Сукупність показників та критеріїв оцінювання рівня технічної досконалості колективних засобів захисту органів дихання

Мета роботи: удосконалити сукупність показників та критеріїв для оцінювання рівня технічної досконалості колективних засобів захисту органів дихання. Метод: факторний аналіз та метод ранжирування. Результати дослідження: удосконалена сукупність показників та критеріїв для оцінювання рівня технічної досконалості колективних засобів захисту органів дихання. Теоретична цінність дослідження: набула подальшого розвитку сукупність показників та критеріїв оцінювання рівня технічної досконалості засобів колективного захисту органів дихання, на відміну від існуючих, дозволяє більш повно врахувати множину цілей організаційно технічних процесів їх функціонування

Identifizierung und Charakterisierung von peripheren Membranproteinen der Zymogengranula des exokrinen Pankreas der Ratte durch subgranuläre Proteomanalyse

Das exokrine Pankreas ist eine tubuloazinöse Drüse, deren Azinuszellen die Verdauungsenzyme (Zymogene) synthetisieren, in Zymogengranula sortieren und reguliert sezernieren. Die Zymogengranula werden am Trans-Golgi-Netzwerk (TGN) gebildet, wobei nur wenige Informationen über die spezifische Interaktion der Zymogenaggregate mit der Membran des TGN vorliegen. Fehler bei der Zymogensortierung und –inaktivierung können zu proteolytischen Prozessen innerhalb der Azinuszellen und nachfolgend zu schwerwiegenden klinischen Krankheitsbildern beitragen. Kenntnisse über den molekularen Aufbau der Granulamembran sowie die Art und Funktion der Membranproteine der Zymogengranula sind daher sowohl von zellbiologischer als auch klinischer bzw. therapeutischer Bedeutung. Die Proteine der Wash-Fraktion (= periphere Membranproteine) ergeben nach 2D-gelelektrophoretischer Auftrennung ein charakteristisches und reproduzierbares Proteinspotmuster, das sich vom Verteilungsmuster anderer Granulasubfraktionen unterscheidet, und lassen sich in eine saure und eine basische Proteingruppe einteilen. Insgesamt wurden 103 reproduzierbare Proteinspots mehrfach analysiert. Von den Proteinen der sauren Gruppe konnten bisher 39% identifiziert werden, was vermutlich auf posttranslationale Modifikationen zurückzuführen ist. Durch Glykostaining-Methoden konnte ich nachweisen, dass die Proteine der sauren Gruppe im Gegensatz zu denen der basischen glykosyliert sind. Zu den identifizierten Proteinen gehören typische Inhaltsproteine der Zymogengranula (z. B. RNAse A) (24%), ein großer Anteil lipidbindender Proteine (41%) sowie periphere Membranproteine der Zymogengranula (16%) (z. B. Annexin IVa, das Ezrin-Radixin-Moesin-(ERM)-binding phosphoprotein, Syncollin, das sekretorische Lektin ZG16p). Der große Anteil lipidbindender Proteine innerhalb dieser Fraktion erklärt sich vermutlich durch die Affinität dieser Proteine zu Membranlipiden, das Auftreten von Inhaltsproteinen der Zymogengranula innerhalb der Wash-Fraktion könnte durch die Interaktion mit der postulierten submembranösen Matrix zustande kommen. Einige der identifizierten Proteine sind mitochondrialen Ursprungs (11%) und stellen Untereinheiten von ATP-Synthase und Cytochrom-c-Oxidase dar, die auch andere Arbeitsgruppen identifizierten. Aber auch Proteine, die bisher nicht in ZG beschrieben wurden, konnten identifiziert werden. Hierzu gehört die Peptidyl-Prolyl-cis/trans-Isomerase B (PPIB), ein klassisches ER-ständiges Protein, sowie die Chymase (RMCP-1), eine mastzellspezifische Serin-Protease, die beide der basischen Gruppe zugeordnet werden. Verschiedene identifizierte Proteine wurden näher charakterisiert. Durch Einsatz spezifischer Antikörper konnte die mastzellspezifische Chymase (RMCP-1) im 2D-Immunoblot sowie nach Granulasubfraktionierung eindeutig als peripheres Membranprotein der Zymogengranula nachgewiesen werden. Andere mastzellspezifische Proteine (z. B. Tryptase) wurden in den Granulafraktionen nicht detektiert. Quantitative PCR-Studien zeigten für die Chymase eine Abhängigkeit der Transkriptionsrate vom Fütterungsverhalten der Tiere. Morphologische Studien wiesen die Chymase auf histologischer als auch elektronenmikroskopischer Ebene als Zymogengranula-assoziiertes Protein aus. Die Chymase wird nicht in AR42J-Zellen, einem exokrinen Modellsystem, exprimiert. Nach Transfektion dieser Zellen mit einem geeigneten Chymasekonstrukt zeigte sich in der Immunfluoreszenz eine Sortierung der exprimierten Chymase in Zymogengranula der AR42J-Zellen. Durch spezifische Antikörper konnte ich auch die PPIB eindeutig im 2D-Immunoblot der Wash-Fraktion und nach Granulasubfraktionierung in den Membranfraktionen detektieren. Andere ER-residente Chaperone wurden kaum bzw. nicht in den Zymogengranulafraktionen identifiziert. Quantitative PCR-Studien wiesen auch für die PPIB im exokrinen Pankreas eine Abhängigkeit der Transkriptionsrate vom Fütterungsverhalten der Tiere nach, was die Ergebnisse der Lokalisationsstudien stützt. Eine potentielle Funktion der granulären PPIB könnte in der Aufrechterhaltung der Konformation bestimmter Verdauungsenzyme liegen. Dies könnte Einfluß auf die autokatalytische Aktivierung dieser Enzyme haben. Eine weitere Funktion könnte in der Sortierung der Zymogene liegen. Interessanterweise können die in dieser Arbeit näher charakterisierten Proteine (Chymase, PPIB, CEL und RNAse A) alle potentiell mit Proteoglykanen interagieren und stützen durch ihre starke Assoziation mit der Zymogengranulamembran die Hypothese der submembranösen Granulamatrix. Der Fokus nachfolgender Experimente soll auf der weiteren Identifizierung neuer Komponenten dieser Matrix sowie in der funktionellen Analyse der im Rahmen dieser Arbeit analysierten Proteine liegen

