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Multidisciplinary diagnostic dilemma in differentiating Madelung’s disease—the value of superb microvascular imaging technique:A case report

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World Journal of Clinical Cases 2021年第21期9卷 6145-6154页

作者： Goda Seskute Austeja Dapkute Dominyka Kausaite Sandra Strainiene Andrius Talijunas irena Butrimiene Clinic of rheumatology Orthopaedics Traumatologyand Reconstructive SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 01513Lithuania Clinic of Neurology and Neurosurgery Institute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 01513Lithuania Faculty of Medicine Vilnius UniversityVilnius 01513Lithuania Clinic of Gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 01513Lithuania Institute of Dentistry Faculty of MedicineVilnius UniversityVilnius 01512Lithuania

BACKGrOUND Madelung’s disease,also known as multiple symmetrical lipomatosis,is a rare,underrecognized disorder of fat metabolism that results in unusual accumulation of subcutaneous fat deposits around the neck,shoulders,upper arms,trunk,hips,and upper *** case demonstrates the importance of differential diagnosis and the value of a superb microvascular imaging technique for suspecting and confirming Madelung’s *** diagnosis and alcohol abstinence could prevent the progression of growing fatty masses and prevent *** SUMMArY A 62-year-old male was admitted to the rheumatology center complaining of symmetric subcutaneous tumors in the area of the parotid and submandibular salivary glands,small soft masses in the occiput and upper third of the forearm,rashes on calves.A high titer of rheumatoid factor and low concentrations of serum complements were *** high-end ultrasound and magnetic resonance imaging examinations of all affected areas of the soft tissues showed predominantly adipose tissue(lipomas)without suspicion of *** biopsy from the small salivary gland revealed no *** evaluating the patient’s clinical presentation(symmetrical lipomatosis,cirrhosis,gynecomastia,anemia,hyperuricemia),Madelung’s disease,type I,along with the psoriatic rash and psoriatic arthritis and secondary liver cirrhosis were *** Madelung’s disease consists of many co-occurring disorders imitating and overlapping with other *** is the first choice for suspecting and confirming symmetrical lipomatosis.

关键词： Madelung’s disease Multiple symmetrical lipomatosis Cirrhosis Salivary gland tumors Superb microvascular imaging Case report

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Immunobiology of congenital cytomegalovirus infection of the central nervous system--the murine cytomegalovirus model

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Cellular & Molecular Immunology 2015年第2期12卷 180-191页

作者： irena Slavuljica Daria Kvestak Peter Csaba Huszthy Kate Kosmac William J Britt Stipan Jonjic Department of Histology and Embryology School of Medicine University of Rijeka Rijeka Croatia Department of Infectious Diseases School of Medicine University of Rijeka Rijeka Croatia Department of Immunology Institute of Clinical Medicine University of Oslo Oslo Norway Department of Microbiology University of Alabama at Birmingham Birmingham AL USA

Congenital human cytomegalovirus infection is a leading infectious cause of long-term neurodevelopmental sequelae, including mental retardation and hearing defects. Strict species specificity of cytomegaloviruses has restricted the scope of studies of cytomegalovirus infection in animal models. To investigate the pathogenesis of congenital human cytomegalovirus infection, we developed a mouse cytomegalovirus model that recapitulates the major characteristics of central nervous system infection in human infants, including the route of neuroinvasion and neuropathological findings. Following intraperitoneal inoculation of newborn animals with mouse cytomegalovirus, the virus disseminates to the central nervous system during high-level viremia and replicates in the brain parenchyma, resulting in a focal but widespread, non-necrotizing encephalitis. Central nervous system infection is coupled with the recruitment of resident and peripheral immune cells as well as the expression of a large number of pro-inflammatory cytokines. Although infiltration of cellular constituents of the innate immune response characterizes the early immune response in the central nervous system, resolution of productive infection requires virus-specific CD8＋ T cells. Perinatal mouse cytomegalovirus infection results in profoundly altered postnatal development of the mouse central nervous system and long-term motor and sensory disabilities. Based on an enhanced understanding of the pathogenesis of this infection, prospects for novel intervention strategies aimed to improve the outcome of congenital human cytomegalovirus infection are proposed.

