ARS Medica Tomitana
vol. XI - nr. 1 (40) january - march 2005

Des aspects cliniques - imagistiques du Syndrome endoantral
Calin Dorelia, Francu L.L., Moldovanu Adriana

ABSTRACT. Introduction. The sinusal involvement of the dental pulp diseases vary between 4.6 and 47 % of the total sinusitis and depend on the pulpal lesion. The acute infectious pulpal diseases are diffusing rapidly and destructively and can involve significantly the adjacent sinus. Various aspects of the endo-antral syndrome and the absence of the typical signs in all these cases can create difficulties of diagnosis and treatment plan. For this reason we have proposed to define more accurately etiological, clinical and imagistical aspects and the management of the disease. Material and methods. The clinical study comprised patients which were examined in the dental surgery for different carious lesionswith detected periapical and sinusal lesions after endodontic treatments. In most of the cases, the patients have presented clinical signs specific to a recent or tardive complication after an endodontic treatment. The imagistic study (radiographies panoramiques, periapical and ocluzal radiographies) has defined more accurately the nature of the lesions. Results. The clinical examination of a patient with a maxillary sinus disease must comprise the extraoral examination (the palpation of the lateral and anterior walls of the sinus, over the prominence of the cheek bones) and intraoral examination on the lateral surface of the maxilla. The possible radiographic changes which can be observed in sinusitis are the thickening of the sinusal mucosa, the presence of an air-fluid level and the total sinusal opacification. The most frequent periapical lesions which were determined by an incorrect endodontic treatment are chronic periapical periodontitis, apical abscess, cysts, osteomyelitis, fibrous scars, and can lead to odontogenic sinusitis. The penetration of the sinus floor during periapical surgery or with endodontic instruments, irrigants, intracanalar medications or root filling materials can be complicated with an acute sinusitis by bacterial contamination. Conclusion. This study is not epidemiological or statistical, but it compels attention on the periapical and sinusal complications of the diseases of dental pulp and incorrect endodontic treatments.

Contributia imagisticii prin rezonanta magnetica la diagnosticul dementelor
R. Baz, Luminita Şapera, Irina Turcuman

ABSTRACT. Dementia is characterised by dysfunction or loss of cognitive functions with keeping vigilance. Dementia is mostly a disease of the elderly, affecting 2% of persons between 65-70 years old and as many as 20% of persons > 80 years old. Since the increase of the average life expectancy, dementia has become a real public health problem, patients requiring a long social dependency and nursing. The aim of the study is to establish the MRI modifications that can lead to the early diagnosis of the dementia syndrome using a prospective group of 73 persons, males and females between 58 and 83 years who were examined MRI by a standard proceeding. Most of the cases showed normal aging modifications and only 4 patients could be diagnosed with Alzheimer’s disease. The border between normal aging modifications and alterations that accompany neuro-degenerative disorders, cerebro-vascular disease and hydrocephalus are not well established, and the certain parting between normal and pathology isn’t always possible just by using imaging means.

Particularitati endoscopice ale cancerului gastric
Nurla Gulserin, V. Sarbu, Mariana Aschie, F. Botea, Isabela Botea

ABSTRACT. The present paper represents a statistical and clinical study on a group of 90 patients admitted in the II nd Clinic od Surgery – Clinical Emergency Hospital of Constanta and investigated in the Department of functional explorations of the same hospital. Our work analysis the morphopathological parameters of the gastric cancer obtained by videoendoscopy and emphasyses the main macroscopical elements of the gastric cancer in the studied group.

