17 research outputs found

    The role of CT and MRI in the diagnosis and management of pilomyxoid astrocytoma with spontaneous intratumoral hemorrhage - a case report

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    Π’ΡŠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: Около ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Π°Ρ‚Π° ΠΎΡ‚ ΠΌΠΎΠ·ΡŠΡ‡Π½ΠΈΡ‚Π΅ Ρ‚ΡƒΠΌΠΎΡ€ΠΈ Π² дСтска Π²ΡŠΠ·Ρ€Π°ΡΡ‚ са астроцитоми. ΠŸΠΈΠ»ΠΎΠΌΠΈΠΊΡΠΎΠΈΠ΄Π½ΠΈΡΡ‚ астроцитом Π΅ агрСсивСн Π²Π°Ρ€ΠΈΠ°Π½Ρ‚ Π½Π° пилоцитния астроцитом. Най-чСсто Ρ‚Π΅Π·ΠΈ Ρ‚ΡƒΠΌΠΎΡ€ΠΈ са Π΄ΠΎΠ±Ρ€Π΅ ΠΎΡ‚Π³Ρ€Π°Π½ΠΈΡ‡Π΅Π½ΠΈ, Π½Π΅ΠΈΠ½Ρ„ΠΈΠ»Ρ‚Ρ€ΠΈΡ€Π°Ρ‰ΠΈ ΠΎΠΊΠΎΠ»Π½Π°Ρ‚Π° Ρ‚ΡŠΠΊΠ°Π½. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ: ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²ΡΠΌΠ΅ случай Π½Π° пиломиксоидСн астроцитом Π² дСтска Π²ΡŠΠ·Ρ€Π°ΡΡ‚, ΠΏΡ€ΠΈΠ΄Ρ€ΡƒΠΆΠ΅Π½ със спонтанно ΠΈΠ½Ρ‚Ρ€Π°Ρ‚ΡƒΠΌΠΎΡ€Π½ΠΎ ΠΊΡŠΡ€Π²Π΅Π½Π΅. Π”Π΅Ρ‚Π΅ Π½Π° 3-годишна Π²ΡŠΠ·Ρ€Π°ΡΡ‚ бСшС ΠΏΡ€ΠΈΠ΅Ρ‚ΠΎ Π² ΡΠΏΠ΅ΡˆΠ½ΠΎΡ‚ΠΎ ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π½Π° Π£ΠœΠ‘ΠΠ› β€žΠ‘Π². ΠœΠ°Ρ€ΠΈΠ½Π°` Π² Π³Ρ€. Π’Π°Ρ€Π½Π° ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄ нСстабилна Ρ…Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ°, повишСна тСлСсна Ρ‚Π΅ΠΌΠΏΠ΅Ρ€Π°Ρ‚ΡƒΡ€Π°, ΠΏΠΎΠ²Ρ€ΡŠΡ‰Π°Π½Π΅ ΠΈ Π·Π°Π³ΡƒΠ±Π° Π½Π° съзнаниС. ΠŸΡ€ΠΈ нСврологичния ΠΏΡ€Π΅Π³Π»Π΅Π΄ сС установи, Ρ‡Π΅ Π·Π΅Π½ΠΈΡ†ΠΈΡ‚Π΅ са двустранно Π½Π΅Ρ€Π΅Π°Π³ΠΈ-Ρ€Π°Ρ‰ΠΈ Π½Π° свСтлина. По Π“Π»Π°Π·Π³ΠΎΡƒ ΠΊΠΎΠΌΠ° скалата ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΡŠΡ‚ ΠΏΠΎΠ»ΡƒΡ‡ΠΈ 6 Ρ‚ΠΎΡ‡ΠΊΠΈ. ΠžΡ‚ ΠΈΠ·Π²ΡŠΡ€ΡˆΠ΅Π½ΠΎΡ‚ΠΎ ΠΏΡ€Π΅Π΄ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΡ‚ΠΎ ΠΊΠΎΠΌΠΏΡŽΡ‚ΡŠΡ€Π½ΠΎ томографско (КВ) изслСдванС сС установи Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ Π½Π° ΠΈΠ½Ρ‚Ρ€Π°Ρ†Π΅Ρ€Π΅Π±Ρ€Π°Π»Π΅Π½ Ρ…Π΅ΠΌΠ°Ρ‚ΠΎΠΌ, причиняващ Π²ΡŠΡ‚Ρ€Π΅ΡˆΠ½Π° хидроцСфалия ΠΈ дилатация Π½Π° Π»Π°Ρ‚Π΅Ρ€Π°Π»Π½ΠΈΡ‚Π΅ Π²Π΅Π½Ρ‚Ρ€ΠΈΠΊΡƒΠ»ΠΈ. Π‘Π΅ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ спСшно ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ с поставянС Π½Π° ΠΈΠ½Ρ‚Ρ€Π°Π²Π΅Π½Ρ‚Ρ€ΠΈΠΊΡƒΠ»Π°Ρ€Π΅Π½ Π΄Ρ€Π΅Π½, послСдвано ΠΎΡ‚ ΠΏΡ€ΠΎΠ²Π΅ΠΆΠ΄Π°Π½Π΅ Π½Π° магнитнорСзонансна томография (МРВ) Π½Π° Π³Π»Π°Π²Π°. МРВ Π΄ΠΎΠΊΠ°Π·Π° Π½Π°Π»ΠΈΡ‡ΠΈΠ΅Ρ‚ΠΎ Π½Π° голяма Ρ‚Ρƒ-ΠΌΠΎΡ€Π½Π° формация с Ρ€Π°Π·ΠΌΠ΅Ρ€ΠΈ 49Ρ…55 ΠΌΠΌ, Ρ€Π°Π·ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π° ΠΈΠ½Ρ‚Ρ€Π°- ΠΈ супрасСларно. Π‘Π΅ ΠΈΠ·Π²ΡŠΡ€ΡˆΠ΅Π½Π° ΠΊΡ€Π°Π½ΠΈΠΎ томия ΠΈ ΠΏΠ°Ρ€Ρ†ΠΈΠ°Π»Π½Π° Скстирпация Π½Π° Ρ‚ΡƒΠΌΠΎΡ€Π° Ρ‡Ρ€Π΅Π· ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π΅ Π½Π° ΠΌΠΈΠΊΡ€ΠΎΡ…ΠΈΡ€ΡƒΡ€Π³ΠΈΡ‡Π½Π° Ρ‚Π΅Ρ…Π½ΠΈΠΊΠ°. Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΡŠΡ‚ ΠΎΡ‚ хистологичното изслСдванС Π΄ΠΎΠΊΠ°Π·Π° ΠΌΠΎΡ€Ρ„ΠΎΠ»ΠΎΠ³ΠΈΡ‡Π½Π°Ρ‚Π° ΠΊΠ°Ρ€Ρ‚ΠΈΠ½Π° Π½Π° пиломиксоидСн астроцитом WHO grade II. Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ ΠΈ обсъТданС: Π’ ранния постопСративСн ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΡŠΡ‚ бСшС Ρ…Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΡ‡Π½ΠΎ стабилСн. ΠžΡ‚ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎΡ‚ΠΎ постопСративно КВ изслСдванС сС установи пСрсистираща ΠΈΠ½Ρ‚Ρ€Π°Π²Π΅Π½Ρ‚Ρ€ΠΈΠΊΡƒΠ»Π°Ρ€Π½Π° хСморагия, Π²ΡŠΠΏΡ€Π΅ΠΊΠΈ Π½Π°Π»ΠΈΡ‡ΠΈΠ΅Ρ‚ΠΎ Π½Π° ΠΈΠ½Ρ‚Ρ€Π°Π²Π΅Π½Ρ‚Ρ€ΠΈΠΊΡƒΠ»Π°Ρ€Π½ΠΈ Π΄Ρ€Π΅Π½ΠΎΠ²Π΅. Π’ΡŠΠ² Ρ„Ρ€ΠΎΠ½Ρ‚Π°Π»Π½ΠΈΡ‚Π΅ дяловС Π±Π΅ забСлязана хиподСнсна лСзия с Π²ΠΈΠ΄ Π½Π° исхСмична. ΠŸΠΎΡ€Π°Π΄ΠΈ липсата Π½Π° ΠΏΠΎΠ΄ΠΎΠ±Ρ€Π΅Π½ΠΈΠ΅ Π² нСврологичния статус, ΠΊΠ°ΠΊΡ‚ΠΎ ΠΈ Π½Π°Π»ΠΈΡ‡ΠΈΠ΅Ρ‚ΠΎ Π½Π° Ρ€Π΅Π·ΠΈΠ΄ΡƒΠ°Π»Π½Π° Ρ‚ΡƒΠΌΠΎΡ€Π½Π° маса, Π±Π΅ ΠΏΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΎ ΠΏΡ€ΠΎΠ΄ΡŠΠ»ΠΆΠ°Π²Π°Π½Π΅ Π½Π° Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅Ρ‚ΠΎ. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅: Въй ΠΊΠ°Ρ‚ΠΎ липсват спСцифична Π·Π° Ρ‚ΠΎΠ·ΠΈ Π²ΠΈΠ΄ Ρ‚ΡƒΠΌΠΎΡ€ ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½Π° изява, Π½Π°ΠΉ-чСсто ΠΏΡŠΡ€Π²ΠΈΡ‚Π΅ симптоми са ΡΠ²ΡŠΡ€Π·Π°Π½ΠΈ с повишаванС Π½Π° ΠΈΠ½Ρ‚Ρ€Π°ΠΊΡ€Π°Π½ΠΈΠ°Π»Π½ΠΎΡ‚ΠΎ наляганС ΠΈ компрСсията Π½Π° ΠΏΠ°Ρ€Π΅Π½Ρ…ΠΈΠΌΠ°, ΠΊΠΎΠΈΡ‚ΠΎ сС ΠΏΡ€Π΅Π΄ΠΈΠ·Π²ΠΈΠΊΠ²Π°Ρ‚ ΠΎΡ‚ мас-Π΅Ρ„Π΅ΠΊΡ‚Π° ΠΈ локализацията Π½Π° Ρ‚ΡƒΠΌΠΎΡ€Π°.Introduction: About half of childhood brain tumors are astrocytomas. Pilomyxoid astrocytomas are an aggressive variant of pilocytic astrocytoma. Generally, these tumors are well circumscribed without infiltration. Materials and Methods: We report a case of pilomyxoid astrocytoma associated with tumoral bleeding in a pediatric patient. A 3-year-old girl presented in the Emergency Department of St.Marina University Hospital in Varna with unstable haemodinamics, fever, vomiting and loss of consciousness. The neurological examination revealed non-reactive to light pupils. The patient was assessed to have a Glasgow Coma Scale (GCS) score of 6. The preoperative CT scan showed an intracerebral haematoma, causing hydrocephalus and dilatation of the lateral ventricles. After an insertion of an external ventricular drain, a MRI scan was performed. It revealed a giant intra- and suprasellar tumor with dimentions of 49x55 mm. The patient underwent craniotomy and microsurgical partial extirpation of the tumor. After a histological examination was performed, the tumor was considered pilomyxoid astrocytoma WHO grade II. Results and Discussion: In the early postoperative period, the patient was haemodinamically stable. The postoperative CT scan demonstrated a persisting intraventricular haemorrhage, despite the inserted external ventricular drains. A hypodense lesion in the right frontal lobe consistent with subacute infarction was noticed. Due to the lack of neurological improvement and the presence of a residual tumor (confirmed by the CT scan), a subsequent surgery was necessary. Conclusion: There is no characteristic clinical presentation and the symptoms will be related to the mass effect and the tumor location, usually symptoms of raised intracranial pressure or parenchymal compression

