ARS Medica Tomitana
vol. XII - nr. 3 (46) - july - september 2006

Serum Modifications In Bed Rest Osteoporosis; Study On A Lot Of Patients With Bone And Joint,s TBC
Veronica Violeta Rosioru, V. Lupescu

ABSTRACT. Bed ridden has always been associated with the increase of bone resumption; afterwards a mobilization of minerals from the osteoid tissue and a increase of calcium and phosphorus seric take place. A group of patients suffering from evolutionary bone and joint’s TBC have been studied between 30 and 180 days of bed rest. During this time the patients were hospitalized and treated at Agigea TBC Sanatorium. Afterwards they have been grouped after bed rest period. At all patients the serum calcium, phosphorus, magnesium, FA are determined at the beginning of the bed rest period and then repeated at 60, 120 and 180 days since the first day. To obtain a good determination it is used the colorimetric method and Johnson& Johnson device. In this period significant changes were registered for all parameters, changes that could be linked with the bed rest period.

Correlations Between The Evolutions Of The Carpal Bones
G. Iordan, Lidia Chircor, D. Ulmeanu

ABSTRACT. The study aimed to reveal the existence of possible correlations between the growth rates of the carpal bones. The batch consisted of 167 subjects (111 males and 56 females), aged between 0 and 16 years, patients of the Paediatric Surgery Department of the Constanţa County Hospital, which have had clinical prescriptions for radiographs of the forearm or hand. On each film the maximal dimensions of the ossification nuclei were measured, in ratio with the distal diaphyso-metaphysary junction of the radius, considered as reference. The individual values thus obtained (size indeces) were statistically analysed and represented in charts. Highly significant correlations were determined between the growth rates of the scaphoid, trapezium and trapezoid. Significant correlations were also noted among the growth rates of the other carpal bones, except for the capitate and pisiform. The scaphoid, trapezium and trapezoid have similar development patterns, which may suggest an inductor role of the radius or a gradient under the influence of the functional implication of the thumb and the index.

Hygienic Status Of Milk And Dairy Products From Mures County
Tarcea Monica, Toma Felicia, Damaschin Floarea

ABSTRACT. The purpose of this work was to evaluate lab test data of main milk and dairies products from Mures supermarkets and from direct producers, in the last nine years (1995-2003). Data were collected from Mures Public Health Department, retrospective for nine years, by various milk and diaries products, quality tested. For the entire period of study, 66.26% of samples tested were not corresponding to all hygiene requirements, 48.48% for chemical parameters and 45.83% for microbiological indicators. For all samples, data trend varied from year to year, with a pick in 2001 (with 74.7% not corresponding samples) and with an important decrease in 2001 to 55.66%. We observed an im proved quality for food samples investigated in the last two years of study, to all quality characteristics evaluated.

Angiogenesis And Age Frequency Distribution In Primary Breast Cancer Patients: An Analysis Of 158 Needle Core Biopsies
S. Vamesu

ABSTRACT. Experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis, which may also permit metastasis. To investigate how tumor angiogenesis correlates with age in breast carcinoma diagnosed on core biopsy, microvessels were counted (and graded the density of microvessels) within the initial invasive carcinomas of 158 patients. Using light microscopy, the number of microvessels was counted manually in a subjectively selected hot spot (in the most active areas of neovascularization per 400x field), and their values were separated as above or below median (low and high), without knowledge of the outcome in the patient or any other pertinent variable. When the mean values of MVD of the various groups defined by age were compared, significant difference was noted (P = 0,045402). When the mean values of MVD of the groups defined by menopausal status were compared, no significant difference was noted (P = 0,140126). When tumours were classified as high or low MVD, based on a cut-off value (30,70175 microvessels / mm2), cases with high MVD were significantly more numerous in patients aged 50–59 years. MVD didn’t show a relationship with groups defined by age (P = 0,060331), or by menopausal status (P = 0,657495). Assessment of tumor angiogenesis may therefore prove valuable in selecting patients with early breast carcinoma for aggressive therapy.