La morphologie quantitative du dispositif vasculaire de l’amygdale palatine
L. L. Francu, Dorelia Calin, Doina Lucia Frincu, Cristina Ghibarsina

RESUME. Introduction. L’amygdale palatine est un organ lymphoépithélial qui appartient au système immun intégré dans la muqueuse du pharynx. La fonction primaire des tonsiles est de prévenir d’une manière vigilante l’invasion des agents pathogènes dans la partie supérieure d’appareil de la respiration, ce qui est possible grace à l’abondance des nodules lymphoïdes qui filtrent et éliminent les bactéries qui circulent par la lymphe, ainsi que d’autres matériaux étrangers, qui ont accesion dans le corp par les cavités nasales et orales. Les vaisseaux intratonsilaire assurent la circulation des lymphocytes et la repeuplement lymphoïd de l’amygdale palatine. Le but de cette étude est de evaluer quantitative la distribution anatomique des vaisseaux tonsilaires, aux différents ages, pour déterminer la modification des paramétres dans conditions pathologiques. Matériel et methodes. On a utilisé des tonsiles palatines aux cadavres ou recolteés d’une manière intraopératoire. L’étude anatomique macroscopique a été realisée par l’investigation endoscopique de la loge et de la tonsile palatine aux 21 personnes avec l’age entre 5 et 71 ans et par la dissection au cadavre (totalement 24 loges tonsilaires palatines). Les fragments ont étè modifiés par la technique avec paraffine et colorés à l’aide des méthodes usuelles et spéciales. L’étude morphologique quantitatives a été realiée sur les sections représentatives employant une programme vidéo digital interactif qui a quantifié les vaisseaux sanguins dans diverses zones topographiques de l’amygdale palatine. On a évalué par la méthode stéréologique les volumes calculés en pour-cent (%) des composants structurales et on a verifié la signification des dates obtenues. Résultats. La tonsile palatine est vascularisée par des artères principales, ayant l’origine dans l’artère pharyngienne ascendante de la carotide externe et palatine ascendante, branche de l’artère faciale qui émit l’artère tonsilaire, à côté des artères tonsilaires accesoires avec des origins multiples. Le nombre et les dimensions des microvaisseaux intrafolliculaires sont plus réduits en comparaison avec ceux-là des microvaisseaux interfolliculaire. Dans le cas d’enfant, les plus nombreux vaisseaux se trouvent d’une manière interfolliculaire (11.12 ± 0.83), mais les lumens détienent le plus grand volume dans les cloisons calculé en pour-cent (15.2). Au adult, les vaisseaux interfolliculaire ont la plus grande densité (19.48 ± 1.21), mais le plus grand volume est détenu par des vaisseaux de la lamina propria d’épithélium d’enveloppe (15.9). Aux vieux, on remarque une réduction, aussi de la densité vasculaire dans les toutes zones étudiées, d’une manière plus ou moins marquée, bien que des volumes % de leur intérieur, le plus évidemment dans les cloisons (9.7). Conclusion. Les résultats quantitatifs démontrent d’une manière objective la modification de la densité et du volume calculé en pour-cent du dispositif vasculaire intratonsilaire palatin, en particulier au-dessous d’épithélium d’enveloppe et péricryptique, dans le même temps avec l’apparition de la sénilité. Attendu que le système vasculaire intratonsilaire joue un rôle important dans la protection, sa diminution peut être responsable de la réduction de la capacité immunitaire.

Aportul tomografiei computerizate in tumorile renale
Emel Osman, S. Osman, M. Beciu

ABSTRACT. Renal tumors, more than ever renal adenocarcinoma, represents a main health problem with an increased frequency above 60 years. To increase the effiency of the medical intervention,both in prehospital than in hospital, it is necessary to be informed about some clinical and paraclinical aspects related with the incidence of renal tumors. The aim of this study is to analyze some data about standard radiological procedure which is an abdominal CT-scan with and without contrast medium. It serves to document the diagnosis of RCC and provides information on the function and morphology of the contralateral kidney.

Consideratii clinice si terapeutice in oftalmia simpatica (caz clinic semnificativ)
Denislam D., Constantin Farah

ABSTRACT. The authors present sympathetic ophthalmitis which is a rare, bilateral, diffuse granulomatous uveitis that occurs following surgical or accidental penetrating ocular trauma. Until the use of steroids, sympathetic ophthalmitis was inevitably associated with visual deterioration and blindness.

