The risk to developing a neoplasm is increased when associated to a patient phakomatosis (Recklinghausen neurofibromatosis, Bourneville's tuberous sclerosis). We analysed 6 cases with phakomatosis and tumours, admitted in the Department of Oncopediatry, between 1993-1998; five of these children had neurofibromatosis and one Bourneville's disease. The associated tumours were hematologic malignancies (juvenile myeloid chronic leukemia) and solid tumors (rhabdomyosarcoma, hepatic carcinoma, CNS tumour, NHL optic glioma). The diagnosis was confirmed by microscopic examination of the bioptic material in all cases. Tumoral staging was performed by clinics, biology and imagistic investigations. All cases had extensive and aggressive tumours at the moment of diagnosis, We noticed a poor response and an early relapse after chemotherapy. A special follow-up and a different management has to be established for the patients with phakomatosis, in order to have a good oncological prophylaxis.

Adolescent↗

PubMedDate not supplied

[Primary obstructive megaureter- diagnosis and treatment].

The authors have treated 13 cases of primary obstructive megaureter (POM) in children, presenting without vesicoureteric reflux. The diagnostic possibilities and the surgical approach options are discussed. Both Cohen and Leadbetter--Politano uretero-vesical reimplantation techniques proved to be successful in this series. Ureteric folding was done in 2 cases. Reported final results are good in 10 cases.

Adolescent↗

PubMedDate not supplied

[Rare case of retroperitoneal malignant Schwannoma].

UNLABELLED: Malignant Schwannoma, recently renamed malignant peripheral nerve sheat tumor retroperitoneally localized, represents 0.01 of retroperitoneal tumours. A 41-year old woman, without pathological record--and without cutaneous neurofibromatosis--hospitalized for increased volume of the abdomen, without symptomatology, is diagnosed after the imaging and biological tests--without CT and RMN--with retroperitoneal tumour. The unusual size of tumour--6000 gr.--the macroscopic aspect suggesting malignancy (histopathologically and immunohistochemically confirmed), the relatively easy extirpation which, nevertheless, required caudal spleen- and pancreatectomy as well as transvers colectomy, the absence of proximity adenopathy and remote secondary determinations, the simple postoperative evolution represent overwhelming elements in this case. Two years after the operation, during which the patient was under chemotherapy, on a routine control we found a relapse at a distance from the initial tumour (primitive tumour ?), totally operable. For the time being, after almost five years from the first operation, there are no clinical, biological and imaging changes. CONCLUSIONS: the retroperitoneal space is quite enough for the development of large tumour masses, without symptomatology. The present case combines most characteristics of retroperitoneal neoplasms: large or very large size, quasi-absent symptomatology, difficulty in preoperative diagnosis, surgical tactics and techniques--quite often, the total extirpation of tumour mass led to the sacrifice of other organs within the limits of a justified risk--and unforeseeable evolution with relapses having the same characteristics.

Adult↗

PubMedDate not supplied

[The great omentum in surgical pathology].

The aim of the survey is to bring forward the relationship structure-function-pathology of the great omentum from the surgical point of view. The common origin (similar) with that of the spleen and the structural particularities give the great omentum distinct responding potentialities in pathology and these have challenged the anatomists, anatomo-pathologists and surgeons to a more careful and deep research for the last one hundred years. The study corroborates data from literature with the authors' experimental, clinical and microscopic research regarding the vascularization, the lymphoreticular component and the innervation, with the aim of emphasizing the functions of the great omentum in pathological conditions: plasticity, adherence to traumatized and swollen areas, neo-vascularization, absorption of fluids and phagocytosis. Concerning the innervation, by using special techniques, we have managed to emphasize neurofibres in interlobular spaces. By using clinical observation and microscopic study, we can notice dynamically the changes of the great omentum in the inflammatory pathology and in front of the malignant tumour invasion. Last but not least, this survey pays our respects to professor Ion Kiricuta, the first who used the great omentum in plastic surgery and whose studies stimulated the research concerning the great omentum that has been a subject for the international conferences for the last 20 years.

Humans↗

PubMedDate not supplied

[Alpha 2 macroglobulin immunoturbidimetric assays (DakoCytomation reagents) on Roche Diagnostic analysers (Modular P, Cobas Integra). Application to FibroTest-Actic-Test].

