REKONSTRUIRANA POSTROJENJA U FUNKCIJI POBOLJŠANJA KVALITETE PROIZVODA

Sažetak Europske norme za motorne benzine i dizelsko gorivo traže značajne promjene postojećih rafinerijskih shema u smislu implementacije novih procesnih jedinica (uglavnom MHC/HDS, proizvodnja vodika), kako bi se udovoljili zahtjevi tržišta i zaštite okoliša. Položaj INA Rafinerije nafte Sisak glede navedenih zahtjeva dodatno je otežan zbog dugogodišnjeg zastoja u razvoju, tj. nemogućnosti investiranja. Da bi se djelomično ublažile posljedice i dostigla tehnološka razina za zadovoljenje traženih zahtjeva kvalitete, Rafinerija nafte Sisak je svoje razvojne programe koncipirala u dvije faze djelovanja, i to: 1. Rekonstrukcija i revitalizacija postojećih procesnih jedinica. 2. Izgradnja novih procesnih jedinica za proizvodnju visoko oktanske benzinske komponente, te obradu srednjih destilata. Rekonstrukcija i revitalizacija postojećih procesnih jedinica djelomično rješava probleme proizvodnje motornih benzina i dizelskog goriva prema zahtjevima EN normi do izgradnje novih neophodnih procesa. U svrhu poboljšanja kvalitete proizvoda u Rafineriji nafte Sisak su izvedene sljedeće rekonstrukcije: - Sekcija 300 Platforming u HDS plinskih ulja. - Sekcija 500 Unifining benzina u HDS plinskih ulja i koksnog benzina. - Vakuum destilacija. - Sulfolan u SULF-X za HDS FCC benzina. Prikazani su učinci izvedenih rekonstrukcija na poboljšanje prinosa i kvalitete motornih benzina i dizelskog goriva

Uloga visokofrekventne mini radijalne endoluminalne sonde u procjeni proširenosti tumorskih promjena probavne cijevi : doktorska disertacija

Incidencija probavnih tumora je velika. Pet od deset najčešćih karcinoma su karcinomi probavog sustava. Cilj moderne dijagnostike u gastroenterologiji je što ranijedijagnosticirati tumorsku promjenu jednjaka, ţeluca i kolona, po mogućnosti u prekarcinomskom stadiju ili T1m stadiju kada je odstranjenje tumora endoskopski (EEP, EMR, ESD) jednostavno, pouzdano i jeftino. Da bi se ocijenio dijagnostički postupak, njegova preciznost i efikasnost načinjena je retrospektivna studija. U studiji su obraĎeni bolesnici kojisuobraĎeniambulantno, brzo primjenom endoskopije sa patohistologijom, miniradijalnog endoskopskog ultrazvuka i višeslojnog CT-a (MSCT).Dokazani tumorski procesi jednjaka (29), ţeluca (57) i kolona (69) odstranjeni su endoskopski (45) i kirurškom resekcijom (110).Iznimno visok stupanj korelacijeminiradijalnim endoskopskim ultrazvukom utvrĎenog stupnja raširenosti tumora (TN) sa definitivno utvrĎenim stadijom bolesti nakon odstranjenja tumora, potvrĎuje da je miniradijalna endosonografija izvanredna metoda za prikaz bliskih struktura, ijako korisnaza analizu strukture i stupnjevanje raširenosti tumorskih promjena jednjaka, ţeluca i kolona.RazlikovanjemT 1m, T 1sm, T2 i T3 stadija tumora ova dijagnostička metoda omogućava pravilan izbor bolesnika za endoskopske zahvate ili kiruršku resekciju.Metoda je za endoskopičare i ultrasoničare lako primjenjiva, cijena je prihvatljiva, a omogućavajući izbor racionalne terapije donosi uštede zdravstvenom sustavu, pri čemu je pacijentu omogućeno da se prema stupnju raširenosti bolesti liječi optimalnom metodom. Rezultati studije ohrabrujui potičuna veću primjenu miniradijalne endosonografije u nas, te na češću primjenu EMR-a koji je metoda izbora za lječenje T 1m tumora jednjaka, ţeluca i kolona.Preciznost procjene dubine prodora primarnog tumora u stijenku iznosi 93 –97 %, što metodu nedvojbeno čini vrlo pouzdanomu procjeni stupnja raširenosti tumora jednjaka, ţeluca i kolona.Miniradijalna sonda prikazom tumora asistira endoskopskoj mukozalnoj resekciji, Včineći je uspješnijom. Dijelu bolesnika ova metoda omogućava preciznije, pouzdanije i poštednije liječenje, gotovo uvijek manje agresivno.There is a great incidence of digestive tumors, five of the ten most common carcinoma are ones localized in the digestive tract. The aim of modern gastroenterological diagnostics is early detection of tumorous esophageal, gastric and colon changes, if possible in their precancerous or T1m stage, when endoscopic removal of tumors (EEP, EMR, ESD) is still simple, reliable and cost-efficient. In order to evaluate the diagnostic procedure, its accuracy and efficiency, we created this retrospective study. In our study we processed patients that had undergone outpatient based workup with prompt endoscopic, pathohistological, mini radial ultrasound and multi-slice CT (MSCT) diagnostics. Verified esophageal (29), gastric (57) and colon (69) tumorous processes have been removed either endoscopically (45) or through surgical resection (110). Exceptionally high level of correlation of mini radial endoscopic ultrasound determined dissemination degree (TN) with the PH verified disease stage confirms that mini radial endosonography is an excellent method in visualizing close structures as well as an useful one when analyzing structure and staging of tumorous esophageal, gastric and colon changes. By differentiating between T 1m, T 1sm, T2 andT3tumor stages, this diagnostic method allows for an appropriate patient selection when considering endoscopic procedures or surgical resection. For endoscopists and ultrasonographers this method is easily applicable and by making room for rational therapy selection, it makes great savings in the health system also enabling the patient to be treated with an optimal method according to the tumor dissemination degree. The results of this study encourage greater use of mini radial endosonography as well as a more frequent use of EMR as a method in treatment of T1m tumors of esophagus, stomach and colon. The accuracy of the primary tumor depth approximation is 93-97%, which makes this the method of choice when evaluating the degree of digestive tumors staging. With excellent tumor visualization, mini radial probe assists VIIendoscopic mucosal resection, making it more successful. Also, for a great deal of our patients, this method allows for a more precise, reliable and almost always, a less aggressive approac

