Ektopično lučenje ACTH udruženo s hiperamilazemijom u bolesnika s karcinomom pluća malih stanica: prikaz slučaja

Histologically confirmed small cell lung cancer associated with Cushing’s syndrome and elevated amylase is rarely described in the literature. We present a case of a 63-year-old patient admitted to cardiology department due to shortness of breath, exhaustion, palpitations and nausea. Elevated values of troponin and electrocardiography suggested that he could have acute coronary syndrome. According to the radiologist’s opinion, plane lung radiography was normal. Elevated level of amylase was found in both serum (3802 U/L, normal range 28-100) and urine (12012 U/L, normal range 0-450 U/L), as well as elevated sodium (156 mmol/L, normal range 137-147 mmol/L), hyperglycemia (12 mmol/L, normal range 3.8-6.1 mmol/L) and lowered serum potassium (1.7 mmol/L, normal range 3.5-5.3 mmol/L). Computerized tomography (CT) of the abdomen revealed a tumor of the left adrenal gland and enlargement of the right adrenal gland with normal structure of the pancreas. During hospitalization, the patient had blood while coughing and CT scan of the lungs showed a tumor 48x38x51 mm in size localized in the laterobasal segment of the left lung with mediastinal lymphadenopathy. He also had bilateral pleural effusions with signs of pulmonary embolism, which explained elevated troponin values. Biopsy confirmed microcellular lung carcinoma and tumor cells were diffusely positive for TT F-1 and focally for CK7, expressing markers of neuroendocrine differentiation (chromogranin +++, synaptophysin +++, NS E ++). Since neuroendocrine tumor was confirmed and the patient had low potassium and high glucose, hypercortisolism was suspected. High morning cortisol (1784 mmol/L, normal range 171-536) and unsuppressed ACTH (214 pg/L, <60), as well as a high level of chromogranin (1339 μg/L, <65) were determined. During hospital stay, the patient developed heart and respiratory failure and died in the second week of hospitalization.Histološki potvrđeni slučajevi karcinoma malih stanica udruženi s Cushingovim sindromom i povišenim vrijednostima amilaze u serumu su jako rijetko opisani u literaturi. Prikazujemo slučaj 63-godišnjeg bolesnika primljenog na odjel kardiologije zbog kratkoće daha, iscrpljenosti, lupanja srca i mučnine. Povišene vrijednosti troponina i elektrokardiogram ukazivali su na mogući akutni koronarni sindrom. Prema mišljenju radiologa i snimaka pluća radiografija je bila normalna. Povišena razina amilaze pronađena je u serumu (3802 U/L, normalni raspon 28-100 U/L) i mokraći (12012 U/L, normalni raspon 0-450 U/L), kao i povišenje natrija (156 mmol/L, normalni raspon 137-147 mmol/L), hiperglikemija (12 mmol/L, normalni raspon 3,8-6,1 mmol/L) i nizak serumski kalij (1,7 mmol/L, normalni raspon 3,5 do 5,3 mmol/L). Kompjutorizirana tomografija (CT) trbuha pokazuje tumor lijeve nadbubrežne žlijezde i proširenja desne nadbubrežne žlijezde s normalnom strukturom gušterače. Tijekom hospitalizacije bolesnik je izbacivao krv dok kašlje i CT pluća pokazuje tumorsku masu veličine 48x38x51 mm, lokaliziranu u laterobazalnom segmentu lijevog pluća s medijastinalnom limfadenopatijom. On je također imao bilateralne pleuralne izljeve sa znakovima plućne embolije, što je bio razlog povišene vrijednosti troponina. Biopsija je potvrdila da se radi o karcinomu pluća malih stanica i tumorske stanice su bile difuzno pozitivne na TT F-1 i fokalno na CK7, izražavajući biljege neuroendokrine diferencijacije (kromogranin +++, sinaptofizin +++, NS E ++). Kako je potrvđen neuroendokrini tumor te kako je bolesnik imao nizak kalij i visoku razinu glukoze, postavljena je sumnja na hiperkortizolizam. To je potvrdio nalaz visoke razine jutarnjeg kortizola (1,784 mmol/L, normalni raspon 171-536) i nesuprimiranog ACTH (214 pg/L, <60), kao i visoka razina kromogranina (1339 μg/L, <65). Tijekom boravka u bolnici u bolesnika se razvila srčana i respiracijska insuficijencija te je preminuo u drugom tjednu hospitalizacije