Evaluarea efectului aditiv al factorilor multipli de risc din ateroscleroza
Elvira Craiu, M. Toringhibel, Nicoleta Violeta Miu, Daniela Avram

ABSTRACT. This pacient demonstrates the importance of assessing the additive effect of a series of risk factors that individually do not appear to justify aggressive treatment. According to the Framingham Risk Scoring calculation (gender, age, systolic BP, HDC-C, TC), high level of risk and significant target organ damage justified an agressive treatment, particulary in the presence of left ventricular hypertrophy (LVH). In order to prevent progression from arterial hypertension to heart failure, optimal treatment of hypertension is necessary

Tratamentul conservator al rupturii de tendon extensor cu deformatie "in ciocan"
I. Bordeianu, T. Mahmoud, Adriana – Mihaela Enache, B.Caraban, I.Bulbuc

REZUMAT. The traumatic break of the extensor aponeurosis for fingers 2-5 at the insertion with a secondary “mallet finger” deformation represents a frequent affection that causes serious problems in treating it. In literature discussions regarding conservatory or surgical treatment for this affection are very different. In the last five years our service has adopted a standardized attitude meaning that we chose conservatory treatment (noninvasive) after years on a row we had obtained satisfactory results with surgical treatment – reparatory. We correctly immobilize interphalangian joint in extension came by emergency or in the first 72 hours from the accident – on a splint made from a plastic material – (even hyperextension from the distal interphalangian) for 20-26 days am we found out that the obtained results are superior to those treated surgically meaning that the recovery is faster and the functionality of the finger is generally better. There have been solved a number of 46 cases with this procedure with very good results in 44 cases that is equivalent to 95,6% – very good results have been considered the ones in which the remaining deformation in flexion was under 10 degrees.

Aspecte ale evolutiei sistemului coronar in perioada fetala
Mirela Cojocaru, Dan Ulmeanu

ABSTRACT. Formation of the coronary vessels is a fundamental event in heart development. The development and patterning of coronary vascular system has important implications for human health. Althrough coronary vessel development is a form of vasculogenesis followed by angiogenesis, this system uses several unique developmental processes not observed in the formation of other blood vessels. We studied foetal hearts from aborted foetuses, resulted from spontaneous abortions. With the corrosion casting technique, coronary vascular system was examined with beautiful results.

Aspects angio-architectoniques cérébelleux
L. L. Onisai

ABSTRACT. The cerebellar arteries are collateral branches of the vertebral artery and the basilar one. The cerebellum arteries generate two groups / categories of branches: superficial ones and branches that perforate the cerebellar peduncles and enter the central area of the cerebellum, being distributed to the cerebellar nuclei (the deep branches). The superficial branches from a network of anatomies of the surface of the cerebellum in contact with pia mater that is inside the subarahnoid area and being wet by the cerebrospinal fluid.

Anemia hemolitica autoimuna – modalitate de debut in lupusul eritematos sistemic
Mihaela Maria Ghinea, Zizi Niculescu


ABSTRACT. Autoimmune haemolytic anemias (AHAI) are divided into two groups according to the immunochemical properties of their antibodies (AAC) : AHAI with warm AAC and AHAI with cold AAC. Each of the two forms can be idiopathic or secundary. In a group of 52 cases of patients with AHAI we studied the incidence of AHAI associated with systemic lupus erythematosus (SLE), the temporal relation between AHAI and SLE, immunoserological and clinical features of AHAI associated with LES. AHAI can be the only manifestation with of the disease and it can occur long time before SLE diagnosis. This oblige the practitioner to allways search for diagnostic criteria of SLE in a patient with apparently primary AHAI.

Consideratii clinice si terapeutice asupra infectiei cu toxocara canis
S. Rugina, Irina Dumitru, Claudia Nina Rugina, Elena Dumea


ABSTRACT. Clinical study on 71 patients (24 mans and 47 women) admitted with toxocarosis in Department of Pharasitology Constanta in the last 2 years. The most frequently affected age groups were 14-19 years (19 cases) and 40-49 years (21 cases). The provenience was especially from urban area (45 cases). The most frequent manifestation was allergic coutaneous involvement (55 cases with generalised eruptions or chronic eczema), in 12 cases the eruptions were associated with facial oedema, Quincke oedema or articulary tumefactions. Pulmonary involvement was noticed in 5 cases (cough, Löffler infiltrate or pleurisy), ocular toxocarosis in 6 cases and neurological manifestations in 5 cases. In 25 cases toxocarosis was associated with toxoplasmosis, ascariosis, giardiosis and teniasis. Toxocarosis is a frequent diseases in the last years, the high prevalence is explain by modern investigations (ELISA reactions) used in diagnosis. Under medical treatment (albendazol, 800 mg/day) we notice a good evolution in all cases.

