ARS Medica Tomitana
vol. X - nr. 2 (37) april - june 2004

Consideratii morfologice asupra arterei polare antero-superioare a rinichiului
P. Bordei, Elena Sapte, D. Iliescu

ABSTRACT. Using as study methods the dissection, contrast medium injection followed by radiography, plastic injection followed by corrosion and the evaluation of renal angiographies, the authors describe the morphological characters of the main, antero-superior polar renal arteries in 400 cases. The origin of the polar renal arteries was assessed, in 163 cases, from the anterior division of the renal artery (pre-pyelic artery), in 112 cases from the trunk of the renal artery, prior to its terminal division, in 48 cases as terminal branch of the renal artery, in 45 cases from the inferior suprarenal artery, in 23 cases directly from the aorta, as supplementary artery and, in 9 cases, from the postrior division of the renal artery (retro-pyelic artery). Except the main antero-superior polar renal artery, the blood supply of the anterior face of the superior pole of the kidney is also provided, in approx. 80% of the cases, by other 1-2 secondary branches, with variable origins. Among all the polar arteries, 237 samples were represented by apical arteries (arteries that enter the superior pole renal parenchyma outside the renal hylum). In 348 cases, the antero-superior polar renal artery expanded its supplied territory towards posterior and, in 134 cases, an unique superior polar artery supplied the entire superior pole of the kidney.

Studiul morfometric al atlasului
H. Varlam, D St Antohe, Raluca-Ozana Chistol

ABSTRACT. Atlas, the first cervical vertebra is one of the major components of the craniocervical junction, together with occipital bone and axis. The first two cervical vertebrae support the skull and allow its various movements. Atlas also participates in forming osteofibrous canals for the spinal cord and vertebral arteries. Congenital malformations, tumours, traumatic and inflammatory injuries that modify the normal anatomy of the atlas could also involve the related vascular and nervous elements. Surgery of the craniocervical junction is now impossible without detailed knowledge concerning the morphometry of the atlantal components. The aim of our study was a morphologic and morphometric analyse of the atlas. We studied 50 dry vertebrae. Anatomic details were observed by means of a Zeiss surgical microscope. Images were recorded on a Sony video line and a digital camera. Morphometric analyze were performed by direct measurements and using the KS-300 program. The anatomic parameters investigated concerned the whole vertebra, lateral masses, anterior arch and atlantal foramen. All simetric structures were measured bilaterally. Data were statistically analyzed and referred to the literature. The anteroposterior diameter was 41,58±3,04 mm and the transvers one was 69,09±4,87 mm. The maximal and minimal diameters of the axial articular surface were respectively, 17,50±1,35 mm and 15,17±1,72 mm and the calculated surface was 202,63±30,94 mm2. The obliquity of the axial surface in coronal plane was between 7,81o si 30,52o, with an average of 19,21o±5,43o. The atlantal foramen had the anteroposterior diameter of 30,91±2,12 mm, the maximal transversal diameter of 27,45±2,19 mm and the minimal transversal diameter of 14,95±2,25 mm.

Particularitati morfologice ale trunchiului coronar stâng
M. Onciu, T. Leonte, Carmen Onciu, R. Baz, Elena Sapte

ABSTRACT. 300 human hearts prelevated from cadavers aged 4 months to 87 years were disected and/or injected and corrodated, injected and radiographed, and microscopically observed for the aims of this study. The opening of the left coronary artery was found to be placed level with the free margin of the corresponding semilunar valve in 74% of cases, immediately above the valvular margin in 20% and below the free margin in 6%. Still, in the vast majority of cases, the opening was placed level with the middle of the valve. The diameters of the left coronary artery opening had means of 4.6 x 3.2 mm. The angle between the trunk of the artery and the aortic wall was over 45° in 84% of cases, of 45-75° in 62% and of 75-90° in 22%. The length of the left coronary artery was found to be highly variable (1 – 20mm), in 77% of cases being of 5 – 15 mm. The ending variants of the arterial trunk were by bifurcation (76%), trifurcation (15%) and direct continuation with the anterior descending artery (9%).

