Compact remanence-free permanent magnet-based variable magnetic field source

We demonstrate a simple and compact variable magnetic field source based on the permanent cube magnet array approximating a Halbach cylinder. The large air gap area accommodates standard cryostat tails while providing a high uniformity and magnetic field stability of up to 0.5 T over regions of up to about a centimeter. It eliminates magnetic remanence effects and produces reproducible fields without the need for feedback. Thanks to the low cost and exceptional energy efficiency, it provides an accessible solution for modest magnetic field requirements in a wide range of research applications.

Molecular Targeting of the BRAF Proto-Oncogene/Mitogen-Activated Protein Kinase (MAPK) Pathway across Cancers

The mitogen-activated protein kinase (MAPK) pathway is essential for cellular proliferation, growth, and survival. Constitutive activation of this pathway by BRAF mutations can cause downstream activation of kinases, leading to uncontrolled cellular growth and carcinogenesis. Therefore, inhibition of BRAF and the downstream substrate MEK has been shown to be effective in controlling tumor growth and proliferation. Over the last decade, several BRAF and MEK inhibitors have been investigated, ranging from primarily melanoma to various cancer types with BRAF alterations. This subsequently led to several Food and Drug Administration (FDA) approvals for BRAF/MEK inhibitors for melanoma, non-small cell lung cancer, anaplastic thyroid cancer, colorectal cancer, histiocytosis neoplasms, and finally, tumor-agnostic indications. Here, this comprehensive review will cover the developments of BRAF and MEK inhibitors from melanomas to tumor-agnostic indications, novel drugs, challenges, future directions, and the importance of those drugs in personalized medicine.

Comminuted intraarticular calcaneal fractures: Multiplanar VA locked plating and interlocked nailing incorporate longitudinal strut and provide superior stability - a biomechanical cadaveric study

Treatment of comminuted intraarticular calcaneal fractures remains controversial and challenging. The aim of this study was to investigate the biomechanical performance of three different methods for fixation of such fractures. Comminuted calcaneal fractures, including Sanders III AB fracture of the posterior facet and Kinner II B fracture of the calcaneocuboid joint (CCJ) articular calcaneal surface, were created in 18 human cadaveric lower legs by osteotomizing. The ankle joint, medial soft tissues and midtarsal bones along with their ligaments were preserved. The specimens were randomized to three groups for fixation with either (1) 2.7 mm variable-angle locking lateral calcaneal plate (Group 1), (2) 2.7 mm variable-angle locking anterolateral calcaneal plate in combination with one 4.5 mm and one 6.5 mm cannulated screws (Group 2), or (3) interlocking calcaneal nail with 3.5 mm screws in combination with three separate 4.0 mm cannulated screws (Group 3). All specimens were biomechanically tested to failure under axial loading in midstance foot position. Each test commenced with a quasi-static compression ramp from 50 to 200 N, followed by progressively increasing cyclic loading at 2 Hz. Starting from 200 N, the peak load of each cycle increased at a rate of 0.2 N/cycle. Interfragmentary movements were captured by motion tracking. In addition, mediolateral X-rays were taken every 250 cycles with a triggered C-arm. Böhler angle after 5000 cycles (1200 N peak load) increased significantly more in Group 1 compared to both other groups (P ≤ 0.020). Varus deformation of 10° between the calcaneal tuberosity and the lateral calcaneal fragments was reached at significantly lower number of cycles in Group 1 compared the other groups (P ≤ 0.017). Both cycles to 10° plantar gapping between the anterior process and the calcaneal tuberosity fragments, and 2 mm displacement at the CCJ articular calcaneal surface revealed no significant differences among the groups (P ≥ 0.773). From a biomechanical perspective, treatment of comminuted intraarticular calcaneal fractures using anterolateral variable-angle locking plate with additional longitudinal screws or interlocked nail in combination with separate transversal screws provides superior stability as opposed to lateral variable-angle locked plating only.

THE INFLUENCE OF FINISHING PROCESSING FEATURES ON THE POLYMERIZED COMPOSITE SURFACE STRUCTURE

The purpose of this work is to assess the influence, feasibility and effectiveness of glycerin as one of the means that prevent the formation of an oxygen-inhibited layer, to search for the most effective polymerization protocol for the final portion of the composite materialThe prepared carious cavities of the first class were sealed with a composite, then the samples were degreased and dried. Since the dental material is a dielectric material and is highly susceptible to charging under the influence of an electron beam, it was decided to apply a thin (30 nm) layer of platinum to the surface of the objects under study.Studies of the surface of the teeth and the applied composite were carried out using a scanning electron microscope (SEM) Tescan Vega 3 SBH.Based on the essence of the mechanism of formation of the oxygen-inhibited composite layer, polymerization protocols were selected. The samples were divided into 4 groups according to each protocol of finishing processing.Based on the study of the surface of composite restoration using a scanning electron microscope (SEM) Tescan Vega 3 SBH, it is concluded that the most optimal protocol for finishing the restoration is polymerization using means that prevent the formation of an oxygen-inhibited layer, and subsequent finishing treatment. This method allows you to achieve a smooth surface of the composite, the absence of pores and microcracks, high-quality edge fit.