    A fatal case of non-Hodgkin lymphoma - a case report

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    Π’ΡŠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: НСходТкиновият Π»ΠΈΠΌΡ„ΠΎΠΌ (НΠ₯Π›) Π΅ Ρ…Π΅Ρ‚Π΅Ρ€ΠΎΠ³Π΅Π½Π½ΠΎ заболяванС, ΠΏΡ€ΠΎΠΈΠ·Ρ…ΠΎΠΆΠ΄Π°Ρ‰ΠΎ ΠΎΡ‚ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½Π°Ρ‚Π° трансформация Π½Π° Π»ΠΈΠΌΡ„ΠΎΡ†ΠΈΡ‚ΠΈ ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π²Π°Ρ‰ΠΎ мноТСство ΠΏΠΎΠ΄Ρ‚ΠΈΠΏΠΎΠ²Π΅, всСки със спСцифични молСкулярни ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½ΠΈ характСристики. ΠšΠ»ΠΈΠ½ΠΈΡ‡Π½Π°Ρ‚Π° манифСстация Π²Π°Ρ€ΠΈΡ€Π° ΠΎΡ‚ вяло ΠΏΡ€ΠΎΡ‚ΠΈΡ‡Π°Π½Π΅ Π΄ΠΎ агрСсивСн Ρ…ΠΎΠ΄. Π Π΅ΡˆΠ΅Π½ΠΈΡΡ‚Π° Π·Π° Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π·Π° ΠΏΡ€Π΅Π΄ΠΏΠΎΡ‡ΠΈΡ‚Π°Π½Π΅ сС правят Π² мултидисциплинарна срСда. ΠŸΡ€Π΅Π· послСднитС дСсСтилСтия сС наблюдава нарастванС Π½Π° случаитС, Π΄ΡŠΠ»ΠΆΠ°Ρ‰ΠΎ сС Π½Π° ΡƒΠ²Π΅Π»ΠΈΡ‡Π°Π²Π°Π½Π΅ Π½Π° срСдната Π²ΡŠΠ·Ρ€Π°ΡΡ‚ Π½Π° насСлСниСто, подобряванС Π½Π° диагностиката, пандСмията ΠΎΡ‚ Π₯Π˜Π’ ΠΈ имуносупрСсивната тСрапия. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ: Дискутира сС ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π΅Π½ случай Π½Π° 65-годишна ΠΏΠΎΡ‡ΠΈΠ½Π°Π»Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ° с НСходТкинов Π»ΠΈΠΌΡ„ΠΎΠΌ. Вя Π΅ диагностицирана ΠΏΡ€Π΅Π· Π°ΠΏΡ€ΠΈΠ» 2017 Π³. с ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½ΠΎ проявСни двустранно ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈ Ρ†Π΅Ρ€Π²ΠΈΠΊΠ°Π»Π½ΠΈ Π»ΠΈΠΌΡ„Π½ΠΈ възли, астСно-Π°Π΄ΠΈΠ½Π°ΠΌΠΈΡ‡Π΅Π½ синдром, Π·Π°ΠΌΠ°ΠΉΠ²Π°Π½Π΅ ΠΈ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»Π½Π° Π±ΠΎΠ»ΠΊΠ°. ΠŸΡŠΡ€Π²ΠΎΠ½Π°Ρ‡Π°Π»Π½ΠΎ тя Π΅ ΠΏΡ€ΠΈΠ΅Ρ‚Π° Π² ΠœΠ‘ΠΠ›-Билистра, ΠΊΡŠΠ΄Π΅Ρ‚ΠΎ Π΅ ΠΎΡ‚ΠΊΡ€ΠΈΡ‚Π° бицитопСния (анСмия ΠΈ тромбоцитопСния), ΠΏΠΎΡ€Π°Π΄ΠΈ ΠΊΠΎΠ΅Ρ‚ΠΎ Π΅ ΠΏΡ€Π΅ΠΏΡ€Π°Ρ‚Π΅Π½Π° към Π£ΠœΠ‘ΠΠ› β€žΠ‘Π². ΠœΠ°Ρ€ΠΈΠ½Π°` във Π’Π°Ρ€Π½Π°. Π€Π»ΠΎΡƒΡ†ΠΈΡ‚ΠΎΠΌΠ΅Ρ‚Ρ€ΠΈΡ‡Π½ΠΎΡ‚ΠΎ изслСдванС Π½Π° ΠΏΠ΅Ρ€ΠΈΡ„Π΅Ρ€Π½Π° ΠΊΡ€ΡŠΠ² Π΄Π΅-монстрира ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΡ‡Π½Π° B-ΠΊΠ»Π΅Ρ‚ΡŠΡ‡Π½Π° популация. Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ ΠΈ обсъТданС: CT сканиранСто Π½Π° Π³Ρ€ΡŠΠ΄Π½ΠΈΡ кош, ΠΊΠΎΡ€Π΅ΠΌΠ° ΠΈ Ρ‚Π°Π·Π° ΠΏΠΎΠΊΠ°Π·Π° Π³Π΅Π½Π΅Ρ€Π°Π»ΠΈΠ·ΠΈΡ€Π°Π½Π° лимфадСнопатия, синдром Π½Π° Π³ΠΎΡ€Π½Π° ΠΏΡ€Π°Π·Π½Π° Π²Π΅Π½Π° ΠΈ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»Π½ΠΎ ΡƒΠ³ΠΎΠ»Π΅ΠΌΠ΅Π½Π° слСзка с лацСрация, пСнСтрация Π½Π° Ρ…Π΅ΠΌΠ°Ρ‚ΠΎΠΌΠ° ΠΏΡ€Π΅Π· капсулата ΠΈ ΠΌΠ°Π»ΠΊΠ° колСкция ΠΊΡ€ΡŠΠ² Π² малкия Ρ‚Π°Π·. ΠŸΠΎΡ€Π°Π΄ΠΈ ниския Π±Ρ€ΠΎΠΉ Π½Π° Ρ‚Ρ€ΠΎΠΌΠ±ΠΎΡ†ΠΈΡ‚ΠΈΡ‚Π΅ тя Π΅ ΠΎΡ†Π΅Π½Π΅Π½Π° ΠΊΠ°Ρ‚ΠΎ високорисков Ρ…ΠΈΡ€ΡƒΡ€Π³ΠΈΡ‡Π΅Π½ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚. По Ρ‚Π°Π·ΠΈ ΠΏΡ€ΠΈΡ‡ΠΈΠ½Π° ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎ Π΅ ΠΈΠ·Π²ΡŠΡ€ΡˆΠ΅Π½Π° Смболизация Π½Π° Π»ΠΈΠ΅Π½Π°Π»Π½Π°Ρ‚Π° артСрия. ΠŸΡ€Π΅Π· август 2017 Π³. сС появява Π·Π°Π³ΡƒΠ±Π° Π½Π° Π°ΠΏΠ΅Ρ‚ΠΈΡ‚, ΠΊΠΎΡ€Π΅ΠΌΠ½Π° Π±ΠΎΠ»ΠΊΠ°, ΠΏΠΎΠ²Ρ€ΡŠΡ‰Π°Π½Π΅, Π·Π°ΠΏΠ΅ΠΊ ΠΈ анурия, ΠΊΠΎΠ΅Ρ‚ΠΎ Π΄ΠΎΠ²Π΅ΠΆΠ΄Π° Π΄ΠΎ ΠΏΡ€ΠΈΠ΅ΠΌΠ°Π½Π΅ ΠΏΠΎ ΡΠΏΠ΅ΡˆΠ½ΠΎΡΡ‚ Π² Π±ΠΎΠ»Π½ΠΈΡ†Π°. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ°Ρ‚Π° остава Π°Π½ΡƒΡ€ΠΈΡ‡Π½Π° Π²ΡŠΠΏΡ€Π΅ΠΊΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π°Ρ‚Π° хидратация ΠΈ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅, ΠΈΠ·ΠΏΠ°Π΄Π° Π² ΠΊΠΎΠΌΠ° ΠΈ Π½Π°ΡΡ‚ΡŠΠΏΠ²Π° Скзитус лСталис. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅: ΠŸΡ€ΠΎΠ³Π½ΠΎΠ·Π°Ρ‚Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅ с НΠ₯Π› зависи Π³Π»Π°Π²Π½ΠΎ ΠΎΡ‚ хистологичния клас, разпространСниСто, Π²ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΈ ΠΎΡ‚ Ρ‚ΠΎΠ²Π° Π΄Π°Π»ΠΈ болСстта Π΅ разпространСна Π² Скстранодални ΠΎΡ€Π³Π°Π½ΠΈ. НаличиСто Π½Π° Ρ‚Π΅Π·ΠΈ прогностични Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΈ Π² дискутирания случай ΠΌΠΎΠΆΠ΅ Π΄Π° обясни ΠΈΠ·Ρ…ΠΎΠ΄Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°.Introduction: Non-Hodgkin lymphoma (NHL) is a heterogeneous disease resulting from the malignant transformation of lymphocytes and includes multiple subtypes, each with specific molecular and clinical characteristics. The clinical presentation ranges from an indolent to an aggressive nature. Treatment decisions are preferably made in a multidisciplinary setting. The last decades have seen a growth due to increased mean age of the population, improvements in diagnosis, the HIV pandemic, and immunosuppressive therapy. Materials and Methods: A case report of a 65-year-old deceased female patient with a non-Hodgkin lymphoma is discussed. She was diagnosed in April 2017 with clinical manifestation of bilaterally enlarged cervical lymph nodes, astheno-adynamic syndrome, dizziness and abdominal pain. She was initially admitted at MHAT-Silistra, where they discovered bicytopenia (anemia and thrombocytopenia) due to which she was referred to Sv. Marina University Hospital in Varna. The flow cytometric analysis of peripheral blood demonstrated a pathological B-cell population. Results and Discussion: CT scan of chest, abdomen and pelvis showed generalized lymphadenopathy, superior vena cava syndrome and significantly enlarged spleen with laceration, penetration of the haematoma through the capsule and a small collection of blood in the lower abdomen. Due to low platelet count she was evaluated as a high-risk surgical patient. A splenic arterial embolization was successfully per formed. In August 2017, she developed loss of appetite, abdominal pain, vomiting, constipation and anuria, which required urgent hospital admission. The patient remained anuric despite proper hydration and treatment, became comatose and died. Conclusion: The prognosis of NHL patients depends mainly on the histological grade, dissemination, patient`s age and whether the disease spreads in extranodal organs. The presence of these prognostic factors in the discussed case may explain the outcome for this patient

