Votive Offerings from Floresti Orthodox Monastery in Romania: An Ophthalmological Lesson from the Eighteenth and Nineteenth Centuries CE.

Since Antiquity, votive offerings were deposited in temples dedicated to deities in order to fulfil a special request of a supplicant. Later, in Orthodox churches, votive offerings entered in the form of anatomical ex-voto or tamata, metallic effigies that realistically represented the disease-affected portion of the body. In this paper, we show four tamata from eighteenth-nineteenth century identified in the museum of the Orthodox monastery of Floresti (Romania); votive offerings that represent ocular pathologies. Even if the supplicants did not have a medical background and often did not fully understand their diseases, the votive offerings demonstrate their ability to observe pathological changes, at the same time emphasising the importance of their faith in the healing process.

The brainstem and its neurosurgical history.

Brainstem is one of the most complex structures of the human body, and has the most complex intracranial anatomy, which makes surgery at this level the most difficult. Due to its hidden position, the brainstem became known later by anatomists, and moreover, brainstem surgery cannot be understood without knowing the evolution of ideas in neuroanatomy, neuropathology, and neuroscience. Starting from the first attempts at identifying brainstem anatomy in prehistory and antiquity, the history of brainstem discoveries and approach may be divided into four periods: macroscopic anatomy, microscopic anatomy and neurophysiology, posterior fossa surgery, and brainstem surgery. From the first trepanning of the posterior fossa and later finger surgery, to the occurrence of safe entry zones, this paper aims to review how neuroanatomy and brainstem surgery were understood historically, and how the surgical technique evolved from Galen of Pergamon up to the twenty-first century.

NEUROPSYCHOLOGICAL GROUNDS IN THE AWAKE BRAIN SURGERY.

Traditionally, the awake cerebral neurosurgical interventions are carried out when the primary motor areas and the areas involved in language are concerned. This procedure is also known as mapping (Intraoperative Brain Mapping). The intraoperative neuropsychological protocol supposes the setting of a list of steps and tasks that the patient must perform during the surgery, taking into account the lesion localization (both the cortical and the subcortical structures), the cognitive functions involved and the individual particularities of each patient. As a result of the high validity of certain tests, we propose a common minimal set of tests, which can allow a minimal standardization and replicability.

Intraorbital foreign body.

Penetrating orbitocranial injuries caused by intraorbital foreign body are a rare cause of morbidity being most common among young people. The term intraorbital foreign body refers to a foreign body that occurs within the orbit but outside the ocular globe. We report the case of a 12-year-old male child who sustained a right cranial facial trauma due to accidental fall on a piece of wood, which penetrated intraorbitally. Native cranial magnetic resonance imaging (MRI -1.5 T) revealed the presence of an intraorbital foreign body, 6 cm long and 1.5 cm wide, near the orbital apex. In our patient, early surgical extraction of the foreign body had a decisive role on his full recovery. In this case, although a large foreign body penetrated the entire length of the orbit, it did not cause damage to any intraorbital structure. Vision and right ocular globe function had an excellent prognosis.

Romanian medical exposure to ionising radiation in 2012.

Medical exposure, the main source of artificial exposure, shows an increasing trend in the last years, manifested both by increasing the number of examinations with ionising radiation and by increasing the patient dose level. Annual results obtained for medical exposure to ionising radiation based on the data collected from Romanian hospitals are useful for the update of the national database and optimisation of diagnostic procedures in radiology and nuclear medicine. Medical exposure level is expressed in terms of annual collective dose and is evaluated from annual frequencies and the average effective dose per procedure for different types of radiological and nuclear medicine procedures. The Romanian hospitals reported during 2012 a number of 5,505,792 radiological examinations and 17,088 diagnostic procedures of nuclear medicine. Based on the data reported, the average effective doses and their contributions to the collective dose were evaluated. The main contributions to the collective dose of the radiological procedures are registered for CT abdomen and pelvis region, followed by thorax CT and head CT examinations. The next positions are fluoroscopic examination of the thorax and gastrointestinal disease and radiographic examination of the lumbar spine and thorax, which in spite of their low effective dose have an important contribution to the collective dose due to the large number of examinations. For nuclear medicine procedures, major contributions to collective dose are given by bone scintigraphy, followed by PET-CT and thyroid scintigraphy.

Realising the European network of biodosimetry: RENEB-status quo.