ANALYSIS OF THE EXISTING METHODS AND SPECIFIC FEATURES OF DRYING SHIITAKE MUSHROOMS

The paper reviews and analyses the advantages and disadvantages of the existing technologies of drying shiitake mushrooms, which are a valuable source of bioactive polysaccharides, vitamins, antioxidants, etc. The findings presented in the paper show how various drying methods and their thermotechnological operating parameters affect the mechanostructural properties, chemical composition, content of aromatic substances and other compounds of mushrooms. It has been demonstrated that the traditional convection drying of shiitake in the temperature range 50–60°C allows maximum preservation of phenolic compounds, organic acids, nucleotides, sulphuric aromatic substances, and enhances the unique aroma of the mushroom. Radiation drying has such advantages as lower shrinkage of dried shiitake mushrooms, a higher coefficient of rehydration and higher hardness, and the drying time reduced by 66% compared with freeze-drying. Vacuum drying makes it possible to obtain high quality products, but significantly increases the duration of the process and reduces the content of aromatics. Radiation drying combined with hot air allows obtaining a dry form of shiitake rich in protein and bioactive polysaccharides and having high physicochemical properties, and reduces the duration of the process by 37.5% compared with convection drying. Spray drying of shiitake mushrooms is highly practical economically and allows organising industrial manufacture of high-quality dry mushroom powder in large volumes. It is characteristic of this drying method that its temperature effect on the product is slight, which makes it possible to preserve thermolabile bioactive substances. When using spray drying, it is advisable to add dextrin additives. This improves the structuring and moisture-conducting properties of the suspensions and their thermal stability, and helps preserve the unique aroma of shiitake mushrooms due to encapsulation of aromatic compounds. Studying the effect of various drying methods on the physicochemical properties of shiitake will lead to improving the existing technological processes and will make it possible to obtain products with desired properties.

METHODOLOGY FOR CONSISTENT COPYING OF THE OVERDENTURE RESTORATION PARAMETERS FOR DENTAL IMPLANT PROSTHESIS IN THE TREATMENT OF TOTAL EDENTIA

Development of a technique for transferring the parameters of a temporary removable prosthesis to a permanent prosthesis based on dental implants. Examination and complex treatment of 55 people with complete loss of teeth were carried out. In the I-study group of patients (n = 30), the treatment was carried out according to the developed prototyping method, in the control group II (n = 25), the patients were treated using the standard method: after the implants were opened, the central ratio of the jaws and the setting of the teeth were re-determined. The transfer of the parameters of the removable prosthesis to the temporary crowns was carried out using an individual tray made by 3D printing. One-jaw prosthetics were performed in 45 patients, and 10 patients received prosthetics on both jaws. In the study group, where prosthetics were performed according to the developed prototyping technique, the number of visits for the manufacture and subsequent corrections of temporary crowns was significantly less than in the control group, and the number of days of adaptation of the patient to temporary crowns also decreased. Treatment of patients with complete absence of teeth using the developed prototyping technique made it possible to increase the accuracy of the manufacture of temporary prostheses based on dental implants, made it possible to shorten the time of prosthetics, reduce the time of adaptation to the prosthesis and achieve high aesthetic results, which makes this technique promising.

Nuclear nanomedicine using Si nanoparticles as safe and effective carriers of 188Re radionuclide for cancer therapy

Nuclear nanomedicine, with its targeting ability and heavily loading capacity, along with its enhanced retention to avoid rapid clearance as faced with molecular radiopharmaceuticals, provides unique opportunities to treat tumors and metastasis. Despite these promises, this field has seen limited activities, primarily because of a lack of suitable nanocarriers, which are safe, excretable and have favorable pharmacokinetics to efficiently deliver and retain radionuclides in a tumor. Here, we introduce biodegradable laser-synthesized Si nanoparticles having round shape, controllable low-dispersion size, and being free of any toxic impurities, as highly suitable carriers of therapeutic 188Re radionuclide. The conjugation of the polyethylene glycol-coated Si nanoparticles with radioactive 188Re takes merely 1 hour, compared to its half-life of 17 hours. When intravenously administered in a Wistar rat model, the conjugates demonstrate free circulation in the blood stream to reach all organs and target tumors, which is radically in contrast with that of the 188Re salt that mostly accumulates in the thyroid gland. We also show that the nanoparticles ensure excellent retention of 188Re in tumor, not possible with the salt, which enables one to maximize the therapeutic effect, as well as exhibit a complete time-delayed conjugate bioelimination. Finally, our tests on rat survival demonstrate excellent therapeutic effect (72% survival compared to 0% of the control group). Combined with a series of imaging and therapeutic functionalities based on unique intrinsic properties of Si nanoparticles, the proposed biodegradable complex promises a major advancement in nuclear nanomedicine.

