[Endoscopic treatment of Mirizzi syndrome].

Mirizzi syndrome is a complication of cholelithiasis occurring in 0.25-6% of cases [1]. Clinical pattern includes jaundice due to prolapse of a large calculus into the common bile duct following cholecystocholedochal fistula.

Building a Chatbot in a Pandemic.

Easy access to evidence-based information on COVID-19 within an infodemic has been a challenging task. Chatbots have been introduced in times of emergency, when human resources are stretched thin and individuals need a user-centered resource. The World Health Organization Regional Office for Europe and UNICEF (United Nations Children's Fund) Europe and Central Asia came together to build a chatbot, HealthBuddy+, to assist country populations in the region to access accurate COVID-19 information in the local languages, adapted to the country context.

Nuclear Magnetic Resonance Treatment Accelerates the Regeneration of Dorsal Root Ganglion Neurons .

Functional recovery from peripheral nerve injuries depends on a multitude of factors. Schwann cells (SCs) are key players in the regenerative process as they develop repair-specific functions to promote axon regrowth. However, chronically denervated SCs lose their repair phenotype, which is considered as a main reason for regeneration failure.

[Endoscopic treatment of duodenal duplication cyst].

Duodenal duplication cyst (DDC) is a rare form of intestinal malformation (2-12% of all gastrointestinal duplications). There are many difficulties in diagnosis and management of DDC. We present a case of successful endoscopic transluminal treatment of DDC in a 30-year-old female.

Perihilar cholangiocarcinoma: A different concept for radical resection.

Background: Long-term outcomes depend heavily on the possibility of performing radical resection.

Purpose: To evaluate long-term results in perihilar cholangiocarcinoma (PHC) patients from the perspective of a new understanding of radical resection.

Methods: Consecutive PHC patients who underwent surgical resection at A.

[X-ray-negative pancreatic dust stones in patients with chronic pancreatiti].

Diagnosis of chronic pancreatitis is not associated with any difficulties in patients with CT signs of pancreatic duct stones as a rule. However, 'classical' picture of chronic pancreatitis is usually absent in case of predominant protein matrix in the calculi. Two cases of X-ray-negative pancreatic dust stones in patients with protein stones of the pancreatic duct are reported.

Combination of laparoscopy and endoscopy as an option for treatment patients with gastric neuroendocrine tumors.

Background: Neuroendocrine tumors (NETs) are relatively rare neoplasms with the increasing survival due to the development of early diagnostics. There is no universal position in treatment and follow up of small (~20 mm) gastric NETs.

Clinical Cases: Two female patients 51 and 66 y.

Effect of the Anti-C1s Humanized Antibody TNT009 and Its Parental Mouse Variant TNT003 on HLA Antibody-Induced Complement Activation-A Preclinical In Vitro Study.

The classic pathway (CP) of complement is believed to significantly contribute to alloantibody-mediated transplant injury, and targeted complement inhibition is currently considered to be a promising approach for preventing rejection. Here, we investigated the mode of action and efficacy of the humanized anti-C1s monoclonal antibody TNT009 and its parental mouse variant, TNT003, in preclinical in vitro models of HLA antibody-triggered CP activation. In flow cytometric assays, we measured the attachment of C1 subcomponents and C4/C3 split products (C4b/d, C3b/d) to HLA antigen-coated flow beads or HLA-mismatched aortic endothelial cells and splenic lymphocytes.

Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature.

We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment.

Diagnostic Contribution of Donor-Specific Antibody Characteristics to Uncover Late Silent Antibody-Mediated Rejection-Results of a Cross-Sectional Screening Study.

Background: Circulating donor-specific antibodies (DSA) detected on bead arrays may not inevitably indicate ongoing antibody-mediated rejection (AMR). Here, we investigated whether detection of complement-fixation, in parallel to IgG mean fluorescence intensity (MFI), allows for improved prediction of AMR.

Methods: Our study included 86 DSA+ kidney transplant recipients subjected to protocol biopsy, who were identified upon cross-sectional antibody screening of 741 recipients with stable graft function at 6 months or longer after transplantation.

The measles outbreak in Bulgaria, 2009-2011: An epidemiological assessment and lessons learnt.

Measles re-emerged in a nationwide outbreak in Bulgaria from 2009 to 2011 despite reported high vaccination coverage at national level. This followed an eight-year period since the last indigenous cases of measles were detected. The Bulgarian National Centre of Infectious and Parasitic Diseases collated measles surveillance data for 2009-2011.

Protective, elective lung irradiation in non-metastatic Ewing's sarcoma.

Ewing's sarcoma in childhood is a disease from family of the peripheral primitive neuroectodermal tumours. For a period of 16 y (1984-2000), 34 children with Ewing's sarcoma were treated and followed in our department. Twenty-seven of these patients were without distant metastases.

Synchronous primary mammary osteosarcoma and invasive breast cancer. A case report - Pathohistological and immunohistochemical analysis.

Primary osteogenic sarcoma of the breast is a rare neoplasm, diagnosed mainly by pathohistological and immunohistochemical analysis. We hereby present a case of primary osteogenic sarcoma in the right breast of a 62-year-old woman with synchronous appearance of an invasive ductal carcinoma. Clinical findings are manifested with two separate painless formations 2.

