[Modern assessment of perimetric progression in glaucoma].

Objective: Analysis of perimetric deficit progression and accurate evaluation of certain factors that are associated with perimetric progression in glaucomatous patients.

Material And Methods: Cohort clinical trial that included a number of 80 eyes in 46 patients having a clear diagnosis of open angle glaucoma or ocular hypertension medically and/or surgically treated in which there have been followed both the dynamics in perimetric deficits and morpho functional parameters related closely and characteristically to the glaucomatous disease. Progression analysis was made using two different methods: manual, testing each spot's sensitivity at a time (EGS criterias were utilized) and automatic (through GPATM--Glaucoma Progression Analysis software).

[Angiogenesis and antiangiogenesis in intraocular tumors].

Angiogenesis, fundamental process that consists in the formation of new vessels, is essential physiologically in the tissue maintenance and of the homeostasis, having in this sense a few positive and negative regulators. Vascular endothelial growth factor and other angiogenical proteins play a major role in the ocular and general angiogenesis. The solid tumors need new vessels in order to survive and grow, therefore the anti-angiogenic agents can represent important instruments in the ocular oncological therapy The intravitreal administration of the anti-VEGF agents delay the growth of the intraocular tumors, decreases the odds of their methastasis at distance, increases the therapeutical effects of the conservative treatment by irradiation and can limit the ocular complications of radiotherapy.

[Tumoral form of abdominal and retroperitoneal actinomycosis].

We present a case of abdominal and retroperitoneal actinomycosis, clinicaly evidenced by a large tumor in the left inferior abdominal quadrant, in a 72-year-old male. Following clinical and laboratory investigations (imaging), strong suspicion of a left colon neoplasm was raised. Surgery consisted in an exploratory laparotomy and multiple biopsies of the great omentum and retroperitoneal space, the case being considered above the therapeutic resources.

[Purtscher retinopathy--case report].

The authors present the case of a 27 years old man who came to our clinic for sudden, painless and profound bilateral loss of visual acuity in both eyes, 14 days ago, during hospitalization for an acute episode of abdominal pain. The clinical aspect correlated with the personal pathological aspects permitted us to establish the diagnosis of Purtscher retinopathy.

[Voluminous complicated epigastric hernia].

Epigastric hernia, apparently minor injury, neglected can reach impressive sizes, with major un-esthetic effect. In an unfavorable clinically context (morbid obesity, chronic respiratory failure, ground cancer, diabetes, heart failure) complications occur (incarceration, strangulation) with a complex picture. We present three clinical observations, including a low occlusion by fixed transverse colon necrosis in a strangulated epigastric hernia with pyo-stercoral phlegmon.

[Optic nerve melanocytoma--associated with age related macular degeneration].

We report the case of a 73 year old patient who presented for decreased vision in his right eye, ocular examination revealed a pigmented tumour in the left optic disc (optic nerve melanocytoma). We briefly mention another case of optic nerve melanocytoma in a 6 year old, Caucasian patient.

[Merkel cell carcinoma in unusual location].

We present a case of Merkel cell carcinoma with buttock location at a 70 years old patient. In literature there are described about 600 observations, of which more than half located in the head and neck. Despite early diagnosis--less than five months after occurrence--a thorough exploration (ultrasonography of soft tissues, pelvi-abdominal CT, histopathological and immunohistochemical examination), correct treatment (broad surgical exeresis, local postoperative radiotherapy) and appropriate follow-up, the patient had a negative evolution.

[Late pancreatic metastasis from primary Grawitz tumor--surgical management].

Renal cell carcinoma (Grawitz tumor) is an epithelial tumor able, to develop, in some cases, very late metastases. The most frequent localization are: lung, bones and liver. Pancreatic metastasis are rare and appear late, sometime even after 12 years from primary renal tumor.

[The role of allergologic tests in asthma].

In order to establish the allergic etiology of asthma, the clinician must correlate some anamnestic details with those offered by the in vivo and in vitro allergological tests. Some specific allergic anamnestic informations (such as particular conditions of starting or worsening, co-existence of other allergic disorders, family atopic status) can be revealed by any experimented clinician but the performance of cutaneous tests must be done only by an allergology physician. EAACI recommends allergological prick tests as a reference method; it must be done only with standardized extracts; it has the optimal diagnostic sensibility.

[Primary antiphospholipid syndrome].

Antiphospholipid syndrome (APS) is a disorder characterised by recurrent arterial or venous thrombosis and/or pregnancy losses, in the presence of persistently elevated levels of anticardiolipin antibodies and/or evidence of circulating lupus anticoagulant (these abnormalities are detected by blood tests). Primary APS occurs when there is no evidence of associated diseases. APS in the presence of an underlying disease, usually systemic lupus erythematosus, is called secondary APS.

[Physiopathologic and clinical aspects of Krukenberg tumors].

Although described for the first time for more than one hundred years ago, Krukenberg tumors still retain some controversial aspects. The lack of consensus and consistency in using a single definition, the difficulty to admit the existence of a primitive form of the tumor, the lack of knowledge concerning the precise mechanisms of metastases and the absence of a distinctive and characteristic clinical symptoms which often contrasts the usually large dimensions of the tumor are some of the aspects which need further elucidation.

