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Ulcerated intussuscepted jejunal lipoma-uncommon cause of obscure gastrointestinal bleeding: A case report

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World Journal of clinical cases 2019年第22期7卷 3765-3771页

作者： Tudor cuciureanu Laura Huiban stefan c.iriac.ana-maria singeap Mihai Danciu Florin Mihai carol Stanciu Anca Trifan Nutu Vlad Department of Gastroenterology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of Pathology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of Radiology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of General Surgery “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania

BAcKGROUND Intestinal lipomas are rare benign gastrointestinal(GI)tumors,usually asymptomatic,but may become symptomatic as the result of some complications such as intussusception,intestinal obstruction,volvulus or *** can occur at any site along the entire GI tract,more frequent in colon and rarely in small *** patient reported here is a very rare case of jejunal lipoma,ulcerated and intussuscepted,diagnosed in an adult investigated for a chronic iron deficiency anemia(IDA),and successfully managed by segmental jejunal *** SUMMARY A 63-year-old male was referred to“***”Hospital,Institute of Gastroenterology and Hepatology,Iasi,to investigate an obscure GI bleeding with an *** upper GI endoscopy and colonoscopy were performed,excluding potentially bleeding lesions,videocapsule endoscopy was then carried out,revealing fresh blood and a protruding lesion in proximal jejunum,findings confirmed by a single-balloon *** biopsies were taken from the lesion,but histological results were ***,contrast-enhanced computed tomography was performed showing jejunal polypoid mass with homogenous fat density,suggestive for lipoma.A week later a laparotomy was performed revealing the intussuscepted jejunal segment which was resected enbloc,and sent for further histopathologic *** patient made an uneventful recovery and was discharged seven days later,and at six months follow-up he had no complains and his hemoglobin returned to normal *** Lipomas are very rarely located in the jejunum,usually asymptomatic,but they may lead to complications such as intussusception and *** resection remains the treatment of choice.

关键词： Lipoma Intussusception computed tomography Video capsule endoscopy Gastrointestinal bleeding case report

Role of ammonia in predicting the outcome of patients with acuteon- chronic liver failure

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World Journal of clinical cases 2021年第3期9卷 552-564页

作者： stefan chiriac carol Stanciu camelia cojocariu ana-maria singeap catalin Sfarti Tudor cuciureanu Irina Girleanu Razvan Alexandru Igna Anca Trifan Department of Gastroenterology “Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania Institute of Gastroenterology and Hepatology "St.Spiridon"Emergency HospitalIasi 700111Romania Intensive care “Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania

BAcKGROUND High venous ammonia(VA)values have been proven to be a part of the mechanism of hepatic encephalopathy in patients with liver cirrhosis(Lc)as well as acute ***,VA has been associated with poor prognosis and high mortality in these clinical ***,the role of ammonia in acuteon-chronic liver failure(AcLF)has not yet been clearly *** To assess the role of VA in predicting the outcome of cirrhotic patients with AcLF in a tertiary care *** We performed a retrospective observational study including consecutive patients with Lc hospitalized for acute non-elective indications such as ascites,hepatic encephalopathy(HE),upper gastrointestinal bleeding,or bacterial infections that fulfilled the Asian Pacific Association for the Study of the Liver(APASL)criteria for *** study was conducted in“***”University Hospital,Iasi,Romania,a tertiary care center,between January 2017 and January *** APASL AcLF Research consortium(AARc)score was calculated and AcLF grade was established ***-haven classification was used for *** analysis was performed using IBM SPSS version *** Four hundred and forty-six patients were included,aged 59(50-65)years,57.4%***-Pugh,model for end-stage liver disease(MELD)and AARc scores were 11(10-12),19.13±6.79,and 7(6-8),respectively.66.4%had AcLF grade I,31.2%AcLF grade II,and 2.5%AcLF grade *** was diagnosed in 83.9%,34%grade I,37.2%grade II,23.5%grade III,and 5.3%grade *** mortality was 7.8%.VA was 103(78-148)μmol/*** operating characteristic analysis showed good accuracy for the prediction of in-hospital mortality for the AARc score[Area under the curve(AUc)=0.886],MELD score(AUc=0.816),VA(AUc=0.812)and a fair accuracy for the child-Pugh score(AUc=0.799).Subsequently,a cut-off value for the prediction of mortality was identified for VA(152.5μmol/L,sensitivity=0.706,1-specificity=0.190).Univariate analysis found acute kidney in

关键词： Venous ammonia Hepatic encephalopathy Acute-on-chronic liver failure Asian Pacific Association for the Study of the Liver Acute-on-chronic Liver Failure Research consortium score cirrhosis Mortality

Did the severe acute respiratory syndrome-coronavirus 2 pandemic cause an endemic clostridium difficile infection?