Elemente de interdependenta intre etiologia si leziunile microscopice bazinetale in hidronefroza
Madalina Bosoteanu, Mariana Aschie, C. Bosoteanu, Liliana Mocanu, Mariana Deacu

ABSTRACT. The present study tries to approach a renal lesion with an increased incidence in the pathology of childhood and maturity – hydronephrosis, that has a complex etiology, leading to the progressive and irreversible deterioration of the renal structure and function. The various causes producing this disease reflect also in the multiple morphological alterations, both macroscopical and microscopical, of the urinary system and of the renal parenchyma. The attentive analisis of 85 cases of congenital and acquired hydronephrosis pointed pelvic histopathological lesions meaningful correlated with the origin of the complaint. The atrophy of the pielic transitional epithelium, malpighian metaplasia of mature or imature type, various grades of urothelial displasia and the evidence in some cases of malignant lesions represented the evident changes of the epithelial layer. In muscularis, we distinguished extensive fibrosis, disorganized architecture and atrophy of smooth muscle fibres. The associations between various histopathological lesions and the etiology of this disease were explained by its pathogenesis.

Determinarea concentratiei de 134Cs in tesutul limfoid amigdalian
O. Teren. D. Dinca, Monica Vasile

ABSTRACT. Nuclear accidents and nuclear explosions in the atmosphere have been release over the time a huge amount of 134Cs in the air. Follow up studies of this isotope in the human body gives information’s over the degree of medium radioactive pollution. The study that we have done reveal a normal concentration of this isotope in the tonsils tissue.

Efectul iradierii in hiperbarism asupra concentratiei acidului uric si a ureei
Monica Vasile, O. Teren. Ileana Ion, N. Schiopu

ABSTRACT. The aim of this study is to put in evidence the protein metabolism products in case of internal exposure to the radiation under hyperbaric conditions for experience animals (Wistar rats). Irradiation and hyperbaric exposure give rise to a cumulative effect by appearance of oxygen free radicals. The variation of the studied parameters shows a significant increase of urea concentration in case of irradiation under hyperbaric conditions. Meanwhile a decrease of uric acid values is taking place.

Studiul factorilor prognostici in faza cronica a leucemiei granulocitare cronice
Mihaela Maria Ghinea

ABSTRACT. Granulocytic chronic leukaemia, a maliqnant disease of pluripotent stem cell, can advance in following stages: chronic phase, therapeutical controlled, accelerated phase, blastic transformation phase. This researche appreciates the patients survival depending on prognostic factor evaluated in chronic phase. There have been studied 40 patients (23 males and 17 females aged beetween 19 and 70 years old). They were diagnosticated in chronic phase and Ph 1 positif. They were grouped, at the diagnosis moment in system with prognostic score (Sokal, Hasford).According to both risk systems, most patients were classified in low risk group and intermediary.Patients included in study were treated with monotherapy (hidroxinree-Hyu) or combined therapy (IFN-alpha associated with Hyu/Caryolisine). The duration of chronic phase is according to risk group, tumoral mass at diagnosis and therapy applicated. As chronic phase has a longer duration as much increases the hope of life.

Aportul Angio-RM in diagnosticul arteriopatiei obliterante ateromatoase a membrelor inferioare
R. Baz, Liliana Gheorghe

REZUMAT. Arteriopatia obliteranta ateromatoasa a membrelor inferioare se defineste ca o afectiune arteriala obstructiva de etiologie ateromatoasa care determina reducerea progresiva a lumenului vascular si a fluxului sanguin spre membre. Angiografia prin rezonanta magnetica are un aport deosebit in evaluarea neinvaziva a arteriopatiei obliterante, evidentiind bine leziunile ateromatoase ale aortei, arterelor iliace si femurale. Evidentierea arterelor gambiere este insa mai putin eficace la unele cazuri cu leziuni extinse, etajate, cu debit distal absent in axul principal. Folosirea curenta a angioRM (ARM) poate reduce substantial indicatia de explorare invaziva diagnostica, cateterismul fiind rezervat cazurilor cu indicatii de interventie percutana prin angioplastie. Principala deficienta a metodei este supraestimarea stenozei cauzata de pierderea semnalului datorata fluxului turbulent. În perioada martie - mai 2004 au fost examinati ARM 12 pacienti cu diagnostic clinic, ecografic si oscilometric de arteriopatie obliteranta ateromatoasa a membrelor inferioare. Examinarile efectuate cu un aparat General Electric Signa Horizon 1,0T a permis obtinerea de imagini ARM de buna calitate la toate cazurile evaluate. Examinarea MIP in rotatie axiala 3D a permis aprecierea aspectelor lezionale si descrierea lor, oferind informatii indispensabile echipei chirurgicale, care a confirmat in toate cazurile leziunile descrise.

