The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Welcome to ModernMedicine
Thursday, October 18 2018 @ 11:19 EEST

View Printable Version

Single-Stage Reconstruction of Distal Third of the Dorsum Nasi Using a Nasolabial Flap after Removal of Basal Cell Carcinoma

2017-01

Tiberiu Paul Neagu, Mirela Tiglis, Ioana Cristina Grintescu, Sebastian Valcea, Serban Arghir Popescu, Ioan Lascar

The nose represents a common site for skin cancer, especially for Basal Cell Carcinoma (BCC) which is the most common malignant tumor in humans[1-3]. The removal of the tumor will lead to a defect that can involve skin, cartilage and even nasal mucosa. Therefore, reconstruction of this tridimensional structure can be a challenge even for the most experienced surgeons[4]. There are many techniques described in the literature for restoring the lining and skeletal framework[1-8], but all of these techniques should be adapted to the patientís needs. In this paper we described our preferred surgical method to cover a medium defect of the distal third of the dorsum nasi after tumor excision using a nasolabial flap. In order to perform a single-stage reconstruction, we pushed the limits of the flap measurements and did some tricks so as the pedicle to be well fitted, leading to good aesthetic results. [...]

View full article
View Printable Version

Transmandibular Excision of Symptomatic Large Parapharyngeal Rhabdomyoma - Case Presentation and Literature Review

2017-01

Andreea Nae, Patrick Sheahan

Adult rhabdomyoma is a very rare slow-growing tumor arising in the head and neck region. It has a male predilection and a mean age of 60 at presentation. The most common head and neck sites for this tumor are floor of mouth, oral cavity and parapharyngeal space[1-3]. Common presenting complains of the patients are fullness around the angle of the mandible or airway obstruction if the tumor is present in the parapharyngeal space. Investigations should include FNA or biopsy and imaging of the neck. Imunohistological studies should be performed as due to its rarity, the rhabdomyoma sometimes could be difficult to diagnose on routine histology and also for confirmation of the diagnosis. Complete surgical excision is mandatory as recurrences occur in incomplete removal of the rhabdomyoma. [...]

View full article
View Printable Version

Iatrogenic Ureteral Injury Following Radical Hysterectomy - Case Presentation

2017-01

Dragos Radu Marcu, Ovidiu Gabriel Bratu, Dan Arsenie Spinu, Ioana Sorina Oprea, Ileana Adela Vacaroiu, Bogdan Florin Geavlete, Camelia Diaconu, Dan Mischianu

Iatrogenic ureteral injuries represent an important complication of abdomino-pelvic surgery with serio-us consequences in the absence of a prompt diagnostic and adequate treatment. According to literature it has been estimated that over 75% of all ureteral injuries are iatrogenic and that the incidence of ureteral lesions during an abdomino-pelvic surgery ranges from 0.5% to 10%[1-5]. Studies concerning this pathology have shown that obstetric and gynecological surgery accounts for approximately 50-60% or even more, followed by colorectal surgery 10-25%, vascular surgery (aortoiliac and aorto-femural bypass) and urological surgery 15-30% (classic, laparoscopic and endoscopic approach)[5-11]. [...]

View full article
View Printable Version

Breast Reconstruction Particularities after Radiotherapy - Case Report

2017-01

Iulia Gabriela Marcu, Ovidiu Stefanescu, Cristian Radu Jecan, Laura Raducu, Tiberiu Paul Neagu, Ioan Lascăr

Postmastectomy radiation therapy decreases the incidence of locoregional disease recurrence in patients with invasive breast cancer and has been proven to reflect a survival advantage for patients with node positive disease[1,2]. The optimal timing and technique of breast reconstruction procedures in patients requiring post-mastectomy radiation therapy are controversial[1] . Patients undergoing postmastectomy breast reconstruction, with a history of prior radiation therapy, present a particular clinical scenario. This is because of their well-documented higher complication rates, secondary to deleterious effects of irradiation on the soft tissue envelope of the remaining breast. [...]

View full article
View Printable Version

Multivisceral Resection for Pancreatic Adenocarcinoma. Case Report and Literature Review

2017-01

Sebastian Valcea, Octavian Enciu, Cosmin Pantu, Mihaela Vartic, Tiberiu Paul Neagu, Mircea Beuran

Pancreatic cancer (PC) remains a deadly disease with a dismal prognosis in which the mortality rate nearly equals its incidence [1,4]. Despite advances in modern chemoradiotherapy, the best and only chance of cure for patients with PC is an oncological surgical resection aimed at complete removal of all gross and microscopic disease[5]. Early disease and curative-intent surgery are the best predictors of outcome. Locally advanced cancer of the pancreatic tail involving adjacent organs is often considered unresectable. Radical distal pancreatectomy with en bloc resection of the invaded viscera with or without vascular reconstruction was introduced to treat these tumors[2,3]. Tumors of the body and tail have evidence of involvement of surrounding structures either by tumor infiltration or inflammatory adhesions. In such circumstances, it is advisable to perform en bloc resections to obtain negative surgical margins[6]. According to Shoup, multivisceral resections are technically feasible and, based on the limited data available, these resections are associated with improved survival (5-year survival rates of 16-22%) [7,8]. Given the high morbidity and mortality associated with these procedures, they should be performed only when the possibility of achieving R0 seems distinctly feasible[3,6,8]. [...]

