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Surgeons attempting thyroidectomy need to have a thorough knowledge of embryology, surgical anatomy and variations of the thyroid gland in order to prevent surgical complications. Safe thyroid surgery requires an operative plan, based on anatomical steps which are fallowed in a logical order. Using the correct technique, the thyroid lobectomy and total thyroidectomy, can be performed with minimal risk of injury to the laryngeal nerves, and the parathyroid glands. Using "capsular dissection" and ligating the tertiary branches of the inferior thyroid artery on the gland surface, we can identify and preserve the external branches of the superior laryngeal nerves (SLN), the recurrent laryngeal nerves (RLN) and the parathyroid glands,along with their blood supply. In this paper we describe the technique of total thyroidectomy using capsular dissection, emphasizing on the importance of understanding the surgical anatomy of the thyroid gland. [ABSTRACT FROM AUTHOR]

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Azoospermia is found in 10-15% of infertile men. Azoospermia has been classified as obstructive (OA) (obstruction of ejaculatory and deferent ducts, or epididymis) or non-obstructive (NOA) (due to primary testicular failure or the lack of pituitary/hypothalamus stimulation). The absence of sperm from the semen probe in non-obstructive azoospermia has been associated in over half of the reviewed cases with the presence of sperm in the testes. The development of microsurgery techniques and of ICSI (Intracytoplasmatic Sperm Injection) has been successful in enhancing the possibility for these patients to have biological children using assisted human reproduction. The retrieval of sperm in non-obstructive azoospermia is usually performed using TESE (Testicular Sperm Extraction) or micro-TESE, the latter having clear advantages in the post-interventional recovery of the patient. Sperm obtained through testicular biopsy may be used for micro-injection within the ICSI procedure or can be cryogenically preserved for later use. Rarely, these procedures are used for pure diagnosis purpose. [ABSTRACT FROM AUTHOR]

Acute and chronic parathyroid insufficiency syndromes are ones of the most common complications after total thyroidectomy. Preservation of the parathyroid glands (PGs) and their vascularity is essential in preventing the hypoparathyroidism after thyroidectomy. The location of the PGs varies widely as a result of different degree of migration during embryological development. A basic knowledge of the embryologic development and the anatomical relationships of the parathyroid glands is very important for the detection of the parathyroid glands in normal or unusual location. Using capsular dissection and ligating the tertiary branches of the inferior thyroid artery on the gland surface during thyroidectomy, we can identify and preserve the parathyroid glands, along with their blood supply. In this paper we describe the anatomical relationships of the PGs and the location variability, emphasizing on the importance of understanding the surgical anatomy of the PGs to the performance of safe thyroid surgery. [ABSTRACT FROM AUTHOR]

Copyright of Infectio.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Backgroung: Cervical cystic hygroma is a rare congenital cystic anomaly of the lymphatic vessels, which determines an excessive accumulation of liquid at this level, a cathegory of lymphangiomas. Case report: We report the case of a 14 weeks fetus with this malformation. The particularity of our case derives from the association of cystic hygroma with Down syndrome, complicated with hydrops fetalis, a situation with an extremely rare incidence and unfavourable prognosis. Conclusion: The morphological analysis of affected fetuses with cystic hygroma is important in understanding the evolution in utero of this pathology which is an essential element for a proper management of pregnant women who present fetuses with this anomaly. [ABSTRACT FROM AUTHOR]

The acardiac twin is a rare congenital abnormality that affects one percent of the monozygotic monochoryonic twins and one in 35,000 pregnancies overall. This rare condition is also known as twin reversed arterial perfusion sequence (TRAP), because the acardiac twin (recipient twin) is perfused by its co-twin or pump twin via placental arterial and venous anastomoses. Due to the suplimentary effort of the pump twin to assure a systemic circulation for the recipient acardiac twin, the first may develop cardiac failure, the perinatal mortality varying from 50 to 75%. Another common event in case of an acardiac twin is the preterm delivery. We report a case of an acardiac twin, whose peculiarities that the pregnancy was carried for 36 weeks, more than the gestational ages reported in the literature, and the pump twin was in perfect health. [ABSTRACT FROM AUTHOR]

Authors have conducted a retrospective study based on the clinical experience of 93 patients admitted to IFACF-ORL "Prof Dr. D. Hociota"- Wards I between January 2010 and January 2015 for mucoceles with different localizations. A mucocele is defined as a mucous filled epithelium lined sac. Mucoceles are commonly caused due to obstruction of the drainage channel of paranasal sinuses. These expansive cystic masses are sometimes filled with mucopurulent secretions, sometimes associated bone destruction is also evident. The most frequent topography of mucoceles was in the paranasal sinuses: 38.6 % in the frontal sinus, followed by ethmoid sinus (24.7%-the most uncommon locations were found in the medium and superior turbinate), maxillary sinus (23.6 %), sphenoid sinus (13%) and early mucoceles (3.22 %). The elective radiological investigation in mucoceles is computed- tomography. Almost all surgeries were carried out under general anesthesia, performed with endoscopes, with which all relevant anatomical structures were visualized without difficulty. In conclusion, the endonasal marsupialisation technique is nowadays the surgical approach of choice in most cases. [ABSTRACT FROM AUTHOR]