Glomerulo-Vascular Lesional Entities in Hydronephrotic Kidney Pathology
Madalina Bosoteanu, Mariana Aschie, C. Bosoteanu, Mariana Deacu, Liliana Mocanu

ABSTRACT. The purpose of this study is to effect the microscopic and morphometric analysis of glomerular and vascular lesions characteristic for hydronephrosis and to establish some connections between their features, the causative agent and the severity of disease. The survey is based on a group of 62 cases (nefrectomy or necropsy specimens) processed in the Clinical Department of Pathology from SCJU Constantza. The histopathological examination of microscopical specimens showed a lesional heterogeneity affecting all the components of renal parenchyma. The stereometric method of Saltykov proved to be very useful to demonstrate the decrease in glomerular volume. An interesting observation is represented by the correlations between glomerular and vascular changes, both of them determined by ischemia, as common pathogenic factor.

Breast Morphologic Changes In Relation To The Menstrual Cycle
Mariana Deacu, Mariana Aschie, Madalina Bosoteanu, Liliana Mocanu, Ulmeanu D.

ABSTRACT. Mammary gland growth and development undergoes upon hormonal influences. In this study we proposed to presents breast morphological aspects into the folicullar and luteal phases of menstrual cycle. We assess microscopically normal breast tissue obtained from 20 women (with regular menstrual cycle in the previous 6 months) surgically trated for fibroadenoma at the Emergency Hospital of Constantza. The cases were subdivided in two groups, 10 patients were in a follicular phase and the others 10 in luteal phase of menstrual cycle. The histological changes of a resting mammary gland in relation to menstrual cycle is best showed by breast lobule. Normal mammary gland tissue undergoes morphological changes in relation to menstrual cycle. The knowledge of breast morphological changes during menstrual cycle is useful in epidemiological studies and surgical treatments of mammary gland tumors.

Tactics of Surgical Therapy for Dupuytren’s Disease – our Experience
Caraban B. M., Bordeianu I., Iordache I. V., Stanescu I., Dilirici L.

ABSTRACT. A retrospective study of the surgical therapeutic tactics for Dupuytren disease was carried on the clinical records of patients operated upon at the Department of Plastic and Reconstructive Surgery, Constanta County Hospital. Two groups were compared: 1.patients who had had surgery from 1992 through 1995 and 2. patients who were operated from 2002 through 2005. During the last time interval we purposefully choose an early surgical approach for the disease. The parameters studied were: the extent of the surgical intervention, the period of time required for the functional recovery of the operated hand, the economical and social costs involved and the frequency of recurrence during the first two years postop. The surgical approach to Dupuytren’s contracture has an obvious advantage.

Common Femoral Artery Stenosis – Etiologic Particularity Case Presentation
Marta Budu, Raluca Pasare, Aurelia Terzi, Cristina Marta, A. Berro

ABSTRACT. In this article we present the case of a female patient with a left common femoral artery stenosis. The patient had the signs of a chronic ischaemia stage II. The etiologic particularity was obvious after the surgical intervention,when we observed that the arterial occlusion was not atherosclerotic. We present the therapeutic management of this patient and the postoperative evolution.

Incisions In Cataract Surgery
D. Denislam, Farah Constantin, Sanda Jurja

ABSTRACT. An incision is performed by exerting pressure with a blade on a tissue, and is of differing shape and depth depending on the force applied, the path in which the cutting instrument is guided, the speed of execution, the instrument’s shape, size and the material with which it is made, and on the hardness, compactness and tightness of the tissue. Hence the parameters of an incision depend on three main variables: the surgeon’s guidance of the instrument, its characteristics and those of the tissue.

Our Experience Upon The Management Of The Politraumatised Patients With Fracture Dominant
B. Obada, N. Obada, V. Lupescu, S. Brovchin

ABSTRACT. The polytraumatism is defined as the association of at least 2 lesions with vital risk, immediately or in the next days. The real number of polytraumatisms is, in generally, underestimated because many of such cases were diagnosed as dominant traumatism. In some opinions, the polytraumatism must be a cataclysmic case with important gravity in emergency, which must be hospitalised in the Anesthesiology – Intensive Care Clinic. There are politraumatisms at which is predominant a medium gravity lesion, which can be hospitalized in the respective profile clinic, if they are stabilized hemodynamic. Our study is concentrated upon the polytraumatisms with fracture dominant, at which the fracture lesion involve vital risk by traumatic, hemoragic or mixed shock. In Orthopaedic-Traumatology Clinic, Emergency Clinical Hospital of Constanta, during 2004-2005 were hospitalized 196 polytraumatised patients with fracture fracture dominant. Our paper propose to establish an efficient therapeutic plan for these cases, by evaluating the measures which were taken in emergency, at resuscitation room, and especially at the surgery room.