关键词： central nervous system congenital infection cytomegalovirus immune response

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Giant-Size Main Pulmonary Artery Aneurysm in an Adult Patient with Ebstein Anomaly and Dextrocardia

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Congenital Heart Disease 2023年第2期18卷 207-212页

作者： Kristina Krzelj irena Ivanac Vranesic Kristina Maric Besic Zeljko Duric Darko Anic Department of Cardiac Surgery University Hospital Centre ZagrebZagrebCroatia Department of Cardiovascular Diseases University Hospital Centre ZagrebZagrebCroatia

Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered *** main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet’s disease,connective tissue disorders,congenital heart disease,vasculitis,syphilis,tuberculosis and *** are some indices that dextrocardia is associated with anomalies of the pulmonary arteries and pulmonary valve.A rare occurrence of main pulmonary artery aneurysms results in a lack of recommendations,so the remaining challenges are whether main pulmonary artery aneurysms should be treated,how,and *** decision on surgical intervention or conservative treatment of the main pulmonary artery aneurysms depends on its size,etiology and accompanying diseases and includes a multidisciplinary heart *** case of the main pulmonary artery aneurysm and pulmonary valve abnormality associated with Ebstein anomaly and dextrocardia in a 67-year-old male patient brings causality considerations and treatment options in such a unique condition.

关键词： Pulmonary artery aneurysm dextrocardia Ebstein anomaly

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Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism

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World Journal of Gastroenterology 2008年第4期14卷 644-646页

作者： Tihomir Kekez Goran Augustin irena Hrstic Dubravko Smud Mate Majerovic Zeljko Jelincic Emil Kinda Department of Surgery Division of Abdominal SurgeryClinical Hospital Center ZagrebKispaticeva 1210000 ZagrebCroatia Department of Internal medicine Division of GastroenterologyClinical Hospital Center ZagrebKispaticeva 1210000 ZagrebCroatia

Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.

关键词： Colonic duplication Constipation Abdominaldistension Hypothyroidism

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Comparative study of microwave-assisted versus conventional heated reactions of biomass conversion into levulinic acid over hierarchical Mn_(3)O_(4)/ZSM-5 zeolite catalysts

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Carbon resources Conversion 2023年第3期6卷 245-252页

作者： Mazizah r.A.Helmi Dyah Utami C.rahayu Arnia P.Pratama irena Khatrin Anita N.ramadhani Yuni K.Krisnandi Department of Chemistry Faculty of Mathematics and Natural ScienceUniversitas IndonesiaDepok 16424Indonesia Solid Inorganic Framework Laboratory Department of ChemistryFaculty of Mathematics and Natural ScienceUniversitas IndonesiaDepok 16424Indonesia

Conversion of delignified cellulose from rice husk biomass,and model compounds of cellobiose and glucose to levulinic acid(LA)over hierarchical Mn_(3)O_(4)/ZSM-5 catalyst was carried out using a household microwave method,and then compared to the established conventional thermos-reaction *** hierarchical ZSM-5 was prepared using a double template method,aiming for micro and mesoporous systems developed in the *** as-prepared ZSM-5 were modified with Mn3O4 through incipient wetness impregnation with Mn2+solution followed by calcination at 550℃.The catalysts were characterized using various techniques such as powder XrD,SEM,BET,AAS,and FT-Ir which indicated the hierarchical structure of MFI zeolite(Si/Al of 30-34)with Mn loading of 2.14 wt%.The conversion products were analyzed using HPLC,1H NMr,and 13C NMr *** microwave-assisted reaction using 600 W for 180 s using delignified cellulose,cellobiose,and glucose gave conversion of 37.27%,46.35%,and 54.29%,respectively which is close to the conversion given by the conventional reaction carried out at 130◦C for 4 h(36.75%,55.62%,and 60.9%,respectively).Interestingly,the LA yield from the microwave-assisted reaction(4.33%,6.12%,and 9.57%)is higher than the yield from the conventional reaction,which only produced 5.2%,4.88%,and 6.93%*** microwaveassisted method is also shown to give less by-products compared to the thermochemical ***,it could be considered an alternative method for converting cellulose to LA.

