Like other fields, also the medicine – in its development – presents many redefinitions about the pathological entities apart from what we speak about some well-known ones or others recently identified. By this point of view, the otorhinolaryngology represents a field with multiple valencies whose relationship with the neighbourhood specialities has still been leading to adopt some new borderlined entities with other pathological characteristics extremly variable ones.
The anatomical base, the close functional relationship and the intrinsec pathology of the head demand more and more to adopt some common therapeutical ways in teamwork with interdisciplinary collaborations. One of these modern and actual cathegories from the literature has been represented by the rhino-sinusal-orbital-ocular pathology. The directing of these cases towards the otorhinolaryngology can take place due to functional and microinvasive surgical possibilities.
The endoscopic diagnosis and mainly the radical treatment benefit from the modern microsurgical methods.
In this way the Sino-orbital Syndrome and FESS relationship has become a current practice giving better chance of recovery of the patients and in the same time holding unbelievable currative possibilities in the future. This is the reason why the autors consider to be oportune presenting these aspects through their more than 10 years experience.

Gh. Mühlfay, Karin Horváth, A. Lupşa

Primary immunodeficiencies are hereditary diseases of the immune system, characterized by recurrent infections, increased susceptibility to cancer and autoimmune diseases. A primary immunodeficiency is suspected in the presence of recurrent infections, infections with unusual localization or with opportunistic agents, or in the presence of symptoms like dystrophia, mucosal candidosis beyond the age of 1 year, oral ulcers, petecchiae, teleangiectasis, ataxia. Investigation of immunodeficiencies needs special laboratories. The World Health Organisation recognises more than 80 primary immunodeficiencies of humoral, cellular or combined type. Treatment includes antibiotics, intravenous immunoglobulins and gene therapy. Though primary immunodeficiencies are rare diseases, the pediatrician has to have them in mind on special occasions.

Adrienne Horvath

Diabetic renal disease is still an extremely important and common complication in diabetic patients. Detailed mechanisms for development of diabetic renal disease remain unclear, whereas it is well established that the major risk factors for development of nephropathy are poor glycemic control and elevated blood pressure. These risk factors are important for only approximately one third of the variability in loss of glomerular filtration rate, so identification of new risk factors for progression of diabetic nephropathy is crucial to delay/prevent end stage renal disease.  Systemic and local generation of angiotensin II is of major importance in the processes that initiate and eventually lead to loss of filtration power in diabetic nephropathy. Therefore, genetic variations in the renin-angiotensin system are potential risk factors for progression of the disease. The angiotensinogene (AGT T174M) – , the angiotensin converting enzyme insertion/deletion (ACE I/D) – and the angiotensin II receptor (AT1 A1166C) – to polymorphism was paid much attention in the pharmacogenetics research, because the observed variations in response to ACE-inhibitors or AT1-receptor antagonists might be associated with these polymorphisms.

Melinda Kolcsar

2006, nr.2

The prognosis of a bronchogenic carcinoma with pleural carcinomatosis is extremely poor and conventional treatment by chemotherapy offers in many cases only palliation. Used as a surgical tool in the treatment of malignant mesothelioma of the pleura, extrapleural pneumonectomy is a highly demanding procedure, which became an option in the surgical treatment of lung cancer with carcinomatous pleuritis (with or without pleural effusion). In some cases intrapleural perfusion using hyperthermo-chemotherapy followed by extrapleural pneumonectomy showed better prognosis then conventional treatment. Many other studies are required to better determine which subgroup of patients with pleural carcinomatosis can most benefit from surgical therapy.

A.Dobrică, P.Boţianu, V.Damian, Alexandra Butiurcă, Ana Maria-Voichiţa Boţianu,   M.Stoian, M.Pop, V.Căreianu, I.Pribac, Eda Baubec

2006, nr.2

The early diagnosis of neoplasms in childhood is very important, their incidence being 1 in 600 children. Ultrasound imaging, the extension of the specialist’s hand is the first choice among imaging techniques in case of a neoplasm, because it is not painful, does not irradiate, requires minimal training and it is relatively cheap.

Leukaemia the most frequent neoplasm in childhood is characterized in ultrasound imaging by homogeneous splenomegaly and hilar or retroperitoneal adenopathy.

Lymphomas the third most frequent neoplasms in childhood appear at ultrasound as focal hypoechogenic zones in a big tumoral mass with anechogenic areas due to necroses.Neuroblastoma appears as an inhomogeneous mass containing hyperechogenic areas due to calcification and hypoechogenic areas due to bleeding, necrosis and cystic alterations. Ultrasonography shows in nephroblastomas an echogenic, homogeneous or inhomogeneous tumoral mass with transonic areas of necrosis, bleeding or hyperechogenic areas with fat and calcifications. Hepatoblastoma and pancreatoblastoma, which appear with less frequency, are hyper- and hypoechogenic tumours with modified outlines.

Since the ultrasonographic appearance of tumoral masses is sufficiently characteristic, often a simple ultrasonography is sufficient to diagnose a tumoral mass with high probability.

Oana Mărginean

2006, no.1