    The capabilities of ultrasound - from standard echocardiography to Transcranial Doppler in the diagnostics of atrial septal defects

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    Π’ΡŠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: Π£Π»Ρ‚Ρ€Π°Π·Π²ΡƒΠΊΡŠΡ‚ Π΅ част ΠΎΡ‚ арсСнала Π½Π° Π»Π΅ΠΊΠ°Ρ€ΠΈ ΠΈ Ρ€Π°Π΄ΠΈΠΎΠ»ΠΎΠ·ΠΈ ΠΏΠΎΠ²Π΅Ρ‡Π΅ ΠΎΡ‚ 50 Π³ΠΎΠ΄ΠΈΠ½ΠΈ, Π½ΠΎ Π½Π΅Π³ΠΎΠ²ΠΈΡ‚Π΅ Π²ΡŠΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΠΈ ΠΈ днСс ΠΏΡ€ΠΎΠ΄ΡŠΠ»ΠΆΠ°Π²Π°Ρ‚ Π΄Π° нарастват Ρ‡Ρ€Π΅Π· Π²ΡŠΠ²Π΅ΠΆΠ΄Π°Π½Π΅Ρ‚ΠΎ Π½Π° всС ΠΏΠΎ-Π½ΠΎΠ²ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΈ Π² диагностиката Π½Π° Ρ€Π΅Π΄ΠΈΡ†Π° ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π•Π΄Π½Π° ΠΎΡ‚ тях са ΠΌΠ΅ΠΆΠ΄ΡƒΠΏΡ€Π΅Π΄ΡΡŠΡ€Π΄Π½ΠΈΡ‚Π΅ сСптални Π΄Π΅Ρ„Π΅ΠΊΡ‚ΠΈ (ASD) ΠΈ ΠΌΠ°ΠΊΠ°Ρ€ стандартната трансторакална Схокардиография (Π’Π’Π•) Π΄Π° Π΅ Π΄ΠΎΠΊΠ°Π·Π°Π»Π° СфСктивността ΠΈ ΠΏΠΎΠ»Π·Π°Ρ‚Π° си във Π²Ρ€Π΅ΠΌΠ΅Ρ‚ΠΎ, днСс Π½Π° Ρ€Π°Π·ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Π½Π° спСциалиститС ΡΡŠΡ‰Π΅ΡΡ‚Π²ΡƒΠ²Π° Π½ΠΎΠ² ΠΈ ΡΡŠΡ‰ΠΎ Ρ‚ΠΎΠ»ΠΊΠΎΠ²Π° Π½Π°Π΄Π΅ΠΆΠ΄Π΅Π½ диагностичСн ΠΌΠ΅Ρ‚ΠΎΠ΄ - транскраниалната Π΄ΠΎΠΏΠ»Π΅Ρ€ Схография (cTCD). ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ: Π”ΠΎΠΊΠ»Π°Π΄ΡŠΡ‚ Ρ€Π°Π·Π³Π»Π΅ΠΆΠ΄Π° нарастващитС Π²ΡŠΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ΠΈ Π½Π° Схографията Π² диагностиката Π½Π° АSD. УстановСно Π΅, Ρ‡Π΅ ΠΎΠΊΠΎΠ»ΠΎ 25% ΠΎΡ‚ свСтовното насСлСниС ΠΈΠΌΠ° пСрсистиращ Ρ„ΠΎΡ€Π°ΠΌΠ΅Π½ ΠΎΠ²Π°Π»Π΅ (ПЀО). ΠœΠ½ΠΎΠ·ΠΈΠ½ΡΡ‚Π²ΠΎΡ‚ΠΎ ΠΎΡ‚ Ρ‚Π΅Π·ΠΈ Ρ…ΠΎΡ€Π° нямат симптоми, ΡΠ²ΡŠΡ€Π·Π°Π½ΠΈ с Ρ‚ΠΎΠ²Π° ΡΡŠΡΡ‚ΠΎΡΠ½ΠΈΠ΅. Π’ΡŠΠΏΡ€Π΅ΠΊΠΈ Ρ‚ΠΎΠ²Π° Π² послСднитС Π³ΠΎΠ΄ΠΈΠ½ΠΈ сС ΠΏΡ€Π΅Π΄Π»Π°Π³Π° становищСто, Ρ‡Π΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅, ΠΏΡ€Π΅ΠΆΠΈΠ²Π΅Π»ΠΈ ΠΊΡ€ΠΈΠΏΡ‚ΠΎΠ³Π΅Π½Π½ΠΈ инсулти ΠΈΠ»ΠΈ Ρ‚Ρ€Π°Π½Π·ΠΈΡ‚ΠΎΡ€Π½ΠΈ исхСмични Π°Ρ‚Π°ΠΊΠΈ (TИА), ΠΈΠΌΠ°Ρ‚ ΠΏΠΎ-висока чСстота Π½Π° ПЀО. cTCD Π΅ ΠΌΠ½ΠΎΠ³ΠΎ чувствитСлна ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠ°, която ΠΌΠΎΠΆΠ΅ Π΄Π° бъдС ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π° Π·Π° ΠΎΡ†Π΅Π½ΠΊΠ°Ρ‚Π° Π½Π° дясно-Π»Π΅Π²ΠΈ ΡˆΡŠΠ½Ρ‚ΠΎΠ²Π΅ (RLS) ΠΏΡ€Π΅Π· ПЀО. Π—Π° диагностиката Π½Π° ASD сС ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π° транстСмпоралСн ΠΈΠ·Π³Π»Π΅Π΄, ΠΏΡ€ΠΈ ΠΊΠΎΠ΅Ρ‚ΠΎ сС изобразява срСдната ΠΌΠΎΠ·ΡŠΡ‡Π½Π° артСрия (БМА). ΠœΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠ°Ρ‚Π° сС ΡΡŠΡΡ‚ΠΎΠΈ Π² ΠΈΠ½Ρ‚Ρ€Π°Π²Π΅Π½ΠΎΠ·Π½Π° апликация Π½Π° ΠΏΡ€Π΅Π΄Π²Π°Ρ€ΠΈΡ‚Π΅Π»Π½ΠΎ ΠΏΡ€ΠΈΠ³ΠΎΡ‚Π²Π΅Π½ Ρ„ΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ‡Π΅Π½ Ρ€Π°Π·Ρ‚Π²ΠΎΡ€, ΠΊΠ°Ρ‚ΠΎ ΠΏΡ€ΠΈ поява Π½Π° ΠΌΠΈΠΊΡ€ΠΎΠΌΠ΅Ρ…ΡƒΡ€Ρ‡Π΅Ρ‚Π° Π² Π·ΠΎΠ½Π°Ρ‚Π° Π½Π° БМА поставя с голяма сигурност Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°Ρ‚Π° ASD. Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ ΠΈ обсъТданС: Π Π΅Π΄ΠΈΡ†Π° проучвания Π΄ΠΎΠΊΠ°Π·Π°Ρ…Π°, Ρ‡Π΅ ΠΏΡ€ΠΈ голям ΠΏΡ€ΠΎΡ†Π΅Π½Ρ‚ ΠΎΡ‚ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅, ΠΏΡ€Π΅ΠΆΠΈΠ²Π΅Π»ΠΈ инсулти ΠΈΠ»ΠΈ ВИА, Π΅ Π½Π°Π»ΠΈΡ†Π΅ Ρ‚Π°ΠΊΡŠΠ² Π΄Π΅Ρ„Π΅ΠΊΡ‚, a спСцифичността ΠΈ точността Π½Π° ΠΌΠ΅Ρ‚ΠΎΠ΄Π° са ΡΡŠΠΈΠ·ΠΌΠ΅Ρ€ΠΈΠΌΠΈ с Ρ‚Π΅Π·ΠΈ Π½Π° Π’Π’Π• ΠΈ трансСзофагСалната Схокардиография (Π’Π•Π•), която сС ΠΏΡ€ΠΈΠ΅ΠΌΠ° Π·Π° Π·Π»Π°Ρ‚Π΅Π½ стандарт. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅: cTCD ΠΈΠΌΠ° сходна чувствитСлност ΠΈ спСцифичност с Ρ‚Π°Π·ΠΈ Π½Π° cTEE ΠΏΡ€ΠΈ ΠΎΡ‚ΠΊΡ€ΠΈΠ²Π°Π½Π΅Ρ‚ΠΎ Π½Π° ASD, Π½ΠΎ ΠΈΠΌΠ° прСдимството Π΄Π° Π΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π΅Π½ ΠΈ Π΄ΠΎΠΊΠ°Π·Π°Π½ΠΎ бСзопасСн ΠΏΡ€ΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ с Π΅ΠΌΠ±ΠΎΠ»ΠΈΡ‡Π΅Π½ инсулт ΠΎΡ‚ нСизяснСн ΠΏΡ€ΠΎΠΈΠ·Ρ…ΠΎΠ΄. Π’ ΠΎΠ±ΠΎΠ±Ρ‰Π΅Π½ΠΈΠ΅, Π΄ΠΎΡΡ‚ΡŠΠΏΠ½ΠΎΡΡ‚Ρ‚Π° Π΄ΠΎ високосСнситивни диагностични Ρ‚Π΅Ρ…Π½ΠΈΠΊΠΈ, ΠΊΠ°ΠΊΠ²Π°Ρ‚ΠΎ Π΅ TCD, осигурява Π²ΡŠΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ Π·Π° Π΅Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π΅Π½ ΠΈ Π½Π°Π΄Π΅ΠΆΠ΄Π΅Π½ скрининг Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ със ΡΡŠΠΎΡ‚Π²Π΅Ρ‚Π½ΠΈΡ‚Π΅ показания.Introduction: Ultrasound has been a part of the arsenal of medical specialists for more than 50 years but its uses keep growing with the invention of newer methods in diagnostics of different pathologies. One of them are the atrial septal defects (ASD) and even though the standard transthoracic echocardiography (TTE) has proven its efficacy, there is nowadays, available to professionals, a new and equally reliable diagnostic method - transcranial Doppler ultrasonog-raphy (cTCD). Materials and Methods: This report reviews the growing capabilities of ultrasound in ASD diagnostics. It is estimated that approximately 25% of the world`s population have patent foramen ovale (PFO). The majority of these people have no symptoms associated with this condition. However, in recent years, it has been suggested that patients with cryptogenic strokes or transient ischaemic attacks (TIA) have higher prevalence of PFO. cTCD is a very sensitive technique which can be used for evaluation of right-to-left shunts (RLS) via PFO. In the diagnostics of ASD transtemporal view is used and the middle cerebral artery (MCA) is visualized. The method is performed by intravenous application of saline and the appearance of microbubbles in the MCA determines with high certainty the diagnosis of ASD. Results and Discussion: Numerous studies have shown that in large percentage of the patients with strokes or TIA such defect is present and the specificity and accuracy of the method are comparable to those of TTE and transesophageal echocardiography (TEE), which is considered a standard method for detecting RLS. Conclusion: cTCD has similar sensitivity and specificity to cTEE in detecting ASD but has the advantage of being noninvasive and reportedly safe in patients with embolic stroke of undetermined source. In summary, the availability of high sensitive diagnostic techniques such as TCD provides the opportunity of effective and reliable screening of patients with appropriate indications