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World Journal of clinical cases 2021年第33期9卷 10180-10188页

作者： camelia cojocariu Irina Girleanu Anca Trifan Andrei Olteanu cristina maria Muzica Laura Huiban stefan c.iriac.ana maria singeap Tudor cuciureanu catalin Sfarti carol Stanciu Department of Gastroenterology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”University HospitalInstitute of Gastroenterology and HepatologyIasi 700115Romania

BAcKGROUND clostridium difficile infection(cDI)has increased in prevalence during the last *** coronavirus disease 2019(cOVID-19)pandemic has negatively influenced patient *** majority of the severe acute respiratory syndrome-coronavirus 2(SARS-coV-2)-infected patients received antibiotics during *** To analyze the factors that influenced cDI development after SARS-coV-2 *** Between March 2020 to December 2020,we performed a prospective observational study including 447 patients diagnosed with cDI who were admitted to our tertiary referral university *** diagnosis of cDI was based on the presence of diarrhea(≥3 watery stools within 24 h)associated with clostridium difficile toxins A or *** excluded patients with other etiology of acute *** Among the total 447(12.5%)patients with cDI,most were male(54.3%)and mean age was 59.7±10.8 ***-six(17.0%)had history of cOVID-19,most being elderly(cOVID-19:62.6±14.6 years vs non-cOVID-19:56.8±17.6 years,P=0.007),with history of alcohol consumption(43.4%vs 29.4%,P=0.017),previous hospitalizations(81.6%vs 54.9%,Pc treatments(60.5%vs 35.5%,Pcomycin and prone to recurrent disease(25.0%vs 13.1%,P=0.011).Age over 60 years[odds ratio(OR):2.591,95%confidence interval(cI):1.452-4.624,P=0.001],urban residence(OR:2.330,95%cI:1.286-4.221,P=0.005),previous antibiotic treatments(OR:1.909,95%cI:1.083-3.365,P=0.025),previous hospitalizations(OR:2.509,95%cI:1.263-4.986,P=0.009)and alcohol consumption(OR:2.550,95%cI:1.459-4.459,P=0.001)were risk factors of cDI in *** cDI risk is unrelated to history of SARS-coV-2 ***,previous cOVID-19 may necessitate higher doses of vancomycin for cDI.

关键词： cOVID-19 infection clostridium difficile infection Risk factors Antibiotic use Pandemic Recurrence

Proton pump inhibitors therapy and risk of clostridium difficile infection: Systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第35期23卷 6500-6515页

作者： Anca Trifan carol Stanciu Irina Girleanu Oana cristina Stoica ana maria singeap Roxana Maxim stefan Andrei chiriac Alin ciobica Lucian Boiculese Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital“Grigore T.Popa”University of Medicine and Pharmacy Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital Department of Research Faculty of Biology“Alexandru Ioan Cuza”University of Iasi Department of Preventive Medicine and Interdisciplinarity “Grigore.T.Popa”University of Medicine and Pharmacy

AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of clostridium difficile infection(cDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and cDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of cDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(cIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and cochran's Q *** publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for cDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of cDI(pooled OR = 1.99, cI: 1.73-2.30, P compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, cI: 1.68-2.38, P cohort(OR = 1.98, cI: 1.51-2.59, P cI: 1.67-2.27, P cI: 1.41-2.91, P center(OR = 2.18, cI: 1.72-2.75, P center(OR = 1.82, cI: 1.51-2.19, P cI: 1.40-2.68, P cI: 1.11-3.81, P cant differences were found in subgroup analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and cant hetero

关键词： Proton pump inhibitors clostridium difficile infection Risk Systematic review Meta-analysis

Simultaneous thermal and contraction/expansion curves analysis for solidification control of cast irons

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china Foundry 2020年第2期17卷 96-110页

作者： Iulian Riposan Stelian Stan Mihai chisamera Loredana Neacsu ana maria cojocaru Eduard stefan Iuliana Stan Politehnica University of Bucharest 313Independentei Spl.6th District060042 BucharestRomania

