Dorina Chişevescu¹, M. Străin¹, S. Blaj², B.  Hoinoiu³, M.Ionac³, F. Lazăr⁴, C.  Neamţu⁵

¹ Department of Gastroenterology, University of Medicine and  Pharmacy „Victor Babeș” Timișoara

² 3^rd Surgery Clinic, Timișoara Emergency County Hospital

³ Pius  Branzeu Center for Laparoscopic Surgery and Microsurgery, Timișoara

⁴ 2^nd Surgery Clinic, Timișoara Emergency County Hospital

⁵ Aenesthesiolgy and  Intensive Care  Unit, Timișoara Emergency County Hospital

From centuries the  surgical abdominal procedures have  been performed using incisions at the  anterior abdominal wall. In the  field  of abdominal surgery, the  last  15-20 years brought forth an important preoccupation for  developing less  and less  invasive procedures against traditional surgery. The  term – minimally invasive surgery – was established with the  first  laparoscopic cholecistectomy per- formed in 1987 by Phillippe Mouret (unpublished data).

Natural Orifice Translumenal Endoscopic  Surgery (N.O.T.E.S) is a technique which allows the  acces in the  abdominal  cavity trough natural orifices (mouth, vagina, anus, urethra) without incisions on the  abdominal wall.

The  aim  of this  paper is to report our  experience in performing NOTES interventions in the  abdominal and  thoracic cavity, to establish if this  new technique is feasible, to report technical difficulties and  complications encountered during surgical interventions.

Our  study included four  experimental groups of  animals (pigs)  in  which we  performed surgical NOTES interventions.  Group A  - 8 pigs on  which we  performed transgastric cholecystectomy, group B – 8 pigs which underwent transvaginal cholecystectomy, group C  - 4  pigs on  which we  performed submucosal endoscopic esophageal  myotomy and  group D  - 4  pigs on  which we  performed transesophageal mediastinoscopy. All experiments were  done under general anesthesia.

Main technical problems encountered were  on  transgastric cholecystectomy because of the  image orientation, triangulation and  ex- posure and  retraction of the  specimen.

Preliminary experiences in the  porcine models have  been encouraging for  translumenal acces to  the  peritoneal and thoracic cavity. NOTES is still in evolution and  newly designed instruments and  devices should be developed in order to offer  safe,  simple and  secure acces in to the  peritoneal and  thoracic cavity.

Raluca Solomon¹, L. Azamfirei², Simona Gurzu³, Ruxandra Copotoiu², Sanda Maria Copotoiu², J. Jung³, G. Grigorescu⁴, J. Szederjesi², T. Ezri⁵

¹ Department of Anesthesiology and  Intensive Care, University Hospital Târgu Mureș

² Department of Anesthesiology and  Intensive Care, Faculty of Medicine, University of Medicine anf Pharmacy, Târgu Mureș

³ Department of Pathology, Faculty of Medicine, University of Medicine anf Pharmacy, Târgu Mureș

⁴ Department of Pneumology, University Hospital Târgu Mureș

⁵ Wolfson Medical Center, Holon, Associate Professor of Anesthesiology Tel Aviv University, Israel;  Outcomes Research Consortium, Cleveland OH,  USA

Objective: To  investigate the  changes both of  the  VEGF  expression and  of  the  specific receptors (VEGF-R1 and  VEGF-R2) in the exudative and  the  proliferative stage of ARDS patients compared to normal pulmonary tissue.

Material and methods: Lung specimens from  61  ARDS patients in the  exudative or proliferative stage, obtained by bronchoscopy (11  patients), or  by  autopsy (50  patients) were  examined immunohistochemical and  histopathological and were  subsequently com- pared to a control group.

