Mandatory multidisciplinary approach for the evaluation of the lymph node status in rectal cancer

Colorectal cancer is the third most frequently reported malignancy and also the third leading cancer-related cause of death worldwide. Lymph node evaluation, both preoperatively and postoperatively, represents an important aspect of the diagnosis and therapeutic strategy in colorectal cancer, such that an accurate preoperative staging is required for a correct therapeutic strategy. Treatment of rectal cancer with positive lymph nodes, a very important predictive prognostic parameter, is currently based on neoadjuvant chemoradiotherapy followed by total/ surgical mesorectal excision and adjuvant regimen. Preoperative evaluation of the lymph node status in rectal cancer is based on endoscopic ultrasound and magnetic resonance imaging, but their accuracy, specificity, and sensitivity still require improvement. Postoperative evaluation also presents points of debate, especially related to the role of sentinel lymph node mapping and their final implication, represented by detection of micrometastases and isolated tumor cells. The pathologic interpretation of tumor deposits represents other points in discussion. From a surgical perspective, extended lateral lymph node dissection vs. abstinence and (neo)adjuvant therapeutic approach represent another unresolved issue. This review presents the major controversies existing today in the treatment and pathologic interpretation of the lymph nodes in rectal cancer, the role/ indication and value of the lateral pelvic lymph node dissection, and the postoperative interpretation of the value of the micrometastatic disease and tumor deposits

Observation of Photovoltaic Effect and Single-photon Detection in Nanowire Silicon Pn-junction

We  study  nanowire  silicon  pin  and  pn-junctions  at  room  and  low  temperature.  Photovoltaic  effects  are  observed  for both devices at room temperature. At low temperature, nanowire pn-junction devices show their ability to detect single photon. This ability was not been observed for pin devices. Phosphorus-boron dopant cluster in the depletion region is considered  to  have  the  main  role  for  single-photon  detection  capability.  Fundamental  mechanism  of  dopant-based single-photon detection in nanowire pn-junction is described in details

Mandatory multidisciplinary approach for the evaluation of the lymph node status in rectal cancer

Colorectal cancer is the third most frequently reported malignancy and also the third leading cancer-related cause of death worldwide. Lymph node evaluation, both preoperatively and postoperatively, represents an important aspect of the diagnosis and therapeutic strategy in colorectal cancer, such that an accurate preoperative staging is required for a correct therapeutic strategy. Treatment of rectal cancer with positive lymph nodes, a very important predictive prognostic parameter, is currently based on neoadjuvant chemoradiotherapy followed by total/ surgical mesorectal excision and adjuvant regimen. Preoperative evaluation of the lymph node status in rectal cancer is based on endoscopic ultrasound and magnetic resonance imaging, but their accuracy, specificity, and sensitivity still require improvement. Postoperative evaluation also presents points of debate, especially related to the role of sentinel lymph node mapping and their final implication, represented by detection of micrometastases and isolated tumor cells. The pathologic interpretation of tumor deposits represents other points in discussion. From a surgical perspective, extended lateral lymph node dissection vs. abstinence and (neo)adjuvant therapeutic approach represent another unresolved issue. This review presents the major controversies existing today in the treatment and pathologic interpretation of the lymph nodes in rectal cancer, the role/ indication and value of the lateral pelvic lymph node dissection, and the postoperative interpretation of the value of the micrometastatic disease and tumor deposits

Сахарный диабет 1 типа у детей: клинические и метаболические особенности в начале заболевания

Department of Pediatric Endocrinology, Emil Cotaga Children’s Republican Hospital, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaThe aim of the study was to determine the clinical and biochemical characteristics of type 1 diabetes mellitus (DM) at presentation in children. The registered data set comprised blood glucose, pH, serum bicarbonate levels, glycosylated hemoglobin and clinical symptoms at disease manifestation. 53 children with type 1 DM were included in this study. Polydipsia (90.1%), polyuria (81.4%), and weight loss (84.1%) were the most frequent symptoms anticipating disease detection. Enuresis was recorded in 32.8%. A total of 73.6% patients had DKA (pH < 7.3) at disease onset. Children under 10 years showed more pronounced ketoacidosis that developed in a shorter period of time. Blood glucose testing in children with enuresis, weight loss and family history of diabetes is essential for timely diagnosis.Данное исследование было выполнено с целью определения клинических и биохимических характеристик впервые выявленного сахарного диабета 1 типа у детей. Были регистрированы и проанализированы следующие показатели: уровень глюкозы, рН и бикарбонат крови, гликированный гемоглобин, клинические симптомы заболевания. Были исследованы 53 детей. Полидипсия (90,1%), полиурия (81,4%) и потеря веса (84,1%) были выявлены как самые распространенные симптомы до подтверждения диагноза. Энурез был зарегистрирован у 32,8% детей. 73,6% пациентов имели диабетический кетоацидоз (рН < 7,3) в момент установления диагноза. Дети до 10 лет показали более выраженный кетоацидоз, который развился в более короткие сроки. Энурез, потеря веса и семейная предрасположенность к сахарному диабету являются показаниями к определению глюкозы в крови у детей для своевременной диагностики заболевания