Testele citogenetice – varianta fiabila si cost eficienta in screening-ul cancerului colorectal
Andra Iulia Suceveanu, Fr. Mixich, A.P. Suceveanu, Fl. Voinea


ABSTRACT. Screening programs for CRC are a necessity worldwide. Diagnostic procedures used in screening have unsatisfactory specificity or costs. Present study is aimed to demonstrate that cytogenetic tests could be introduced as a feasible and cost-efficient method in screening for CRC. We studied 10 patients with CRC diagnosed using conventional methods (FOBT tests and colonoscopy/biopsy). Fecal and biopsy samples were analyzed in order to detect genetic mutations using denaturing gradient gel electrophoresis. Selected genes for analyse were: APC, MLH1, MSH2 and MSH6, genes usualy implicated in CRC pathogeny. Samples were worked in Genetica Mixich SRL Lab, Craiova. Results reveal the similarity of genes mutations between the two kinds of samples. This is the clear prove that mutations detected in desquamated cells from faeces could be used in screening for CRC as a feasible and cost-efficient method, decreasing the high number of high-cost unnecessary colonoscopies.

Eficienta tratamentului combinat fizio-kineto-medicamentos in umarul dureros simplu si umarul blocat. Studiu clinic comparativ
Ioana Ureche, Madalina Iliescu, S. Ureche


ABSTRACT. The scapulo-humeral periarthritis is a clinical syndrome well defined by pain, stiffness and functional impotence of the shoulder joint, associated with different degrees, in relation with the pathological processes that involves the structures surrounding the joint and the joint capsule; the multitude of clinical aspects and the difficulties of a therapy plan still represents a real challenge for the clinician. Our study describes the results of a combined treatment, physio-kinetical and general and local medical (infiltrations and blockage of the suprascapular nerve), applied to the patients that showed simple or blocked painful shoulder, selected from a larger number of scapulo-humeral periarthritis in the Clinical county hospital in Constanta within two years of observation (2002-2004). The lot was composed of 297 patients with simple painful shoulder and 18 with blocked painful shoulder, which we applied local and general non-steroid anti-inflammatory treatment and local infiltration with corticosteroids, associated with blockage of the suprascapular nerve and combined with physical-kinetic treatment (electrotherapy, ultrasounds and hydrotherapy). The treatment was followed by a special exercise program of articular mobilization and improvement of the muscular force.


Rezultatele tratamentului endoscopic la pacientii cu ulcer hemoragic
Luana Alexandrescu, E. Dumitru, Andra Iulia Suceveanu, A. P. Suceveanu, Laura Ene


ABSTRACT. Bleeding duodenal and gastric ulcers continue to be a common and serious problem. Endoscopy is the key diagnostic tool for management of acute upper gastrointestinal bleeding. Endoscopy has beyond doubt reduced morbidity, hospital stay, risk of recurrent bleeding and need for surgery in patients with non-variceal upper GI bleed. Several endoscopic hemostatic methods are available including thermocoagulation and local injection of adrenaline or alcohol for active bleeding, haemoclips and laser therapy, advocated effectively for the control of gastrointestinal bleeding. Optimal use of endoscopic therapeutic modalities shall continue to play a pivotal role in management of UGI bleed in the years to come. The aim of this study was to evaluate by comparison the therapeutic results of different endoscopic hemostatic methods used for the control of gastrointestinal bleeding due to peptic ulcer haemorhage. Consequently, we evaluated the primary and late hemostasis, rebleeding, need for emergency surgery, hospital stay and mortality. The evaluation was made by comparing each and different hemostatic methods, including single and combined therapy.

Facultuy of Medicine
Constanta

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Ovidius University
Constanta

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