A Beam from Protvino to the Mediterranean Sea

The report overviews preliminary results on the feasibility to produce a neutrino beam based on the U-70 proton synchrotron at Protvino for a very long baseline experiment with the deep water ORCA detector in the Mediterranean Sea.

Contribution of metabolic disease to bone fragility in MAGP1-deficient mice

Microfibril-associated glycoprotein-1 (MAGP1) is an extracellular matrix protein that interacts with fibrillin and is involved in regulating the bioavailability of signaling molecules such as TGFβ. Mice with germline MAGP1 deficiency (Mfap2^-/-) develop increased adiposity, hyperglycemia, insulin resistance, bone marrow adipose tissue expansion, reduced cancellous bone mass, cortical bone thinning and bone fragility. The goal of this study was to assess whether the Mfap2^-/- bone phenotypes were due to loss of MAGP1 locally or secondary to a change in whole body physiology (metabolic dysfunction). To do this, mice with conditional deletion of MAGP1 in the limb skeleton were generated by crossing MAGP1-flox mice (Mfap2^lox/lox) with Prx1-Cre mice. Mfap2^Prx-/- mice did not show any changes in peripheral adiposity, hyperglycemia or insulin sensitivity, but did have increased bone length and cancellous bone loss that was comparable to the germline Mfap2^-/- knockout. Unlike the germline knockout, marrow adiposity, cortical bone thickness and bone strength in Mfap2^Prx-/- mice were normal. These findings implicate systemic metabolic dysfunction in the development of bone fragility in germline Mfap2^-/- mice. An unexpected finding of this study was the detection of MAGP1 protein in the Mfap2^Prx-/- hematopoietic bone marrow, despite the absence of MAGP1 protein in osseous bone matrix and absent Mfap2 transcript expression at both sites. This suggests MAGP1 from a secondary site may accumulate in the bone marrow, but not be incorporated into the bone matrix, during times of regional MAGP1 depletion.

Synthesis, Characterization, and Photocatalytic Properties of Sulfur- and Carbon-Codoped TiO2 Nanoparticles

One-step TiO2 nanoparticle synthesis based on the interaction between thiourea and metatitanic acid is applied for sulfur and carbon anatase codoping. The synthesis of the doped TiO2 has been monitored by means of differential thermal analysis and thermogravimetric analysis (DTA-TG), which allows determining the optimal thermal conditions for the process. Electron microscopy showed micrometer-sized (5-15 μm) randomly distributed crystal aggregates, consisting of many 15-40-nm TiO2 nanoparticles. The obtained phase composition and chemical states of the doping elements are analyzed by means of X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), infrared (IR) and Raman spectroscopies, and electron paramagnetic resonance (EPR). XRD displays in both samples (doped and pristine) the existence of only one crystalline phase-the tetragonal modification of TiO2-anatase. Further data assessment by means of Rietveld refinement allowed detection of a slight c lattice parameter and volume increase related to incorporation of the doping elements. XPS demonstrated the presence of carbon and sulfur as doping elements in the material. It was confirmed that carbon is in elemental form and also present in oxygen-containing compounds, which are adsorbed on the particle surface. The binding energy for sulfur electron core shell corresponds to the established data for sulfate compounds, where sulfur is in 6+ oxidation state. The synthesized S- and C-codoped TiO2 showed excellent photocatalytic performance during the degradation of organic dyes (rhodamine B, methylene blue), gas-phase oxidation of ethanol under visible light, and photocatalytic hydrogen generation from ethanol under ultraviolet light.