Reconstruction of the contact point with the palodent V3 system.

Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. The contact point has a very important role in protecting the interdental papillae; it spreads uniformly the masticatory pressure that is developed during the mastication act. Aim of the study. To achieve a three-dimensional restoration of the proximal surface with punctiform contact. Materials and methods. The study was based on the use of matrices with anatomical relief from the Palodent V3 system, with the control of matrix adherence at the cervical and lateral sides on clinical simulators. Reconstruction of the contact point on the clinical simulators was performed by the direct method, using atraumatic pins, anatomic relief matrices and strong Ni-Ti rings. The titanium nickel rings are long lasting, surpassing the stainless steel rings. The strength of the ring retainer improves the retention in the tooth. Rings and wedges can overlap and work well in complicated class II restorations, such as those with a missing cusp. The matrices, wedges and protection wedges are anatomically designed to provide a better seal and narrower contacts. Results. The Palodent V3 system components work together to seal and shape the restoration, minimizing the required time to finish it, as well as the possibility to re-do the restoration due to a poor contact. The system can be configured for multiple restorations at once, and the WedgeGuard provides added efficiency by protecting the adjacent tooth, allowing the clinician to prepare the cavity without complications. The tines on the rings help to provide excellent retention on the tooth and the system seals the restoration to minimize the amount of finishing required. It was noticed that adapting the wedges to the matrix leads to firm gingival closure and firm predictable contacts. The narrow rings adapt the matrix to the lateral teeth and enlarge the interdental space at the micron level. Conclusions. The use of the Palodent V3 system allows us to get a predictable, easy and fast result