[General principles of abdominal wall reconstruction--20 years of experience].

After 20 years of reconstructive abdominal wall surgery and almost five thousand surgical interventions for this pathology, most of them resolved with prosthesis, authors present a retrospective study concerning to increased biocompatibility, world dynamics of alloplastic solution and also the technical surgical problems that appears in incisional hernia repair. There are underlined two concepts: first--the maximal transversal diameter--that define the size of musculo-aponeurosis defect and the span of alloplastic substitution, in opposition to the old idea that allude to the size of hernia sack; the second concept--receptor prosthetic layer--define the interface between abdominal viscera and prosthetic material. This is not just a mechanical divider, being also a conjunctive and vascular support, helping prosthetic tissue integration.

[Malignancy of familial adenomatous polyposis. Diagnosis and treatment].

Familial adenomatous polyposis with features of malignancy find in a 23 years old patient, whose diagnosis has been established on endoscopical basis. Total proctocolectomy is performed with terminal ileostomy. Histopathologically, the diagnosis is revealed, with establishing of multiple areas of malignancy in rectum and sigmoid colon.

[Prophylactic antibiotics in neurosurgery].

Because of a low risk of infection (around 2-3%), prophylactic use of antibiotics in neurosurgery is a controversial issue. Some neurosurgeons consider that there are strong arguments against the use of antimicrobials (promotion of antibiotic-resistant strains of bacteria, superinfection and adverse drug reactions) and meticulous aseptic techniques could be more usefully than prophylactic antibiotics. On the other hand, despite of being rare, the consequences of a neurosurgical infection can be dramatic and may result in a rapid death, caused by meningitis, cerebritis, abscess formation or sepsis.

[Optic neuropathy in multiple sclerosis].

The inflammation of the optic nerve called optic neuropathy could be an onset marker of multiple sclerosis. The authors review the place of optic neuropathy (neuritis) in the inflammatory demyelinating disease continuum, especially as the onset symptom of multiple sclerosis. We present the clinical symptoms, the aetiology of optic neuritis and the adjacent methods used to investigate optic neuritis.

[Short bowel syndrome due to a severe complication related to Meckel's diverticulum].

A 17 years old patient, admitted and operated in emergency with acute diffuse peritonitis which had been had the onset four days before. During surgery, a huge volvulus of the small intestine is revealed due to an adherence between Meckel's diverticulum and mesentery, with large intestinal necrosis. Extended enterectomy is performed with jejunostomy.

[Resection--reconstruction in malignant tumors of the locomotory apparatus].

The malignant bone and soft tissue tumors, represents, like any other type of cancer, a continuous challenge for surgeon, who is constrained to search and find new techniques, to improve not only the life expectancy, but the quality of the life too. This aim determined orthopedic surgeons to perform new operations, with a complex technique, like resection - reconstruction of the limb. In orthopedic clinic of Elias Hospital, we had 35 patients with malignant tumors of the limbs; we performed 14 resection--reconstructions, with or without preserving the joint mobility.

[Laparoscopic surgery of profund endometriosis with rectal affect].

Objective: To present the principles of laparoscopic treatment for rectal endometriosis and to discuss possible postoperative outcomes.

Material And Methods: Our series included women managed for rectal endometriosis during consecutive 20 months in the Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen--France. Patient's characteristics, symptoms, imaging examination results, surgical treatment and postoperative outcomes were all evaluated retrospectively.

[Krukenberg tumors of gastric origin versus Krukenberg tumors of colorectal origin].

The aim of this study was to analyze the incidence and origin of Krukenberg tumors in our region to determine their clinical behavior and to compare some anatomo-clinical features of Krukenberg tumors of gastric origin versus those of colorectal origin. This is a retrospective, descriptive and comparative study of Krukenberg tumors diagnosed and treated in the IV-th Surgical Clinic of Cluj-Napoca. The epidemiologic features concerning global incidence, age, and menopausal status overlap the data from literature.

[Macular hole--a rare complication of toxocariasis].

Macular hole is a condition that characterizes older patients, being rare in adolescent patients and exceptionally at children. The etiopathogenic mechanism of most macular holes in children and adolescent is idiopathic. The suggested etiopathogenic mechanism is vitreoretinal traction due to a toxocara granuloma for a 9 years old girl.

[Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations].

Acute appendicitis remains an up to date issue, being the most frequent cause of surgical acute abdomen round the globe. The complications that occurs creates important therapeutically difficulties. The study, based on 114 cases, had analyzed not only the pathogen flora (type, association, frequency of certain germs, the relation between them and different pathological lesion), but also the immune response of the organism to septic aggression.

[Postoperative pain management in elderly patient].

Pain is a common occurrence for the hospitalized elderly, and may often be under recognized and inadequately managed. Insufficient pain management can lead to the sequelae of emotional distress and depression, delirium, anxiety, sleep disturbances, and physical disabilities, as well as increased health care costs. Effective pain management of the older adult begins with pain assessment using the proper tools.

[Pancreas divisum--a rare cause of chronic pancreatitis].

Pancreas divisum (P.D.) is a congenital anatomic variant, characterized by the nonunion of dorsal and ventral pancreatic ducts.