关键词： Hierarchical ZSM-5 zeolite Levulinic acid Lignocellulose conversion Microwave-assisted synthesis Cellobiose Glucose

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The Importance of the Creation of CEFTA-2006 for the Western Balkans＇ Trade Exchange of Goods

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Chinese Business review 2011年第10期10卷 844-854页

作者： Kikerkova irena Ss Ciril and Methodius University Skopje Republic of Macedonia

By integrating 32 bilateral free trade agreements, CEFTA-2006 became the first multilateral free trade agreement of the Western Balkan countries. Signed at the end of 2006, it was supposed to establish a free trade area among the following member-states： Albania, Bosnia and Herzegovina, Croatia, Macedonia, Moldova, Monte Negro and Serbia.l The free trade area was supposed to be fully functional by the end of 2010 and should provide trade liberalization by elimination of all tariff and non-tariff barriers for agricultural and non-agricultural goods, as well as trade facilitation by simplification of rules of origin and transit procedures. It should also provide mutual recognition of national sanitary, phytosanitary and technical standards. The free trade area should also enable free trade of services, full protection of intellectual rights, fair rules of public procurement procedures and liberalization of capital investment. The beginning of the creation of the free trade area of the Western Balkan countries created a positive effect upon the increment of the trade exchange of goods among its member-states. However, the weak individual economic capacity of each of them immediately caused a decrement in the exports of goods towards trading partners out of CEFTA-2006. Positive effects realized in the beginning of the creation of the free-trade area were very soon annulated by the influence of the economic crises in 2008. At present, the region experiences a slight, but very slow recovery.

关键词： CEFTA-2006 republic of Macedonia free trade area trade liberalization trade facilitation tradeexchange of goods

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risk of conduction disturbances following different transcatheter aortic valve prostheses:the role of aortic valve calcifications

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Journal of Geriatric Cardiology 2022年第3期19卷 167-176页

作者： Francesco Pollari Ferdinand Vogt irena Großmann Jill Marianowicz Marie Claes Steffen Pfeiffer Johannes Schwab Theodor Fischlein Cardiac Surgery Cardiovascular CenterKlinikum NürnbergParacelsus Medical UniversityNurembergGermany Cardiology Cardiovascular CenterKlinikum NürnbergParacelsus Medical UniversityNurembergGermany radiology Klinikum NürnbergParacelsus Medical UniversityNurembergGermany

OBJECTIVES To assess the impact of prosthesis choice and aortic valve calcifications on the occurrence of conduction disturb-ances after transcatheter aortic valve implantation(TAVI).METHODS We retrospectively analyzed the preoperative clinical characteristics,electrocardiograms,contrast-enhanced mul-tidetector computed tomography scans and procedural strategies of patients who underwent TAVI in our center between January 2012 and June *** of calcium volume was performed for each aortic cusp above(aortic valve)and below(left ventricular outflow tract,LVOT)the basal *** analysis was performed to evaluate risk factors for the onset of new bundle branch block(BBB),transient and permanent atrioventricular block(tAVB,pAVB).rESULTS A total of 569 patients were included in the *** different prostheses were implanted(Edwards Sapien XT,n=162;Edwards Sapien 3,n=240;Medtronic CoreValve,n=27;Medtronic CoreValve Evolut r,n=21;Symetis Acurate,n=56;Sy-metis Acurate neo,n=63).The logistic regression analysis for BBB showed association with baseline left anterior *** logistic regression for tAVB,found the prior valvuloplasty and the balloon post-dilatation associated with the *** left and right BBB,degree of oversizing,and LVOT calcification beneath the non-coronary cusp were associated with *** the prosthesis model,nor the use of a self-expandable prosthesis showed statistical significance with the above-men-tioned outcomes on univariate *** LVOT calcification beneath the non-coronary cusp,baseline left anterior hemiblock,right BBB,balloon post-dilatation,prior valvuloplasty and oversizing are independently associated with postprocedural conduction disturbances after *** of a self-expandable prosthesis may show a lower incidence of AVB,if applied in lower calcified aortic valves.