Lymphadenectomy in the surgical management of the malignant gastric tumors

Scopul lucrării. Tumorile gastrice de-a lungul anilor rămân o provocare chirurgicală nu numai în Republica Moldova, dar și la nivelul mondial. Tratamentul chirurgical pe tot parcursul evoluției rămâne o metodă principală, evoluând de la unica posibilitate de tratament la o etapă de abordare multidisciplinară. În clinica chirurgie 2 s-a schimbat și tactica chirurgicală, de la rezecție gastrică simpla la gastrectomii totale sau subtotale asociate cu limfodisectie extinse, metastazectomii sau rezecții multiviscerale. Pentru a atinge principalul scop în tratamentul CG, prelungirea supraviețuirii generale a acestor pacienți, s-a adoptat o abordare chirurgicală agresivă pentru obținerea eventualii rezecabilități oncologice. Materiale și metode. Retrospectiv s-au analizat 386 pacienți internați în clinica chirurgie 2 pe parcursul anilor 2000-2019 cu diagnosticul de CG. 316 (81,9%) au fost supuși tratamentului potențial curativ (rezecție chirurgicală), iar alții 94 (18,1%) au beneficiat doar de tratament paliativ. Rezultate. Complicațiile CG (hemoragii profuze, perforații cu peritonită) au fost motivul de intervenții chirurgicale pe indicații vitale în 29 cazuri. Spectrul de intervenții chirurgicale programate: disecție submucoasă a CG în stadiul Tis, T1, gastrectomii totale sau subtotale asociate cu limfadenectomie D1, D2, D3, gastrectomii asociate cu metastazectomii hepatice, pancreatectomie distală și/ sau splenectomie, rezecții pluriviscerale în CG cu invazie în organe vecine. Ca rezultat am obținut morbiditatea postoperatorie 16%, mortalitatea 2%. Supraviețuirea generală la 5 ani în toate stadiile 37%. Supraviețuirea generală la pacienții în stadiul II și III după limfadenectomie D1, D2 și D3 este 38%, 44% și 45% corespunzător. Pacienți operați în stadiul IV local avansat au o supraviețuire similară de 28-30% în toate modalitățile de limfadenectomie. La fel rezecția R0 oferă o supraviețuire generală la 5 ani și supraviețuire fără recidivă mai lungă în stadiul II, III (41%) vs R1(34%) și nu prezintă diferență în stadiul IV local avansat (28%). Concluzii. Paralel cu evoluția tratamentului adjuvant s-a schimbat și atitudinea chirurgicală față de cancerul gastric CG. Studiile clinice și evoluțiile tehnice moderne au facilitat puternic utilizarea unei abordări multimodale în tratamentul CG. Abordarea chirurgicală este diversă de la intervenții endoscopice minim invazive până la gastrectomii totale cu limfodisectii extinse și rezecții pluriviscerale. Gastrectomiile asociate cu limfadenectomie D2 a devenit operație standard în orice stadiu al CG.Aim of study. Gastric cancer (GC) over the years remains a surgical challenge not only in the Republic of Moldova, but also in the world. Surgical treatment throughout evolution remains a major method, evolving from the unique treatment option to a multidisciplinary approach. Over the years, Surgery Clinic 2 has also changed surgical tactics, from simple gastric resection to total gastrectomies or subtotal gastrectomies associated with extensive lymphodissection, metastasectomy, or multivisceral resections. In order to achieve the main goal in the treatment of GC, to prolong the overall survival of these patients, an aggressive surgical approach was adopted to obtain eventual oncological resection. Materials and methods. We analyzed 386 patients admitted to Surgery 2 clinic during the years 2000-2019 with the diagnosis of GC. Out of which 316 (81.9%) were subjected to the potential curative treatment (surgical resection), 94 (18.1%) benefited only from palliative treatment. Results. Complications of gastric cancer (profuse haemorrhage, perforation with peritonitis) have been the cause of vital signs surgery in 29 cases. The spectrum of surgery: submucosal dissection of GC in stage Tis, T1, total or subtotal gastrectomy associated with lymphadenectomy D1, D2, D3, gastrectomy associated with hepatic metastasectomy, distal pancreatectomy and/or splenectomy, plurivisceral resections in gastric cancer with invasion in adjacent organs. Postoperative morbidity 16%, 2% mortality. Overall survival at 5 years at all stages 37%. Overall survival in Stage II and III patients after D1, D2 and D3 lymphadenectomy is 38%, 44% and 45%. Patients operated in the locally advanced stage IV have similar survival rates of 28-30% in all lymphadenectomy modalities. Similarly, R0 resection provides overall 5-year survival and recurrence free survival in Stage II, III (41%) versus R1 (34%) and no difference in locally advanced stage IV (28%). Conclusions. With the progression of adjuvant treatment, surgical attitude for GC has also changed. Clinical studies and modern technical developments have greatly facilitated the use of a multimodal approach to the treatment of gastric cancer. The surgical approach is varied from minimally invasive endoscopic interventions to total gastrectomies with extensive lymphadenectomy and plurivisceral resections. Gastrectomy associated with D2 lymphadenectomy has become standard surgery in any stage of GC