    Radiotherapy. stages of planning of the radiotherapy process. TNM classification

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    Π’ Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅Ρ‚ΠΎ днСс сС ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Ρ‚ Π΄Π²Π΅ основни Π³Ρ€ΡƒΠΏΠΈ ΠΉΠΎΠ½ΠΈΠ·ΠΈΡ€Π°Ρ‰ΠΈ Π»ΡŠΡ‡Π΅Π½ΠΈΡ - Ρ„ΠΎΡ‚ΠΎΠ½ΠΈ ΠΈ Π·Π°Ρ€Π΅Π΄Π΅Π½ΠΈ частици. Π€ΠΎΡ‚ΠΎΠ½ΠΈ са Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ²ΠΈΡ‚Π΅, Π³Π°ΠΌΠ° ΠΈ високоСнСргийното спирачно Π»ΡŠΡ‡Π΅Π½ΠΈΠ΅ (Π₯-Π»ΡŠΡ‡ΠΈΡ‚Π΅), a частици - Π±Π΅Ρ‚Π°-Π»ΡŠΡ‡ΠΈΡ‚Π΅, ускорСнитС Π΅Π»Π΅ΠΊΡ‚Ρ€ΠΎΠ½ΠΈ, ΠΏΡ€ΠΎΡ‚ΠΎΠ½ΠΈΡ‚Π΅, ΠΏΠΈ-ΠΌΠ΅Π·ΠΎΠ½ΠΈΡ‚Π΅ ΠΈ Ρ‚Π΅ΠΆΠΊΠΈΡ‚Π΅ ΠΉΠΎΠ½ΠΈ. Π”ΠΎ скоро Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ²Π°Ρ‚Π° ΠΈ тСлСгаматСрапията бяха Π²ΠΎΠ΄Π΅Ρ‰ΠΈ Π² Π‘ΡŠΠ»Π³Π°Ρ€ΠΈΡ. Π‘ въвСТданС Π½Π° Π»ΠΈΠ½Π΅ΠΉΠ½ΠΈΡ‚Π΅ ускоритСли Π½Π°ΠΉ-ΡˆΠΈΡ€ΠΎΠΊΠΎ Π΅ ΠΏΡ€ΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅Ρ‚ΠΎ Π½Π° Π₯-Π»ΡŠΡ‡ΠΈΡ‚Π΅ ΠΈ ускорСнитС Π΅Π»Π΅ΠΊΡ‚Ρ€ΠΎΠ½ΠΈ. Π Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ²Π°Ρ‚Π° тСрапия сС ΠΏΡ€ΠΈΠ»Π°Π³Π° ΠΏΡ€ΠΈ ΠΊΠΎΠΆΠ½ΠΈ Π»Π΅Π·ΠΈΠΈ с ΠΌΠ°Π»ΠΊΠΈ Ρ€Π°Π·ΠΌΠ΅Ρ€ΠΈ.ΠŸΡ€ΠΎΡ†Π΅ΡΡŠΡ‚ Π½Π° ΠΏΠ»Π°Π½ΠΈΡ€Π°Π½Π΅ Π½Π° Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅Ρ‚ΠΎ Π΅ Ρ‚Ρ€ΡƒΠ΄Π΅Π½, ΡΡŠΠ΄ΡŠΡ€ΠΆΠ° ΠΌΠ½ΠΎΠ³ΠΎ ΡΡ‚ΡŠΠΏΠΊΠΈ ΠΈ високорискови дСйности, Ρ‚ΡŠΠΉ ΠΊΠ°Ρ‚ΠΎ Π²ΠΊΠ»ΡŽΡ‡Π²Π° ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π΅Ρ‚ΠΎ Π½Π° ΠΌΠ½ΠΎΠ³ΠΎ ΠΈΠ·Ρ‚ΠΎΡ‡Π½ΠΈΡ†ΠΈ Π½Π° информация ΠΈ взаимодСйствиСто Π½Π° Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΈ спСциалисти, участващи Π² Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π±Π½ΠΈΡ процСс. TNM класификацията сС ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π° Π·Π° опрСдСлянС ΠΈΠ½Π΄ΠΈΠΊΠ°Ρ†ΠΈΠΈΡ‚Π΅ Π·Π° Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅.ΠŸΡ€ΠΈ всички Π±ΠΎΠ»Π½ΠΈ, ΠΊΠΎΠΈΡ‚ΠΎ сС ΠΎΠ±Π»ΡŠΡ‡Π²Π°Ρ‚ с Π»ΠΈΠ½Π΅ΠΉΠ½ΠΈ ускоритСли, сС ΠΏΡ€ΠΈΠ»Π°Π³Π° Ρ‚Ρ€ΠΈΠΈΠ·ΠΌΠ΅Ρ€Π½ΠΎ ΠΏΠ»Π°Π½ΠΈΡ€Π°Π½Π΅. ΠžΡΠ½ΠΎΠ²Π½ΠΎΡ‚ΠΎ Π΅, Ρ‡Π΅ ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½ΠΈΡΡ‚ ΠΎΠ±Π΅ΠΌ ΠΈ ΠΊΡ€ΠΈΡ‚ΠΈΡ‡Π½ΠΈΡ‚Π΅ ΠΎΡ€Π³Π°Π½ΠΈ сС Π·Π°Π΄Π°Π²Π°Ρ‚ Π² ΠΏΠΎΡ€Π΅Π΄ΠΈΡ†Π° ΠΎΡ‚ срСзовС с Π΄Π΅Π±Π΅Π»ΠΈΠ½Π°, ΠΏΠΎ-голяма ΠΎΡ‚ 0,5 см. По Ρ‚ΠΎΠ·ΠΈ Π½Π°Ρ‡ΠΈΠ½ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»Π½ΠΎ сС повишава точността ΠΈ качСството Π½Π° ΠΏΠ»Π°Π½ΠΈΡ€Π°Π½ΠΎΡ‚ΠΎ Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅. Π’Π΅Ρ…Π½ΠΈΠΊΠΈΡ‚Π΅ Π½Π° ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½Π΅, ΠΏΡ€ΠΈΠ»Π°Π³Π°Π½ΠΈ с Π»ΠΈΠ½Π΅Π΅Π½ ускоритСл, са ΠΈΠ·ΠΎΡ†Π΅Π½Ρ‚Ρ€ΠΈΡ‡Π½ΠΈ ΠΈ Π½Π°Π»Π°Π³Π°Ρ‚ ΠΌΠ°Ρ€ΠΊΠΈΡ€Π°Π½Π΅ Π½Π° ΠΈΠ·ΠΎΠ΅Π½Ρ‚ΡŠΡ€Π° Π½Π° ΠΊΠΎΠΆΠ°Ρ‚Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΈΠ»ΠΈ Π½Π° ΠΈΠΌΠΎΠ±ΠΈΠ»ΠΈΠ·ΠΈΡ€Π°Ρ‰ΠΈΡ‚Π΅ устройства. Π˜Π·ΠΎΡ†Π΅Π½Ρ‚ΡŠΡ€ΡŠΡ‚ сС поставя ΠΏΡ€ΠΈ ΠΏΡŠΡ€Π²ΠΎΡ‚ΠΎ ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½Π΅ Π½Π° тСрапСвтичния Π°ΠΏΠ°Ρ€Π°Ρ‚ Π² ΠΏΡ€ΠΈΡΡŠΡΡ‚Π²ΠΈΠ΅Ρ‚ΠΎ Π½Π° Π»Π΅ΠΊΠ°Ρ€ ΠΈ Ρ„ΠΈΠ·ΠΈΠΊ-дозимСтрист, ΠΈΠ·Π³ΠΎΡ‚Π²ΠΈΠ» индивидуалния ΠΏΠ»Π°Π½.