Genetic, Genomic and Epigenomic Studies of Balkan Endemic Nephropathy (Ben)

BEN is a primary, chronic tubulointerstitial nephritis characterized with chronic anemia, absence of edema, xantoderma, normal blood pressure and normal findings on the fundus oculi. The disease is distributed in restricted areas in Bulgaria, Romania, Croatia, Bosnia, Former Yugoslavia. Despite numerous studies on genetic and environmental factors and their possible involvement in BEN, its etiopathogenesis still remains elusive. Our recent study aim to elucidate the possible epigenetic component in BEN development. Whole genome DNA array methylation analysis was applied to compare the methylation profiles of male and female BEN patients from endemic regions in Bulgaria and Serbia and healthy controls. All three most prominent candidate genes with aberrations in the epigenetic profile discovered with this study are involved in the inflammatory/immune processes and oncogenesis. These data are in concordance with the reported pathological alterations in BEN. This research supports the role of epigenetic changes in BEN pathology. Exome sequencing of 22.000 genes with Illumina Nextera Exome Enrichment Kit revealed three mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients which encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN.

[RECONSTRUCTIVE AND COSMETIC SURGERY IN TREATMENT OF VULVAR CANCER]

The aim of our research work was to show our results in the field of reconstructive and cosmetic surgery for vulvar cancer.

MATERIAL AND METHODS

We evaluated 18 patients for 10 years period.

RESULTS

We applied all surgical techniques that are possible at the moment in the world: laps from mons pubis, rhomboid flaps, myocutaneous flaps from gluteal region. We used surgical techniques with the following muscle groups: musculus gracilis, musculus gluteus maximus, musculus tensor fasciae latae, musculus rectus abdominis.

CONCLUSIONS

With our research work we tried to better the quality of life of our patients, to achieve better esthetic and cosmetic effect after very radical surgical interventions connected with vulvar cancer.

[INFLUENCE OF STIMULATION PROTOCOL ON MATURITY AND MORPHOLOGICAL FEATURES OF OOCYTES IN PATIENTS WITH LOW OVARIAN RESERVE: STUDY OF 72 IVF/ICSI TREATMENT CYCLES]

The current study presents the results of a retrospective and prospective observation of the maturity and morphological features of the oocytes and the way they are influenced by the therapeutic approaches and the protocol for controlled ovarian hypersimulation (COH) in patients with low ovarian reserve.

MATERIALS AND METHODS

The study includes 184 oocytes, derived from 72 patients with low ovarian reserve involved in an infertility treatment program through in vitro fertilization from February 2011 to February 2014. The applied therapeutic approaches and COH protocols are microdose agonist short protocol, antagonist short protocol, mild stimulation protocol and natural cycle in vitro fertilization.

RESULTS

Our study hasn't found a statistically significant dependence between the applied ovarian stimulation protocol and the maturity and morphology.

[FEMALE STEROID HORMONES - MODULATORS OF IMMUNE RESPONSE TO GENITAL CHLAMYDIA TRACHOMATIS INFECTION.]

In the recent years according to WHO, genital chlamydia is the mos't common sexually transmitted infection. Chlamydia Trachomatis is an intracellular parasite which target are the tubular epithelial cells of the urethra, endocervix, endometrium, endosalpinx, conjunctiva, synovial lining of the joints, Glisson's capsule of the liver Our study, as well as some international researches, shows that in the cases of genital chlamydia there are changes in the ovarian hormones (estradiol and progesterone), their impact on the immune system and their importance for the development and the complications of the infection with Chlamydia trachomatis. The physiological level of the steroid hormones in its turn contributes for the normalization of the local immunity and reduces the possibility of recurrences.

[ENDOMETRIOSIS FERTILITY INDEX]

In women suffering from endometriosis and infertility, the decision as to when and how to perform surgical excision and/or fertility treatment is mainly based on clinical guidelines and expert opinions. However, so far data from randomized controlled trials or meta-analyses to answer the question whether surgical treatment of moderate to severe endometriosis can indeed enhance pregnancy rates compared with expectant management are lacking, as not all studies report fertility outcome or supply sufficiently detailed information. The most frequently used staging system for endometriosis is the revised American Fertility Society (rAFS) score (ASRM, 1997). Unfortunately, this classification system has some serious limitations, including not effectively predicting clinical outcomes of treatment, especially pregnancy rates in infertile patients. For this reason, Adamson and Pasta (2010) developed the endometriosis fertility index (EFI). EFI is a scoring system which includes assessment of historical factors at the time of surgery (age, duration of infertility and pregnancy history), of adnexal function at conclusion of surgery (functional score of Fallopian tubes, fimbriae and ovaries bilaterally), and of the extensiveness of endometriosis (rAFS endometriosis lesion score and total rAFS score). The EFI is intended as a clinical tool to counsel patients on the approach towards fertility after surgery.

