ARS Medica Tomitana
vol. XI - nr. 3 (42) july - september 2005

Importanta medico-chirurgicala a variantelor morfologice ale arterelor renale
P. Bordei, Elena Sapte, D. Iliescu

ABSTRACT. Based on an extensive group of samples (over 1000 kidney’s), the authors describe some morphological variations of the renal arteries, in what concerns their aortic origin in relation with the vertebral column, their traject, ending manner and location, together with the number of renal arteries and the symmetry of their terminal branches. In 57,45% of the cases, the renal arteries originated from the aorta at the level of L1, in 53,72% of the cases the right renal artery originating higher than the left one. Most often, the renal arteries end by bifurcation (65,67% of the cases), with the level of termination: pre-hylum (40,44% of the cases), next to the hylum (33% of the cases), and inside the hylum (26,56% of the cases). Supplementary renal arteries appear quite often, especially the double ones (54% cases), compared with the triple ones, in just 16 cases. Variation in symmetry of the anterior and posterior branches of the renal arteries were encountered in 11% of the cases.

Defectul septal interatrial multiplu - frecventa si particularitati morfologice
Andreea Teodorescu, Corina Siminiceanu, C. Calin, B.A.Popescu, Ioana Stoian, E. Apetrei, Carmen Ginghina

ABSTRACT. Multiple interatrial septal defects are a morfological variant of ASDs about which there is little data in literature, but that became more important in the last few years. Objective: to determine the frequency of multiple ASDs, their morphological features and the association with other cardiac anomalies. Methods. We carried out a retrospective study on 389 consecutive patients with ASD admitted in the Cardiology Department between 2000 – 2005. The patients with multiple ASDs were selected upon their transthoracic and/or transesophageal echocardiography. In patients who have undergone a surgical repair of the defect, the echocardiographic findings were compared with surgical data. Results. 16 patients of 312 (for whom an echocardiographic examination was available) had multiple ASDs (5.12%) with an “increase” in frequency in the last two years (9 patients of 90 - 10%). The difference may be due to a higher technical support and an increased number of TEE. Most of the patients (10 of 16) were diagnosed with multiple ASD by a transthoracic 2 - dimensional color Doppler examination. In the majority of cases (12 of 16 patients) the multiple ASDs were of ostium secundum type. The most frequent anomalies associated with multiple ASDs were the septal aneurysm and the anomalous pulmonary venous drainage. Conclusions. Multiple interatrial septal defects are relatively rare (5.12% of ASD), with an increasing frequency due to better echocardiographic techniques. The most frequent associated anomalies were the septal aneurysm and the anomalous pulmonary venous connections which were also noninvasively diagnosed by echocardiography.

Modificari ale filtrabilitatii eritrocitare la pacientii cu tromboza venoasa profunda tratati cu heparine cu greutate moleculara mica
Alexandra Cojocaru, N. Ceamitru, Ileana Ion, V. Lupescu

ABSTRACT. In deep vein thrombosis or pulmonary embolism, anticoagulant therapy is a major indication. In this case, we use different substances, such as heparin, but nowadays we prefer new products, as low-molecular weight heparins (LMWHs), because monitoring during the treatment is easier and the results have the same efficiency. Even more, the risk of thrombocytopenia, hemorrhage and osteoporosis is lower. The findings have shown significant modifications (Pt< 0, 05) of aggregability and deformability of the study group, treated with LMWHs, comparative with the control group. Red blood cell’s aggregability decreases and the deformability increases when using LMWHs, by that preventing the rouleaux formation and the appearance of venous stasis, so they are benefic preventing deep vein thrombosis.

Consideratii anatomice asupra dezvoltarii oaselor in carenta de Vitamina D si Calciu
Chircor Lidia, Popescu Steliana, Sava Victoria, Cojocaru Mirela

ABSTRACT. The bone developpment due to the lack of calcium and D vitamin is the 3rd cause of illnes in urban infancy population of Banat and Muntenia region, and the 1st in the rural infancy population of Muntenia Study on every modification of bones morphology will help to determine the status and degree of calciprivia more early, .to establish possible correlations between the intensity of these aspects, their topographic localisation and the moment of their aparition.and thereby to increase the specificity and sensitivity of the diagnosis. The present study refer to 102 cases dianosed by clinical and radiological exam between January 2002 - December 2005 in Constanta city. The lack of calcium and D vitamin disturb the bone development, inducing characteristic aspects in the first three years, characterised by one increased rhytm of the bone growth. The favorizant factors are: prematurity, male sex, gemelarity, diet with D vitamin restriction. The hyperpigmentation of the skin which acts like a barier again the sun lights is another risk factor. The lack of calcium and D vitamin during the childhood modify the long bones’development and reduce the length of the affected children, both males and females. The most affected are the bones with the most increased rate development: metaphysis of the long bones of the limbs. The bones’abnormal growth is accompanied by modified external aspects and modified internal structure. The chronic lack of calcium and D vitamin during the bone development induce the angulation of the radius and ulna and bone bark warp in the engagement of periosteum and hypertrophy of the cortical layer.