Ако всСки Π»ΡŠΡ‡Π΅Ρ‚Π΅Ρ€Π°ΠΏΠ΅Π²Ρ‚ΠΈΡ‡Π΅Π½ Ρ†Π΅Π½Ρ‚ΡŠΡ€ Ρ€Π°Π·ΠΏΠΎΠ»Π°Π³Π° с пълСн Π½Π°Π±ΠΎΡ€ ΠΎΡ‚ Π»ΡŠΡ‡Π΅Ρ‚Π΅Ρ€Π°ΠΏΠ΅Π²Ρ‚ΠΈΡ‡Π½Π° Π°ΠΏΠ°Ρ€Π°Ρ‚ΡƒΡ€Π°, Ρ‚ΠΎΠ²Π° Π΄Π°Π²Π° Π²ΡŠΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ Π·Π° Π°Π΄Π΅ΠΊΠ²Π°Ρ‚Π½ΠΎ ΠΈ ΡΡŠΠ²Ρ€Π΅ΠΌΠ΅Π½Π½ΠΎ ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½Π΅ Π½Π° всички Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Π½Π° злокачСствСни ΠΈ доброкачСствСни новообразувания, с ΠΈΠ½Π΄ΠΈΠΊΠ°Ρ†ΠΈΠΈ Π·Π° Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅. Π’ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡ‡Π½Π°Ρ‚Π° ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΎΠ½Π½Π° систСма сС ΡΡŠΡ…Ρ€Π°Π½ΡΠ²Π°Ρ‚: Π»ΠΈΡ‡Π½ΠΈΡ‚Π΅ Π΄Π°Π½Π½ΠΈ Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½Π°Ρ‚Π° информация относно заболяванСто ΠΈ Π²ΠΈΠ΄Π° Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅, дозимСтричният ΠΏΠ»Π°Π½ Π½Π° ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½Π΅Ρ‚ΠΎ, ΠΊΠ°ΠΊΡ‚ΠΎ ΠΈ ΠΏΠΎΠ΄Ρ€ΠΎΠ±Π½Π° информация Π·Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎΡ‚ΠΎ Π»ΡŠΡ‡Π΅Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅. Π˜Π½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΡΡ‚Π° сС Π°Ρ€Ρ…ΠΈΠ²ΠΈΡ€Π° с Π²ΡŠΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡ‚ Π·Π° справка Π½Π° броя Π½Π° ΠΈΠ·Π²ΡŠΡ€ΡˆΠ΅Π½ΠΈΡ‚Π΅ сСанси ΠΈ ΠΎΠ±Π»ΡŠΡ‡Π²Π°Π½ΠΈ ΠΎΠ±Π΅ΠΌΠΈ, ΠΊΠ°ΠΊΡ‚ΠΎ ΠΈ статистичСски Π°Π½Π°Π»ΠΈΠ· Π½Π° мноТСство Π΄Π°Π½Π½ΠΈ, отнасящи сС Π΄ΠΎ цялостния Π»ΡŠΡ‡Π΅Ρ‚Π΅Ρ€Π°ΠΏΠ΅Π²Ρ‚ΠΈΡ‡Π΅Π½ процСс.In modern radiotherapy two main groups of ionizing radiation are used - photons and charged particles. The photons consist of orthovoltage x-rays, gamma rays and high-energy x-rays, and the particles are beta-rays, accelerated electrons, protons, pi mesons and heavy ions. Until recently orthovoltage and telegamatherapy have been the main types of radiotherapy in Bulgaria. Now with the installation of linear accelerators, x-rays, and accelerated electrons are most commonly used. Orthovoltage radiotherapy is used for small skin lesions.The planning process of radiotherapy is difficult and contains many steps and high-risk activities as it includes the use of many sources of information and the collaboration of different specialists participating in the radiotherapy process. TNM classification is used to define the indication for radiotherapy. Three-dimensional planning is applied to all patients that are treated at a linear accelerator. The main issue here is that the target volume and the critical organs are defined as a series of consecutive CT scans with thickness of less than 0.5 cm. Thus, the accuracy and the quality of the planned radiotherapy are significantly improved. Isocenter irradiation techniqes are used with linear accelerators and this requires marking the isocenter on the patient`s skin or on the immobilization devices.The isocenter is marked during the first irradiation at the treatment machine in the presence of a physician and a physicist-dosimetrist who has developed the individual plan.If a single radiotherapy department is equiped with the full set of radiotherapy machines, this will provide adequate and modern irradiation of all malignant tumors and benign conditions requiring radiotherapy. The oncology information system stores the demographic data of the patient, the clinical information about the disease and treatment methods, the treatment as well as detailed information about the radiotherapy course . The information is archived and allows the checking of the number of performed fractions, the irradiated volumes as well as the performing of a statistical analysis of multiple data related to the entire radiotherapy process