Creating a sustainable network in biological and retrospective dosimetry that involves a large number of experienced laboratories throughout the European Union (EU) will significantly improve the accident and emergency response capabilities in case of a large-scale radiological emergency. A well-organised cooperative action involving EU laboratories will offer the best chance for fast and trustworthy dose assessments that are urgently needed in an emergency situation. To this end, the EC supports the establishment of a European network in biological dosimetry (RENEB). The RENEB project started in January 2012 involving cooperation of 23 organisations from 16 European countries. The purpose of RENEB is to increase the biodosimetry capacities in case of large-scale radiological emergency scenarios. The progress of the project since its inception is presented, comprising the consolidation process of the network with its operational platform, intercomparison exercises, training activities, proceedings in quality assurance and horizon scanning for new methods and partners. Additionally, the benefit of the network for the radiation research community as a whole is addressed.

Is prosthetic repair of the abdominal wall in clean-contaminated surgical interventions possible?

The present study tries to provide an expressive, customized answer to the question in the title. The study relies on a ten-year experience (2000-2009), evaluated retrospectively on a group of 488 prosthetic repairs of incisional herniae, out of which 432 were performed in a clean environment and 56 cases in a clean-contaminated one. The two groups are superimposable based on the Apache score. The visceral surgical procedures associated to the surgery of the parietal defect were varied (cholecystectomy, appendectomy, enterectomy enterorrhaphy,colectomy colotomy-colorrhaphy, hysterectomy with adnexectomy). The assessment of postoperative suppurative complications showed no significant differences between the two groups (p 0.001). These results lead us to the idea of defining the indication for parietal prosthetic repair in a contaminated environment. The major factors of this decision are: the nature, the source and the amount of the septicinoculum, the duration of exposure, the intensity of the host inflammatory response (more difficult to quantify), and finally the surgical judgment. The last mentioned factor will evaluate the above-mentioned data and will take into account that not all bacterial contaminations are necessarily followed by an established infection. Thus, additional exaggerations - which would mean taking useless, ineffective precautions- as well as negative exaggerations - which would mean hazardous boldness- will be avoided.

Realising the European Network of Biodosimetry (RENEB).

In Europe, a network for biological dosimetry has been created to strengthen the emergency preparedness and response capabilities in case of a large-scale nuclear accident or radiological emergency. Through the RENEB (Realising the European Network of Biodosimetry) project, 23 experienced laboratories from 16 European countries will establish a sustainable network for rapid, comprehensive and standardised biodosimetry provision that would be urgently required in an emergency situation on European ground. The foundation of the network is formed by five main pillars: (1) the ad hoc operational basis, (2) a basis of future developments, (3) an effective quality-management system, (4) arrangements to guarantee long-term sustainability and (5) awareness of the existence of RENEB. RENEB will thus provide a mechanism for quick, efficient and reliable support within the European radiation emergency management. The scientific basis of RENEB will concurrently contribute to increased safety in the field of radiation protection.

[Family income--nutrition correlation in a group of Negresti Vaslui preschool children]. / Relatia venitul familiei--alimentatie la un lot de prescolari din orasul Negresti judetul vaslui.

UNLABELLED: Growth and development are influenced by genetic and environmental factors. From the environmental factors, nutrition plays a key role and is income dependent. OBJECTIVES: Assessing food intake according to family financial status. MATERIAL AND METHOD: A study was conducted on 134 preschool children (ages from 3 to 7 years of age) from a Negresti kindergarten. Questionnaires were filled by parents for weekly food intake and family financial situation. Statistical analysis used Pearson test. RESULTS: According to income the group is structured in: very low income (32.8%), low income (28.3%), average income (26.8%) and above average income (12.1%). The majority of the families provides milk to their children (58.9%), varying from 54.5% (very low income) to 63.1% (low income). Poultry is present in the diet mainly for 2-3 times per week (45.5%) going from 36.8% in low income families to 55.5% in average income families. Daily fruit intake is present in 59.7% of families, varying from 45.4% (very low income) to 68.7% (above average income). Recorded differences have no statistic significance. CONCLUSION: Families income is different but the nutrition provided to children is similar, being strongly influenced by traditional nutritional habits.

[Pancreatic pseudo-cyst]. / Pseudochistul pancreatic.

Pancreatic pseudo-cyst (PKP) represents a late complication of acute and chronic pancreatitis and of pancreatic trauma. Male sex is predominant (22/27). Average age is 43.9. PKP was most frequently associated with chronic ethylism (16), chronic pancreatitis (14) and acute pancreatitis (9), cancer (1). Ultrasonography (US) is the method used for surgical indication (parietal maturation, content) and lesion follow up. Internal drainage was used for 15 patients: 13 Jurasz cystogastroanastomy and 2 transduodenal cysto duodenostomy. External drainage was used with 9 patients. Topography was: cephalic (4), corporeal (6) corporeo caudal (13); with 4 patients topography could not be set (PKP over 15 cm). Postoperative complications occurred with 7 patients: upper digestive bleeding (4), pancreatic abscess (2), hemi-peritoneum (1). Surgical abstention (3 patients) was determined by: lack of cyst parietal maturation, progressively reduced dimensions and an acute pancreatitis episode. One patient deceased due to haemorrhagic recurrence in tryptic erosion of the portal vein. Surgical decision is supported by US. Surgical tactics shall be adapted to the topography and lesion. Inner derivation represents election indication in mature PKP. In some circumstances, external drainage is however necessary.