Results: For  the  bioptic lung  samples, following the  time frame for  the  exudative stage of ARDS we  noted a VEGF-R1 decrease. It was still expressed in some alveolocytes. As for  VEGF,  its expression decreased in the  pulmonary tissues (p < 0.01). In the  prolifera- tive  stage, after  the  appearance of the  hialyne membranes, VEGF  is expressed in the alveolocytes, but  the  expression of VEGF-R1 decreased significantly, except for  some alveolocytes located in pulmonary areas free  of hyaline membranes which continued to  be positive for  VEGF-R1. VEGF-R2 was marked out  only  in the  bronchial epithelium, both in the  exudative and  the  proliferative stage. The  same alterations were  observed for the  necroptic lung  samples, but  the  number of alveolar cells  positive for VEGF-R1 was lower compared to the  bioptic ones (p < 0.01).

Conclusions: The persistence of VEGF-R1 in the alveolar cells  located in pulmonary areas free of hyaline membranes proves that  only a part of these cells  were  destroyed in ARDS. The  number of non-damaged alveolar cells  seems to be critical for the  survival.

Phenotypic expression at the time of first presentation and also in the evolution of autosomal dominant polycystic kidney disease may differ considerably among patients who belong to the same families.
The paper presents four member of the same family with autosomal dominant polycystic kidney disease. The ages at onset of first symptoms, the type of first symptoms, the progression to end stage kidney disease were very different between family members.
Moreover, two cases were misdiagnosed until end stage renal disease was confirmed.
In the paper, a brief discussion about the clinical manifestations of autosomal dominant polycystic kidney disease and about the differential diagnosis of renal cysts is provided.

Carmen Caldararu, G. Dogaru, Mirela Gliga

Tooth agenesis is the one of the most common anomaly of the human dentition. The etiology is genetic and clinically heterogeneous. Two genes have been identified as causing this condition namely, MSX1 and PAX9, both have been associated with two different types of tooth agenesis. The MSX1 (muscle segment homeobox 1) gene is a member of MSX family and has a critical role in odontogenesis and craniofacial skeleton. Mutations in MSX1 coding regions cause tooth agenesis affecting preferential premolars, mutations in PAX9 coding regions causes preferential tooth agenesis of molars. The aim of our study was to assess whether a mutation in MSX1 is responsible for the lower premolar hypodontia affecting an 11-year-old boy and his 35-year-old mother both from a family with autosomal dominant inheritance model of dental agenesia.

Noemi Meszaros, Nicoleta Andrescu, Monica Stoian, D. Belengeanu

INTRODUCTION: Surgery procedure applatissation-plication in the treatment of pulmonary abscesses is highly recommended on patients with critical state which do not tolerate a major lung resection. MATERIAL AND METHOD: We present a 35 old patient, treated conservative for 2 months for purulent cough, thoracic pain, fever (left pneumonia). In evolution she developed a left giant pulmonary abscess and she is admitted to our Clinic for surgical treatment. We performed abscess sequential applatisation-plication, Botianu procedure, without direct closure of the bronchial fistulae.  RESULTS: Postoperative evolution was uneventful with complete symptoms resolution and with general state improvement.  CONCLUSIONS: Without extensive pulmonary resection the anesthetically and surgical risks are reduce, this procedure being in concordance with principles of modern thoracic surgery: respect for the pulmonary parenchyma.

Alexandra Butiurca, A. Boţianu, P. Boţianu, A. Dobrică, Iringó Kézdi, V. Damian, L. Gyorbiro

As a result of the synthetisation of peresthers and nitrones directly in the polarographic cell we have obtained data which allow us to interpret some of the structure-properties-polarographic behaviour relations, these being-qualitative and quantitative also. The electrochemical transformations of peresthers of X-C6H4-CO-O-O-C(CH3)3 type have led to interesting results,as for as p-nitro-peresthers are concerned we have observed that the product of electrochemical decomposure is HOOC-C6H4-NH-OH and N-substituted-hidroxilamine, which in reaction with carbonilics derivates leads to nitrones, linking these two classes of substances. Close observation allows us to associate these synthetisations to a higher combinatorial character, and because of the electrochemical processes they are included in combinatorial electrochemistry. We foresee a development of these combinatorial electrosynthesis through the diversification of the substituents and their transformation in other functional groups with the view of obtaining some compounds having medication potential respectively.

