Epidemiological and pathological characteristics of spinal metastases from gastrointestinal cancers - a series of 40 cases.

Spinal metastases from gastrointestinal (GI) cancer are rare and as a result there are only case reports or small series in the literature. The aim of our work was to identify the demographic aspects, the location, and the histopathological aspects of spinal metastases from GI cancers diagnosed and treated in a reference Hospital in Romania over a period of nine years, and comparing the data obtained with those from the recent literature. This is a retrospective case series study on spinal metastases from GI cancers, developed in patients older than 18 years that were surgically treated between January 2013 and December 2021 within three Neurosurgery Clinics from Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iasi, Romania, which is a tertiary Hospital in Romania regarding the surgical treatment of spinal metastases. We included in our study the patient's demographic data (age and gender), clinical data (location of spinal metastases), radiological investigations and pathological features of the lesions. Regarding the immunohistochemical stainings, the following antibodies were used: anti-cytokeratin (CK)7, anti-CK20, anti-CK19, anti-caudal-type homeobox 2 (CDX2), anti-human epidermal growth factor receptor 2 (HER2), and anti-Ki67. Our series included 40 adult patients (≥18 years old) with a male:female ratio of 3:1, in favor of male patients. The mean age of all patients was 66.42 years. The primary sites of spinal metastases from GI cancers were from all segments of the GI system: the most frequent, however, was from the colorectal level (40%) and the least from the oral cavity level (2.5%). The most common site of spinal metastases from GI cancer was predominantly lumbar region (47.5%), and the most frequent histological type was adenocarcinoma (57.5%), followed by hepatocellular carcinoma (27.5%), pancreatic ductal carcinoma (5%) and squamous cell carcinoma (2.5%). Our results have important clinical implications because they suggest that there are certain subsets of patients with certain types of GI cancers that cause metastases in certain regions of the spine.

Anatomical considerations on the masseteric fascia and superficial muscular aponeurotic system.

The masseteric region is considered by the most researchers as a subdivision of the parotideomasseteric region. Because of its surgical significance, we emphasize it has distinctive morphofunctional features. The aim of this manuscript is to highlight particular characteristics of the masseteric region and practical applications of this concept. The material used was represented by 12 embalmed cephalic extremities dissected in "Ion Iancu" Institute of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, 10 operating specimens from the Clinics of Maxillofacial Surgery and Plastic Surgery of the "St. Spiridon" University Hospital, Iasi, Romania, and computed tomography (CT) and magnetic resonance (MR) images from the same patients. Our results underline the importance and individual arrangement of the superficial muscular aponeurotic system (SMAS) of the face, at the level of masseteric region. The superficial fascia facilitates adhesion to the dermis of the mimic muscles of the region. This reveals that the masseteric superficial fascia will follow the masticatory movements of the mandible and masseter, but also those of the minor and major zygomaticus muscles. These muscles are the infra-SMAS layer and thus take part in the formation of a unitary complex together with the superficial fascia. The particularities of the SMAS in the masseteric region are especially important in plastic and reconstructive surgery.

CONSIDERATIONS ON ANATOMY AND PHYSIOLOGY OF LYMPH VESSELS OF UPPER AERO DIGESTIVE ORGANS AND CERVICAL SATELLITE LYMPH NODE GROUP.

The almost constant local regional development of the cancers of upper aero digestive organs requires the same special attention to cervical lymph node metastases, as well as to the primary neoplastic burning point. The surgical therapy alone or associated has a mutilating, damaging character, resulting in loss of an organ and function, most of the times with social implications, involving physical distortions with aesthetic consequences, which make the reintegration of the individual into society questionable. The problem of cervical lymph node metastases is vast and complex, reason why we approached several anatomical and physiological aspects of lymph vessels of the aero digestive organs. Among the available elements during treatment, the headquarters of the tumour, its histologic degree, and its infiltrative nature, each of them significantly influences the possibility of developing metastases.

[Study on the association of imaging and clinical anatomic data in the prediction of difficult intubation]. / Studiu privind asocierea metodelor imagistice cu datele anatomo--clinice în predictia intubatiei dificile.

UNLABELLED: Difficult intubation is a serious challenge for emergency doctors and anesthesiologists. AIM: This study was aimed at investigating the effectiveness of imaging methods combined with clinical anatomic data in predicting difficult intubation by developing a score as thorough and easy to use as possible. MATERIAL AND METHODS: This prospective study was carried out on a series of 121 patients (51 males and 70 females), aged between 18 and 85 years (mean age 45.5 years) in the interval September 2010 0 June 2011. The patients, scheduled for various surgical interventions requiring general anesthesia by oral tracheal intubation, were randomly selected and gave a written consent. Children and pregnant women were excluded. The criteria for clinical anatomic assessment and cerebral and cervical imaging methods were used in all patients. By corroborating these data, a difficult intubation prediction score, named OMLET, was developed. It included 5 parameters: obesity (IMC), Mallampati score (modified), position of the larynx as to the spine, cervicothoracic angle (CTA), and head extension (DTM). Each variable was attributed 0 or 2 points, the highest score being 10 points, the obtained score being directly proportional with the expected difficulty during oral tracheal intubation. RESULTS: Of the 121 patients, 9 were difficult cases, the incidence of difficult intubation being 7.43%. The Cormack-Lehane score predicted a difficult intubation in 11 of the 121 cases (sensitivity 77.78%, specificity 96.43%), while the OMLET score predicted 6 of the 9 difficult intubations (sensitivity of 66.67%, specificity of 95.43%. positive predictive value 54.55%, and negative predictive value 97.27%). CONCLUSIONS: The OMLET score proved effective in predicting difficult intubation expressed in its high specificity and sensitivity, and could be used especially in patients with conditions of the cephalic extremity and neck inevitably requiring before surgery investigation of these areas.

