (composting, K) and installation of a plant that carries out processes of extensive aerobic degradation, and there is also reproduction of good farming practices (GFP) which include the creation of conditions for uncontrolled aeration for the duration of 180 days. It is established that the AR combines to a maximal degree, environmental priorities with economic priorities as there is the production of a gas fuel and a biosludge, which exists in its highest value as a fertilizer. A modified mathematical model is proposed to optimize the technological parameters of AR. In order to obtain optimal concentration (7-8%) to achieve maximum environmental efficiency (criteria R - maximum degree of degradation of organic matter in fertilizer), a sevenfold dilution of the substrate in water is required. Seven times the amount of product (biosludge) with a relatively low dry matter content- 4.08 %, is obtained.The possibility of separating the biosludge has been studied. The liquid phase, which contains 65% of the dry matter, is found to include 60% of the organic matter and forms the predominant part of the biogenic elements: 87% of the nitrogen, in point, and 92% of the ammonium ions; 90% of the potassium, 74% of the magnesium and 79% of the calcium. More than a 1/3 of the dry matter (35%) and 40% of the organic matter remain in the solid phase, but its content of the plant-based macronutrients is much lower: for nitrogen- 13%, for phosphorus- 24%, for potassium- 10%, for magnesium- 26% and for calcium- 21%.About 20% of the energy generated as biogas is consumed for the separation and granulation of the solid fraction. To improve energy efficiency, proposed is the creation of a three-module ecotechnical system for efficient utilization of biosludge, by depositing in the soil of the agrocenosis for feed production by the method of Petrov et al (1981) every 10 months yearly and separating the biosludge during the other two months, through which soil tillage is impossible due to meteorological conditions. During this period, the liquid phase is stored in cement reservoirs and separation is managed appropriately to avoid sedimentation of the solid phase of the biosludge during storage.</jats:p

ECOLOGICAL RISK ASSESSMENT OF LEAD AND CADMIUM CONTENT IN EGGS FOUND IN ECOTECHNOLOGICAL SYSTEMS

Lead and cadmium studies have been conducted in the egg eco-system trophic chain, which is a continuation study on the chemical heterogeneity of the biosphere, assessed at the ecosystem level. For the realization of the ecologilization, a two-module model of an eco-technical system for production of eggs with models of the two main types of trophic chains is proposed: pasture and detritus type.The main product of the linearity of the technological processes in livestock breeding is fertilizer. From the point of view of efficient management of eco-technical systems to minimize environmental risk, the ecological assessment of the fertilizer for the purpose of its utilization is appropriate. It belongs to the Odum Classification Conglomerates I (1975), which includes organic substances that are potentials of nutrients and energy, and should be utilized as resources for recipients in agro-ecological or aquatic ecosystems. The fertilizer is materially different from other products under this group due to the large number of pathogenic microorganisms. Organic substances in the fertilizer are a risk factor due to the emission of greenhouse gases and toxic substances to the atmosphere and pathogenic microorganisms are biological pollutants with high risk potential due to the risk of it causing human and animal diseases.Our research has focused on the quality of products used for human food and the particularities of the movement of matter in eco-technical systems (Baykov, 1994, Baykov &amp; Tyrawska, 1991, Baykov et al., 1996, Baykov et al. 2003). The experiments were carried out in models of eco-technical systems for eggs on the scale of "mesocosmos" via classification of Odum (1986) by analyzing the physicochemical indicators of the two elements of the incoming stream: feedstock and drinking water and an assessment of the chemical heterogeneity at the ecosystem level was performed by analyzing and hygienically assessing the physical characteristics of products used for human food.Proposed, are criteria for assessing the ecological risk of chemical heterogeneity at ecosystem level: eco-technical Clark (Ec), Clark of safety (Cs), Clark of concentrating (Cc) and Clark of technology (Ct). The results show the possibility of assessing environmental risk through the Cs criterion applied to mass of the egg/ feedstock /and for the processed manure. The ecological risk is managed through the Cs and Ct criteria by regulating the amount of toxic factors in the input stream to guarantee safe for human health secondary biological production.</jats:p

