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Summary. Background: Chronic venous insufficiency (CVI) results when the veins in the legs no longer pump blood back to the heart effectively. Microparticles (MPs) are small membrane vesicles released by several circulating and vascular cells upon activation or apoptosis. Objectives: The purpose of this study was to assess the subpopulations of circulating endothelial (EMPs) and platelet microparticles (PMPs) in CVI, and to disclose their contribution in mediating dysfunction of human peripheral venules. Patients and methods: Human peripheral venules were explanted during leg surgery on patients with CVI and on control subjects (C); concurrently, blood samples were collected and circulating MPs isolated. The techniques used were: flow cytometry, fluorescence and electron microscopy, myograph technique and western-blotting technique. Results: The results showed that compared with controls, patients with CVI had: (i) a marked elevation of circulating EMPs and PMPs; (ii) a structural modification of the venous wall consisting of activation of endothelial and smooth muscle cells, an abundance of intermediary filaments and synthesis of hyperplasic-multilayered basal lamina; (iii) a significantly altered reactivity of the venous wall, closely associated with EMPs and PMPs adherence; (iv) altered contractile response to noradrenaline, acetylcholine, 5-hydroxytryptamine and KCl, and an impeded relaxation in response to sodium nitroprusside; and (iv) a substantially increased protein expression of tissue factor (TF) and of P-Selectin both in the venular vascular wall and on the surface of EMPs and PMPs. Conclusions: The findings indicate that CVI is accompanied by an enhanced release of EMPs and PMPs that contribute to altered dysfunctional response of the venous wall.

Radiofrequency ablations (RFA), a new therapeutic option for liver metastases, proceeded by open surgery or laparoscopic approach, provide an acceptable control of local tumor process, involved lower risks than resection surgery.We analyzed this procedure, for classic indication in hepatic metastatic tumors, based on four years experience, focused on perioperative complications, recurrence rate and long distant evolution.Between December 2006 and December 2010, 61 patients with liver metastases underwent RFA; 46 cases had metastatic lesions from colo-rectal cancer, 9 cases from breast cancer, 4 cases from gastric cancer and 2 cases from ovarian cancer. RFA was performed in 55 patients via open surgery and laparoscopic approach in 6 patients. Postoperative course was followed with CT scan at 1 month, and then at 3 month interval, in correlation with tumor markers level.Perioperative complications occurred in 8 cases, consist of prolonged fever, severe hepatic cytolysis, without other complications such, biliary tract injury, hemorrhage, and peritonitis; no mortality caused by RFA procedure. 10 cases had local recurrence, at 6 and 25 month after post RFA procedure.Initial experience shows that RFA is a safe procedure for treatment of liver metastases, with low rate of morbidity and local recurrence, indicated for patients with unresecable lesions or high risks for surgical resection.

This study aimed to evaluate the optimal conditions for laparoscopic management of neonatal subacute volvulus with malrotation.Between 1994 and 2002, 13 neonates with midgut volvulus and malrotation entered the authors' institution. Five of these neonates met the eligibility criteria for laparoscopy: good hemodynamic parameters, no gut perforation, and no severe ischemic distress of the bowel shown on preoperative ultrasonography.The results were excellent for only three infants, associated with a shorter postoperative course. One underwent reoperation for a residual duodenal band, and one conversion to open laparotomy was necessary. The predictors of success were no difficulty identifying the abnormal anatomy, no important chylous stasis, and the learning curve of the surgeon.Despite its previously reported feasibility, neonatal laparoscopy for volvulus with intestinal malrotation is appropriate only for a small number of patients. Strict selection criteria with a clear understanding of the optimal conditions for success may improve the outcome.

The Adrenal glands can be viewed as sustaining vital processes in the human body, through two different but related components: the cortex and the medulla. It is well known that the close connection between the cortical cells is able not only to support the adrenal functions, but in the same time to serve the better understanding of the normal way of its hormonal production. Using the ultrastructural study of the adrenal gland, we obtain images which can provide informations about details of the cellular structure, in the eventuality that all this work will continue to improve to the point that we might be able to completely understand the complex interrelations between the structure of each cell and the function of the whole organ.

We evaluated the frequency of elevated intraocular pressure (IOP) the first 1-3 postoperative days for a group of patients undergoing standard or phacoemulsification extracapsular cataract extraction (ECCE). IOP was measured in the pre and postoperative period using non-contact tonometer. From the 356 operated patients, 21 patients (6%) had early elevated IOP. The frequency of elevated IOP was greater among the patients that received anterior chamber (AC) IOL (25%) as compared to that of patients that received posterior chamber (PC) IOL (5.5%). The viscoelastic substance was responsible for a great percentage of cases (51%). The results show that the majority of elevated IOP is transient, recovered spontaneously or by treatment with carbonic anhydrase inhibitors or beta-adrenergic blockers. Elevated postoperative IOP occurs more frequently in the presence of glaucoma, cataract associated with systemic diseases, in complicated and traumatic cataract.

