Appendicular mucocele. Clinical case

Scopul lucrării. Mucocelul apendicular este o entitate patologică caracterizată prin dilatarea chistică a apendicelui, datorită secreției anormale de mucinos apendicular. Prezintă incidența scăzută, secundar afecțiunilor benigne (hiperplazie mucinoasă și chistadenom) sau maligne (chistadenocarcinom). Materiale și metode. Am analizat cinci pacienți tratați pentru mucocel apendicular în perioada 2012-2023 în Clinica Chirurgie nr.2, USMF ,,N.Testemițanu,, cu vârsta cuprinsă între 24-92 de ani și evaluată modalitatea de diagnostic și tratament chirurgical. Rezultate. Manifestările clinice au fost variate, nespecifice, frecvent au simulat alte afecțiuni chirurgicale abdominale. Examenul preoperator imagistic, ecografic de rutină şi tomografia computerizată în 3 cazuri au confirmat mucocelul apendicular. Diagnosticul a fost confirmat intraoperator, volumul intervenției chirurgicale fiind rezolvat individual. Studiul anatomopatologic a pieselor operatorii a stabilit diagnosticul etiologic și histopatologic. Explorarea intraoperatorie a organelor cavității peritoneale și a bazinului mic a fost obligatorie în diagnosticul diferențial cu formațiunile chistice ale anexelor uterine și ale organelor cavității abdominale. Concluzii. Mucocelul apendicular se referă la bolile chirurgicale rare, manifestând un tablou clinic nespecific. Explorarea clinicimagistică, histopatologică minuțioasă a fiecărui pacient, determină corect strategiile chirurgicale.Aim of study. Appendicular mucocele is a pathology characterized by cystic dilatation of the appendix, due to abnormal secretion of appendicular mucinous. It has low incidence, secondary to benign (mucinous hyperplasia and cystadenoma) or malignant (cystadenocarcinoma) conditions. Materials and methods. We analyzed five patients treated for appendicular mucocele in the period 2011-2023 in Surgery Clinic no.2, USMF,, N. Testemitanu,, aged between 24-92 years and evaluated the method of diagnosis and surgical treatment. Results. Clinical manifestations were varied, nonspecific, and frequently simulated other abdominal surgical conditions. Preoperative imaging, routine ultrasound examination and computed tomography in 3 cases confirmed the appendicular mucocele. The diagnosis was confirmed intraoperatively, the volume of surgical intervention being solved individually. Anatomopathological examination of the operative parts established the etiological and histopathological diagnosis. Intraoperative exploration of the organs of the peritoneal cavity and small pelvis was mandatory in differential diagnosis with cystic formations of the uterine appendages and organs of the abdominal cavity. Conclusions. Appendicular mucocele refers to rare surgical diseases, manifested by a nonspecific clinical picture. The thorough clinical – imaging, histopathological exploration of each patient correctly determines surgical strategies

Blending PEG-based polymers and their use in surface micro-patterning by the FIMIC method to obtain topographically smooth patterns of elasticity

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.We have designed and fabricated a library of polyethylene glycol (PEG)-based polymer blends, including blends of two PEG-based polymers that are liquid at room temperature where the optimisation of the blending method allows for the incorporation of higher molecular-weight PEG-based polymers which are solid at room temperature. The absence of a solvent in these blends makes them perfect candidates for use in our recently developed Fill-Molding in Capillaries (FIMIC) patterning method. As our FIMIC samples have shown to be not completely smooth (a small topography up to several nanometers has been seen previously), and this is likely to affect the cellular behaviour, we have improved our technique in order to obtain virtually smooth samples that exhibit a pattern of elasticity only. It is demonstrated that, by taking advantage of the differential swelling of the pattern components, we can level out the undesired topographic difference. In particular, by employing blends of materials, (1) the swelling degree of each component can be fine-tuned to even out any topography and (2) the use of the same blends in the sample, yet with varying cross-linker amounts, ensures the swelling degree and elasticity change without changing the surface chemistry significantly. Genuine, binary patterns of elasticity can thus be fabricated, which are a great asset to study cell migration phenomena in systematic detail.DFG, EXC 314, Unifying Concepts in Catalysi

Unhealthy weight among children in Spain and the role of the home environment

Objective: Unhealthy weight is a major global health concern. This study examines unhealthy weight among children in Spain and the role of the home environment therein. Data are from a 2010 national survey of families with children. We examined unhealthy weight among children ages 5-10 years using the WHO Child Growth Standards and used multivariate logistic regression to assess associations with family characteristics. Results: There was a high prevalence of unhealthy weight, with only 46% of children at normal weight. Both underweight and obesity were higher among boys (14%; 22%) than girls (13%; 12%). Underweight and obesity were higher among children of mothers with obesity and those with unemployed parents. Obesity was higher among children of mothers who were less educated (35%) and among children of immigrants (19%). We find high levels of unhealthy weight in children, with both underweight and obesity being predicted by the same family environment characteristics

