ARS Medica Tomitana
vol. XIV - nr. 3 (54) - july - september 2008


Subcutaneous Fat Compartments of the Lower Face
F. Anderhuber, U. Pilsl

ABSTRACT. In human face subcutaneous compartments of fatty tissue are to be found. They can be confined against each other by strings of connective tissue. Neither a chin compartment nor a submental compartment had been described up to now. One distinct compartment -the so called jowls - have been discussed very different in literature. Even in the area of the chin compartments could be found based on subcutaneous injections of gelatines in different colours into the various regions. The chin compartment is confined comparatively well against the adjacent compartments. The upper border is defined by the mentolabial groove, the lower border is formed by the submental ligaments, lateral demarcation is due to labiomendibular groove. The submental compartment is delimited to the chin by the submental ligaments, laterally by the paramedian platysma retaining ligaments, the lower delimitation is formed by the hyoid ligament. Wide gaps in between the ligaments keep this very compartment connected with the adjacencies. The compartment of the jowls is described in a very different way. On the one hand it is argued that in the aging face the fatty tissue of the cheek is lowered beyond the margin of the mandible, on the other hand a separate subcutaneous compartment may exist or even a lowered submandibular gland could be on hand. The subcutaneous injections of gelatines pointed out, that a Jowl is concerning with an own compartment – the floor of which is being formed by the platysma, whereas in addition all boundaries to the adjacent regions are formed by ligaments, the so called retaining ligaments. The upper border towards the fat of the cheek is formed by both the mandibular ligament and the platysma-mandibular ligament, the anterior border towards the submental region is formed by the paramedian retaining ligament and the dorsal boundary towards the lateral cervical region is due to the submandibular platysma retaining ligament.

Application Of An Intelligent Study And Research Support System For Clinical Anatomy In A Cooperation Scenario
Gaglio, E. Ardizzone, D. Peri, R. Pirrone, V. Cannella, F. Popa, A. Ispas, V. Chupină, P. Bordei, V. Astărăstoae, D. Păduraru, A. Nechita, D. Firescu, R. Lagalla, E. A. Cardinale, B. Valentino,and G. Peri

ABSTRACT. Scientific research and teaching are strongly interrelated. A student should be educated both to the fundamentals of a discipline and to the research tasks as the future development of a discipline is entrusted to the students of today. Computer based tutoring systems already showed useful in pursuing the former target while the Intelligent Study and Research Support System developed at DINFO may be used to fulfill both in an integrated manner. This paper introduces the possible application of the ISRSS to training of Clinical Anatomy in a scenario of international cooperation among academic institutions.

Radio-Anatomie Du Foramen Intervertebral Cervical Normal Et Pathologique
J.P. Francke, X. Demondion

ABSTRACT. L’objectif de cette mise au point est de décrire à partir de données anatomiques (coupes anatomiques et dissections) et de données d’imagerie (radiographies, coupes de scanner et d’IRM) l’anatomie normale du foramen intervertébral et de son contenu à l’étage cervical mais également les différents processus pathologiques pouvant entraîner une compression de la racine nerveuse au sein de cette région anatomique stratégique.

Un modele en cuir de dissection du cou rt de la tete, par J. Labauttrie, 1848
P. Le Floch-Prigent

ABSTRACT. Une pièce en cuir, creuse (galerie Chabolle, rue de l’Université, Paris 7ème) représentait la dissection des plans superficiels du cou : régions antérieure et supra-claviculaire droite, et également du crâne et de la face, et enfin deux abords vasculaires artériels : sub-claviculaire et intercostal interne, supérieur, gauche. Dans le but d’en apprécier la véracité anatomique, la technique de fabrication et la place parmi les modèles anatomiques du 19ème siècle, la pièce a été examinée, photographiée, mesurée. Ses dimensions hors-tout étaient de 51,5 cm de hauteur sur 41cm de largeur et 8 cm de profondeur, inscrites sur une pièce de bois de 59,5 cm x 50,5 cm x 1 cm d’épaisseur, à laquelle elle était clouée par éversion de 5 à 10 mm à sa périphérie. La représentation anatomique de la dissection de la thyroïde et de la gouttière jugulo-carotidienne était exacte ainsi que celle du creux supra-claviculaire droit. Des traces de peinture étaient nombreuses : rouge et bleu pour les vaisseaux. La signature de Labauttrie et la date de 1848, étaient inscrites en rouge sur sa tranche inférieure, représentant un plissé. La pièce était totalement creuse. Les modèles anatomiques de dissection en cuir sont rares. Leur apparence un peu pauvre, ne préjuge pas de leur qualité de représentation anatomique qui annonce les grandes collections en plâtre, moulées sur des plans de dissection successifs du début du 20ème siècle. Il est probable que le modelage du cuir, ait été réalisé sur une forme dure, par exemple un contre-moule en plâtre d’une dissection réelle.

