Sudden death from ruptured choroid plexus arteriovenous malformation.

Brain vascular malformations are recognized as having potential to produce hemorrhage, but leading to sudden death in children is uncommon. Arteriovenous malformations may be situated in any region of the brain, but very rarely, they can be restricted to the choroid plexus. We report here a rare case of sudden death in a child, caused by a ruptured vascular malformation with an unusual location, which was not identified grossly but only on histological examination. The size and the location of the lesion, as well as the age of our patient, were contributing factors of the massive bleeding. Autopsy remains an important tool because it provides valuable information about the etiology of such bleedings, improves knowledge about these lesions, and enhances epidemiologic data.

Surgical Treatment of Dermatofibrosarcoma Protuberans Using a Reversed Adipofascial Sural Flap - Case Report.

Dermatofibrosarcoma protuberans is a rare superficial tumor characterized by high rates of local recurrence and low risk of metastasis. Dermatofibrosarcoma protuberans occurs most commonly on the trunk and proximal extremities, it affects all races, and often develops between the second and the fifth decade of life. The tumor grows slowly, typically over years. We present a rare case of a young male patient, 21 years old, with an asymptomatic calf tumor which was suspected to be an angioma, but after the initial excision histology and imunohistochemistry proved to be a Dermatofibrosarcoma protuberans without safety limits. After 2 weeks, we excised the remaining scar with 4 cm tissue limit and the defect was covered using an adipofascial reversed sural flap from the posterior part of the left calf and after another 2 weeks we applied a skin graft from the thigh. The patient had a good evolution, with full recovery, without local recurrences or metastasis, and the histology was within good safety limits.

[The influence of ocular surgery for lacrimal secretion]. / Influenta interventiilor chirurgicale pe gldb deschis asupra secretiei lacrimale.

Dry eye syndrome remains a constant health problem while more and more patients are being involved and final data concerning the etiopathology is still missing. This study investigates the hypothesis that ocular surgery inflicts damage on the tear production (regarding quantity, quality or the compositional aspect). Ocular symptoms were registered with the help of a questionnaire. Lacrimal tests were applied before and after surgery at 6 weeks. Basic and reflex tear secretion was differentiated through Schirmer tests and tear quality was assessed with BUT. Proteomic analysis (global proteins, electrophoresis) and conjunctival biopsy was realized before surgery. Open eye surgery altered tear secretion in 91% of the 22 patients examined.

[Dry eye--etiopathogenic and histopathologic correlations]. / Ochiul uscat--corelatii etiopatogenetice si histopatologice.

AIMS: To assess the role of the common inflammatory mechanism in the pathogenesis of the dry eye syndrome. METHODS: 64 patients with eye surface symptoms were studied using a diagnostic algorithm: questionnaire (eye symptoms were graded and a symptomatology SCORE was calculated), objective eye examination (including Schirmer's test and the tear film breakup time-BUT). Histopathological examination of 14 conjunctival bioptic fragments was performed. RESULTS: 59.37% of the patients had a positive Shirmer's test, while only 23% tested positively for the BUT. No statistically significant correlation was established between Schirmer's test and the BUT or the symptomatology SCORE. There was a significant correlation between BUT and the symptomatology SCORE (p<0.05) and between BUT and the duration of the disease (p<0.01). The histopathological examination of the dry eye conjunctival samples evidenced the following alterations: loss of calyciforme cells, squamous metaplasia of the epithelium, subepithelial inflammation. CONCLUSIONS: The histological analysis confirms the implication of inflammation in the pathogenesis of the disease. The time of onset of the inflammation cannot be established, it may be initial or it may occur with the quantitative decrease of tears or with eye surface alterations.

[Changes in lacrimal secretion in rabbits according to meibomian glands activity]. / Variatia secretiei lacrimale la iepuri în functie de afectarea glandelor accesorii meibomiene.

PURPOSE: The purpose of this issue is to create an experimental animal model of dry eye and study the alteration of lachrymal secretion in time. MATERIALS AND METHODS: We used a group of 8 rabbits in which the Meibomian gland orifices of the right eye were individually closed by cauterization, the results being related to the sound left eye. RESULTS: We studied: the quantitative alteration of the lachrymal secretion using Schirmer 1 test; the alteration of lachrymal film using rose-bengal and fluorescein staining; the variation in tear protein concentration and histopathological changes in conjunctiva. CONCLUSIONS: We found histopathological changes in conjunctiva and in the lachrymal secretion consisting in conjunctival goblet-ceil density decrease and watery secretion increase, probably due to lachrymal viscosity decrease mechanism.

[Keratotic basal cell carcinoma with orbital extension--case report]. / Carcinom bazocelular keratotic cu invadare intraorbitala--caz clinic.

This is a description of a case of a 72-year-old female who developed a basal cell carcinoma of the external angle of the eyelid, with intraorbital extension. This type of cancer of the eyelid developed on keratotic skin lesions of the face; the invasion of the orbit occurred only for two years. The tumour of the eyelid and orbit was completely removed with good postoperative course and a good outcome without recurrence in the past 3 years.

[Intraocular mass lesion--case report]. / Leziune de "masa" a globului ocular--prezentare de caz.

The authors present a case of a 27 years old patient, admitted in the Ophthalmological Department, presenting an intraocular mass lesion of the right eye, which consist of 2 different tumours of the eyeball (with different shape and location). The patient presents scleral staphiloma due to the intraocular tumours of the eye ball, the change of the shape and colour of the anterior aspect of the eye, loss of vision for two months. The complementary examinations for the diagnosis, that have been done (A Scan and Bscan, MRI of the eye ball) pointed to a possible choroidal hemangioma of the middle tunic of the eyeball. This diagnosis was confirmed by the histopathologic exam after surgery.

[Complications of palpebral epitheliomas: diagnostic, therapeutic, and prognostic implications]. / Complicatii ale epitelioamelor palpebrale--implicatii diagnostice, terapeutice si prognostice.

PURPOSE: To illustrate two cases of palpebral tumors that determined local complications, with consequences on the preoperative diagnosis and the surgical treatment (case 1) and on the functional prognosis of the eye (case 2). METHOD: The history and evolution of the cases, the surgical techniques, the histopathological reports and the anatomical and functional results are described and analyzed. RESULTS: In case 1, the extension of the tumor led to a considerable tissular defect that claimed for a long and hard surgery for the anatomical and functional repair of the region. In case 2, the vegetant evolution of the tumor determined the irritation of the cornea and consecutive corneal ulcer that perforated, with the functional loss of the eye. CONCLUSIONS: The two cases are revealing aspects that are less frequent in the ophthalmic practice. They signalize, besides the deffisient adresability of the patient, the problem of the "territorial dispute" over the palpebral surgery between different specialties.