Assembled PTO based on an array of double-acting hydraulic cylinders for WECs: From Conceptual Design to an Adjusted Detailed Model

All Wave Energy Converters (WECs) based on wave activated bodies comprises a Power Take- Off (PTO) system among other subsystems like the reaction mechanism, the supervisor of the system and the electrical generator. One of the most applied PTO systems consists of oil high pressure hydraulic devices. These devices are able to apply high forces, to store large quantities of energy through accumulators and to provide smoother power output to the motor coupled to a generator. In these systems the poor efficiency and the oil leakages contaminating the environment are considered main drawbacks. Despite of this, they are widely used in several promising WECs with the aim of optimizing the harvested wave energy along the time. The initial challenge to absorb an oscillating movement of ±30º at 5rad/s as a maximum angular speed absorbing up to 16000Nm from a specific WEC, led to the development of a simplified hydraulic model before manufacturing a PTO prototype to be verified in a Test Bench (Figure 1). The experimental results of PTO under different conditions have been used to adjust a full detailed PTO Model using Mathworks® software platform. This work presents a patented oil high pressure hydraulic PTO prototype based on an array of four double-acting hydraulic cylinders. This prototype has been designed and completely modelled as a proof concept at 1:4 scale being able to apply a variable Coulomb type damping torque through the activation of each hydraulic cylinder independently and through the modification of geometrical parameters easily. The complete model of the PTO has been accurately tuned up through adjustment of model parameters using the results of the experimental tests. This will allow the study of control strategies to optimize the extracted wave energy from a specific WEC, like point-absorbers

"Better Safe than Sorry" - Individual Risk-free Pension Schemes in the European Union - Macroeconomic Benefits, the Mobile Working Citizen's Perspective and Why Nots

Variations between the diverse pension systems in the member states of the European Union hamper labour market mobility, across country borders but also within the countries of the European Union. From a macroeconomic perspective, and in the light of demographic pressure, this paper argues that allowing individual instead of collective pension building would greatly improve labour market flexibility and thus enhance the functioning of the monetary union. I argue that working citizens would benefit, for three reasons, from pension saving in a risk-free savings account. First, citizens would have a clear picture of the accumulation of their own pension savings throughout their working life. Second, they would pay hardly any extra costs and, third, once retired they would not be subject to the whims of government or other pension fund managers. This paper investigates the feasibility of individual pension building under various parameter settings by calculating the pension saved during a working life and the pension dis-saved after retirement. The findings show that there are no reasons why the European Union and individual member states should not allow individual risk-free pension savings accounts. This would have macroeconomic benefits and provide a solid pension provision that can enhance mobility, instead of engaging workers in different mandatory collective pension schemes that exist around in the European Union

New evidence of the Green Tuff deposits and post-caldera, recent explosive volcanic activity at Pantelleria volcano (Sicily Channel, Italy) recorded in near-vent marine areas

The record of the explosive activity of Pantelleria volcano is well documented by several distal tephra collected in various areas in and around the Mediterranean, while few tephrochronological studies exist on proximal marine areas. In this paper, we investigate three selected coring sites from the northern shoulder of the Pantelleria graben, about 15–30 km from the island, in near-vent position with respect to that volcanic source. Our multiproxy analyses revealed nine tephra layers, totally composed of juvenile materials, mostly ash and pumice fragments, as well as a coarse-grained tephra deposit at the bottom of one of the cores. The major element composition of glass shards indicates a very homogeneous geochemical composition for the tephra layers, suggesting their primary origin. Using litho-stratigraphic and paleoenvironmental proxies, we associated the tephra layers to the latest (<∼13.7 ka) explosive activity of Pantelleria. The coarse-grained deposit, instead, due to its distinctive composition is considered to represent the near-vent, marine equivalent of the distal Y-6 tephra layer, related to the ∼45 ka old co-ignimbrite fallout deposit of the Green Tuff event. The geochemical characterization of such deposit, mostly rhyolitic and partly trachytic, appears to enlarge the bimodal composition recorded in other distal tephra (Y-6) reported in the literature, highlighting the potential of near-vent record in providing additional information on the eruptive history

The opportunities of diagnosis and treatment of benign strictures of extra-hepatic biliary ducts