Les nerfs de la face par Tramond: pièce anatomique en cire du Musée Delmas Orfila Et Rouvière À Paris
F. Drifi, P. Le Floch-Prigent

ABSTRACT. Vérifier la véracité anatomique de la pièce en cire n° 262 des musées Delmas, Orfila et Rouvière, 45 rue des Saints Pères, Paris 6ème, réalisée par le Dr Tramond, intitulée « les nerfs de la face » était l’objet de cette étude. Nous avons successivement effectué des prises de vues photographiques numériques sous divers angles de vues ; décrit anatomiquement les nerfs de la face tels que représentés sur la pièce, corrélé la véracité anatomique de la pièce avec les données d’ouvrages classiques de référence ; approché des bases techniques de fabrication ; numérisé des photographies successives de la pièce sur un plateau tournant, avec des prises de vue tous les 5° sur 180°, permettant ensuite la rotation animée sur ordinateur grâce programme Quick Time®. La taille de la pièce n°262 était supérieure à la grandeur nature, ce qui exclut un montage sur un squelette naturel. La technique de fabrication de la pièce était déduite de données connues mais ne peut être totalement élucidée. La véracité anatomique de la pièce était excellente. Les difficultés de réalisation en cire d’une pièce de cette taille ont été résolues à la fin du 19ème siècle, à Paris par la maison Tramond ; elles étaient inégalées.

Remodeling Of The Major Tight Artery And Veins In The Peripheral Arterial Disease: A Morphological Approach To The Lower Limb Endovascular Surgery
D. Stavrev, G. Marinov

ABSTRACT. The progress of reconstructive vascular surgery of the lower limb needs knowledge about morphological status of the vessels as its object. In the development of peripheral vascular disease (PVD) the wall of femoral artery (AF), great saphenous vein (VSM) and femoral vein (VF) undertake remodeling and the process makes progress with the development of the disease, affecting most severely the wall of AF. The intima is most severely damaged among the three layers of the artery wall while media and adventitia are slightly damaged. Because of this, a total removing of the intima under endarterectomy of AF does not lead to discussion, while the degree of removing the media need to be done taking into consideration the degree of media damage. When looking for reliable site of anastomosis of the venous by-pass graft, a special attention must be paid to the adequate preservation of the intima and media of the artery in the region of anastomosis. The progress of medial changes found especially at terminal stages of the disease provokes us to make a hypothesis that when the intervention is made early enough the result is more favorable. In the development of PVD, VSM and VF independently of the changes affecting them are suitable for autograft material because of the lumen passаbility, the surface free of thrombotic masses and fibrinous coating, the preserved endothelium, the unchanged considerably construction of the elastic and collagen structures especially in the media and adventitia. As a result they preserved considerably their biomechanical characteristics. In our study the VF taken from patients with amputation was preserved to a greater extent than corresponding VSM. This allows us to estimate positively the great interest of many vascular surgeons to the larger utilization of this vein in reconstructive vascular surgery.

Numerical Variations Of The Hepatic Veins
P. Bordei, C. Dina, E. Dumitru, D. Iliescu,C. Ionescu

ABSTRACT. Using as study methods the dissection, the contrast substances injection followed by radiography and plastic injection followed by corrosion and also hepatic ultrasound on young subjects without hepatic diseases, we evaluated 192 samples of hepatic veins, 25 of them (13.02% of the cases) being supranumerary (multiple) hepatic veins. Among the 25 cases, 19 of them showed double hepatic veins (9.90% of the cases), 17 on the right hepatic veins (5 ultrasounds, 8 dissections and 2 samples of plastic injection), which represents 8.85% of the cases and 68% of the cases with supranumerary hepatic veins. In 2 cases (1 dissection and 1 sample of plastic injection) we describe 2 middle hepatic veins (1.04% of the cases and 8% of the cases with supranumerary hepatic veins). In 5 cases we assessed 3 right hepatic veins (4 cases by dissection and 1 sample of plastic injection), which represents 2.60% of the total cases and 20% of the cases with supranumerary hepatic veins. A single case (0.52% of the total cases and 4% of the cases with supranumerary hepatic veins) showed 4 right hepatic veins, the one above being obtained by injection of barium sulphate. We did not encountered a single case with more that 4 right hepatic veins. We also describe 2 cases with double middle hepatic veins.

Histopathological Characterization Of Breast, Ovarian And Colonic Carcinoma, And Immunohistochemical Markers Analyze
Mariana Aşchie, Anca Florentina Papuc, Anca Dobre, I. Poinăreanu, Andreea Ilieşiu, Anca Antonela Crăciun, I. Aşchie, I. Popescu, Simona Dima, V. Herlea, C. Pechianu

ABSTRACT. World wide, cancer is the second cause of death, but with increasing the medium life duration, it may be estimated that more than half of the population could be diagnosticated with a form of cancer in a moment of their life. Our project focuses on the study of most frequent cancer forms: breast, ovarian and colon carcinoma, trying to establish a correlation between the three types of carcinoma with the help of imunohistochemical and genetic markers. Regardless if it appears to a single person or to more persons in a family as a hereditary character, cancer is considered a genetic disease because the initiation and development of a tumor involve successive mutation production in multiple genes, generating the activation of the oncogenes and the inactivation of tumor growth suppressor genes, specific to every carcinoma type. There were identified somatic mutations in the following genes, common to the studied carcinomas: K-RAS oncogene, tumor supresor gene TP53 si OPCML (common candidate gene for ovarian and colorectal carcinomas). The results obtained in the Pathology Department of Clinic County Emergency Hospital Constanta and in the Surgery and Hepatic Centre of Fundeni Institute, will be included in a database to calculate the correlation indexes between immunohistopathological modifications and morphological exam.