Production of bacterial nanocellulose (BNC) and its application as a solid support in transition metal catalysed cross-coupling reactions

Bacterial nanocellulose (BNC) emerged as an attractive advanced biomaterial that provides desirable properties such as high strength, lightweight, tailorable surface chemistry, hydrophilicity, and biodegradability. BNC was successfully obtained from a wide range of carbon sources including sugars derived from grass biomass using Komagataeibacter medellinensis ID13488 strain with yields up to 6 g L-1 in static fermentation. Produced BNC was utilized in straightforward catalyst preparation as a solid support for two different transition metals, palladium and copper with metal loading of 20 and 3 wt%, respectively. Sustainable catalysts were applied in the synthesis of valuable fine chemicals, such as biphenyl-4-amine and 4'-fluorobiphenyl-4-amine, used in drug discovery, perfumes and dye industries with excellent product yields of up to 99%. Pd/BNC catalyst was reused 4 times and applied in two consecutive reactions, Suzuki-Miyaura cross-coupling reaction followed by hydrogenation of nitro to amino group while Cu/BNC catalyst was examined in Chan-Lam coupling reaction. Overall, the environmentally benign process of obtaining nanocellulose from biomass, followed by its utilisation as a solid support in metal-catalysed reactions and its recovery has been described. These findings reveal that BNC is a good support material, and it can be used as a support for different catalytic systems

Promene linearnih i nelinearnih mera nizova RR i QT intervala posle uzimanja piva

BACKGROUND: /Aim. There are only several studies on the acute effect of alcoholic drinks intake on heart rhythm and this phenomenon is still not well understood. We wanted to examine whether linear and nonlinear measures of RR interval and QT interval series could quantify the effect of beer in healthy subjects. Methods. Eighteen young volunteers drank 500 mL of beer (21 g of ethanol). Electrocardiogram (ECG) recordings were taken in supine position: 20 minutes before (relaxation) and 60 minutes after drink intake. The RR interval series and the QT interval series were extracted from ECG and we calculated short-term (α1) and long-term (α2) scaling exponents and sample entropy (SampEn) for both series; low frequency (LF) and high frequency (HF) spectral components from RR interval series and QT variability (QTV). Blood pressure was measured every 10 minutes. Results. It was shown that beer induced changes in variability and correlation properties of these series. Immediate effect of beer intake was detected as a transient increase in the QT variability, heart rate and blood pressure. Delayed effects of beer were shortening of the RR and QT intervals and reduction of the HF spectral component. Beer intake also increased short-term scaling exponent (α1) of the RR time series and long-term scaling exponent (α2) of the QT time series. Conclusion. Our results suggest that acute effects of beer are reduced parasympathetic control of the heart and changed dynamic complexity of the ventricular repolarization.Uvod/Cilj. Akutni efekat uzimanja alkoholnih pića na kardiovaskularne ritmove je fenomen koji još uvek nije dovoljno razjašnjen i u literaturi postoji svega nekoliko radova na tu temu. Cilj rada je bio da se ispita da li se linearnim i nelinearnim merama nizova RR i QT intervala može kvantifikovati akutni efekat male količine piva kod zdravih osoba. Metode. Osamnaest mladih zdravih muškaraca je pilo po 500 mL piva (21 g etanola). Elektrokardiogram (EKG) je beležen u ležećem položaju: 20 minuta pre (u relaksaciji) i 60 minuta neposredno posle uzimanja pića. Iz digitalizovanog zapisa EKG-a izdvojeni su nizovi RR i QT intervala. Iz oba niza smo izračunali kratkodometni (α1) i dugo-dometni skalirajući eksponent (α2), kao i entropiju uzorka (SampEn). Iz nizova RR intervala određene su spektralne komponente niskofrekventnih (LF) i visokofrekventnih (HF) opsega, a iz nizova QT intervala varijabilnost QT intervala (QTV). Krvni pritisak je bio meren svakih 10 minuta. Rezultati. Pokazali smo da pivo menja varijabilnost i korelacione osobine ovih nizova. Neposredni efekat uzimanja piva ogleda se u prolaznim povećanjima QT varijabilnosti, srčane frekvence i krvnog pritiska, a produženi u skraćenju dužine RR i QT intervala i smanjenju spektralne komponente HF. Uzimanje piva je takođe dovelo do porasta kratkodometnog skalirajućeg eksponenta (α1) RR niza i dugodometnog skalirajućeg eksponenta (α2) QT niza. Zaključak. Akutni efekat uzimanja piva je redukovana parasimpatička kontrola srca i izmenjena kompleksnost dinamike ventrikularne repolarizacije