The aim of this paper was to evaluate the types of pneumatization of anterior ethmoid cells according to their relationship to the fossa of the lacrimal sac. For this purpose, we decided to evaluate 100 computed-tomography examinations of the paranasal sinuses (200 ethmoid masses). The examinations were randomly chosen from our collection and were divided into two groups according to their gender into a male and female group. We evaluated the three types of ethmoid sinus regarding their relation to the fossa and the symmetry between the right and left ethmoid masses using transverse plane acquisitions. Also we compared our results with results from papers with similar topics. [ABSTRACT FROM AUTHOR]

The neuro-oculomotory system is a generic term, adapted to a complex anatomical system, which contains a series of structures of the brain, posterior cranial fossa, middle cranial fossa and cavernous sinus and superior orbital fissure and finally the orbit and extrinsic muscles of the eye. The aim of the study was to create a didactic model presenting, in a new manner, useful for medical students and residents, the descriptive, functional and topographic anatomy of the neuro-oculomotory system, thus helping them in screening oculomotory pathology through imagistic techniques. [ABSTRACT FROM AUTHOR]

Non-obstructive azoospermia used to be considered an untreatable cause of male infertility. By the microinjection technique, sperm that has been surgically extracted from the testis can be injected into the oocyte cytoplasm to obtain an embryo. Severe asthenozoospermia, severe oligozoospermia and azoospermia have all been success fully treated by using the ICSI technique. Sperm retrieval in combination with ICSI is the only medical procedure for an azoospermic man to father a child. Different techniques, especially testicular sperm extraction (TESE), have evolved over time and have dramatically improved the outlook for men with testicular azoospermia. However sperm retrieval rates are associated not only with the operation proposed but especially with a distinct pattern of prognostic factors that must be effectively managed for all these infertile patients for their best benefit. This report is on a case of non-obstructive azoospermia that was successfully treated by testicular biopsy (TESE) with ICSI procedure in private Hospital, MedLife Bucharest. The result is the birth of 2 baby-boys perfectly healthy. [ABSTRACT FROM AUTHOR]

Introduction: Fraser syndrome is a rare genetic multisystem malformation with an autosomal recessive pattern of inheritance that in most cases comprises 3 major defects: cryptophthalmos, syndactyly and renal anomalies. Case report: We report the case of a female fetus with a length of 39 cm and a weight of 1250 g with multiple abnormalities. The abnormal facial features were: bilateral cryptophtalmos, triangular face, low-set ears, broad nose with depressed or flat nasal bridge. The limbs are also malformed, presenting cutaneous syndactyly. We also detected laryngeal stenosis, clitoromegaly, imperforate anus and bilateral renal agenesis. Due to the fact that the specimen met the criteria necessary the diagnosis of Fraser syndrome was established. Conclusion: The case reported is a typical manifestation of Fraser syndrome, a rare plurimalformative disease. The diagnosis was established after an extensive morphological examination that revealed the most frequent anomalies associated with this condition. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea - hypopnea syndrome (OSAHS) is a frequent pathology, affecting an increasing percent of adult population in modern times. The pathophysiology is represented by repetitive episodes of apnea and hypopnea occurring during sleep. The signs and symptoms of OSAHS include increased daytime sleepiness, lack of concentration, morning headaches and a general decreased quality of life. Conservative treatment using Continuous Positive Airway Pressure (CPAP) or its variations is the standard procedure for OSAHS, with good results generally. There are still some cases in which the treatment cannot be used, it is not accepted by patients, or it is not enough for a favorable outcome. In these cases, there are a series of surgical therapies that can be used for treatment, or which can ease the use of CPAP. The goal of this paper is to underline the advantages of surgical treatment for obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Copyright of Practica Veterinara.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future. [ABSTRACT FROM AUTHOR]

Lennox-Gastaut syndrome represents a serious form of generalized epilepsy, with an unknown etiology, characterized by frequent seizures and different seizure types. It is a difficult to treat form of childhood epilepsy that most often appears between the second and the sixth year of life. It is often accompanied by developmental delay, psychological and behavioral problems. This article aims to bring to the attention of a hard case framed in a particular pathology. In this case in the course of the disease were observed plenty of issues that don't fit into the classic defined syndrome. [ABSTRACT FROM AUTHOR]

The ethmoid sinus is considered one of the most variable structures in the human skull. Its variability is mainly determined by pneumatization of ethmoid cells. These variants are important for an academic point of view, but also in medical praxis as the ethmoid sinuses are considered the most important in drainage of the paranasal sinuses. Concha bullosa is one of the most common ethmoid variants and it represents pneumatization in one of the nasal turbinates, usually at the level of the middle turbinate. Causes of development of concha bullosa have been long discussed among anatomists and sinus surgeons, but these causes are still unclear. Also, implication of concha bullosa in development of sinus pathology is still not convincing. This paper reviews accepted theories in development in concha bullosa and statistical data relevant to its implication in sinus and nasal pathology. [ABSTRACT FROM AUTHOR]