    Kidney stone disease (Nephrolithiasis) - Pathogenesis, types of imaging diagnostic methods in contemporary medicine

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    Π ΠΈΡΠΊΡŠΡ‚ ΠΎΡ‚ Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ Π½Π° Π½Π΅Ρ„Ρ€ΠΎΠ»ΠΈΡ‚ΠΈΠ°Π·Π° Π² Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΡ‚Π΅ страни Π΅ ΠΎΠΊΠΎΠ»ΠΎ 12% ΠΏΡ€ΠΈ ΠΌΡŠΠΆΠ΅Ρ‚Π΅ ΠΈ 6% ΠΏΡ€ΠΈ ΠΆΠ΅Π½ΠΈΡ‚Π΅. Бялата раса Π΅ ΠΏΠΎ-засСгната ΠΎΡ‚ Ρ‡Π΅Ρ€Π½Π°Ρ‚Π°. ЧСстотата Π½Π° заболяванСто сС ΡƒΠ²Π΅Π»ΠΈΡ‡Π°Π²Π° ΠΏΡ€Π°Π²ΠΎΠΏΡ€ΠΎΠΏΠΎΡ€Ρ†ΠΈΠΎΠ½Π°Π»Π½ΠΎ Π½Π° ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½Π°Ρ‚Π° чСстота Π½Π° Π·Π°Ρ…Π°Ρ€Π΅Π½ Π΄ΠΈΠ°Π±Π΅Ρ‚ Ρ‚ΠΈΠΏ Π†Π† ΠΈ Π½Π°Π΄Π½ΠΎΡ€ΠΌΠ΅Π½ΠΎΡ‚ΠΎ Ρ‚Π΅Π³Π»ΠΎ. Π‘ΡŠΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΠ΅Ρ‚ΠΎ мъТС / ΠΆΠ΅Π½ΠΈ Π΅ 1,3:1. ЧСстотата сС ΡƒΠ²Π΅Π»ΠΈΡ‡Π°Π²Π° във Π²ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π° Π½Π°Π΄ 20 Π³ΠΎΠ΄ΠΈΠ½ΠΈ, a ΠΏΠΈΠΊΡŠΡ‚ Π½Π° патологията Π΅ във Π²ΡŠΠ·Ρ€Π°ΡΡ‚ΠΎΠ²Π°Ρ‚Π° Π³Ρ€ΡƒΠΏΠ° ΠΌΠ΅ΠΆΠ΄Ρƒ 40-60 Π³ΠΎΠ΄ΠΈΠ½ΠΈ, слСд ΠΊΠΎΠ΅Ρ‚ΠΎ намалява ΠΈ остава константа. НСфролитиазата Π΅ извСстна ΠΎΡ‰Π΅ ΠΊΠ°Ρ‚ΠΎ Π±ΡŠΠ±Ρ€Π΅Ρ‡Π½ΠΎ-ΠΊΠ°ΠΌΠ΅Π½Π½Π° болСст ΠΈ сС Ρ€Π°Π·Π²ΠΈΠ²Π° ΠΏΡ€ΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ с Π³Π΅Π½Π΅Ρ‚ΠΈΡ‡Π½Π° прСдиспозиция, ΠΏΡ€ΠΈ ΡˆΠΈΡ€ΠΎΠΊ ΡΠΏΠ΅ΠΊΡ‚ΡŠΡ€ ΠΎΡ‚ ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΡ‚Π½ΠΈ заболявания, a ΡΡŠΡ‰ΠΎ ΠΈ ΠΏΡ€ΠΈ мноТСство ΠΊΠΎΠΌΠΎΡ€Π±ΠΈΠ΄Π½ΠΈ ΡΡŠΡΡ‚ΠΎΡΠ½ΠΈΡ. ΠŸΠΎΠ²Π΅Ρ‡Π΅Ρ‚ΠΎ камъни са ΠΈΠ·Π³Ρ€Π°Π΄Π΅Π½ΠΈ ΠΎΡ‚ ΠΊΠ°Π»Ρ†ΠΈΠ΅Π² оксалат ΠΈ ΠΏΠΈΠΊΠΎΡ‡Π½Π° кисСлина, струвит (Π°ΠΌΠΎΠ½ΠΈΠ΅Π²ΠΎ-ΠΌΠ°Π³Π½Π΅Π·ΠΈΠ΅Π² сулфат), цистин, Π°ΠΌΠΎΠ½ΠΈΠ΅Π² ΡƒΡ€Π°Ρ‚. НапослСдък сС повишава чСстотата Π½Π° лСкарствСно ΠΈΠ½Π΄ΡƒΡ†ΠΈΡ€Π°Π½Π°Ρ‚Π° Π½Π΅Ρ„Ρ€ΠΎΠ»ΠΈΡ‚ΠΈΠ°Π·Π°, която сС наблюдава ΠΏΡ€ΠΈ ΠΈΠΌΠΎΠ±ΠΈΠ»ΠΈΠ·ΠΈΡ€Π°Π½ΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ.ΠžΠ±Ρ€Π°Π·Π½ΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡ‚ΠΈΡ‡Π½ΠΈΡ‚Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ Π·Π°ΠΏΠΎΡ‡Π²Π°Ρ‚ с ΡƒΠ»Ρ‚Ρ€Π°Π·Π²ΡƒΠΊΠΎΠ²ΠΎΡ‚ΠΎ изслСдванС Π½Π° ΠΏΠΈΠΊΠΎΡ‡ΠΎ-ΠΎΡ‚Π΄Π΅Π»ΠΈΡ‚Π΅Π»Π½Π°Ρ‚Π° систСма. Π’ΠΎ ΠΎΡ‚ΠΊΡ€ΠΈΠ²Π° голям ΠΏΡ€ΠΎΡ†Π΅Π½Ρ‚ ΠΎΡ‚ всички ΠΊΠΎΠ½ΠΊΡ€Π΅ΠΌΠ΅Π½Ρ‚ΠΈ, ΠΊΠ°ΠΊΡ‚ΠΎ ΠΈ ΠΏΠ°Ρ€Π΅Π½Ρ…ΠΈΠΌΠ½ΠΈ процСси, ΠΊΠΎΠΈΡ‚ΠΎ Π±ΠΈΡ…Π° ΠΌΠΎΠ³Π»ΠΈ Π΄Π° ΠΈΠΌΠΈΡ‚ΠΈΡ€Π°Ρ‚ Ρ€Π΅Π½Π°Π»Π½Π° ΠΊΠΎΠ»ΠΈΠΊΠ°. ΠžΠ±Π·ΠΎΡ€Π½Π°Ρ‚Π° рСнтгСнография Π½Π° Π±ΡŠΠ±Ρ€Π΅Ρ†ΠΈ, ΡƒΡ€Π΅Ρ‚Π΅Ρ€ΠΈ, ΠΏΠΈΠΊΠΎΡ‡Π΅Π½ ΠΌΠ΅Ρ…ΡƒΡ€ (Π‘Π£Πœ) прСдставлява Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ²ΠΎ изслСдванС Π½Π° ΠΎΡ‚Π΄Π΅Π»ΠΈΡ‚Π΅Π»Π½Π°Ρ‚Π° систСма, ΠΊΠΎΠ΅Ρ‚ΠΎ дСмонстрира ΠΊΠΎΠ½ΠΊΡ€Π΅ΠΌΠ΅Π½Ρ‚ΠΈ с ΠΊΠ°Π»Ρ†ΠΈΠ΅Π²ΠΎ ΡΡŠΠ΄ΡŠΡ€ΠΆΠΈΠΌΠΎ; ΠΎΠ±ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΎ ΠΏΡ€Π΅Π΄ΡˆΠ΅ΡΡ‚Π²Π° Π²Π΅Π½ΠΎΠ·Π½Π°Ρ‚Π° урография ΠΈ Π΄Ρ€ΡƒΠ³ΠΈ Ρ€Π΅Π½Ρ‚Π³Π΅Π½ΠΎΠ²ΠΈ изслСдвания. Π’Π΅Π½ΠΎΠ·Π½Π° урография - ΠΌΠ΅Ρ‚ΠΎΠ΄ΡŠΡ‚ Π΄Π°Π²Π° информация ΠΊΠ°ΠΊΡ‚ΠΎ Π·Π° позицията ΠΈ Ρ€Π°Π·ΠΌΠ΅Ρ€Π° Π½Π° ΠΊΠΎΠ½ΠΊΡ€Π΅ΠΌΠ΅Π½Ρ‚Π°, Ρ‚Π°ΠΊΠ° ΠΈ Π·Π° ΡΡŠΡΡ‚ΠΎΡΠ½ΠΈΠ΅Ρ‚ΠΎ Π½Π° Π±ΡŠΠ±Ρ€Π΅Ρ‡Π½Π°Ρ‚Π° функция. ΠœΠ΅Ρ‚ΠΎΠ΄ΡŠΡ‚ ΠΎΠ±Π°Ρ‡Π΅ ΠΈΠΌΠ° риск ΠΎΡ‚ извСстна нСфротоксичност. ΠšΠΎΠΌΠΏΡŽΡ‚ΡŠΡ€Π½Π° томография Π±Π΅Π· ΠΈΠ·ΠΏΠΎΠ»Π·Π²Π°Π½Π΅ Π½Π° контрастна матСрия дСмонстрира ΠΊΠΎΠ½ΠΊΡ€Π΅ΠΌΠ΅Π½Ρ‚ΠΈ във всяка Π΅Π΄Π½Π° част ΠΎΡ‚ ΠΎΡ‚Π΄Π΅Π»ΠΈΡ‚Π΅Π»Π½Π°Ρ‚Π° систСма.