Rolul limfoscintigrafiei in tratamentul cancerului de col uterin
D. Raica, M. Cambrea, R. Stanca

ABSTRACT. Aim: the use of limphoscintigraphy to asses the lymph node invasion, correlated with the precision of the surgical intervention and postoperative attitude in cervical cancer. 32 patients have been histological diagnosed with cervical cancer; before surgery they were clinically investigated, had a limphoscintigraphy and a MRI, and after the surgical intervention they have repeated the limphoscintigraphy. The limphoscintigraphy was performed with a high resolution gamma camera, powerful image acquisition software and a workstation computer for acquiring the data. The product used in each patient was 99mTc-Nanocoll, injected subcutaneous in the perianal region, on both sides, laterally. Preoperative, the MRI showed at the level of the uterine cervix, tumors of 35 – 40 mm diameters, irregular surface and slightly not homogenous structure. The preoperative limphoscintigraphy showed right iliac adenopathy, left iliac adenopathy, two cases with left mesenteric adenopathy and one case with vesical adenopathy. Limphoscintigraphy became essential in the pretherapeutic assessment of cervical cancer because of: early detection of the lymph node metastasis; is one of the most valuable investigation in the efficiency and accuracy of the surgical procedure.

Studiul histologic si al dinamicii dispozitivului capilar in tegumentul supus agresiunii chimice inainte si dupa tratamentul cu Bioxiteracor
Rodica Mehedinti, Mihaela Hincu, Malina Coman, T. Mehedinti

ABSTRACT. The usual result of continuous and excessive exposure of the skin to soaps and detergents is impaired alkaline- neutralization with drying, fissuring and defeating of the keratin layer leading to increased permeability of comparatively innocuous substances can lead to sensitization with resultant allergic contact dermatitis subsequent to the original primary irritant effect. It can be almost self-sustaining, and many laundry soaps contain chemical additives which are the actual irritants (e.g., sodium silicate, sodium phosphate, sodium carbonate). Hand cleaner soaps contain small harsh particles to assist in grease removal, such as pumice, talc, borax, corn meal or wood fluor. These are sometimes irritating. Some yellow laundry soaps contain “rosin” to make the bar more soluble, which is also a sensitizer.

Evolutia diametrelor cordului in perioada fetala
Mirela Cojocaru, D. Ulmeanu

ABSTRACT. This study tries to appreciate the stages of heart development during fetal life by morphometry of the heart, correlating the results with the fetal age. The motivation of this study is the fact that there are no recent reference results in the specialty literature. We studied a number of fifty six fetal hearts from aborted fetuses resulted from spontaneous abortions and from death. Finally the results were statistically processed and they were correlated with the size of heart and the fetal age.

Optimizarea metodologiei de investigare si tratament in cancerul de orofaringe
L. T. Hangan, Gh. I. Comsa, Emanuela Gurgas

ABSTRACT. In the same time with the increasing of investigation methods for uncover the ENT cancers in an earlier stage possible, we actually can notice that the number of malignant tumours is higher with more and different locations. These conclusions became an alarm bell and led to a reconsideration of the therapeutically attitude, regardless surgery or physiotherapy. In the last years, along classical method of treatment as surgery and external radiotherapy there are brachytherapy, laser, immune therapy or cryotherapy. However, the improvement of treatment for oropharyngeal cancer can be accomplished with enhancement of traditional methods or by new associations between them.

Corelatii intre expunerea la zgomot si variatiile tensiunii arteriale la personalul navigant maritim
Ninela Radulescu, Cristina Farcas, Cecilia Adumitresi, Carmen Ciufu, Ileana Ion, G. Badiu, O. Teren

ABSTRACT. In the recent years, noise has become a very important “stress factor” in the environment of the exposed population. Working exposure to noise greater than 87 dBA for a long period of time may lead to professional diseases (impairment or loss of hearing), but also to job-related diseases: arterial hypertension, digestive diseases, nervous breadowns, increased risk for accidents. The life and working conditiones on the ships (noise, vibrations, pitching), the periodicity of embarkments, the psyhical and neuropsychic strain, responsibility and remoteness from family and society, characterize the seamen’s life. The noxious effect of noise have been studied on two groups of subjects: engine crew and deck crew, taking into account the age, the length of service, personal pathological and heredo-collateral antecedents, body mass index (BMI), salt in diet, alcohol consumption and smoking. The analysis of the data showed statistically significant differences between the blood pressure values, higher among the engine crew than among the deck crew.