Stable bundles on hypercomplex surfaces

A hypercomplex manifold is a manifold equipped with three complex structures I, J, K satisfying the quaternionic relations. Let M be a 4-dimensional compact smooth manifold equipped with a hypercomplex structure, and E be a vector bundle on M. We show that the moduli space of anti-self-dual connections on E is also hypercomplex, and admits a strong HKT metric. We also study manifolds with (4,4)-supersymmetry, that is, Riemannian manifolds equipped with a pair of strong HKT-structures that have opposite torsion. In the language of Hitchin's and Gualtieri's generalized complex geometry, (4,4)-manifolds are called ``generalized hyperkaehler manifolds''. We show that the moduli space of anti-self-dual connections on M is a (4,4)-manifold if M is equipped with a (4,4)-structure.Comment: 17 pages. Version 3.0: reference adde

Management surgical perforation of the colon neoplastic

Clinica 2 Chirurgie „Constantin Ţîbîrnă”, 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 2011Scopul: Evaluarea atitudinei terapeutice în perforaţiile neoplastice a colonului.Materiale şi metode: S-au analizat 38 perforaţii de colon în funcţie de localizare a procesului tumoral, durata şi gradul de răspîndire a peritonitei, perturbările sistemice în perioada 2005-2010. Repartiţia pe grupe de vîrsta şi sex atestă predominarea sexului masculin 22 cazuri (58,7%) şi un maxim între 60-80 ani. Incidenţa perforaţiilor în funcţie de localizaret: caecul 4 cazuri (10,5%), colonul ascendent şi unghiul hepatic 6 cazuri (15,7%), colonul transvers 2 cazuri (5,2%), unghiul lieneal si colonul descendent 2 cazuri (5,2%), sigmoidul 24 cazuri (63,4%). In funcţie de mecanismul de perforaţie: peforaţii directe în abdomenul liber 6 cazuri (15,8%), perforaţii în doi timp a abcesului paratumoral 25 cazuri (65,8%), perforaţii în spaţiul retroperitoneal 4 cazuri (10,5%), perforaţia diastatică (prin supraumplere) 3 cazuri (7,9%). In 10 (26,3%) cazuri s-a constatat peritonita fecaloidă generalizată, 13 cazuri (34,2%) peritonita difuză, 11 cazuri (28,9%) peritonita localizată, 4 cazuri (10,5%) flegmon retroperitoneal.Înlăturarea radicală a segmentului tumoral s-a efectuat în 34 cazuri (89,5%), respectiv în 4 (10,5%) cazuri s-a recurs la colostomia paliativă. La 21 pacienţi intervenţia chirurgicală s-a finisat cu aplicarea anastomozei primare, în 17 cazuri colostoma. Complicaţii postoperatorii au survenit la 11 pacienţi: 2 cazuri dihiscenţă de anastomoză, 9 cazuri complicaţii septice. Letalitatea peransamblu în lotul de studiu a constituit 22,5%. La pacienţii, unde s-a aplicat anastomoza primara letalitatea a constituit 9,5%. Concluzii: In condiţiile duratei scurte de la momentul perforaţiei <de 12 ore şi raspîndirea limitată a peritonitei pacienţii pot fi trataţi prin intervenţie chirurgicală într-o singură etapă. Rămîne discutabile volumul intervenţiei chirurgicale în cazurul peritonitei avansate.Aim: Evaluation of therapeutic attitude in neoplastic perforation of the colon. Materials and methods: We analyzed 38 colon perforations depending on the location of the tumor process, duration and degree of spreading peritonitis, systemic disturbances in the period 2005-2010. Distribution by age and sex groups show male predominance of 22 cases (58.7%) and a peak between 60-80 years. The incidence of perforation according localizaret: caecul 4 cases (10.5%), ascending colon and hepatic angle 6 cases (15.7%), transverse colon in 2 cases (5.2%), and descending colon lieneal angle 2 cases ( 5.2%), sigmoid 24 cases (63.4%). Depending on the mechanism of perforation: direct abdomen peforaţii free 6 cases (15.8%), perforation of the abscess in two time paratumoral 25 cases (65.8%), retroperitoneal perforation in 4 cases (10.5%) diastatică perforation (with overfill) 3 cases (7.9%). In 10 (26.3%) cases were found faeces generalized peritonitis, 13 cases (34.2%) diffuse peritonitis, 11 cases (28.9%) localized peritonitis, 4 cases (10.5%) retroperitoneal phlegmon. Radical tumor removal was performed in segment 34 cases (89.5%) and in 4 (10.5%) cases recourse to palliative colostomy. In 21 patients surgery was completed with the application of primary anastomosis in 17 cases colostomy. Postoperative complications occurred in 11 patients: 2 cases of anastomosis dihiscenţă, 9 cases septic complications. Per ansamblu lethality in the study group was 22.5%. Patients, primary anastomosis was applied where lethality was 9.5%. Conclusions: In conditions when the short duration of perforation <12 hours and dissemination of limited peritonitis patients may be treated by surgery in one stage. Volume remains questionable surgery in advanced cases of peritonitis