Terapia compresiva si flebotonica in prevenirea recidivelor ulcerelor venoase de gamba
Anca-Raluca Pistolea

ABSTRACT. Venous ulcer epithelization does not mean the key for all problems of one patient with stage IV chronic venous insufficiency, because venous disturbances have to undergo continuos correction using elevation, compression, tonics for vein, surgery or combination between theese methods. Without therapy for venous stasis, the patient is liable to reccurences. We studied 23 patients clinically diagnosticate with stage IV chronic venous insufficiency with healed ulcers. We indicate them to continue the therapy using compression stockings or bandages, venotonic drugs ( Detralex 2 tablets/ day) and surgery for certain patients. This patients has been clinicaly evaluated every month for one year. We analized, too, if the main risk factors for ulceration reccurence are present: compliance to therapy, history of deep venous trombosis, aria of healed ulcer, time necessary to heal the ulceration. Reccurences rate at one year was 34,75%, beeing as higher as the compliance to therapy was lower. The most efficient method was association between compression and venotonic drugs.

Aportul ultrasonografiei in diagnosticul si monitorizarea bolii Crohn
Andra Iulia Suceveanu, A. Suceveanu, Luana Alexandrescu, FL. Voinea

ABSTRACT. Bowel examination by transabdominal ultrasound (US) has recently been introduced as diagnostic investigation in Crohn’s Disease (CD). We followed-up by US 12 patients with clinical symptoms of Inflammatory Bowel Disease (IBD) suggesting CD, in Gastroenterology Department, Clinical Hospital of Constanta, over a period of 24 months. The benefit of US in intestinal pathology was demonstrated by the richness of mophopatological findings in positive diagnosis and CD follow-up. US examination revealed the presence of stiff and thickening of bowel walls (>7 mm), variably associated with persistence or disappearance of bowel stratification and peristalsis in the small bowel and loss of haustra coli in the colon in more than 80%. Other frequent US findings such as mesenteric hypertrophy and enlarged lymph nodes were discovered in higher percents. The most important role of US was the follow-up of known CD patients for early diagnosis of intraabdominal complications such as stenoses, abscesses or fistulae.

Infectiile bacteriene ale meningelui - modalitati evolutive, prognostic
Stela Halichidis, S. Rugina, Claudia Nina Rugina

ABSTRACT. We studied bacterial meningitis evolution, excepting those with mycobacterial etiology starting 2000, bacterial meningitis being still severe diseases, because their high mortality and sequelles. I studied 216 cases of bacterial meningitis (excepting those with mycobacterial etiology and those on HIV-infected patients), registered in Clinical Infectious Diseases Department, during 3 years (2000, 2001, 2002). The majority of the patients were completely cured (67,59%). 25,93% of cases remained with sequelles and 6,48% of patients died. In Constantza, the fatality rate of bacterial meningitis is placed between 3,85 and 9,23.

Date epidemiologice despre stopul cardiorespirator
Rodica Tudoran, Alina Oancea

ABSTRACT. Cardiorespiratory arrest is a major emergency, frequent in the activity of the resuscitation teams. To increase the efficiency of the medical intervention, in prehospital as well in the hospital, is necessary to be informed about some aspects related with the incidence of cardiorespiratory arrest, it’s etiology, and mechanism which induce cardiac arrest. The aim of this study is to analyze some epidemiological data about cardiorespiratory arrest in Emergency Department of Clinical County Emergency Hospital of Constantza.

Efecte adverse ale terapiei in hepatitele cronice cu Virus Hepatitic C
A. Suceveanu, Andra Iulia Suceveanu, E. Dumitru, FL. Voinea

ABSTRACT. Chronic hepatitis C remains one of the leading causes of chronic liver disease in the whole World. Therapy has improved over the last decade. These newer agents such as long-acting pegylated interferons are significantly more effective than earlier versions of standard interferons but the side effect profile of interferon-based therapies has remained largely un¬changed.The aim of the study was to establish the principals side effects of therapy for Chronic Hepatitis C and the adherence amoung patients who must be treated by associated therapies. There were a few causes of dose reductions or premature withdrawal from therapy because of adverse events. Our study shows that newer therapy agents lead to a better virusological sustained response ( ~70%) and have better tolerability.

Chist hepatic parazitar (Toxocara canis) fisurat in parenchimul hepatic, cu reactie anafilactica
B. Cimpineanu, I. Tofolean, Irina Dumitru

ABSTRACT. A frequent patology during the guard servicices is represented by alergic reactions which are known to have a potential severe evolution. Secondary to the management of the alergic reaction it is mandatory to precise the etiology. In such cases it is realy dificult for the physician to establish the positiv diagnosis because are requested knowledge, experience and diagnostic posibilities. Between the causes of a severe alergic reaction it is Toxocara canis, a relatively rare parasitosis which is subevaluated either by omission, either by reduced diagnostic posibilies.

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