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

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

INTRODUCTION: Cholelithiasis is a metabolic disorder, leading to stone formation in the bile ducts and gall­bladder. 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 contracep­tives. 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. Bili­ary 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 bili­ary 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 sta­tistical and graphical analysis.RESULTS: Accurate diagnosis requires a compound approach. Anamnesis of biliary colic initiates it. Abdomi­nal ultrasonography is the fastest and most accessible imaging method for finding gallstones. It can also pres­ent 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 cholelithi­asis 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 path­ways 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 con­trol 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

INTRODUCTION: The discovery of X-rays in November 1895 by Roentgen opened a new chapter in the scientif­ic 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 consti­tutes 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 bene­fits 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

Comparative determination of antimicrobial activity of the Balkan endemic species Stachys thracica Davidov during the process of ex situ conservation

Stachys thracica Davidov – Thracian woundwort is a Balkan endemic plant included in The Red Data Book of Bulgaria with conservational status “rare”. The plants from genus Stachys have a long history of use to treat various diseases, inflammatory conditions, coughs, ulcers, genital tumors, and infected wounds. Due to its limited distribution the information on the biological activity and chemical composition of S. thracica is rather scarce. The aim of the present research is the comparative determination of the antimicrobial activity of methanolic extracts obtained from in situ wild, in vitro cultivated and ex vitro adapted S. thracica plants. The in vitro shoot culture of the Thracian woundwort was maintained in hormone-free MS medium under controlled environmental conditions. The methanolic extracts from in situ, in vitro cultivated and ex vitro adapted S. thracica plants were active mainly against Gram-negative bacteria. All three extracts showed equal activity against Acinetobacter calcoaceticus. The establishment of in vitro shoot culture and its subsequent adaptation in ex vitro conditions was an appropriate alternative approach for the ex situ conservation of S. thracica as well as for the study of its biological activity

Phylogenetic identification of Balkan endemic Stachys species and genomic stability during ex vitro conservation

The genus Stachys is one of the largest in the Lamiaceae family. Representatives of the genus are among the most ancient medicinal plants used in the ethnomedicine. The Balkan endemic species S. thracica, S. bulgarica and S. scardica are included in The Red Data Book of Bulgaria and due to their endangered status are scarcely studied. The aim of the present work was to examine the genetic status of these three endemic Stachys species during the process of their ex situ conservation. To gain information about their taxonomic position in the genus Stachys, we applied the DNA barcoding approach. Nuclear (ITS) and plastid (rbcL, matK and trnH‑psbA) DNA barcodes were generated and aligned with accessions available in the data base. In the constructed phylogenetic trees S. thracica was placed in a cluster together with S. alpina, S. germanica and S. cretica, while S. bulgarica and S. scardica were clustered with S. officinalis. The ex situ conservation was achieved by the initiation of in vitro shoot cultures and their subsequent adaptation in ex vitro conditions. To check the genomic stability of the plants during the acclimatisation from in vitro conditions to ex vitro, analysis by sequence-related amplified polymorphism (SRAP) markers was performed. No difference was detected between the SRAP profiles of in vitro cultivated and ex vitro adapted S. thracica and S. scardica plants. In S. bulgarica, only 0.4% fragment difference was detected. The obtained results indicated that the three Stachys species preserved their genetic stability during the process of in vitro multiplication, which is a prerequisite for conserved bioactive capacity