Ocular Tissues And AIDS
Sanda Jurja, Gabriela Lilios, A. Fono, Carmen Ciufu

ABSTRACT. AIDS may cause disastrous consequences for vision, in cases with poor general state, as part of general damages in the entire organism. The clinical cases presented in our paper had different lesions, such as: uveitis, retinal haemorrhages, retinal yellow spots, retinal necrosis, and even retinal detachment; less severe aspects may also appear: giant palpebral moluscum, palpebral herpes. It is important to notifie that many of these manifestatios involving eye tissues cause vision loss. The challange for the ophthalmologist is not only to recognise and treat known ocular expressions of AIDS, but also to be able to identify yet undescribed eye lesions caused by AIDS.

Multivariable Analysis As Clinical Prediction Model In Obstetrics And Gynecology
Vlad I. Tica, Stelian Bafani, Irina Tica, Ovidiu Teren, Mohamed Zaher

ABSTRACT. The different prediction methods contributed for many years to improve the clinicians decisions and patients choices both in obstetrics as in gynecology. Different investigators have attempted to provide clini¬cians with predictive models with similarly simplified scoring systems that were generated by logistic multi-variable techniques. Multivariable analysis used as clinical prediction model in Obstetrics and Gynecology is one of the most important types of predictive methods. Its qualities are an improved accuracy and relatively ease of clinical application. Multivariable analysis resolves some problems that occurred when univariable analysis is used to form the basis of a prediction.

Optimal Antihypertensive Therapy In Patients With Metabolic Syndrome
A. Rusali, Lucia Bostan, Nicoleta Miu, Elvira Craiu

ABSTRACT. The metabolic syndrome is a very common disorder with worldwide distribution and increasing incidence. Several line of evidence suggests that the MS components, acting together synergistically, are associated with increased cardiovascular risk. A linear association exists between the number of components of the MS and target organ damage, but and between different antihypertensives. Class differences in the effects of antihypertensives on metabolic indices may therefore be an important consideration when choosing treatment. The aim was to study profile treatment in arterial hypertension in patients presenting MS referring to adults treatment panel III (ATP III). All the patients enrolled underwent the following physical examinations, laboratory tests on basal and after 12 months of therapy with diuretic nonthiazidic, nebivolol, moxonidine 0,2-0,4mg/day (one group) and diuretic nonthiazidic, nebivolol, candesartan 8-16 mg/day (second group).Initially, mean age was 65±5 years, 56 female and 44 male, BMI=33.5±2.7kg/m2; SBP=165±15 mm Hg and DBP=92±5 mm Hg; HbA1c=8.3±2.1%; total cholesterol= 282.4±19.8; LDL-C=187±17.2; HDL-C=33.1±5.7; triglycerides =163±130.4; triglycerides/HDL-C ratio (R) = 4.92±6. After 12 months of treatment, in the group with moxonidine, there are favorable metabolic effects in clinical parameters. In patients with metabolic syndrome there was a tendency to lesser control of their BP despite a greater number of antihypertensive drugs. Raven ratio equal or more than 3 was a good predictor of poor blood pressure control in MS defined by ATP III; moxonidine is at least as efficient as candesartan in the treatment of hypertension in patients with MS.

Obesity And Liver Pathology Relationship
Zizi Niculescu, Mihaela Ghinea, B.Cîmpineanu, C. Niculescu, A. Mitroi

ABSTRACT. In obese persons a high incidence of hepatic disorders is recorded such as: fatty liver, nonalcoholic steatohepatitis, and hepatic cirrhosis. It was demonstrated that hepatic involvement is present to all types of obesity: the risk factor is represented by android "abdominal" obesity with an increased waist / hip ratio. The transition of the disease from steatosis to steatohepatities and fibrosis may be made in two different ways: one is insulino-resistance, which determines lipidic deposits inside the hepatic cells with secondary hepatic steatosis, and the other is represented by the disorders of lipidic metabolism, which generates oxidative stress. Cell changes induced by mitochondrial oxidative stress are the most probable cause of evolution from steatosis to necrosis and fibrosis. Recent studies confirmed that steatosic involvement of liver is associated with obesity complications: dyslipidemia, diabetus mellitus, arterial hypertension, and atherosclerosis.