关键词： aortic balloon conduction

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Particular Ways of Planting in Cemeteries of Siauliai City （Lithuania）

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Journal of Life Sciences 2012年第2期6卷 200-208页

作者： irena Burneckiene Siauliai University Siauliai LT 76351 Lithuania

The issue of cemetery planting is not yet sufficiently studied in Lithuania. Cemetery is one of the sites where people could give way to their subjective comprehension of beauty. Analysis of the cemetery planting revealed certain noticeable features that could be ascribed to the forms of folk art. These are various objects with implied specific content or ornamented compositions. The aim of the research was to ascertain and distinguish graves characterised by specific planting features associated with plants, their layouts on graves. Analysis of the research results shows that two options form the peculiarities of grave planting： depiction of specific objects and *** think that majority of the ornaments are made with the single purpose of decoration, and do not associate with symbolic meanings. During this research the graves decorated with planted symbolic objects and ornaments were distinguished. This phenomenon becomes more and more popular in cemeteries of Siauliai city in Lithuania.

关键词： Types ornamental patterns cemetery planting Siauliai.

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Liver transplantation for non-resectable colorectal liver metastases

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 595-597页

作者： Hassan Aziz Saima Sharif irena Gribovskaja-rupp Alan W.Hemming University of Iowa Hospitals and Clinics Iowa CityIAUSA

At present,there are no absolute practice guidelines for liver transplants in colorectal liver metastases(CrLM),and treatment protocols for unresectable CrLM are institution-specific(1).One of the first prospective studies evaluating the safety of liver transplants for CrLM was the SECA-I trial(1,2).A 5-year overall survival rate of 60% was observed in this trial,which far outperformed survival with chemotherapy alone(3).In the SECA-Ⅱ trial,enrollment was increased,and patients with better prognostic factors,including at least a 10% response to chemotherapy before the transplant,were selected.

关键词： Colorectal liver metastases(CrLM) liver transplant International Hepato-Pancreato-Biliary Association transplant oncology

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Laboratory Diagnosis of Bacterial Meningitis in a Patient with COVID-19

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Journal of Biosciences and Medicines 2021年第4期9卷 110-115页

作者： irena Ivanova Gencheva-Angelova Medical University Pleven Bulgaria

Against the background of a COVID-19 infection, the overlap of bacterial coinfection is associated with an increased risk of poor treatment outcomes. A 76-year-old man was treated for ischemic stroke in the period of one week. During his hospital stay, he showed symptoms of a viral infection, due to which a PCr sample was taken for SArS-CoV-2. The test result was positive. Meningoencephalitis is suspected on the basis of the clinical symptoms shown and the initial blood test. K. pneumonia was detected by a cerebrospinal fluid (CSF) microbiological examination. The risk of bacterial coinfection with COVID-19 remains unclear. Timely and rapid diagnosis and treatment of bacterial meningitis, in the context of a proven COVID-19 infection, require a variety of biological tests and a multidisciplinary approach. In the early stages of acute bacterial and viral meningitis, the signs and symptoms are often nonspecific and it is not always possible to make a differential diagnosis. Laboratory tests, characterizing COVID-19, should determine the type, prognosis, and outcome of a bacterial coinfection. Refining the laboratory diagnosis of a bacterial infection with COVID-19 is a new challenge for doctors.

关键词： Meningitis Laboratory Prognosis CSF COVID-19

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