I.P. Dancs, B. Tőkés, Gabriella Dónáth-Nagy

For this work were studied the rheological parameters (penetration capacity and stretching capacity) of the obtained suppositories with valproic acid with lipophile and hydrophile bases by classical metod in accordance with current good manufacturing practice. Suppositories prepared with valproic acid and lipophile bases have a higer penetration capacity than suppositories prepared with valproic acid and hydrophile bases.  After one months it was observed the decrease of penetration capacity and the decrease of stretching capacity for all formulas . Stretching capacity is not influenced by the presence of valproic acid.

Alexandrina Tăurean, R. Cazacincu

Ceftazidime is identified by means of infrared (IR) spectroscopy and dosed by ultraviolet (UV) spectroscopy. IR spectra for both the reference substance (ceftazidime) and the commercial product containing this substance (Fortum® 1g – powder for injection) were obtained under identical conditions. The technique involving potassium bromide tablets was used for preparation of samples in IR. Assignment of the main absorption bands is achieved, characteristic of the studied molecule. We deployed the IR method for identification of ceftazidime in the commercial product, i.e. the UV dosing spectrometric method.

G.T.A. Burcea Dragomiroiu, V. Ghemigian, M.Popescu, Adina Cimpoiesu, Maria Bârcă, M. Hîrjău, C. Baloescu

The present study has in view the practical application of the native species Portulaca oleracea L (purslane) traditionally used as an anti-inflammatory, diuretic, antidiabetic and antiulcerogenic remedy in different countries.  The species is used in a tincture or extracts form, as an ingredient in various cosmetic products. The objectives of the following consist in researching the phenolic and sterolic compounds. For revealing the chemical compounds we made the chemical analysis of the solutions obtained by successive extractions with ether (A), ethanol (B) and water (C) through specific chemical reactions and through thin layer chromatography. The flavonoids were quantitatively determined by a spectrophotometrically method after complexing with aluminium chloride and the sterols by a colorimetric method using chloramine T and sulphuric acid. There were identified: sterols and carotenoids in solution A, coumarinic derivatives and phenolic acids in solution B, polyholosides and reductive compounds in solution C. The presence of beta sitosterol, coumarin, umbelliferone and caffeic and chlorogenic acids, kaempferol, quercetin was confirmed through thin layer chromatography. The total flavonoids content varies between 0.030 and 0.066g%, that of sterols is 1.125g% (in 100g of dried plant material).

Adriana Anghel, Viorica Istudor, Mihaela Dinu, Ligia Duţu, Ioana Tudor, O. Olaru

Physalis alkekengi L. (Winter cherry), a species of the plant family of Solanaceae is distributed in many regions of Europe, Asia and America. Its fruits are used in traditional folk medicine especially as diuretic, anti-rheumatic, analgesic and as a vitamin source. European winter cherry fruits have been extensively studied with regard to their carotene content. However, no specific studies on mineral content have been carried out. The aim of the present study was to determine the mineral element content of this fruits. Inductively coupled plasma atomic-emission spectrometry (ICP-AES) was used to determine mineral element content of Alkekengi fructus and of different aqueous (infusion and decoction) and hydro-alcoholic extracts (20%, 40%, 70% and 96% alcohol), overall 13 elements (macro elements: Ca, K, Mg, Na, P, S; trace elements: Al, B, Ba, Cu, Fe, Mn, Zn) were considered. Generally, aqueous extract of fruits of Physalis alkekengi L. contain macro and trace elements in higher amount as the hydro-alcoholic extract. Comparing the aqueous extracts, we observed that minerals extractability, excepting Ca and Na, is better with decoction than with infusion. The minerals extractability decreases with the increase in alcohol concentration of solvents used for the extraction. Therefore, when a mineral supply is required we suggest consumption of fruits or aqueous extracts of Winter cherry fruits.

Eszter Laczkó-Zöld, Klára Szentmihályi, C. Csedő, Sigrid Eşianu