Clinical Presentation Modalities Of Myeloid Blast Crisis In Chronic Myelogenous Leukemia
Mihaela Ghinea, Zizi Niculescu, Alina Nicoara, A. Mitroi

ABSTRACT. The heterogenity of the blastic transformation in chronic myeloid leukemia (CML) has stirred up a large interest along the time. Although the great majority of cases (65%) have a myeloid phenotype, there are also cases with a lymphoid transformation (30%), as well as erythroid, megacarioblastic and undifferentiated phenotype (5%). The present paper purposes to study blast crisis in the beginning of CML, in 100 patients with CML hospitalized within 14 years (1992-2006) in II nd Medical Clinic – County Emergency Hospital Constanta. In our studied lot, blast crisis occurred in the beginning in 18 patients (18%). Myeloid type of blast crisis was present in 15 cases and lymphoblastic transformation in 3 cases. M2 was the most frequent hystological type in myeloblastic transformation. Lymphoblastic type of blast crisis in CML has a higher span life comparing with myeloblastic type. Standard treatment according to LAL protocol influences survival. So is necessary to use all diagnostic methods for certain specification of blast cell type.

Disostosis Of Pelvic Belt: Hip Dysplasia
Gabriela Lilios, Lenuta Malcea

ABSTRACT. The disostosis is the conformity or structure vice of a bone or anatomic area, with or without the involvement of other vicinity tissue. Within disotosis, the hip dislocating dysplasis is an ailment with significant bearing. When hip dysplasis occurs, uterine shaping by way of intrinsic and extrinsic forces plays an important role, but also bone plasticity, which is the more significant, the younger the fetus age. The work intends to identify cases of hip dislocating dysplasis on the new born, frequency, association with other malformations, presentation ratio, etc. A retrospective study was made on a period of two years, on a number of 9407 new born in Constanta maternity ward. A number of 310 postural deformations were identified (3, 3% of the total of new born), 62 being hip dislocating dysplasis (48 bilateral; 45 with the female sex; 57 at the gestation age of 37-42 weeks; 19 in pelvic presentation). Deformations are frequent occurrences in maternity wards; female sex, pelvic presentation, cesarean operation, family history constitute risk factors for hip dysplasis.


Anatomical Considerations On The Origin Of The Common Hepatical Artery
Cristina Chiriloaie, P. Bordei, Loderanda Surdu, C. Ionescu

ABSTRACT. Our study has been carried out on a number of 134 cases, out of which 99 cases with unique hepatic artery and 35 with double hepatic artery. The origin of the unique hepatic artery was found growing up at different levels of the celiac trunk in 78 cases and in 21 cases it had its origin in the aorta. For the hepatic artery which has its origin in the hepatic trunk have described several variants: of the three-branch celiac trunk on the same level (22 cases),of hepatosplenic trunk 34 cases, of hepatogastric (12 cases), in 3 cases of celiomesenteric trunk and in four-branch ended celiac trunk and in 4 cases in a five-branch ended trunk. From the 21 cases in which the hepatic artery had its origin in the aorta, in 14 cases there was no celiac trunk, all of its three terminal branches growing up from the aorta. In the 35 cases with double hepatic artery, one of the arteries had its origin in the celiac trunk and the second one in the aorta (15 cases), in the celiac trunk (12 cases) or in the superior mesenteric artery (8 cases). Knowing the variants of the origin of the hepatic artery is extremely important for the morphologist, but even more important for the surgeon who performs a hepatic segmentectomy or a hepatic transplant, the existence of a supplementary hepatic artery or of a unique hepatic artery with its origin outside the celiac trunk creating serious problems. The rate variability of different origins of the hepatic artery which can be found in the literature of the specialty might be due to the geographical area and to the human race the studied cases derive from. Within the same habitat the vascular variability would also depend on some environmental factors which would activate during the organogenesis.