Bortezomib in late antibody-mediated kidney transplant rejection (BORTEJECT Study): study protocol for a randomized controlled trial.

Background: Despite major advances in transplant medicine, improvements in long-term kidney allograft survival have not been commensurate with those observed shortly after transplantation. The formation of donor-specific antibodies (DSA) and ongoing antibody-mediated rejection (AMR) processes may critically contribute to late graft loss. However, appropriate treatment for late AMR has not yet been defined.

Clinicopathological relevance of granular C4d deposition in peritubular capillaries of kidney allografts.

While linear C4d staining in peritubular capillaries (PTC) is established as a marker of antibody-mediated rejection, the significance of a distinct granular C4d deposition pattern has not yet been clarified. In this study, 329 renal allograft recipients who underwent indication biopsies were analysed for immunohistochemical C4d staining characteristics. Fifty-six (17%) recipients showed granular C4d in PTC, without any relationship to conventional risk factors and morphological features of rejection.

Measles outbreak in Bulgaria: poor maternal educational attainment as a risk factor for medical complications.

Background: An 8-year era of interrupted indigenous measles transmission in Bulgaria came to an end in April 2009 when a large epidemic occurred that would eventually claim 24,253 cases and 24 deaths; infants, children and young adults of the Roma community were disproportionally affected. Compared with Western Europe, case-fatality rate and proportion of medical complications were uncharacteristically high.

Methods: To disentangle underlying drivers of the outbreak and reasons for these medical complications, we assembled a number of national ecologic variables as well as regional individual-level data for 206 measles cases, randomly selected from national medical records.

Modified solid-phase alloantibody detection for improved crossmatch prediction.

Virtual crossmatching based on single-antigen bead (SAB) assays for the detection of donor-specific antibodies (DSA) has limited accuracy of predicting complement-dependent cytotoxicity crossmatch (CDCXM) results. In this study, 672 crossmatch combinations (32 allosensitized patients tested against cells from 21 high resolution-typed individuals) were analyzed to assess the potential of modified SAB tests in predicting T- or B-cell-CDCXM outcomes. Test modifications included measurement of C4d-fixation to detect complement-activating DSA ([C4d]DSA), or addition of dithiotreitol to abrogate the prozone effect ([IgG/DTT]DSA).

Anti-A/B antibody depletion by semiselective versus ABO blood group-specific immunoadsorption.

Background: Recipient desensitization using blood group (BG)-specific immunoadsorption (ABO-IA) has proven to enable successful kidney transplantation across major ABO barriers. In this context, the efficiency of non-antigen-specific (semiselective) IA adsorbers has not yet been established. The objective of our study was to quantify anti-A/B antibody depletion by protein A-, peptide ligand- and anti-human immunoglobulin-based semiselective IA in comparison to ABO-IA.

Nosocomial transmission of measles among healthcare workers, Bulgaria, 2010.

This report describes 326 cases of nosocomial transmission of measles with 286 cases among non-healthcare workers who acquired the disease in a hospital setting. Between October 2009 and April 2010, 40 healthcare workers from seven different regions in Bulgaria have contracted the disease.

An update on an ongoing measles outbreak in Bulgaria, April-November 2009.

Earlier this year, an outbreak of measles was detected in Bulgaria, following an eight-year period without indigenous measles transmission, and continues to spread in the country. By the end of 48 week of 2009 (first week of November), 957 measles cases had been recorded. Most cases are identified among the Roma community living in the north-eastern part of the country.

Primary mucosal sinonasal melanoma-Case report and review of the literature. The role of complex treatment-surgery and adjuvant radiotherapy.

Aim: The place of adjuvant radiotherapy in the treatment of sinonasal melanoma.

Background: Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy.

An ongoing measles outbreak in Bulgaria, 2009.

After seven years without indigenous transmission of measles in Bulgaria, an increasing number of cases have been reported since 15 April 2009. By 19 June, the total number of notifications reached 84. To date, 64 were confirmed as measles cases and 15 cases, for whom laboratory results are pending, have been classified as probable.

Conservative treatment of invasive lobular breast cancer.

Purpose: To assess the efficacy of breast conserving surgery (BCS), followed by postoperative radiation treatment (RT), chemotherapy and/or hormonotherapy in patients with early invasive lobular breast cancer (ILC).

Patients And Methods: 48 patients with TNM stages I and II ILC of the breast were treated conservatively by BCS (quadrantectomy) and axillary dissection to levels I and II, followed by RT and adjuvant chemotherapy or hormonal treatment. In patients with pN0 the remaining breast with scar and chest were treated by RT, with a total radiation dose (TRD) of 50 Gy.

Desmoid-type fibromatosis in childhood: report of 3 cases with review of the literature.

During the last 20 years we observed 3 cases with the rare condition of desmoid fibromatosis in childhood. This benign tumor with infiltrating potential has therapeutic difficulties for the achievement of a stable local tumor control (LTC). In this paper we present our experience with the therapeutic manipulations applied to our patients and go through the relevant literature on desmoids tumors.