Pressure Reducing Valve Characterization for Pipe System Management

Abstract Pressure control strategy through Pressure Reducing Valves (PRVs) has been deeply investigated as management strategy, aimed at water leakage reduction avoiding very expensive pipe replacement programmes. On the contrary, few experimental data are available in literature, particularly in unsteady-state conditions. In this paper, the results of some tests carried out at the Water Engineering Laboratory of the University of Perugia (I) in order to characterize a PRV with two set points for high and low pressures are presented. The PRV is installed in a single high-density polyethylene (HDPE) pipe supplied by a tank in which the pressure is assured by pumps of different characteristics. Two types of tests are considered: steady-state tests, to characterize the PRV, and extended period tests, to check its dynamic behaviour

Hydraulic characterization and transient response of pressure reducing valves: laboratory experiments

Abstract A pressure reducing valve (PRV) regulates the outlet pressure regardless of the fluctuating flow and varying inlet pressure, thereby reducing leakage and mitigating the stress on the downstream water distribution network (WDN). Notwithstanding the crucial importance of PRVs, few experimental data are available in the literature. The aim of this paper is to overcome this gap by means of the results of a large number of tests carried out at the Water Engineering Laboratory of the University of Perugia, Italy. These tests have been executed on a standard type of PRV in steady-state conditions, to characterize it, and in unsteady-state conditions, to check its transient response. A broad range of laboratory conditions simulating possible events in WDNs has been examined and both short and long duration monitoring have been carried out. The analysis of the tests demonstrates the versatility of PRVs as a powerful tool for pressure management, and also when the flow condition changes according to the users' demand pattern. In fact, their transient response is appropriate with small pressure oscillations generated by the PRV self-adjustment. Moreover, proper PRV modelling has to include both its mechanical behaviour and the characteristics of the pressure pipe system in which it is installed

Transient Effects of Self-adjustment of Pressure Reducing Valves

AbstractPressure control strategy through Pressure Reducing Valves (PRV) has been deeply investigated as management strategy, aimed at water leakages reduction avoiding very expensive pipe replacement programs. On the contrary, few experimental data are available in literature, with regard to PRV transient behavior in terms of its response to incoming pressure waves, as well as the time required for achieving the pressure set point. In this paper, the results of some experimental tests are presented. The PRV is installed in a single high density polyethylene pipe and transients are generated by operating the downstream end valve. Two types of tests are considered: a partial valve closure and opening simulating a water demand decrease and increase, respectively. The analysis of the experimental pressure traces points out the valuable effects of the PRV on transient characteristics with respect to the case of a partially closed in-line valve with a constant opening degree

Microtest system for rapid microbiological diagnosis of candidal vulvovaginitis

Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Opportunistic infections of mycotic etiology are included in the group of new infectious diseases, and their proportion is higher in the framework of infectious diseases, especially, in the context of the misuse of antibiotics synthesis. Material and methods: 72 samples, collected from women with various gynecological diseases have been examined. In 41 cases the fungi with Candida spp. have been detected. Results: The nutrient, which allows a rapid detection of fungus Candida spp. has been developed. For the first time has been developed a nutrient medium of a new culture in the form of a micro film for isolation, multiplication and a rapid identification of yeast form fungi of Candida species, which allows to detect the microbes beginning from the time of 4-5 hours to 9-24 hours depending on their initial concentration in 1 ml; individual cells need more than 9-24 hours and the concentrations of 103 -104 c.m./ml are detected within 4-5 hours of the incubation period at the temperature of 370 C and higher. The medium MDC-Cand has a selectivity, mainly for yeast form fungi of Candida species. Conclusion: This nutrient medium is sensitive, economical and simple for the usage in microbiological laboratories of various levels. The period of storage of the medium is 2 years