[PRIMARY CYTOREDUCTIVE SURGERY VERSUS NEOADJUVANT CHEMOTHERARY IN TREATMENT OF ADVANCED OVARIAN CANCER (STAGE III C-IV). OUR AND FOREIGN EXPERIENCE]

INTRODUCTION

The advanced ovarian cancer usually have bad prognosis. The main methods for treatment of these types of tumors are: primary cytoreductive surgery and platin-based chemotherapy.

AIM

Our aim was to evaluate our and foreign experience in treatment of advanced ovarian cancer stage III C--IV treated by neodjuvant chemotherapy followed by cytoreductive surgery and patients treated by primary cytoreductive surgery followed by adjuvant chemotherapy. We wanted to research the survival rate, postoperative adverse effects, mortality rate, the size of residual tumor and the metastases in these patients.

MATERIAL AND METHODS

We researched for 10 years period--50 patients treated by primary cytoreductive surgery and 50 patients treated by neoadjuvant chemotherapy.

RESULTS

The postoperative adverse effects and mortality rate are lower by neoadjuvant chemotherapy followed by cytoreductive surgery. The most important independent prognostic factor for overall survival rate was the lack of residual tumor in both types of treatment.

CONCLUSION

The neoadjuvant chemotherapy followed by cytoreductive surgery in ovarian cancer stage III C--IV is considered as a standard treatment.

[OVARIAN CANCER RECURRENCES IN PARAAORTIC LYMPH NODES]

The authors'surgical experience on 14 patients with ovarian cancer recurrences in paraortic lymph nodes --infrarenal and suprarenal-celiac and triad, were presented. Complete cytoreduction was achivied in all recurrent patients (no visible tumor). The median time to recurrence was 16,5 months (from 10 to 36 months). The median operating time was 90 min (range from 30 to 120 min). The median blood loss was 200 ml (from 100 to 300 ml.). No intra- or postoperative complications were noted. The median postoperative period was 5 days (from 4 to 6 days).

[Squamous cell carcinoma (SCC)--nature and usage in patients with cervical carcinoma]

Squamous cell carcinoma antigen (SCC) is isolated as a heterologic antiserum against cells of cervical carcinoma in 1977 by Kato u Torigoe. It is not specific for cervical carcinoma and rises up in cases of carcinoma vulvae, esophageal carcinoma, carcinoma pulmonum, ext. High levels are detected also in psoriasis, sarcoidosis, liver and kidney diseases. SCC is not a reliable marker in diagnosis and screening. Some trials show a correlation between the preterapeutic levels of SCC and the prognosis, but none of them is randomized. So the predictive value of SCC, except the nodal metastasis, stays on a low level of evidence and recommendation. On the contrary is the data for SCC as a monitoring marker for a local recurrence in patients after primary treatment. The sensitivity and specificity of the marker for a cervical carcinoma recurrence varies between 56 and 86% sensitivity and 83 and 100% specificity. A new possibility for an early recurrence finding in patients with rising SCC gives FDG PET/CT. The method is highly potent in detection of local recurrence and distant metastasis in patients with cervical carcinoma and is suitable for staging, restaging and monitoring of these patients.

[COMBINED APPLICATION OF FETAL FIBRONECTIN AND INSULIN-LIKE GROWTH FACTOR IN PRETERM DELIVERY DIAGNOSIS--OUR RESULTS]

The insulin-like growth factor IGFBP-1 is a binding protein (IBP-1), also known as placental protein (PP12), is encoded in people as IGFBP-1 gene. The IGFBP-1 is an especially vital hormone in the female reproductive physiology. The presence of it in large quantities in the amniotic fluid can be used as a biochemical marker for preterm birth and premature rupture of membranes. Fetal fibronectin is a high-molecular glycoprotein, that is produced during pregnancy and has a role as biological glue, binding the foetus membranes to the endometrium. fFN can be found in the cervicovaginal secretions until 22nd gestational week and later on during the last trimester (1 to 3 weeks before birth). fFN is usually absent between 24th and 34th gestational week. Thirty sixth (30%) of all the 120 females tested had positive fFN test results and were, therefore, at high risk for preterm delivery. Despite the implemented tocolytic therapy, 15 (12.5%) of them delivered before the 37th gestational week. The results from the investigation for the presence of pLGFBP-1 in 120 pregnant women show that 35.8% (43 women) were positive and 15(12,5%) of them delivered before the 37th gestational week despite the implemented tocolytic therapy In both tests, the average gestational age of the premature fetus was 32.5 ÷ 2.8 gestational weeks.