The first part of the paper summarizes the performance of two mould devices,illustrating by representative shrinkage tendency results in ductile cast iron as affected by mould rigidity(green and furan resin sand moulds)and inoculant type(FeSi-based alloys).Less rigid green sand moulds encourage the formation of contraction defects,not only because of the high initial expansion values(ε(di))(max),but also because of the increased solidification undercooling.A high inoculation efficiency means not only lowering the carbides formation sensitivity and increasing the nodule count,but also a prolonged graphitization through to the end of the eutectic freezing,as observed by the high population of small late forming nodules,which leads to minimizing the tendency for *** second part of the paper illustrates an application of this equipment to commercial foundry *** conducts thermal analysis and volume change measurements in a single ceramic cup with cast iron quality as a ***-bearing FeSi inoculant appears to be more effective than RE(Rare Earth)-FeSi alloy in FeSiMgca treated irons(no RE),in terms of reducing eutectic undercooling and(ε(di))(max),favourable for lower sensitivity to shrinkage *** also compared solidification patterns for white[WI],grey[GI]and ductile[DI]irons,to correlate the most important events between the cooling curves and contraction curves,to evaluate the sensitivity to shrinkage *** of the irons have similar values for initial expansion up to the start of eutectic freezing,but,after that,the graphite formation promotes expansion(more than 5 times for nodular graphite),resulting in a difference in maximum expansion(2 times higher for DI).The graphitic expansion has two contrary *** graphitic expansion(force)leads to a higher shrinkage sensitivity during the first part of the eutectic reaction,but also to a decrease of shrinkage at the end of solidification,due to forcing the last liquid i

关键词： white,grey and ductile castiron solidification undercooling structure simultaneous thermal and contraction analysis graphite graphitic

Micropatterning of Superhydrophobic Silicone Nanofilaments by a Near-Ultraviolet Nd:YAG Laser

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Nano Research 2010年第12期3卷 889-894页

作者： ana Stojanovic Georg R.J.Artus stefan Seeger Institute of Physical chemistry University of ZurichWinterthurerstrasse 1908057 ZürichSwitzerland

We demonstrate that a recently developed coating composed of superhydrophobic silicone nanofilaments can be selectively functionalized to yield well defined micron-scale patterns of contrasting wettabilities(superhydrophobic/hydrophilic and amphiphobic/amphiphilic).Nanofilament ablation was performed using a near-ultraviolet(UV)laser with a wavelength of 355 nm and a repetition rate of 10 *** is a highly promising approach for open channel microfluidics and microarray analysis due to its simplicity,the chemical and environmental stability of the coating,and the low cost.

关键词： Superhydrophobic ultraviolet(UV)laser ablation wettability open channels

cancer stem cells: Involvement in pancreatic cancer pathogenesis and perspectives on cancer therapeutics

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World Journal of Gastroenterology 2014年第31期20卷 10790-10801页

作者： cristiana Pistol Tanase ana Iulia Neagu Laura Georgiana Necula cristina Mambet ana-maria Enciu Bogdan calenic maria Linda cruceru Radu Albulescu Department of Biochemistry-Proteomics Victor Babes National Institute of Pathology stefan S Nicolau Institute of Virology carol Davila University of Medicine and Pharmacy National Institute for chemical Pharmaceutical Research and Development

Pancreatic cancer is one of the most aggressive and lethal malignancies. Despite remarkable progress in understanding pancreatic carcinogenesis at the molecular level, as well as progress in new therapeutic approaches, pancreatic cancer remains a disease with a dismal prognosis. Among the mechanisms responsible for drug resistance, the most relevant are changes in individual genes or signaling pathways and the presence of highly resistant cancer stem cells(cScs). In pancreatic cancer, cScs represent 0.2%-0.8% of pancreatic cancer cells and are considered to be responsible for tumor growth, invasion, metastasis and recurrence. cScs have been extensively studied as of late to identify specific surface markers to ensure reliable sorting and for signaling pathways identified to play a pivotal role in cSc self-renewal. Involvement of cScs in pancreatic cancer pathogenesis has also highlighted these cells as the preferential targets for therapy. The present review is an update of the results in two main fields of research in pancreatic cancer, pathogenesis and therapy, focused on the narrow perspective of cScs.