Има Ρ€Π΅Π΄ΠΈΡ†Π° заболявания, ΠΊΠΎΠΈΡ‚ΠΎ ΠΌΠΎΠ³Π°Ρ‚ Π΄Π° ΠΈΠΌΠΈΡ‚ΠΈΡ€Π°Ρ‚ симптомитС Π½Π° Π‘ΠšΠ‘ ΠΈ ΠΏΠΎΡ€Π°Π΄ΠΈ Ρ‚Π°Π·ΠΈ ΠΏΡ€ΠΈΡ‡ΠΈΠ½Π° Π΅ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ Ρ‚Π΅ Π΄Π° Π±ΡŠΠ΄Π°Ρ‚ ΠΈΠ·ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈ Π² Ρ…ΠΎΠ΄Π° Π½Π° диагностичния процСс. ДнСс Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅Ρ‚ΠΎ Π½Π° Π½Π°ΡƒΠΊΠ°Ρ‚Π° допринСсС Π·Π° ΠΏΠΎ-Π·Π°Π΄ΡŠΠ»Π±ΠΎΡ‡Π΅Π½ΠΎ Ρ€Π°Π·Π±ΠΈΡ€Π°Π½Π΅ Π½Π° ΠΏΡ€ΠΈΡ‡ΠΈΠ½ΠΈΡ‚Π΅ ΠΈ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠΈΡ‚Π΅ Π·Π° ΠΎΠ±Ρ€Π°Π·ΡƒΠ²Π°Π½Π΅ Π½Π° камъни ΠΈ ΡΡŠΠΎΡ‚Π²Π΅Ρ‚Π½ΠΎ - Π·Π° ΠΌΠ½ΠΎΠ³ΠΎ ΠΏΠΎ-Π΅Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½ΠΎ диагностициранС ΠΈ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅. НСобходимо Π΅ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ΠΈΡ‡Π½ΠΎ Π΄Π° сС слСди здравословното ΡΡŠΡΡ‚ΠΎΡΠ½ΠΈΠ΅ Ρ‡Ρ€Π΅Π· Ρ€Π΅Π΄ΠΎΠ²Π½ΠΈ консултации с Π½Π΅Ρ„Ρ€ΠΎΠ»ΠΎΠ³ ΠΈΠ»ΠΈ ΡƒΡ€ΠΎΠ»ΠΎΠ³, ΠΊΠΎΠΉΡ‚ΠΎ Π΄Π° ΠΈΠ·Π²ΡŠΡ€ΡˆΠ²Π° Схографско изслСдванС.The risk of nephrolithiasis in developed countries is roughly 12% in men and 6% in women. Caucasians are more likely to form kidney stones than black people. The frequency of this pathology increases proportionally to the rising frequency of type II diabetes mellitus and obesity. The ratio of male to female sufferers is 1.3:1. The disease is mostly observed in individuals over the age of 20, while the pique is between 40 and 60 years. Nephrolithiasis is more commonly known as kidney stone disease and develops primarily in genetically predisposed patients, patients with metabolic disorders, and multiple comorbidities. Most stones are made up of calcium oxalate and uric acid, struvite (magnesium ammonium phosphate), cystine, ammonium urate. Recently there has been an increase in medicamentation-induced nephrolithiasis, observed in immobilized patients.The imaging diagnostics begins with abdominal ultrasonography - it can find a large percentage of all calculi, as well as parenchymal processes which could simulate a renal colic. Plain abdominal radiographs can demonstrate calcium-containing stones, and usually precedes venous urograms and other exams. Venous urograms provide insight into a calculus position, as well as regarding renal function. It is, however, associated with potential nephrotoxicity. Computed tomography can natively (without contrast material) demonstrate virtually all stones in every part of the excretory system.There are several conditions which mimic the symptoms of kidney stone disease, and must therefore be exlcuded along the diagnostic pathway. Currently, advanced understanding of the reasons and mechanisms of calculus formation have contributed to more effective diagnostic and treatment methods. Periodic consultations and ultrasonographies with a nephrologist or urologist are advisable

    Imaging diagnostic methods for colorectal cancer in contemporary medicine. Types and prevention