Types of medical imaging methods applied in diagnosing Crohn`s disease

Болестта на Крон е описана за пръв път почти едновременно в САЩ и в Германия. Заболяването носи наименованието си от името на своя откривател - д-р Бърил Крон, който пръв го описва през 1932 г. със своите колеги д-р Леон Гинзбург и д-р Гордън Опенхаймер (2). Тя е рядко, тежко и хронично заболяване, което не подлежи на окончателно излекуване и след като бъде диагностицирано, изисква лечение и поддържане през целия живот. Официално е известно като Ileitis terminalis - според терминалната част на илeума - най-често засегнатият фокус. Болестта може да порази различни части от устата до ануса. Накратко казано, по целия храносмилателен тракт. Процесът не е задължително да обхване цялата дължина на дебелото или на тънкото черво, както е при тоталните форми на улцерозен колит, a са налични характеристичните „прескачащи` лезии с интервали от незасегнато черво помежду им. Най-често е поразено тънкото черво, но в много случаи са налице тъй наречените дистални форми, при които е засегната крайната част на дебелото черво. Тази публикация цели подобряване на осведомеността на пациентите и медицинския персонал относно методите на диагностично-лечебния процес при болестта на Крон като социално значимо заболяване, започвайки от основата на диагностичната верига. Едно от големите предизвикателства е диагностиката на заболяването. Изясняването също е много трудно, защото липсват типични лабораторни, биохимични или имунологични маркери. След начална диференциална диагноза от общопрактикуващ лекар всеки пациент подлежи на доуточнителни ендоскопски, рентгенови и други процедури, целящи да финализират диагнозата: рентгеноскопия, сондово контрастиране на тънкото черво, конвенционалната ендоскопия, капсулна ендоскопия, компютърна томография, ядрено-магнитен резонанс. При установена болест на Крон терапевтичният план се определя от активността, разпространението и еволюцията на болестта.Crohn`s disease was described for the first time almost simultaneously in the USA and Germany. The condition was named after Dr. Burrill Crohn who first described it in 1932 together with his colleagues Dr. Leon Ginzburg and Dr. Gordon Oppenheimer. It is a rare, severe and chronic disease which is not subject to a definitive curing and after being diagnosed it requires treatment and maintenance during the whole life of the patient. The condition is officially known as Ileitis terminalis - as per the terminal part of the ileum - the most frequently affected area. The disease can affect different areas from the mouth to the anus; in short, it can affect the whole gastrointestinal tract. The process does not necessarily cover the whole extent of the large or the small intestine as the total expressions of ulcerative colitis; the disease rather shows characteristic patchy lesions with intervals of non-affected intestine between them. Most frequently, the disease affects the small intestine but in many cases the so-called distal forms are present. There the terminal part of the large intestine is affected. This publication aims to improve the awareness of patients and medical staff on the diagnostic and treatment process methods for the Crohn`s disease as a socially significant condition starting from the base of the diagnostic chain. One of the main challenges is diagnosing the disease. Clarification is also difficult as in this case any typical laboratory, biochemical and immunological markers are absent. After establishing the initial differential diagnosis by a general practitioner, every patient is subject to additional endoscopic, radiographic and other procedures aiming at finalizing the diagnosis: radioscopy, test with probe contrast of the small intestine, conventional endoscopy, capsule endoscopy, computed tomography, MRI. When the disease is diagnosed with certainty, the therapeutic plan is determined by the activity, the extent and the evolution of the disease

Antiviral activity of Stachys Thracica Dav. extracts against Human Herpes virus type 1 and 2

Antiviral activity of Stachys Thracica Dav. extracts against Human Herpes virus type 1 and

Antiviral activity of Stachys Thracica Dav. extracts against Human Herpes virus type 1 and 2

Objective: Human Herpes Virus (HHV) type 1 and 2 are cause of hidden pandemics in global scale, as well as sever clinical symptoms associated with active replication in the human host. As until now there are 11 license anti-herpes drugs. Most of them are based on acyclovir and his derivative. Their frequent usage leads to the selection of drug resistance strains and patients offen experience unwanted side effects. Natural products (for ins. plant extracts) are tolerated better by living organisms and their complex composition prevent appearance of resistant virions. The aim of our work is to study the effect of Stachys Thracica Dav extracts against Human Herpes Virus type 1, strain F and Human Herpes Virus type 2, strain BA.Materials and methods: The extracts are obtained from in vivo, in vitro and ex vitro cultivated plants, using methanol extraction. All tests are done in in vitro experimental settings. We use MDBK cell line, and also laboratory strain F of HHV – 1. The following methods were applied: MTT assay to determine cell survival, direct contact assay to test virucidal activity and modified MTT assay to determine effect against virus replication in cell culture.  Results: Obtained data shows that two of the extracts – those from in vitro and ex vitro cultivated plants are with close MNC (maximal nontoxic concentration) (2mg/ml), and the third one is more toxic (MNC is 1mg/ml). The tested extracts do not influence the replication of HHV – 1 and HHV-2. The results about virucidal activity show that the extracts strongly inhibited extracellular virions of HHV-1, strain F (extracts from in vitro cultivated plants reach ~ 100% at 240 minutes of the contact), but the effect of the extracts on extracellular virons of HHV-2, strain BA is more slight.Conclusions: Tested extracts do not have effect against virus replication in cell culture but show strong virucidal activity against HHV-1 and slight activity against HHV-2