关键词： cancer stem cells Pancreatic cancer cancer stem cells signaling pathways Targeted therapy miRNA

Heterostructure and Q-factor engineering for low-threshold and persistent nanowire lasing

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Light(Science & Applications) 2020年第1期9卷 1609-1618页

作者： stefan Skalsky Yunyan Zhang Juan Arturo Alanis HAruni Fonseka ana M.Sanchez Huiyun Liu Patrick Parkinson Department of Physics and Astronomy and The Photon Science Institute The University of ManchesterManchester M139PLUK Department of Electronic and Electrical Engineering University College LondonLondon WC1E 7JEUK Department of Physics University of WarwickCoventry CV47ALUK

continuous room temperature nanowire lasing from silicon-integrated optoelectronic elements requires careful optimisation of both the lasing cavity Q-factor and population inversion *** apply time-gated optical interferometry to the lasing emission from high-quality GaAsP/GaAs quantum well nanowire laser structures,revealing high Q-factors of 1250±90 corresponding to end-facet reflectivities of R=0.73±*** using optimised direct-indirect band alignment in the active region,we demonstrate a well-refilling mechanism providing a quasifour-level system leading to multi-nanosecond lasing and record low room temperature lasing thresholds(~6μJ cm^(−2) pulse−1)for Ⅲ-Ⅴ nanowire *** findings demonstrate a highly promising new route towards continuously operating silicon-integrated nanolaser elements.

关键词： lasing alignment interferometry

The 3rd Global Summit of Research Institutes for Disaster Risk Reduction:Expanding the Platform for Bridging Science and Policy Making

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International Journal of Disaster Risk Science 2017年第2期8卷 224-230页

作者： Andrew collins Hirokazu Tatano Wilma James chadia Wannous Kaoru Takara Virginia Murray charles Scawthorn Jim Mori Sarah Aziz Khalid M.Mosalam stefan Hochrainer-Stigler Irasema Alcántara-Ayala Elisabeth Krausmann Wei-Sen Li ana maria cruz Subhajyoti Samaddar Tom De Groeve Yuichi Ono Kelvin Berryman Koji Suzuki Mark Ashley Parry Peter McGowran John G.Rees Department of Geography/Disaster and Development Network (DDN) Northumbria University Disaster Prevention Research Institute (DPRI) Kyoto University United Nations Office for Disaster Risk Reduction (UNISDR) Public Health England United Nations Office for Disaster Reduction (UNISDR) Scientific and Technical Advisory Group and Integrated Research on Disaster Risk (IRDR) Scientific committee Pacific Earthquake Engineering Research center (PEER) University of CaliforniaBerkeley centre for Southeast Asia Disaster Prevention Research Initiative (SEADPRI) Universiti Kebangsaan Malaysia Department of civil and Environmental Engineering Pacific Earthquake Engineering CenterUniversity of CaliforniaBerkeley International Institute for Applied Systems analysis (IIASA) Institute of Geography National Autonomous University of Mexico (UNAM) European commission Joint Research Centre (JRC) APEc Emergency Preparedness capacity Building center (EPcc) International Research Institute of Disaster Science Tohoku University Natural Hazards Division GNS Science National Research Institute for Earth Science and Disaster Resilience (NIED) British Geological Survey and Research councils UK

The Global Alliance of Disaster Research Institutes held its 3rd Global Summit of Research Institutes for Disaster Risk Reduction at the Disaster Prevention Research Institute,Kyoto University,Japan,19–21 March,*** Global Alliance seeks to contribute to enhancing disaster risk reduction(DRR) and disaster resilience through the collaboration of research organizations around the *** summit aim was to expand the platform for bridging science and policy making by evaluating the evidence base needed to meet the expected outcomes and actions of the Sendai Framework for Disaster RiskReduction 2015–2030 and its Science and Technology *** summit reflected the international nature of collaborative research and action.A pre-conference questionnaire filled out by Global Alliance members identified323 research projects that are indicative of current *** were categorized to support seven parallel discussion sessions related to the Sendai Framework priorities for *** discussion sessions focused on research that aims to deepen the understanding of disaster *** cross-cutting sessions focused on research that is aimed at the priorities for action on governance,resilience,and *** summaries were presentedin plenary sessions in support of outcomes for widely enhancing the science and policy of DRR.

关键词： Disaster risk reduction research GADRI global summit Policy Science