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    INTRODUCTION: Colon cancer (colorectal carcinoma) is a malignant tumor, stemming from the wall of the colon. It is the second most common carcinoma in men (after pulmonary and before stomach cancers) and the third most common in women (after breast and uterine carcinomas). Its frequency has been increasing steadily in the last years. It most often affects people past 50 years of age, but about 20% of cases occur before that point. Histologically, 80% of cases are of adenocarcinoma and about 20% - mucinous. Carcinomas generally develop on the basis of adenomas.AIM: To examine the types, the prevention and the imaging diagnostic methods for the cancer of the large intestine and of the colon of modern medicine.MATERIALS AND METHODS: This research applies statistical methods. The data was processed through statistical and graphical analyses.RESULTS: Screening methods applied with success are as follows: rectoromanoscopy, fibrocolonoscopy, irigography, computed tomographic colonography, magnetic resonance tomography. The most frequently used two are irigography with a barium enema and fibrocolonoscopy. The former allows for a thorough radiological topographical analysis of the whole colon, while the latter allows for direct mucosal visualization and biopsy (both cytological and histological) without radiation by means of a flexible metallic tube inserted retrogradely. Fibrocolonoscopy enables minor minimally invasive surgery such as polyp and small tumor removal. Rectoromanoscopy is a dated method, solely with historical significance. The latest imaging diagnostic methods are the tomographic ones - computed tomography, computed tomography virtual colonoscopy, and magnetic resonance tomography. They are highly informative for all diseases of the colon, contributing considerably to tumor staging, and to preoperative assessment.CONCLUSIONS: Screening programs, timely consultations with specialists and the increasing availability of imaging diagnostic equipment lead to a marked tendency of decreasing colorectal carcinoma mortality in Bulgaria

    Gallstone disease (Cholelithiasis) - pathogenesis, prevention and contemporary methods of imaging diagnostics

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    INTRODUCTION: Cholelithiasis is a metabolic disorder, leading to stone formation in the bile ducts and gallΒ­bladder. The stones are classified by their composition as cholesterol, pigment, and mixed. The condition is more frequent in overweight individuals, with a stationary way of life, diabetics, and women on oral contracepΒ­tives. There is a female predilection with a 3.5:1 ratio. The disease has several forms. The latent one is devoid of complaints - stones are an incidental finding. The acute form manifests with right upper quadrant pain. BiliΒ­ary colic is typical - it comes in fits of right subcostal pain, nausea, and frequently - vomiting. Complications are frequent - gallbladder and bile duct inflammation, biliary obstruction, gallbladder perforation, and biliΒ­ary peritonitis.AIM: To analyze the pathogenesis, the prevention and the modern medical imaging methods related to the gallstones disease.MATERIALS AND METHODS: This research applied statistical methods. The data was processed through staΒ­tistical and graphical analysis.RESULTS: Accurate diagnosis requires a compound approach. Anamnesis of biliary colic initiates it. AbdomiΒ­nal ultrasonography is the fastest and most accessible imaging method for finding gallstones. It can also presΒ­ent the gallbladder itself - whether it is enlarged, inflamed, or folded. Additional methods include magnetic resonance imaging (MRI), computed tomography (CT), and some hybrid techniques. If the data of cholelithiΒ­asis is ambiguous, the latter can be confirmed by endoscopic retrograde cholangiopancreatography (ERCP) - an endoscope is introduced to the level of the papilla of Vater, and contrast is injected into it. The biliary pathΒ­ways also used to be imaged by percutaneous transhepatic cholangiography, which now is a dated technique.CONCLUSIONS: Prophylaxis includes avoiding risk factors of alimentary nature and undergoing periodic conΒ­trol ultrasonographies, especially in individuals with a family history of gallstones. This is crucial, as chroni

    The effect of X-ray radiation on the human body - pros and cons. Radiation protection in medical imaging and radiotherapy

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    INTRODUCTION: The discovery of X-rays in November 1895 by Roentgen opened a new chapter in the scientifΒ­ic development and pretty soon it became clear that these rays can be useful for diagnostics and treatment. The most frequent use of X-rays is related to their ability to pass through matter. The main fields of application of the rays are medicine, industry, checks of goods and packages and scientific studies. Modern medicine constiΒ­tutes approximately 80% of the overexposure. The contribution of diagnostic radiology is approximately 22% of the total exposure of Bulgarian population. The quality of the medical services depends to a great extent on the accurate and timely diagnoses set through different methods using also ionizing radiation. The exposure of the patient should be reasonably justified and optimized but cannot be limited. The risk of exposure to high doses of radiation is justified only if this is appropriate for the diagnosis or the treatment. Each overexposure, including medical irradiation, is related to certain radiation risk. Radiation protection is a means to apply the measures intended to protect the health from ionizing radiation-related risks. It is essential to know the beneΒ­fits and risks of the medical procedures.AIM: To investigate radiation protection means, and the benefits and risks of medical procedures.MATERIALS AND METHODS: An analysis of literature sources was conducted.RESULTS: The medical control of the radiation protection divides exposure into three categories: professional exposure, medical exposure and exposure of the population. Irradiation by any source should be conducted by optimizing the protection and the safety, maintaining the size of the individual dose, the number of exposed persons and the exposure at levels as low as reasonably achievable considering the social and economic factors. This is the so-called optimization of the protection

    Verkehrskonzept Innenstadt - Sliven/Bulgarien

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    Zusammenfassung in englischer SpracheIn der vorliegenden Diplomarbeit wurde ein Verkehrskonzept fΓΌr die Verbesserung des Verkehrs in der Innenstadt - Sliven auf Grund der Analyse des Ist - Zustandes dem Straßennetz und der Verkehrsorganisation dargestellt. Im Einleitungsteil der Diplomarbeit wird stΓ€dtebauliche Beurteilungen und Kommunikationsproblemen entsprechend dem Masterplan der Stadt gezeigt. FΓΌr die Zusammenstellung des Verkehrskonzeptes werden genaue Ziele entsprechend ihrer Bedeutung definiert. Die Ziele beinhalten im Wesentlichen eine Γ„nderung des Modal - Splits. Im Verkehrskonzept werden ausfΓΌhrliche Untersuchungen der Ist-Zustand und Entwicklungstendenzen in Bezug auf die geografische Lage, BevΓΆlkerungsentwicklung, Verkehrsinfrastruktur und auch des Untersuchungsanteils jeder Verkehrsart. Methodisch baut das Verkehrskonzept fΓΌr die Innenstadt auf einer Haushaltbefragung auf. Diese Methode wird verwendet, um der MobilitΓ€tsverhaltens fΓΌr Haushaltmitglieder fΓΌr einen Stichtag sowie bei einer Reihe von zusΓ€tzlichen Fragestellungen bezΓΌglich Probleme und resultierenden MaßnahmenvorschlΓ€gen zu ermitteln. Die Planung und Analyse im bestimmten Stadtteil aus der Innenstadt umfassen die HauptmobilitΓ€tsarten als Fußverkehr, Radfahrverkehr, Γ–PNV, Autoverkehr und auch die Parkraumbewirtschaftung. Die Planungen fΓΌr die verschiedenen MobilitΓ€tsformen werden auf Grund der ΓΆsterreichischen Richtlinien.12

    Identification of the Reference Genes for Relative qRT-PCR Assay in Two Experimental Models of Rabbit and Horse Subcutaneous ASCs

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    Obtaining accurate and reliable gene expression results in real-time RT-PCR (qRT-PCR) data analysis requires appropriate normalization by carefully selected reference genes, either a single or a combination of multiple housekeeping genes (HKGs). The optimal reference gene/s for normalization should demonstrate stable expression across varying conditions to diminish potential influences on the results. Despite the extensive database available, research data are lacking regarding the most appropriate HKGs for qRT-PCR data analysis in rabbit and horse adipose-derived stem cells (ASCs). Therefore, in our study, we comprehensively assessed and compared the suitability of some widely used HKGs, employing RefFinder and NormFinder, two extensively acknowledged algorithms for robust data interpretation. The rabbit and horse ASCs were obtained from subcutaneous stromal vascular fraction. ASCs were induced into tri-lineage differentiation, followed by the eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) treatment of the adipose-differentiated rabbit ASCs, while horse experimental groups were formed based on adipogenic, osteogenic, and chondrogenic differentiation. At the end of the experiment, the total mRNA was obtained and used for the gene expression evaluation of the observed factors. According to our findings, glyceraldehyde 3-phosphate dehydrogenase was identified as the most appropriate endogenous control gene for rabbit ASCs, while hypoxanthine phosphoribosyltransferase was deemed most suitable for horse ASCs. The obtained results underscore that these housekeeping genes exhibit robust stability across diverse experimental conditions, remaining unaltered by the treatments. In conclusion, the current research can serve as a valuable baseline reference for experiments evaluating gene expression in rabbit and horse ASCs. It highlights the critical consideration of housekeeping gene abundance and stability in qPCR experiments, emphasizing the need for an individualized approach tailored to the specific requirements of the study
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