Studiu comparativ histologic al glandei suprarenale in conditii de stress psihoemotional si chimic
Mihaela Hincu, Rodica Mehedinti, Malina Coman, T. Mehedinti

ABSTRACT. Our study aims to document, using methods from the classical histology and biometry, the dynamics of the suprarenal gland under various kinds of overstress. The chemical overstress by inducing alloxanic diabetes, and physical overstress by experimental burning. The goal of this synthesis paper is both to follow the degree to which various components of the suprarenal gland participate to the balancing mechanisms of the body, and to establish the degree of involvement of the medullar and of the different cortical areas in the suprarenal gland in this process (the cortical/ medullar ratio).

Etiopatogenia lichidului pleural la bolnavii cu ciroza hepatica
Zizi Niculescu, Mihaela Ghinea, I. Tofolean, B. Cimpineanu, F. Stoian

ABSTRACT. Cirrhotic hydrothorax it is defined as a pleural liquidian effusion to a cirrhotic patient with or without ascities, in absence of a cardiac or respiratory disease. In more than 65 % of cases the pleural fluid is located on the right side, the left side location being suggestive for tuberculosis or neoplasm. The efficient treatment of cirrhotic hydrothorax it is related with the treatment of ascities and is based on hyponatremic diet, diuretic treatment and repetitive paracentesis.

Anemia hemolitica autoimuna asociata limfoamelor maligne
Alina Nicoara, Andreea Daniela Gheorghe

ABSTRACT. Autoimmune hemolytic anemia (AHA) was observed in 4 patients with Hodgkin disease from 92 patients and in 5 patients with non-Hodgkin lymphoma, from 64 patients, followed within 5 years, in II-nd Medical Clinic, I-st Medical Clinic and Oncology – County Hospital, Constanta. All patients with lymphoma who developped AHA, were in advanced stages, and 7 patients presented systemic symptoms. Warm hemolysis was found in 7 patients, and in 2 patients the antierythrocyte antibodies were IgM type. In most patients the presence of AHA was associated with lymphomas relapses. Corticotherapy constituted the elective treatment in AHA and lymphomas, regardless the hemolysis type. The undelying disease prognosis wasn’t modified by the presence of AHA.

Frecventa complicatiilor hemoragice si trombotice in trombocitemia esentiala
Mihaela Maria Ghinea, Zizi Niculescu

ABSTRACT. Essential thrombocytemia (ET) represents a chronic myeloproliferrative disease with high survival rate at long term. The patients quality of life is affected by haemorrhagic and thrombotic complications of the disease. This paper’s aim is to appreciate the quality of life of the patients with ET depending on the incidence of the haemorrhagic and thrombotic complications. We studied 23 cases of ET, 14 women and 9 men, patients in the evidence of the Department of Haematology of the County Hospital of Emergency in Constanta. The dominant clinical features in the studied lot were the thrombotic ones (13 cases), more frequently localised in the small vessels and the haemorrhagic ones (8 cases) with more frequent mucosal location. The majority of patients with haemorrhagic disorders presented a platelet count of more than 1 million while the ones with thrombotic disorders presented less than 1 million platelets. Generally is admited that in ET, the tendence to thrombosis occurs when the number of platelets is significantly lower than the platelet number in which the tendence to haemorrhage occurs.

Oportunitatea lavajului bronhoalveolar in diagnosticul alveolitei alergice extrinseci (pneumopatia de hipersensibilitate)
N. Ioncica

ABSTRACT. Bronchoalveolar lavage (BAL) methods are employed to assess lesions involving the alveolar regions of the lung. For this technique, a bronchoscope is inserted into a segmental or subsegmental bronchus, with lumenal occlusion. Infusion of 150-200 ml of isotonic saline solution in 50 ml aliquots is performed, with collection of material after infusion of each aliquot. BAL proved to be efficient both in the diagnosis of EAA, and in the differential diagnosis between EAA and sarcoidosis by evaluation of the dynamic of neutrophils, macrophages and mast cells.

Rubeola congenitala – consideratii pe marginea unui caz clinic
Larisia Mihai, Valeria Stroia

ABSTRACT. Rubella is an infectious disease produced by rubella virus, having a benign evolution in children and adults, but with sever consequences in pegnant women. The authors pesent an infant with congenital rubella, born from a mother with subclinical infection. They focuses on the importance of specific prevention , especially in women of childbearing age.

Valoarea echografiei in diagnosticul tumorilor renale maligne
F. Voinea, E. Caeridin, Claudia Voinea

ABSTRACT. This work represents a retrospectiv study of the problems appeared in diagnosis and treatment for kidney and upper tract urothelial tumors.We have treated 131 patients between January 2001 and December 2004. Ultrasonography was made using Logiq 700 vascular Doppler, CDS, power doppler. For all patients we have also perform CT and IVU.Sensitivity and specificity of ultrasonography was segnificant: we have also performed needle biopsy, diagnosed distant metastazes; utility of this metode in screening of kidney cancer.

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