[Ca-125 in diagnosis and monitoring of patients with ovarian cancer]

The carbohydrated antigen Ca-125 is identified by Bast et al. in 1981. The cut off value of 35 KU/l for serum levels of the marker covers in fact 98-99% of the healthy women. There are some variations in the levels of pre- and post menopausal women, and also some race- dependent and cycle-dependent differences. Although Ca-125 is the only one accepted tumor marker for ovarian cancer, its screening usage is controversial, because of the high percentage of false positive results. Ca-125 and HE4 are both validated serum markers for differential diagnose of pelvic masses. The Ca-125 main role is monitoring patients, having ovarian cancer in their chemotherapy, early recurrence finding and progression. Ca-125 rising values in monitoring patients are predictor of image or clinical recurrence in 59-96% of the cases. FDG PET/CT gave a new standard in ovarian cancer staging, especially in patients, having high levels of Ca-125, but negative conventional imaging examinations.

[PROGNOSTIC GROUPS FOR RELAPSE IN STAGE IB1 CERVICAL CANCER]

Risk factors for relapse in stage IB1 cervical cancer were analized and identified by the following statistical tests-Kaplan-Meier, Cox regression, Log-rank test, Breslow and Tarone-Ware tests. A quantitative analysis of significant factors for relapse in group submitted to surgery and adjuvant radiotherapy(group 1) and group submitted only to surgery (group 2), was done. These methods allow us to difine 3 different prognostic groups, requiring different therapeutic approaches.

[GYNECOLOGIC MALIGNANCIES DURING PREGNANCY]

Cervical cancer is the most common gynecologic malignancy during pregnancy. Laparoscopic pelvic lymphadenectomy and the nodal status are the main factors to tailor therapeutic approaches and to terminate or preserve the pregnancy. In node-negative pregnants neoadjuvant chemotherapy can be administered safely after 13 week of gestation in order to achive fetal maturity. In these cases, mostly in early stages, fertility- preserving techniques, such as vaginal simple or radical trachelectomy can be performed.

[THE ROLE OF POSITIVE PERITONEAL CYTOLOGY DURING THE SURGERY OF ENDOMETRIAL CANCER]

A survey to investigate the incidence rate and prognostic factors for positive peritoneal cytology in patients with endometrial cancer has been conducted.

[CONGENITAL UNILATERAL HYDROTHORAX--A CASE REPORT]

A case of isolated unilateral congenital hydrothorax with unknown etiology, graduated abortion for medical reasons in 23 weeks. The patient was later covered by antenatal care and during the examination one foetus with the massive right-sided hydrothorax was found, (diagnosed by ultrasonography and NMR) The incidence of congenital fetal hydrothorax is estimated at approximately 1 in 15,000 pregnancies. Early ultrasound diagnosis is of paramount importance for the adequate monitoring of the pregnancy and timely proof of deviation in normal fetal development.

[LAPAROSCOPIC SACROCOLPOPEXY]

Numerous surgical procedures have been described for the management of pelvic organ prolapse. Laparoscopic sacrocolpopexy has evolved from classical abdominal sacrocolpopexy and provides the potential to combine the success rate of an abdominal approach with faster recovery time associated with a minimally invasive technique. Pelvic organ support was assessed objectively using the pelvic organ prolapse quantification scale (POP-Q). Tissue dissection and mesh placement are facilitated by magnification of the operating field using laparoscopic approach. Our results confirm previous findings that laparoscopic sacrocolpopexy is a safe and efficacious surgical treatment for pelvic organ prolapse. It provides excellent support and good functional outcome with overall improvement in sexual function.

Epiphytic fruticose lichens as biomonitors for retrospective evaluation of the (134)Cs/(137)Cs ratio in Fukushima fallout

In 2011-2013, sampling of epiphytic fruticose lichens of the genera Usnea, Bryoria and Alectoria was carried out on Sakhalin and Kuril Islands (the Sakhalin region, Russia) to investigate contamination of these organisms with the Fukushima-derived (134)Cs and (137)Cs. Activities of the radionuclides were determined in all 56 samples of lichens taken for the analysis. After correction for radioactive decay (on 15 March 2011), the activity concentrations ranged from 2.1 Bq kg(-1) (d.w.) to 52 Bq kg(-1) for (134)Cs and from 2.3 Bq kg(-1) to 52 Bq kg(-1) for (137)Cs. Cesium-134 and (137)Cs activities for the whole set of lichens (n = 56) were strongly positively correlated; Spearman's rank correlation coefficient was calculated as 0.991 (P < 0.01). The activity concentrations of (134)Cs and (137)Cs in Usnea lichens from the Sakhalin and Kunashir islands declined with a factor of three in the period from 2011 to 2013. The average biological half-time for both cesium radionuclides in lichens of the genus Usnea is estimated as 1.3 y. The mean of 0.99 ± 0.10 and median of 0.99 were calculated for the decay corrected (134)Cs/(137)Cs activities ratios in the lichens (n = 56). The radionuclides ratio in the lichens did not depend on location of sampling site, species and the time that had passed after the Fukushima accident. The regression analysis has shown the background pre-Fukushima level of (137)Cs of 0.4 ± 0.3 Bq kg(-1), whereas the ratio between the Fukushima-borne (134)Cs and (137)Cs in the lichens was estimated as 1.04. The (134)Cs/(137)Cs activities ratio in lichens from the Sakhalin region is consistent with the ratios reported by others for the heavy contaminated areas on Honshu Island in Japan following the Fukushima accident. The activity concentrations of natural (7)Be in lichens from the Sakhalin region varied between 100 Bq kg(-1) and 600 Bq kg(-1); the activity concentrations did not exhibit temporal variations during a 2y-period of observations. The applicability of epiphytic fruticose lichens as retrospective bio-monitors for the air-borne radiocesium contamination of the environment is discussed.