Morphology of Electrochemically and Chemically Deposited Metals

This book describes the newest achievements in the area of electrochemically and chemically deposited metals and alloys. In particular, the book is devoted to the surface morphology of deposited metals and alloys. It contains an in-depth analysis of the influence of the parameters of electrodeposition or chemical deposition of metals and alloys, which will likely lead to technological advances in industrial settings world-wide. Professionals in electrometallurgical and electroplating plants will find the book indispensable. This book will also be useful in the automotive, aerospace, electronics, energy device and biomedical industries. In academia, researchers in electrodeposition at both undergraduate and graduate levels will find this book a very valuable resource for their courses and projects

Hyperprolactinemia: Diagnosis and treatment principles

Prolactin (PRL) is a peptide hormone that consists of 198 aminoacids and synthesizes in lactotrophs which present about 20 % of cells in hypophysis. The levels of prolactin can be increased due to physical and psychological stress, temperature, increased physical activity, general anesthesia, acute coronary syndrome and meals. The secretion of prolactin is under tonic inhibitory control by hypothalamic dopamine. Prolactinomas are benign pituitary tumors of lactotrophs in adenohypophysis, with unknown etiology. Clinical symptoms and signs of hyperprolactinemia in women include amenorrhea, infertility, and galactorrhea, and decreased libido and visual impairment in men. Dopamine agonists decrease tumor mass in the majority of patients and are used as the primary therapy. The therapy should be initiated at a low dose, which should be increased slowly to minimize side effects, such as gastrointestinal symptoms and orthostatic hypotension. Pituitary function should be tested in patients with micro and macroadenomas until normalizing PRL level and recovering hypogonadism. Repeat MR of hypophysis and visual field testing are mandatory when tumors are adjacent to the optic chiasm. Dopamine agonists are not approved for use during pregnancy and should be discontinued once pregnancy occurs. A normal serum prolactin level is the goal in treating hyperprolactinemia, decreasing galactorrhea and symptoms of hypogonadism, as well as reduction of tumor mass. Dopamine agonists are recommended for first-line therapy and typically decrease both prolactin levels and tumor mass, thereby relieving symptoms

Effect of the Deposition of Vanadium-Oxide on the Photocatalytic Activity of TiO2 Nanotubes and Its Photodiode Performance Interfaced with CH3NH3PbI3 Single Crystal