Uloga visokofrekventne mini radijalne endoluminalne sonde u procjeni proširenosti tumorskih promjena probavne cijevi : doktorska disertacija

Incidencija probavnih tumora je velika. Pet od deset najčešćih karcinoma su karcinomi probavog sustava. Cilj moderne dijagnostike u gastroenterologiji je što ranijedijagnosticirati tumorsku promjenu jednjaka, ţeluca i kolona, po mogućnosti u prekarcinomskom stadiju ili T1m stadiju kada je odstranjenje tumora endoskopski (EEP, EMR, ESD) jednostavno, pouzdano i jeftino. Da bi se ocijenio dijagnostički postupak, njegova preciznost i efikasnost načinjena je retrospektivna studija. U studiji su obraĎeni bolesnici kojisuobraĎeniambulantno, brzo primjenom endoskopije sa patohistologijom, miniradijalnog endoskopskog ultrazvuka i višeslojnog CT-a (MSCT).Dokazani tumorski procesi jednjaka (29), ţeluca (57) i kolona (69) odstranjeni su endoskopski (45) i kirurškom resekcijom (110).Iznimno visok stupanj korelacijeminiradijalnim endoskopskim ultrazvukom utvrĎenog stupnja raširenosti tumora (TN) sa definitivno utvrĎenim stadijom bolesti nakon odstranjenja tumora, potvrĎuje da je miniradijalna endosonografija izvanredna metoda za prikaz bliskih struktura, ijako korisnaza analizu strukture i stupnjevanje raširenosti tumorskih promjena jednjaka, ţeluca i kolona.RazlikovanjemT 1m, T 1sm, T2 i T3 stadija tumora ova dijagnostička metoda omogućava pravilan izbor bolesnika za endoskopske zahvate ili kiruršku resekciju.Metoda je za endoskopičare i ultrasoničare lako primjenjiva, cijena je prihvatljiva, a omogućavajući izbor racionalne terapije donosi uštede zdravstvenom sustavu, pri čemu je pacijentu omogućeno da se prema stupnju raširenosti bolesti liječi optimalnom metodom. Rezultati studije ohrabrujui potičuna veću primjenu miniradijalne endosonografije u nas, te na češću primjenu EMR-a koji je metoda izbora za lječenje T 1m tumora jednjaka, ţeluca i kolona.Preciznost procjene dubine prodora primarnog tumora u stijenku iznosi 93 –97 %, što metodu nedvojbeno čini vrlo pouzdanomu procjeni stupnja raširenosti tumora jednjaka, ţeluca i kolona.Miniradijalna sonda prikazom tumora asistira endoskopskoj mukozalnoj resekciji, Včineći je uspješnijom. Dijelu bolesnika ova metoda omogućava preciznije, pouzdanije i poštednije liječenje, gotovo uvijek manje agresivno.There is a great incidence of digestive tumors, five of the ten most common carcinoma are ones localized in the digestive tract. The aim of modern gastroenterological diagnostics is early detection of tumorous esophageal, gastric and colon changes, if possible in their precancerous or T1m stage, when endoscopic removal of tumors (EEP, EMR, ESD) is still simple, reliable and cost-efficient. In order to evaluate the diagnostic procedure, its accuracy and efficiency, we created this retrospective study. In our study we processed patients that had undergone outpatient based workup with prompt endoscopic, pathohistological, mini radial ultrasound and multi-slice CT (MSCT) diagnostics. Verified esophageal (29), gastric (57) and colon (69) tumorous processes have been removed either endoscopically (45) or through surgical resection (110). Exceptionally high level of correlation of mini radial endoscopic ultrasound determined dissemination degree (TN) with the PH verified disease stage confirms that mini radial endosonography is an excellent method in visualizing close structures as well as an useful one when analyzing structure and staging of tumorous esophageal, gastric and colon changes. By differentiating between T 1m, T 1sm, T2 andT3tumor stages, this diagnostic method allows for an appropriate patient selection when considering endoscopic procedures or surgical resection. For endoscopists and ultrasonographers this method is easily applicable and by making room for rational therapy selection, it makes great savings in the health system also enabling the patient to be treated with an optimal method according to the tumor dissemination degree. The results of this study encourage greater use of mini radial endosonography as well as a more frequent use of EMR as a method in treatment of T1m tumors of esophagus, stomach and colon. The accuracy of the primary tumor depth approximation is 93-97%, which makes this the method of choice when evaluating the degree of digestive tumors staging. With excellent tumor visualization, mini radial probe assists VIIendoscopic mucosal resection, making it more successful. Also, for a great deal of our patients, this method allows for a more precise, reliable and almost always, a less aggressive approac