BACKGROUND: Alpha2Macroglobulin (A2M) measure showed a revival since it was introduced into FibroTest-ActiTest-Fibro (FT-AT-Fibro) algorithm. More often than not, this assay is performed in immunonephelemetry. Progresses in the comprehension of fibrosis dynamics and better treatment efficacy follow-up will increase FT-AT-Fibro prescriptions. Despite efforts to standardize methods of enzymatic activity measure and proteins measure, we still observe important interlaboratory and intersystem variability. AIM: The primary aim of the study is to validate immunoturbidimetric measure of A2M on Modular P and Cobas Integra analysers (Roche Diagnostics) in utility channel using DakoCytomation reagents in order to extend the analytical system range allowed to measure A2M. The secondary aim of the study is to verify transferability of the six FT-AT composants (A2M, haptoglobin, apolipoprotein A1, total bilirubin, GGT and ALT) to Roche Diagnostics equipment by comparing with results measured on the reference system. RESULTS: A2M measures (n = 146) showed linearity, repetitiveness and were reproducible. Readjustments to adapt A2M measures were required. A corrector factor of 0.84 for Modular P and of 0.87 for Cobas Integra was introduced in order to readjust the immunoturbidimetric method to the immunonephelemetric method. The rationale of proposed corrector factors is based on the use of Dade Behring and DakoCytomation reagents (antisera and calibrant). Biologist vigilance is required to point out modifications or variations in reagents that could be done by the company. The six parameters results transferability from the reference system to Roche Diagnostics was demonstrated by statistic analysis. FT-AT showed excellent correlations to the reference system for Modular P and Cobas Integra analysers. In this study no difference more than 0.11 was recorded and only few subjects had differences between 0.05 and 0.10. Therefore this very low inter-analysers variability has no significant clinical impact. CONCLUSION: This study showed that the analytical system made of Modular P, Cobas Integra, Roche Diagnostics and DakoCytomation reagents can be used for FibroTest-ActiTest-Fibro parameters assessment. Their statistical and clinical variability were acceptable compared to the reference system.

Automation↗

PubMedDate not supplied

[Cosmetology in the treatment of acne].

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Acne Vulgaris↗

PubMedDate not supplied

[Pseudo-Meigs syndrome, a rare variant].

The pseudo- Meigs syndrome is defined as a pelvic tumour, other than the ovarian fibroma complicated with ascites and hydrothorax that can be recovered after the tumour is surgically extirpated. The uterine leiomyoma is an extremely rare cause of this syndrome, only 24 cases have been recorded so far, most of them presenting hydropic degeneration or necrosis. The case exposed by us, a 50- year old obese,with nanism woman, presented clinical, biological and imaging characteristics of the syndrome; moreover, she had arterial high blood pressure for more than five years, fact that didn't need postoperative treatment. She was sent to the ER because she had severe respiratory insufficiency, arterial high blood pressure, tachycardia and, at the clinical examination, she presented massive right hydrothorax, ascites, and pelvic tumour. The biologic explorations (the benign cytology in the pleural liquid and ascites, CA-125 with ten times the normal value) and the imagery completed the picture of a Meigs/ pseudo-Meigs syndrome that implied the laparotomy. The H-P examination and the postoperative evolution confirmed the diagnosis. We presented this case in order to emphasize both its rarity and its real positive and differential diagnosis problems.

Ascites↗

PubMedDate not supplied

[Surgical management of acute pancreatitis. One hundred years of evolution].

The aim of the paperwork is to present the evolution of surgical management of acute pancreatitis for a period of more than a century, by using the literature data that reveal the important moments in the knowledge of patho-etiology, in clarifying the definition and classification and, last but not least, in the progress of biological and image exploration, the right timing and the permanent development of surgical procedures so that the general mortality should decrease up to 10-15%, as it nowadays. The need for surgical intervention in acute pancreatitis is the controversy that appeared during this period. Until the mid of the 20th century, mainly on the basis of the clinic diagnosis, only the severe cases were recognized and became subjects of surgical exploration, with disastrous results. A great step forward was the dosage of urinary and serum amylase that allowed the non-surgical diagnosis of the disease, so that some patients could be treated successfully without surgery. Introduction of prognosis criteria by Ranson, the dosage of C-reactive protein together with CT scanning of the injury: interstitial - edematous or necrosis,the fine needle aspiration for bacteriology and the adoption of a definition and unitary classification resulted in a major change in therapy, in general, and in the surgical procedures. Necrosectomy combined with a drainage method, practised and developed by Beger since 1982, becomes a surgical dogma. Minimally invasive procedures became a reliable alternative to classic procedures due to the diversity and permanent development of laparoscopic, endoscopic and radiologic techniques.

Acute Disease↗

PubMedDate not supplied

[Sexual problems in dermatovenereology consultations].

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Dermatology↗

PubMedDate not supplied

[The diagnosis and treatment of benign tumors of the subdiaphragmatic digestive tract].

One hundred twenty-two benign tumors of subdiaphragmatic digestive tract admitted in the interval 1975-1988 at the III-rd Surgical Clinic of Iaşi are reported. Out of these patients 120 required surgical treatment, the remainder of 2 being treated conservatively (diffuse intestinal angiomatosis, Peutz-Jeghers' syndrome). The clinical evolution being atypical, the surgical intervention was required, in most of the cases, due to hemorrhagic and occlusive complications. Histologically, the polyps and schwannomas were prevalent. The diagnostic difficulties, especially in the cases with jejuno-ileal localization, are mentioned.

Diaphragm↗