This paper presents theoretical aspects concerning the physiopathological mechanisms involved in producing the glaucoma following trauma, especially the lens related glaucoma, correct identification of the ethiopathogeny of the intraocular pressure elevation in this situation is essential for the appropriate management. These aspects are illustrated by two cases of recent glaucoma following trauma lens related (lens subluxation) treated by medication and surgery. The surgical procedure consisted of intracapsular extraction of the lens, anterior vitrectomy, iridectomy and implantation of sulcus sutured posterior chamber lens. We present the technique, the difficulties met intra- and postoperative, evolution and prognosis.

The most important factor for functional and anatomic prognosis of an injured eye is the appropriate emergency assistance. This paper presents a case of penetrating ocular trauma with minor clinical sings which associates severe lesions of posterior pole discovered intraoperatively. Careful history and clinical examination allowed the best surgical management, with complete anatomical and functional recovery of the eye.

Ocular onset is seldom for an arachnoid cyst. We present the case of a young man whose only symptom when hospitalized, was the unilateral peripheral field contraction. It was afterwards specified the presence of the arachnoid cyst and it's pathogenic feature, the compression of the optic nerve.

This paper presents the case of a pacient operated for organized hemoftalmus after central retinal vein thrombosis (total vitrectomy) and whom five days after surgery a macular hole was observed and internal indendation with gas was performed. Postoperative evolution was good. Two months after surgery the pacient returns with cvasitotal regmatogen retinal detachment. The possible causes in bringing about of the retinal detachment in this case will be discussed as well as the factors that condition the success in posterior pole surgery.

This paper presents two cases of corneal abscess and their therapeutically approach which was the surgical treatment (penetrant keratoplasty). First case was a corneal ulcer which failed to abscess under medical therapy. The second case was a corneal abscess complicated with impending perforation after intracorneal foreign body. The particular aspects for each case are emphasized as well as the common aspects for corneal infections summarized as an algorithm.

Fine-needle biopsy is used in the thyroid pathology especially for the differential diagnosis concerning malignant lesions. From a total of 59 cases of thyroiditis, in 12 was possible to proceed to fine-needle biopsy, in large goiters and nodules larger than 1 cm in diameter; in these cases were obtained smears, stained in May-Grünwald-Giemsa technique. In 9 cases of the 12 investigated, in the smears appeared lymphocytes and macrophages, cells commonly found in the infiltrates of the thyroid gland, in autoimmune thyroiditis, and sometimes also few normal thyrocytes. Fine-needle biopsy is important in the diagnosis algorithm of the thyroid nodules, involving 4, up to 7% of the general population. It has also the advantage of reducing the number of cases solved by surgical therapy, as it is the case with the diagnosis of Hashimoto's thyroiditis.

This work is based on dissection and the analysis of the arteriographies of two mesenteric arteries and it analyses the type of intermesenteric anastomoses and their importance in surgical practice. The morphological varieties of Riolan's arcade depends on its pillars, as well as on the eventual presence, especially in the middle part of the transversal mesocolon, of the secondary arcades; it seems that the colic wall necrosis depends less upon the location of the lesion or the level of the suture of the arcade, but more so on the stretch of the destruction of the mesocolon. The intermesenteric trunk, a second way of intermesenteric anastomoses is a embryological remaining, non-functional in normal conditions, but capable to partially or completely replace the Riolan's arcade when the later is sutured or interrupted.

The selection of the material for this study was governed by the idea that at the newborn like at the adult, the cortex of the adrenal gland is complete, including all the three zones, while medulla is not structured until 12-36 month; for this reason, we used only the cellular cortical elements. The quantitative method of evaluation of the cellular diameter, as well as the interpreting and correlation of the values with age, have confirmed that the dynamics of the cellular components of the adrenal gland depends on age, indicating significant differences. The cell diameter is usually bigger at the newborn compared with the adult (with zonal variations). The variability is relatively small which means that the individual values are placed in a limited field.

The aim of our study is to point out the influence of the cerebral development on the evolution of the middle cerebral artery (MCA) system. Brains of 20 fresh fetuses (16-22 weeks) were injected with gelatin-ink China mixture, observed and dissected under surgical microscope in correlation with the evolution of the sylvian fossa. Ending pattern of MCA and territories of distribution of its branches were also discussed.