Shipboard determination of radiocesium in seawater after the Fukushima accident: results from the 2011-2012 Russian expeditions to the Sea of Japan and western North Pacific Ocean

A total of 88 seawater samples were collected during two Russian research expeditions (April-May 2011 and August-September 2012) to the Sea of Japan, the Oyashio Current region near Kuril Islands and the Kuroshio-Oyashio transition area in the western North Pacific Ocean. The observations were made aboard the R/V Pavel Gordienko and Akademik Shokalsky in order to study the impact of the Fukushima accident on radioactive contamination of the marine environment. On the board of a ship, the water samples were passed through filters to retain particles with the size of >1 micron. Cesium was extracted from the large volumes (100-3000 L) of the filtrated water using a selective fiber chemisorbent impregnated with copper ferrocyanide. Measurements of (134)Cs and (137)Cs activities in 83 samples of sorbents and 21 samples of filters were performed in the ship-based laboratory with a semiconductor HP-Ge detector. The quantified activity concentrations of dissolved radiocesium ranged from 1 Bq m(-3) to 34 Bq m(-3) for (137)Cs and from 0.2 Bq m(-3) to 29 Bq m(-3) for (134)Cs. Activity concentrations of (137)Cs and (134)Cs were strongly correlated with each other (r = 0.993, n = 59). The (137)Cs/(134)Cs activities ratio in the Fukushima-derived radiocesium inventory for the study areas was deduced to be 0.99 ± 0.03 (on 15 March 2011) and the pre-Fukushima background level of (137)Cs in seawater was estimated as 1.3 ± 0.3 Bq m(-3). The lowest activities of both isotopes were determined in the western part of the Sea of Japan near the Russian coast, while the maximal levels were observed in the open Pacific Ocean, some 500-800 km offshore the Fukushima Dai-ichi Nuclear Power Plant. Contamination with (134)Cs at a level of 0.3-2.6 Bq m(-3) was registered in seawater samples collected in 2011 near the Kuril Islands and Kamchatka in the Oyashio Current region. During the period from April-May 2011 to August-September 2012, activity concentrations of (137)Cs and (134)Cs in surface waters had decreased for all seven stations repeatedly sampled in the study. A detailed observation of radiocesium distribution within the water column down to the depth of 200 m at nine stations from the Kuroshio-Oyashio Interfrontal Zone and Kuroshio Extension in 2012 revealed maximal activity concentrations of both cesium radionuclides in the 100-200 m depth layer. The average inventory of Fukushima-derived (137)Cs in the top 200 m of the water column for the nine stations was estimated as 1.19 kBq m(-2) (decay corrected to 15 March 2011) which is 4.6 times higher than the background value of 0.26 kBq m(-2) expected for this depth. The monitoring results obtained in the study and relevant data published by others show that following the Fukushima accident, the Oyashio current acts as a provider of low-contaminated subarctic waters to the heavily contaminated Kuroshio-Oyashio mixed water region.

NGS nominated CELA1, HSPG2, and KCNK5 as candidate genes for predisposition to Balkan endemic nephropathy

Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression leading to terminal renal failure. The results of molecular biological investigations propose that BEN is a multifactorial disease with genetic predisposition to environmental risk agents. Exome sequencing of 22 000 genes with Illumina Nextera Exome Enrichment Kit was performed on 22 DNA samples (11 Bulgarian patients and 11 Serbian patients). Software analysis was performed via NextGene, Provean, and PolyPhen. The frequency of all annotated genetic variants with deleterious/damaging effect was compared with those of European populations. Then we focused on nonannotated variants (with no data available about them and not found in healthy Bulgarian controls). There is no statistically significant difference between annotated variants in BEN patients and European populations. From nonannotated variants with more than 40% frequency in both patients' groups, we nominated 3 genes with possible deleterious/damaging variants--CELA1, HSPG2, and KCNK5. Mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN.