Significance of Mini Radial Endoscope Ultrasound (MREUS) in Diagnosis and Therapy of Colorectal Neoplasia

In the pursuit to advance diagnostic procedures with colon carcinoma patients, we included the 15 MHz mini radial endoscopic ultrasound (MREUS) in our work up algorithm, following PH verification. When compared to surgical and final pathohistological (PH) findings, MREUS shows that it can differentiate colon layers in great detail and therefore we can determine the degree of carcinoma dissemination (T1, T2, T3, T4) as well as to make a correct therapeutic choice. MREUS (12–15–20 MHz) is a highly reliable colon layer structural analysis method. As we have shown in our study, the accuracy of T stage colon carcinoma visualization in correlation to equivalent PH studies varies from 90–100% which makes MREUS the best as well as the most reliable method in determining preoperative T stage colon carcinoma

Significance of Mini Radial Endoscope Ultrasound (MREUS) in Diagnosis and Therapy of Colorectal Neoplasia

In the pursuit to advance diagnostic procedures with colon carcinoma patients, we included the 15 MHz mini radial endoscopic ultrasound (MREUS) in our work up algorithm, following PH verification. When compared to surgical and final pathohistological (PH) findings, MREUS shows that it can differentiate colon layers in great detail and therefore we can determine the degree of carcinoma dissemination (T1, T2, T3, T4) as well as to make a correct therapeutic choice. MREUS (12–15–20 MHz) is a highly reliable colon layer structural analysis method. As we have shown in our study, the accuracy of T stage colon carcinoma visualization in correlation to equivalent PH studies varies from 90–100% which makes MREUS the best as well as the most reliable method in determining preoperative T stage colon carcinoma

Inflammatory Fibroid Polyp of the Small Intestine: A Case Report and Systematic Literature Review

Aim: Starting from a case presentation, this review aims to present literature data on inflammatory fibroid polyps (IFPs) of the small intestine. Methods: Case report and systematic review. A comprehensive systematic review of English literature using PubMed was conducted, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The used key words were: "inflammatory fibroid polyp" or "Vanek", including only cases with IFPs localized of the small intestine, published from 1976 to 2019. Results: We present a case of a 38-year old patient with intestinal IFP presenting with acute abdomen due to intussusception diagnosed with ultrasound (US) based on a target sign and visible solid tumor in the small intestine leading to prompt surgical treatment. A diagnosis of IFP was made based on the pathohistological findings. Moreover, a systematic review of small intestine IFPs was conducted which is, to our knowledge, the first comprehensive systematic literature review on this topic. The analysis included 53 case reports or case series concerning 77 cases of small bowel IFPs. The patients were aged from 4 to 75 years (average 45.2), with a female predominance (59.7%). The most common localization was the ileum in 77.9% cases, followed by the jejunum (13%) and the duodenum (6.5%). The most common clinical presentation was abdominal pain due to intussusception (63.6%). Regarding diagnostic methods, computed tomography (CT) was frequently used as primary diagnostic method (26%) followed by exploratory laparotomy (16.9%), endoscopy (7.8%) and US (6.5%). Combination of US and CT contributed to the diagnosis in 9.1% of cases. The majority of cases were treated surgically (92.21%), while only a minority benefited of minimally invasive techniques such as endoscopy. Conclusions: Small bowel IFPs, ones of the least common benign tumors, are characterized by variable clinical signs and symptoms and can potentially lead to serious consequences for the patie