View full article
View Printable Version

A Retrospective Forensic Study in Head Trauma Patients with Undiagnosed Skull Fractures at Computerised Tomography (CT) Scans

2017-01

Roxana-Maria Duncea, Relu-George Calota, Alec Cosmin Moldovan, Vladimir Belis

Computerized tomography (CT) scan is the primary screening modality of investigations in head trauma victims[1]. Since 1971 when it was invented, CT scan has advanced significantly from time-intensive single-section scanning to multi-detector row CT[2]. Nowadays, rapid and accurate assessment of injuries in emergency departments is based on CT scans. Th ere is a high degree of difficulty in terms of causal link, between the injury and the death causing mechanism in patients, with multiple affections and head trauma[3]. [...]

View full article
View Printable Version

The Effect of Allopurinol on Endothelial Function, Serum Uric Acid and NT-proBNP in Acute Decompensated Heart Failure

2017-01

Madalina Sorina Ababei, Alexandru Campeanu, Diana Cornelia Nistorescu, Ondin Zaharia, Gabriela Gheorghe, Ileana Peride, Andrei Niculae, Ioan Tiberiu Nanea

Acute decompensated heart failure has an increasing incidence and poor prognosis, being a major cause of death and hospital readmission and requiring urgent optimized therapy[1]. Under the influence of some decompensation risk factor, such as infections, arrhythmias, decompensation of some comorbidities, lack of adherence to the treatment, patients with a history of heart failure may suffer a progressive symptomatology worsening; therefore, more than 70% of cases of acute heart failure represent the clinical worsening of chronic heart failure - ADHF[2]. [...]

View full article
View Printable Version

Contrast Enhanced Ultrasonography in Diagnosis of Hypertensive Nephrosclerosis

2017-01

Liliana Albusoiu, Alexandru Campeanu, Marina Budau, Viorel Jinga, Ileana Peride, Andrei Niculae, Cristiana David, Ioan Tiberiu Nanea

The link between kidney damage and HT remains a challenge in medical research from a century when HT concept was defined, taking in consideration than HT is a major risk factor for cardiovascular disease morta-lity worldwide, due to the increasing prevalence, poor compliance to treatment and many complications[1-3]. The hypertensive nephrosclerosis is currently diagnosed in the latest stages of the disease because, for a long period of time, the injuries are compensated by kidney and therefore the clinical presentation is not specific[4]. The current diagnostic methods are non-specific, especially for early diagnosis of hypertensive nephrosclerosis, except the renal biopsy which is considered the gold standard but is rarely indicated in clinical routine due to its invasiveness and possible severe complications[5]. The pathogenic mechanism is complex and not very well understood but renal microcirculation impairment seems to be responsible for the onset and progression of this disease[6]. Therefore, any method that can accurately assess the early microvasculature changes of renal cortex, easy to use, simple and safe, with no invasiveness, could be an important diagnostic tool in hypertensive nephrosclerosis approach. [...]

View full article
View Printable Version

Pharmacodynamics of Serotonin. Emphasis on 5HT-3 Antagonists and SSRI Medication (II)

2017-01

Mihnea Costescu, Horia Paunescu, Sorina Vasile, Aurelian Zugravu, Oana Andreia Coman, Ion Fulga

5-HT4 receptors are a G-protein-coupled family of re-ceptors coupled with Gs protein that stimulates the pro-duction of the intracellular signaling molecule cAMP. It has two isoforms (5-HT4S and 5-HT4L), differing in the length and sequence of their C-termini[1]. 5-HT4 are present both in the central nervous system and peripheral tissues; in the brain, are found mostly in basal ganglia and the hippocampus[2]. In the periphery, 5HT4 play an important role in the functioning of gastrointestinal tract, urinary bladder, heart and adrenal gland. Gastrointestinal 5-HT4 receptors potentiate peristalsis, and electrolyte secretion. In the urinary bladder, acti-vation of 5-HT4 receptors modulates cholinergic and purinergic transmission. Stimulation of atrial 5-HT4 receptors produces tachycardia and arrhythmias. In the adrenal gland, activation of 5-HT4 receptors releases cortisol, aldosterone and corticosterone[3]. [...]

View full article
View Printable Version

HPV and Bladder Cancer - Is There a Connection?

2017-01

Dan Arsenie Spinu, Ovidiu Gabriel Bratu, Dragos Radu Marcu, Andrei Niculae, Bogdan Florin Geavlete, Camelia Diaconu, Dan Mischianu

HPV represents without any doubt one of the biggest health problems nowadys. Since the early days of its discovery by zur Hausen[1] the importance of this pathogen has risen. It is role in cervix neoplasia has been already demonstrated and steps have been made to counter this threat (vaccine). There are proofs that link this virus to other ano-genital neoplasia (here we include the penis, vulva, ano-rectal region and later the laryngeal neoplasia). [...]

View full article