BIOCENOTIC HETEROGENEITY IN ANTHROPOZOOCENOSES FOR EGGS. ASSESSMENT OF THE ENVIRONMENTAL RISK

The biosphere and ecosystems are characterized by energy, chemical and spatial heterogeneity. To assess the effectiveness of anthropogenic activity in the transformation of a natural environment into an eco-technical system for eggs, the criterion of "biocenotic heterogeneity" is proposed which connects the said heterogeneities and is therefore considered to be integral.When biosynthesis is formed in eco-technical systems, a characteristic feature is the continuity of the production process, which requires anthropogenic formation of a new type of trophic chain. The lack of autotrophic organisms in biosynthesis and the transformation of the ecotope from a source of food resources (as in natural ecosystems) into a habitat of the economically useful population is the cause of the torn circle of matter in the eco-systems of egg, meat or milk production. The break of the matter circle is at 4 points: the introduction of biogenic elements and energy with the ration, which includes components derived from ecotopes geographically remote from the ecotechnical system; in drinking water, which also occurs in many farms from a geographically remote ecotope; in the export of the secondary organic production used for human food; in the disposal of organic waste /manure, animal bodies, etc./. The lack of biopotentials of a bioreduction unit forces the resulting waste biomass to be removed from the ecotope.Two-component mesocosmos model has been applied to modeling the eco-technical system for eggs, and studies have been conducted with 5 lines of laying hеns. The increase in biocenotic heterogeneity has led to a hundredfold increase in bio-productivity at the primary bio-consumers level, with the ability to manage the quality of the produced produce. the environmental risk is increased as it stems from the linearity of the technological processes, which results in organic manure. The manure is a prominent risk factor, so this is the reason to make a risk assessment of his storage for 180-days. There are greenhouse gases and nitrogen emission. The environmental risk is also due to pathogenic microorganisms in the manure. In the fresh manure the microbial landscape is as follows: total number – 2.8.1010; Cl. perfringens – 3.9.103; E. coli -6.1.104 and Enterococcus - 2.2.108.. When we have a storage of manure for 180 days, we do not have a microbial decontamination. The changes in a number of hygiene indicator microorganisms in the manure (calculated on a dry matter basis) are as fallow: increase of total number with 336%; Cl. perfringens –with 564%, E. coli - with 180,3% and reducing of microorganisms of the genus. Enterococcus – with 66,4%.</jats:p

BIOCENOTIC HETEROGENEITY IN ANTHROPOZOONOSIS FOR EGGS - ECOTECHNOLOGICAL CHAINS OF DETRITY TYPE FOR THE LIMITING OF LINEARITY OF TECHNOLOGIES

Experiments have been conducted that looked into the transformed ecotope in eggs that have undergone anthropozoonosis, in which there was introduced, a group of age matched, biomass and health ascribed status of birds of species of Gallus gallus category laying hens, breed ISA-Brough (ISA-Brown) at 18 weeks of age, 5 lines aligned for age, and grown for 300 days.Involved are 3 models of detritus trophic chain, which are trophotechnological, and also are representative of reproducing technologies for the processing of manure on the basis of the degradation of organic substances used in practice: biotechnological chain for anaerobic degradation of fertilizer (AR); biotechnology for controlled aerobic degradation (composting) (K), and detrital technological chain for extensive aerobic degradation, replicating good farming practices (DFP), which include the creation of conditions for uncontrolled aeration for duration of 180 days.Aerobic technologies use open technology systems with free (DFP) or regulated (K) atmospheric air flow. Providing aerobic conditions is related to the release of some of the biogenic elements in the manure as gaseous products that pollute the atmosphere. The nitrogen is partially released in the form of ammonia (under the simulated/modeled conditions, the amount of ammonia reaches 20 ppm). For this reason, there is a redistribution compared to the outputted raw material: the content of nitrogen in the standing fertilizer (DFP) is 74.6%, in the compost - 94%, in AR the amount is 135%. The dynamics of the other investigated macronutrients listed in Table 1 are analogous to this. Redistribution of toxic elements is also established (Table 2). Regardless of the differences in their dynamics, in all three technologies of processing, the content of toxic elements is regulated as acceptable levels for application and use in soil, with the exception of zinc, which has a low toxicity. A modified mathematical model is proposed to optimize the technological parameters of AR. Organic fertilizer with a dry matter content of 48.16% is introduced at the entrance to the system with AR. In order to obtain optimal concentration (7-8%) for maximum ecological efficiency (criteria R – which is the maximum degree of degradation of organic matter in the fertilizer), a sevenfold dilution of the substrate is required. A sevenfold increase in product (biosludge) with a relatively low dry matter content of 4.08% is obtained.</jats:p