Oropharyngeal And Hypopharyngeal Cancer Incidence And Actual Therapy
G. I. Comşa, L. T. Hangan, M. D. Cobzeanu

ABSTRACT. The authors make a retrospective study between 1996 and 2000 on 105, respectively 182 cases with oropharyngeal and hypopharyngeal cancer registered in ENT Clinic of Constanta and in ENT Clinic “Sf. Spiridon” Hospital Iasi. Also they present actual level of therapy against cancer. Therapeutically approach consisted in: surgery, radiotherapy and chemotherapy. The study presents the comparative results in both clinics over the time. The statistical results are grouped upon evaluative stage (TNM classification). Pre and post therapeutic aspects were evaluated. The survival rate is corresponding with prompt diagnosis and discerning therapy.

A New Landing In Psoriatic Arthritis Diagnosis And Treatment
Maria Şuţa, Camelia Pană

ABSTRACT. Psoriatic arthritis is a clinical condition that may be characterized by peripheral inflammatory arthritis, axial involvement, dactylitis and enthesitis, in the presence or absence of psoriasis. Much like rheumatoid arthritis (RA), psoriatic arthritis can lead to chronic joint damage and increased disability and mortality. There has been some discrepancy in the literature regarding incidence and prevalence, with prevalence figures ranging from 20 to 100 per 100 000.(1) One contributing reason for this discrepancy is that there are no universally agreed upon or properly validated case definitions of PsA. Current classification criteria do not allow a clear separation between RA and PsA.(2) As already noted, it is necessary to define combinations of more specific features that distinguish PsA from other arthropathies. Establishing the case definition for PsA is therefore an important and fundamental issue.

Investigations Regarding The Vascular Architecture Of The Papillary Muscles
L. Onisai

ABSTRACT. Given the fact that cardiovascular ischemic disease has the highest frequency regarding heart disfunctions in individuals aged 40 and over, the study of the processes which lead to this disease can lead to valuable practical solutions. The postnecrotic effraction syndrome of the ventricular structures, which includes papillary muscle rupture, holds great importance for determining the mortality through acute myocardic infarction. Papillary muscles from left and right ventricles had been gathered, processed and analyzed. The study reveals the existence of a double distribution gradient of the vessels in the papillary muscles: a longitudinal one, in which the diameter of the vessels decreases from base to top, and a transversal gradient which indicates three concentric areas which differ in matter of the caliber of the vesels which they contain (large caliber and few capillaries in the central area, decreasing caliber and higher capillary density towards the margins).

Congenital Abnormalities As One Of The Main Cause Of Death During Last Two Decenies (1985 – 2005) In Constanţa County
Lidia Chircor, Mirela Cojocaru, C. Dina, C. Ionescu

ABSTRACT. Abnormalities CA and mortality by CA between 1985-1997 in Constanţa County impose to identify the place of the congenital abnormalities among the children death’s causes in the first years of life and to investigate the mortality rate of congenital malformed children, aged 0-4 years. The material consists of the new-born population of Constanţa County, registered in the Constanţa Clinic County Hospital from 1985 to 1997 – 2000 - 2005. The method used the usually study following the Romanian Health Minister topics concerning: anamnesis study, maternal behaviours in the pregnancy, clinical exam. We calculated the lethality rate afferent to each type of congenital abnormality with Mathematics 2 C Program, which we applied the polynomial function of 3rd degree. The results reveal that CA are the principal third cause of children’s death in their first 4 years of life. Probability of death at the end of the first year of life in CA population is double (9.3) than in normal population (4.8). The life hope level in congenital abnormalities population in the first week is 2/3 from the one of normal population and increases at 62.29 from 70.52, at the end of the first year of age. At 5 years, the life hope in the CA population is equal to that of the normal population. In Constanţa County as well as world wide there is a ascending incidence of the congenital syndromes.

The Clinical And Therapeutical Aspects In Entero-Mesenteric Infarct
C. Grasa, V. Sârbu, T. Iusuf, D. Costea, Iulia Candea, A. Ivanoschi

ABSTRACT. Most patients with an acute abdomen can be managed using simple clinical skills. An accurate history and a thorough examination are often sufficient to make a diagnosis and recommend treatment; modern investigations can help and may reassure the anaesthetist that the patient is fit for an operation. The primary objective, when the patient and the doctor first meet, is, therefore, to elicit the symptoms and the signs necessary to make a rapid and accurate diagnosis. This paper work represents a retrospective clinical study over 57 patients, males and females during 1999-2007. The most populated decade in our study prove to be the 7th . Absence of intestinal motility was the main complain for the patients registered. Segmentary enterectomy was the surgical procedure chosen intraoperatively for 39 patients while the rest of 18 had an subtotal enterectomy performed.

Facultuy of Medicine
Constanta

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Ovidius University
Constanta

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