In this study, we report the influence of vanadium oxide (VO), as a photosensitive component, on the photoactivity of TiO2 nanotubes (TNTs). A series of TNTs of varying tube diameter were synthesized by the anodization of titanium foils at different voltages, while vanadium oxide was deposited on TNTs by wet chemical deposition. An improvement in the optical properties of nanotubes was observed after the deposition of vanadium oxide. An improvement in the optical properties (redshift in UV-Vis spectra) of TNTs and TNT/VO was noted. The photocatalytic activity was improved with increasing tube diameter, while it was weakened after the deposition of VO. Furthermore, photoactivity was investigated in photodiodes based on TNTs or TNT/VO and single crystals of CH3NH3PbI3. The photoelectric measurement revealed that different TNT diameters did not influence the I-V characteristic of the photodiodes, while the deposition of VO improved the photocurrent for smaller TNTs

Effect of the Deposition of Vanadium-Oxide on the Photocatalytic Activity of TiO₂ Nanotubes and Its Photodiode Performance Interfaced with CH₃NH₃PbI₃ Single Crystal

In this study, we report the influence of vanadium oxide (VO), as a photosensitive component, on the photoactivity of TiO2 nanotubes (TNTs). A series of TNTs of varying tube diameter were synthesized by the anodization of titanium foils at different voltages, while vanadium oxide was deposited on TNTs by wet chemical deposition. An improvement in the optical properties of nanotubes was observed after the deposition of vanadium oxide. An improvement in the optical properties (redshift in UV-Vis spectra) of TNTs and TNT/VO was noted. The photocatalytic activity was improved with increasing tube diameter, while it was weakened after the deposition of VO. Furthermore, photoactivity was investigated in photodiodes based on TNTs or TNT/VO and single crystals of CH3NH3PbI3. The photoelectric measurement revealed that different TNT diameters did not influence the I-V characteristic of the photodiodes, while the deposition of VO improved the photocurrent for smaller TNTs

The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient.

BackgroundThe utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown.PurposeThe purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM).MethodsSeventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0-800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis.ResultsThe interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p ConclusionIVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass-forming cholangiocarcinoma and hypovascular liver metastases

Synthesis and characterization of nanocrystalline polyhedral oligo silsesquioxanes (POSS) with cross-linkable functionalities

A facile synthesis was employed for three polyhedral oligo silsequioxanes (POSS), obtaining incompletely condensed structures with fern-like and cubic morphologies. Proton nuclear magnetic resonance spectroscopy (H-1 NMR) indicated the successful synthesis of the proposed POSS structures. The hydroxyl groups affected the manner and type of POSS morphology, as seen under a scanning electron microscope (SEM) and a transmission electron microscope (TEM). Fourier-transform infrared spectroscopy (FTIR) showed the availability of surface hydroxyl groups that contributed to the formation of a higher amount of char residue, as found from TGA analysis. The highest decomposition temperature (281 degrees C) and the least char residue were found for a cross-linkable POSS, obtained by esterification of the hydroxyl groups with methacryloyl chloride

Evidence for genetic diversity of Toxoplasma gondii in selected intermediate hosts in Serbia

To contribute to the insight into the worldwide population structure of Toxoplasma gondii, we genetically characterized a total of eight strains isolated from intermediate hosts including humans, sheep and pigeons in Serbia. Although parasite DNA was detected in 28.2% (60/213) of the human samples from 162 patients serologically suspected of active toxoplasmosis, as well as in 5/7 seropositive pigeons and in 2/12 seropositive sheep examined, multilocus PCR-RFLP genotyping, using SAGI, 5'SAG2, 3'SAG2, GRA6, 5'GRA7 and 3'GRA7 as markers, was successful in only four human isolates (of which one was isolated from both the bronchoalveolar lavage fluid and blood samples of a single patient), one sheep and three pigeons. Of the eight isolates, five were type II (62.5%), one was type III, one was atypical, and one had a type I allele at GRA6 as the single locus genotyped. Although type II, as elsewhere in Europe, predominated, these results may suggest a higher genetic diversity of T. gondii in Serbia, reflecting local environmental contamination and also the geographical position of the country in South-East Europe