ASSESSMENT OF THE ENVIRONMENTAL RISK DUE TO MODIFICATION IN THE NITROGEN CIRCUMROTATION ECO-TECHNICAL SYSTEM FOR EGGS

At the end of the 19th century Clarke (evidenced by Dobrovolskiy, 1990) finds that the lithosphere is chemically inhomogeneous, and Vernadsky (1923) proves that the chemical inhomogeneity is typical for the entire biosphere. When studying the eco-technical systems for eggs and meat the “Clarke of concentration” criterion has been applied to describe the movement of toxic elements in the following unit of the trophic chain: bioproducers /fodder + water/ - primary bioconsumers /poultry and their production/ /Baykov, B.,1987, Baykov &amp; Tyrawska, 1991, Baykov, B.,1994. Baykov et al., 1996/Trials are carried out in an integrated two-module model of an eco-technical system for egg production. The two main types of trophic chains are modelled: pasture type and detritus type. Insufficiently effective use of nitric compounds from the ration for synthesis of specific egg whites is found.Concentration of total nitrogen in the manure, as well as high content of non-protein nitric, nitrite and ammonium nitrogen is proved in comparison with the amounts at the system inlet.The consequences of this distribution in the two products of the outflow /egg mass and manure/ for the human health and ecosystems are studied. The content of toxic non-protein compounds of nitrogen in the egg mass used as human food resource is below the admissible values in accordance with the EC Regulation on foods, and therefore the assessment shows that there is no direct risk for the human health.The indirect ecological risk related to the consequences from the linearity of technologies is significant: obtaining of manure with high content of nitric compounds, which are changed for all the three modelled technologies for manure use by increasing the non-protein nitrogen. Significant nitrogen losses are found in the two trial aerobic technologies for manure processing.It is most ecologically feasible to process manure in industrial biogas installation that ensures conditions for intensive and controlled anaerobic decomposition, where biogenic elements are fully preserved, where no greenhouse gas emissions are observed, and where, in addition to biosludge, which is an alternative of the highly energy consuming mineral manures, gas fuel is generated /biogas/.</jats:p

RISK ASSESSMENT IN DOG FOOD PROCESSING

We conduct a comparative study that includes an analysis of three different types of dog foods processing – dry-extruded, wet and raw ones.Our aim was to compare the technological stages of these three three different types of dog foods processing and to analyze the Critical Control Points and risk factors throughout the production cycles.The Critical Control Points at the production cycles in three types of dog food were analyzed. A risk assessment of the food production stages with a view to their safety by comparison of the shelf life of different types of dog food has been carried out using the principles of the Hazard Analysis and Critical Control Point (HACCP) system as adopted by the Codex Alimentarius.The technological processes used in the production of different types of dog food have their own advantages and disadvantages. Critical Control Points are identified in the first and second production technologies, the first one being in the heat treatment (cooking and drying), and the second is one in the sterilization stage. With the latest technology (raw food), CCP have not been analyzed, despite the presence of biological hazards, the appearance of which is prevented from GMP compliance. Good Manufacture Practices (GMP) also apply to other production processes under Regulation (EC) № 1069/2009 and the Bulgarian Feed Law, although CCP have been established at certain stages of production.Future studies in this area should enrich the information related to the technological processes and the assessment of the risk analysis according to the modification of the normative requirements of the European and national legislation.</jats:p