[Alloplastic or autoplastic in incisional hernia]. / Autoplastic sau aloplastic în cura eventratiilor.

The study is retrospective and includes 194 patients with incisional hernia (IH). Local and general factors involved in IH pathogeny were tried to be identified, namely tactical and technical solutions for surgically solving the abdominal parietal deficiencies. Main risk factors, for the lot having been studied, are general: obesity, diabetes, cancer and local: wound suppuration, repeated surgical operations, emergency surgery, multiparity and physical effort. Simple suture and aloplastic procedures prevailed being adapted to the type of lesion, intraoperatory identified. For patients with multiple orifices different techniques were used during the same surgical operation.

[The technical modalities of duodenojejunoplasty in large parietal defects of the duodenum]. / Modalitati tehnice de duodenojejunoplastie în defecte parietale mari ale duodenului.

The authors present two technical modalities for solving extensive defects of the duodenal wall which occurred during surgery for large duodenal ulcers, which in one case involved the entire anterior part of D1-D2. In another case the duodenal wall defect was due to tumoral invasion by cancer of the hepatic angle of the colon. The solution consisted in duodenoplasty with excluded intestinal loop in "Y", in the first case, and duodenoplasty on an omega loop associated with GEP in the second case.

Experimental preparation of deantigenized vascular heterografts and study of tolerance after transplantation.

A new technique in preparing a heterograft is presented. Deantigenized calf carotid arteries are obtained by papain digestion and formol tanning. The biochemical determinations show a pronounced reduction in total protein content after papain digestion. The formol tanning gives a good rigidity and elasticity in adapting to different blood volumes without aneurysmal dilatation. Eight dogs were grafted : two died after surgery, two were killed after 35 days and two others 60 days after transplantation, one died after 8 months and one is alive 30 months after transplantation. The good in vivo tolerability has been appreciated. There have been no haemodynamic troubles and no cell changes of rejection. An insignificant quantity of immunoglobulins G has been found in the sera of the animals with heterografts. These data draw attention on the possibility of the use, in clinical practice, of the deantigenized calf arteries.

[Current aspects of infectious mononucleosis]. / Aspecte actuale în mononucleoza infectioasa

The authors discuss present aspects in infectious mononucleosis, with reference to the cases admitted to the Clinic of communicable Diseases of Cluj-Napoca, i.e. 115 cases during the 1954--1973 period (3 to 13 cases a year). In most cases the clinical symptomatology was mild and the laboratory tests typical not giving rise to any diagnostic difficulties. However, 28 cases (25%) presented jaundice, with positive hepatic tests, so that a differential diagnosis was established with viral hepatitis. In 9 cases nervous manifestations were reported: 4 encephalitis, 1 neuritis of the hypoglossal nerve, 2 facial paralysis, 2 benign serous meningitis cases, all of which fully recovered. The Paul Bunnel-Hanganutiu test was positive in titers of 1 : 40 -- 1 : 1280, in all the cases. Corticotherapy was applied with good results in 24 cases. All the cases ran a favourable course. On admission, 45% of the patients came with a diagnosis of infectious mononucleosis; the others were admitted with a diagnosis of : diphteric angina, viral hepatitis, influenza, German measles, mups, typhoid fever, prolonged febrile syndrome.

[Staphylococcal infections in the Cluj-Napoca Clinic of Infectious Diseases during the years 1967-1972]. / Infectiile stafilococice in Clinica de boli infectioase, Cluj-Napoca, pe anii 1967--72.

Over a six year period, in the Clinic of Communicable Diseases of Cluj Napoca, 2301 patients with staphylococcal infections were admitted to the Clinic, representing 8% of the total number of patients admitted, and 3513 staphylococcal strains were isolated. A number of 43 of the 2301 patients died (1.8%), but staphylococcal infection was actually the cause of death in only 35 cases (1.5%) (septicemia, staphylococcal meningitis and pulmonary infections). Eight of the patients died from the basic disease (hepatitis, tetanus, paratyphoid C fever etc.). A number of 2246 Staphylococcus hemolyticus aureus, 80 non-hemolytic Staphylococcus aureus and 162 Staphylococcus albus strains were isolated; most of the strains were resistant to antibiotics in different proportions.