With the constant increase in energy demand, using renewable energy has become a priority. Geothermal energy is a widely available, constant source of renewable energy that has shown great potential as an alternative source of energy in achieving global energy sustainability and environment protection. When exploiting geothermal energy, whether is for heating or cooling buildings or generating electricity, a ground heat exchanger (GHE) is the most important component, whose performance can be easily improved by following the latest design aspects. This article focuses on the application of different types of GHEs with attention directed to deep vertical borehole heat exchangers and direct expansion systems, which were not dealt with in detail in recent reviews. The article gives a review of the most recent advances in design aspects of GHE, namely pipe arrangement, materials, and working fluids. The influence of the main design parameters on the performance of horizontal, vertical, and shallow GHEs is discussed together with commonly used performance indicators for the evaluation of GHE. A survey of the available literature shows that thermal performance is mostly a point of interest, while hydraulic and/or economic performance is often not addressed, potentially resulting in non-optimal GHE design.

Stricter ecological standards in combination with increasing demand for transportation of perishable cargo, demand changes in shipping industries in the years to come. Until more ecological power systems are implemented, increasing energy efficiency, and reducing carbon footprint have become a priority for shipping industries. Due to smaller greenhouse gas emissions, LNG-powered vessels are gaining more attraction and when LNG is used, considerable waste cold energy can be utilized. In this research, waste cold heat of LNG is used for precooling of outside air for cargo hold ventilation. It is shown that by precooling the air with LNG waste cold heat, the energy consumption of transported refrigerated containers can be reduced up to 25%.

of the palms develops with conjunctival hyperemia and cracking of the lips. Perivascular hyperechogenicity in the coronary arteries snd mild mitral regurgitation was registered on the echo. K.A.B., a 4-year-old girl, her disease started with fever and enlarged cervial lymph nodes on the right measuring 5x3 cm, so she was hospitalized and ceftriaxone therapy was introduced. Diagnosis of KD was made after the development of polymorphic rash, conjunctival hyperemia, edema and erythema of the palms and soles, and dry, cracking lips. Echocardiography revealed mild mitral regurgitation and uniformly broad LCA with hyperechogenicity. I.Š., a 7-year-old girl had fever and right-sided cervical lymphadenopathy four days before admission and was treated as an outpatient with peroral cephalosporin. During hospitalization antibicrobial therapy was changed initially to ceftriaxone and azithromycin, then due to the absence of clinical and laboratory response to cefazolin and clindamycin. On the tenth day of the disease swelling of the hands and feet with conjunctival hyperemia and raspberry tongue were noted. Echocardiographically ectatic proximal part of LCA (3.9 mm) was registered and IVIG with ASA introduced. During the longterm follow-up no residual changes in the coronary arteries were recorded. Conclusion The aim of this paper is showing that in an acute febrile disease one must also think about Kawasaki disease, especially when there is absence of adequate response to antibiotic therapy. Immunoglobulin therapy has been shown to prevent the development of serious cardiovascular complications and remains the first choice in the treatment of children with KD. In case of persistent fever and resistant cases, corticosteroids and other immunomodulatory and biological therapy may be considered.

anomalies, and a typical number of other phenotypes, including occurrence of cardiac fibroma. The syndrome is caused by microdeletion of the long arm of chromosome 9, in the region q22.3-q31 which includes the PTCH tumor suppressor gene. The diagnosis is made clinically, through large and small criteria that include the already mentioned clinical characteristics.Case Report We will present the case of a 5yearold girl diagnosed with Gorlin -Goltz syndrome with the presence of fibroma in the left ventricular wall. The patient has an uneven psychomotor development and shows atypicalities in the field of socio-emotional functioning. Phenotypically, we find increased neurocranium, rough facial features, divergent strabismus, and a wider nasal root. The girl was initially hospitalized for the clinical presentation of heart failure: she was clinically tachydyspnoic, with audible crepitations in the lungs, enlarged liver, and pretibial edema. Echocardiographically, it was diagnosed with dilated cardiomyopathy, with an ejection fraction of 25%, while the formation of an unclear etiology was seen in the left ventricle. The patient was treated with anticongestive therapy with low molecular weight heparin and further treatment was performed. MRI of the heart showed a formation that according to radiological criteria corresponds to a large fibroma. Due to the opinion that dilated cardiomyopathy and fibroma with phenotypic characteristics could be parts of systemic disease, molecular karyotyping was performed which found microdeletion of the long arm of chromosome 9 in the q22.3 region, which includes the PTCH gene that regulates cell growth and functions as a tumor suppressor gene. Haploinsufficiency of this gene has been described as Gorlin -Goltz syndrome, which is characterized by phenotypic traits such as those found in our patient. Among patients with Gorlin-Goltz syndrome, 10% develop cardiac fibroma with the most common localization in the left ventricular cavity. Symptoms of cardiac fibroma depend on the size of the tumor, the involvement of the conduction system, and the possible existence of intracavitary obstruction. The patient we present has an extensive tumor located intramurally in the anterolateral wall of the left ventricle, measuring 5.8x4.8 cm. Measured values of cardiac pressures obtained by invasive cardiac treatment indicate impaired systolic and diastolic heart function and increased pulmonary pressure, as a result of dilated cardiomyopathy with clinical signs of heart failure. Discussion The presence of dilated cardiomyopathy with markedly impaired systolic function may be secondary to the tumor or as primary disease, that is why genetic processing of cardiomyopathy is ongoing. Cardiac fibroma can be treated by surgical resection, but in a situation of severely impaired systolic function, transplantation treatment is more likely, with the risk of immuosuppression in a patient with a tumor suppressor gene disorder.

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