Développement d'un capteur colorimétrique innovant pour la détection directe du phénol dans l'air et dans l'eau

International audienc

Benign obstructive pathology of extrahepatic biliary ducts: diagnosis and treatment

Catedra Chirurgie nr.2, USMF ”Nicolae Testemiţanu”, LCŞ “Chirurgia reconstructivă a tractului digestiv”, Spitalul Clinic Republican, Secţia Endoscopie, Spitalul Internaţional “Medpark”, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Tratamentul de elecţie în patologia benignă a căilor biliare extrahepatice (CBE): stenoza papilei duodenale mari (PDM), stricturi ale căii biliare principale (CBP), colangite, coledocolitiaza pe fondalul malrotaţiei duodenale (MRD) asociată cu duodenostază, este chirurgical. Metodele endoscopice: colangiopancreatografia retrogradă endoscopică (CPGRE), papilosfincterotomia endoscopică (PSTE) cu sau fără litextracţie permit stabilirea diagnosticului de patologie a CBE şi selectarea tratamentului potrivit. Scopul studiului: Optimizarea tratamentului chirurgical al pacienţilor cu patologie benignă a CBE pe fondal de MRD asociată cu duodenostază. Material şi metode: Lotul de cercetare – 140 pacienţi selectaţi în perioada 1998-2014. Toţi au fost examinaţi conform algoritmului diagnostic stabilit în Clinica Chirurgie nr.2. Apreciate clinic trei grade ale duodenostazei: compensată, subcompensată, decompensată. Rezultate: Tratamentul chirurgical a fost bazat pe principii etiopatogenetice în funcţie de gradele clinice. I – Stricturile PDM și duodenostază compensată – CPGRE+PSTE – 130 pacienţi (92,8%); II – Stricturile PDM + coledocolitiază + angiocolită şi duodenostază subcompensată – CPGRE + PSTE + litextracţie + sanarea CBE cu terapie medicamentoasă complexă – 98 pacienţi (70,0%); III – Megalocoledoc şi duodenostază decompensată – transecţie supraduodenală de CBP cu implantarea ei în ansa jejunală în ”Y a la Roux”, cu o lungime optimă a ansei de 80 cm – 12 pacienţi (8,57%). Concluzii: Metoda tratamentului chirurgical aplicat depinde de gravitatea patologiei CBE şi stadializarea duodenostazei. Eficienţa acestui tratament chirurgical este determinată de dispariţia semnelor clinice de colangită cronică, cu rezultate bune în perioada postoperatorie – 131 (93,57%) pacienţi, ce au fost reintegraţi socio-familial şi profesional.Introduction: The elective treatment in the pathology of extrahepatic biliary ducts (EBD): stenosis of large duodenal papilla (LDP), stricture of the main biliary duct (MBD), cholangitis, coledocholithiasis on the background of duodenal malrotation (DMR) associated with duodenostasis is a surgical one. Endoscopic methods: endoscopic retrograde cholecistopancreatography (ERCP), endoscopic papilosphyncterotomy (EPST) with or without stones extraction can determine the diagnosis of EBD pathology and treat it as well. The aim of the study: optimizing of surgical treatment of patients with benign EBD pathology on the background of DMR associated with duodenostasis. Material and methods: Studied group – 140 patients selected from 1998 to 2014 period. All of them were examined according to the algorithm proposed by Surgical Department Nr.2. There were three clinical stages of duodenostasis: compensated, subcompensated, decompensated. Results: Surgical treatment – based on ethiopathogenetic principles related to clinical stages. I – LDP strictures and compensated duodenostasis – ERCP+EPST – 130 patients (92.8%); II – LDP strictures + choledocolithiasis + cholangitis and subcompensated duodenostasis – ERCP + EPST + litextraction + MBD sanation and complex drug therapy – 98 patients (70.0%); III – Megalocholedoc and decompensated duodenostasis – supraduodenal transsection of MBD with its implantation in a 80 cm long “Y a la Roux” intestinal loop – 12 patients (8.57%). Conclusions: The chosen surgical method depends on the gravity of EBD pathology and duodenostasis stage. The efficiency of surgical treatment is determined by disappearance of clinical signs of chronic cholangitis with good postoperative results – 131 (93.75%) patients reintegrated in socio-familial and professional aspects