[Anterior cervical spine hyperostosis--a rare cause of difficult intubation in emergency]. / Hiperostoza cervicala anterioara--o cauza rara de intubatie dificila în urgenta.

DISH (Diffuse idiopathic skeletal hyperostosis) of cervical spine is a rare condition which causes dysphagia in 23% of cases and occasionally dyspnea. The authors report the case of a 74 years old male, known with progressive dysphagia and recurrent episodes of dysphonia and dyspnea, who suffered a sudden episode of respiratory distress that need finaly tracheotomy after ineffective attempts of orotracheal intubation.

[Anatomical variations of landmarks in endoscopic surgery of the paranasal sinuses revealed by MRI imaging]. / Variante anatomice ale reperelor din chirurgia endoscopica a sinusurilor paranazale evidentiate imagistic prin RMN.

Continue development of endoscopic techniques of rinosinusal approach involves knowledge about the anatomy of this region, with a three-dimensional orientation before surgery, a therapeutic plan well thought, anticipating the gesture controller, taking into account the particularities of each case. Endoscopic surgical anatomic variants parts at this level can be well identified by imaging methods (CT, MRI). CT study of patients who are candidates for surgery Fess is on top, as the technique of choice. MRI is the imaging method to supply the CT data, providing a study carried out the normal anatomy and standard deviation of the numerous variants, single or in combination. This paper aims a randomized retrospective study of 120 MRI of the head and face region, to investigate and highlight the anatomical variations of structures at this level of impact and those with sinusitis etiopatologia, as well as those with operative risk (bleeding complications, ocular, vital risk) to determine the prevalence in the general population and have to compare the data with the literature. Using all sections (axial, sagittal and coronal) with the aid of different sequences (T1, T2, Flair and diffusion) allowed study of three-dimensional images of whole rhino-sinus-related pathology. Anatomic variations of surgical landmarks have investigated a wide range of expression, which are unique or associated with a complex architecture, with sufficient accuracy and visible on MRI. Their prevalence in the group studied was generally consistent with the literature studied.

[Nickel and magnesium effects in the rat kidney, treated with acid retinoic. Comparative study]. / Efectele comparative ale nichelului si magneziului asupra rinichiului de sobolan Tratat experimental cu acid retinoic.

UNLABELLED: Magnesium and nickel are ions with an important role in the human body, but their effects are not completely understood. AIM: To clarify the actions of magnesium and nickel on the rat kidney, which was experimentally treated with retinoic acid, an important therapeutic agent. MATERIAL AND METHOD: The first lot of animals was the witness lot and didn't receive any substance. The second lot received retinoic acid, 50 mg/kg weight/day for 30 days. The third lot received retinoic acid in the same way and magnesium acexamate, 0.5 mEq /kg weight/day for 30 days. The fourth lot received retinoic acid in the same way and NiCl2, 0.5 mEq /kg weight/day for 30 days. RESULTS: The retinoic acid has a toxic effect on the rat kidney. The magnesium decreases this toxic effect but the nickel increases this toxic effect and destroys some urinary tubes.

[Chief teratogenic factors in facial abnormalities]. / Principalii factori teratogeni la nivelul fetei.

Congenital anomalies of the face mainly originate in chromosomal and teratogenic factors. Cleft lip and cleft palate are common anomalies of the face and palate. Cleft lip, with or without cleft palate, occurs about once in 1000 births. Cleft palate occurs about once in 2500 births. Most cases of cleft lip and palate are determined by multiple factors, genetic and nongenetic, each causing only a minor developmental disturbance. This is called multifactorial inheritance. The purpose of this study is a review on teratogenic factors with action on the newborn face.

[Modern morpho-functional concepts in cephalic arterial distribution]. / Conceptii morfo-functionale moderne in distributia arteriala cefalica.

The present paper provides a general morphofunctional study of the oro-maxillary-facial cephalic arterial area that shows some particular hemodynamic characteristics. The internal maxillary artery supplies a very large territory, with numerous and wide anastomoses. In order to understand the hemodynamic characteristics of this artery, we analyzed some older theories, such as: Ludwig von Bertalanffy's General Systems Theory, Walter Zimmermann's Telome Theory, and some general rheological principles also.