[Lymph node dissection in early ovarian cancer]

AIM

Our aim was to evaluate and summarize our experience in surgical treatment for early ovarian cancer, the way and extend of metastases, as well as the need and effectiveness of applying radical pelvic and paraaortic lymph node dissection. We compared our results with the results of prominent clinics all over the world in this special field.

MATERIAL AND METHODS

We researched retrospectively patients, operated for early ovarian cancer for 15 years period. We evaluated the use of lymph node dissection and the level of its radicality. Examining the volume and borders of the lymph node dissection we tried to sintesize the main practical conclusions and refferences, which can be applied practically by the colleagues working in gynaecological and oncogynaecological clinics in our country

RESULTS

According to us and the most foreign authors the ovarian cancer, must be removed intact, and frozen section biopsy must be used. The surgical staging includes: total abdominal histerectomy, bilateral salpingooophorectomy and total pelvic and/or paraaortic lymph node dissection. The surgical staging in all patients is obligatory and includes: a) cytological examination of ascites. b) when ascites is absent--cytological smear. c) Examination of intraabdominal organs and surfaces. d) Biopsies are taken from all suspicious regions. e) The diaphragm is examined by biopsy and scraping. f) Infracolic omentectomy is performed. g) Retroperitoneal spaces are dissected and examined. h) The paraaortal area is examined. When enlarged lymph nodes are found--they are resected and examined. If enlarged paraaortal lymph nodes are found--total paraaortic lymph node dissection is performed.

DISCUSSION

The extend of the lymph node dissection in early ovarian cancer is connected with better survical rate in these patients.

CONCLUSIONS

The lymph node dissection helps for precise surgical staging in early ovarian cancer. The volume of the lymph node dissection is significant prognostic factor for better survical rate, as well as age, stage, histological type and the grade of the disease.

[The insulin-like growth factor IGFBP-1--specific marker for preterm delivery in pregnant women with clinical symptoms]

The insulin-like growth factor IGFBP-1 is a binding protein (IBP-1), also known as placental protein (PP12), is encoded in people as IGFBP-1 gene. This gene encodes a protein in the domain of IGFBP-1 and domain thyroglobulin. During the last years highly phos-phorylated versions of IGFBP-1 (IGFBP-1 pM) have been found in decidual cells--a marker of threat for preterm birth. The quantity analysis of the insulin-like growth factor in the serum or heparinized plasma is used to locate diseases related to growth. Its levels in the plasma can scarcely be determined after birth and steadily rise with age while they reach their maximum during puberty. These levels rise constantly during pregnancy.

[Laparoscopic vs abdominal myomectomy]

The aim of this study is to determine the most appropriate method for operative treatment of uterine myoma through comparison of laparoscopic myomectomy (LM) and abdominal myomectomy (AM). We will examine perioperative indicators and results for patients with uterine myomas. We operated 172 women for the period from January 2011 to April 2014. 106 patients were operated by abdominal myomectomy and 66 were operated by laparoscopic myomectomy. In this study were included only cases with intramural fibroids bigger than 5 cm. We explored the following indicators: age, BMI, preoperative Hgb, preoperative Hct, size, number and location of the myomas for both groups. We analyzed intra- and postoperative indicators operating time, hospital stay, postoperative Hgb and Hct. Data shows less postoperative decrease of Hgb and Hct, less blood loss, shorter hospital stay for the group with laparoscopic myomectomy, but significantly increased operative time compared to the group with abdominal myomectomy.

[Risky factors in ovarian cancer (our and foreign experience)]

AIM

Our aim was to summarize our and foreign experience and evaluate and research the most common risky factors for development of ovarian cancer. In this way we wanted to summarize also the prevanantive factors for ovarian cancer.

MATERIAL AND METHODS

We researched for 10 years period patients with ovarian cancer (2000 patients). The most common risky factors were examined and researched.

RESULTS

All patients with ovarian, tube and peritoneall cancer--must be tested for BRCA 1 and BRCA2 gene mutations. The patients who want to preserve their reproductive functions orto postpone the preventive surgery, have to go through 6 months screening by TVS. The patients with Lynch Syndrome are advised for prophylactic salpingoophorectomy or hysterectomy. When there was a high risk the patients are advised to take oral contraceptives before family planning.

CONCLUSION

Nevertheless these results future research and clinical trials will give additional light in this field.