Catedra 2 Chirurgie USMF „N.Testemiţanu”, Chişinău, Republica Moldova, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere. Diagnosticul şi atitudinea chirurgicală în stricturile benigne (SB) ale căilor biliare extrahepatice (CBE) reprezintă o filă dificilă şi actuală a chirurgiei biliare. Materiale şi metode. Pe parcursul anilor 1980-2010 în Clinica 2 Chirurgie au fost trataţi 213 pacienţi cu SB a CBE. Evaluarea clinică a bolnavilor a includea: 1) stabilirea diagnosticului etiopatogenetic; 2) decompresiunea preoperatorie a arborelui biliar; 3) actul chirurgical reconstructiv. Algoritmul diagnostic al SBCBE includea câteva etape consecutive: I etapă - testarea biochimică, examenul sonografic; II etapă - contrastarea directă a arborelui biliar executând CPGRE, sau CPT, sau colangiofistulografie. În cazurile de dificultăţi de diagnostic sa efectuat colangiografia prin rezonanţa magnitonucleară. Pregătirea preoperatorie sa realizat prin decompresiunea mini-invazivă a arborelui biliar (drenajul naso-biliar(9,39%), hepatostoma percutană transhepatică(14,8% ) sau stentare endoscopică(8,45%)), tratamentul antibacterial şi farmacoterapeutic de detoxicare şi corecţie a funcţiei hepatice. Rezultate. Tratamentul chirurgical al SB a CBE a fost în raport direct cu nivelul localizării. Pentru SB de tip I-58(27,23%) cazuri a fost optimă coledocojejunostomie termino-laterală cu ansa izolată în Y a la Roux. În SB de tipII la 80(37,56%) cazuri s-a efectuat coledoco- şi hepaticojejunostomie pe ansa izolată în Y a la Roux, În 62(29.11%)observaţii cu SB tipIII am realizat hepaticojejunostomie termino-laterală pe ansa izolată în Y a la Roux cu o protejare transanastomotică separată a canalelor hepatice. În SB tip IV la 13(6.1%) pacienţi restabilirea fluxului biliar în tractul digestiv s-a soluţionat cu bihepaticojejunostomie pe ansa izolată a la Roux cu drenarea transanastomotică a ambilor canale hepatice. Derivaţiile pe parcursul ultimilor 4 ani sau realizat cu suturi atraumatice doar într-un singur plan. Letalitatea postoperatorie 6(2.82%)cazuri. Concluzii: Tratamentul chirurgical al SB a CBE este în raport direct cu nivelul şi tipul afectării. Optimale sunt derivaţiile pe ansa izolată a la Roux realizate într-un plan de sutură atraumatică, ce exclude totalmente refluxul digestiv în arborele biliar şi previne stenozele postoperatorii la distanţă.Introduction. Surgical treatment of benign strictures (BS) of extrahepatic biliary ducts (EBD) presents the difficult page of biliary surgery from the point of view of diagnosis and clinical manifestations. Material and methods. During the period 1980-2006 in surgical clinic II were treated 207 patients with BS of EBD. The clinical evaluation of patients included: 1) etiopathogenic diagnosis establishing; 2) biliary tree decompressing preoperatively; 3) surgery reconstructing. The diagnosis algorithm of BS of EBD had been included a few consequence steps: I step–biochemical testing, US; II step- bile tree contrasting directly by ERCPG, or CT, or cholangiofistulography. In cases of difficulties in diagnosis was performed MRI in regimen of cholangiography. Preoperative preparing was realized via mini-invasive decompression of biliary tree (nazo-biliary drainage, percutaneous transhepatic hepatostomy or stunting endoscopical), antibacterial treatment, detoxification and correction of hepatic function. Result. Surgical treatment of BS of EBD was in direct ratio with the level of localization. For BS of type I-57(27.54%) cases was optimal termino-lateral choledochojejunoanastomosis on the Y loop by Roux. In situation of BS of type in 79(38.16%) cases was performed choledocho- and hepatica-jejunostomy on the Y loop by Roux. In 59(28.5%) cases of BS of type III was realized termino-lateral hepaticojejunostomy on the Y loop by Roux and transanastomotical separate drainage of biliary ducts. In BS of type IV in 12(5.8%) cases the restoring of bile flux in digestive tract was realized via bi-hepaticojejunostomy on the loop by Roux with transanastomotic’s drainage of hepatic ducts. The postoperative lethality was 5(2.42%) cases. Conclusions Surgical treatment of BS of EBD is in direct ratio with the level and type of affection. The optimal solution is derivation on the loop by Roux with complete exclude digestive of reflux in biliary tree and prevents the late postoperative stenosis