The evolution of paranasal sinuses extends over a long period of time, pre- and postnatal, at birth only the maxillary and some of the ethmoidal cells are developed. The goal of this study was to analyze and demonstrate which structures play a promoter role in the evolution and configuration of the paranasal sinuses, and if evolution is determined genetically or by local factors which modify their influence in different moments of prenatal development. Our study was performed on fetal skulls and cephalic extremities (with soft parts) from fetuses of different ages, ranging from 14 to 33 weeks, which were examined by CT and through anatomic, macroscopic and mezoscopic dissection techniques. Pieces were photographed and the images underwent digital processing. The analysis of CT images combined with their corresponding anatomic sections, digitally processed revealed that the soft tissues, especially the epithelial mucosa of the nasal fossae expand and they determine a certain rhythm and amplitude to the process of chondrification and ossification of the surrounding structures, structures which are more dense and take the shape and size of the soft parts surrounding them, in the rhythm these grow and develop. This process is later completed by partial resorbtion of mucosa through a genetic mechanism, often met in organogenesis, called apoptosis. In conclusion, the morphogenesis of the paransal sinuses is genetically determined, but it is also follows the .environmental theory.; the development of the sinuses is related to fetal cranial growth, through all three of its components (basal, capsular and bone resolution), the volume of pneumatic spaces being defined through a process of mucosal resorption, phenomenon which takes place in different moments of pre- and postnatal development (apoptosis). [ABSTRACT FROM AUTHOR]

In rectal cancer lymph nodes invasion is a major independent prognostic factor and is also included in TNM and Dukes staging systems, which differentiate the treatment. Lymphatic pathways of the mid and upper rectum are draining in one upward direction following the superior rectal artery (SRA). Also mesorectum contains multiple lymph nodes. The aim of our study was to evaluate rectal lymph nodes distribution. There were performed multiple dissections on formalized adult and fetuses bodies. After standard abdominal wall incisions the sigmoid and upper rectum were exposed. The superior rectal artery and mesorectum were dissected, sharply dividing the "holy plane" to the pelvic floor and also the pelvic side walls. We considered rectal lymph nodes those described distal to the classic "Sudek point" and those in the mesorectum. There were two males, one female and two fetuses. None of them had recto-sigmoid neoplasm or ano-rectal malformations. In the adults we found multiple groups of lymph nodes on the SRA course but most of them were distal to the SRA dichotomy. The entire mesorectum contained nodes but they were concentrated in the upper part of it. In the fetuses, besides lymph nodes identified along the SRA and in the mesorectum, some iliac and retro-iliac lymph nodes were observed. Most of the rectal lymph nodes were focused posteriorly to the mid-rectum but they exist in the entire mesorectum and along to the SRA. Iliac and retro-iliac lymph nodes developed the idea of lateral lymph drainage of mid-rectum. [ABSTRACT FROM AUTHOR]

The incidence of iatrogenic ureteral injuries varies depending on the type of surgery, however 52%-82% occur during gynecologic procedures. Even if the prevalence of ureteral injuries in oncologic surgery is high, most of the iatrogenic ureteral injuries occur during gynecological procedures concerning benign tumors, especially in patients with modified pelvic structure -- dystocic pelvises. Therefore any surgeon -- gynecologist that performs pelvic surgery may injure the ureter and therefore must have knowledge on the ureteral anatomy and the most common sites of iatrogenic ureteral injuries, especially in dystocic pelvises, so that he may anticipate the occurring potential of a specific ureteral trauma. [ABSTRACT FROM AUTHOR]

Mesorectum, described in Nomina Embriologica, but not in Nomina Anatomica, gained practical significance when Heald found a marked decrease in local recurrence after rectal neoplasms surgery using TME technique with the preservation of intact hypogastric and pelvic splanchnic nerves. The study aim was to provide an anatomic basis for surgical mesorectal dissection and to find a correspondent of it in the fetal life. There were performed dissections on human cadavers kept in formaldehyde. Two fetuses were also included. After standard abdominal incisions and flap removal, the rectosigmoid junction was exposed. Next to mesosigmoid incision, the left ureter and the superior rectal artery (SRA) have been identified. The rectal dissection was circumferentially conducted to the levatorani. The fetuses were examined by taking pictures with a high resolution macro lens. All bodies contained mesorectum as a perirectal adipose structure containing blood vessels and lymph nodes. All cases clearly delineated a lower limit of the mesorectum, the levatorani; an absolute upper limit couldn't be distinguished, however the lower mesosigmoid was considered the upper limit. The "holy plane" has been identified by dissecting down through the SRA plane. At least one hypogastric nerve was identified in all cadavers. A pelvic splanchnic nerve was discovered in one of the bodies. No middle rectal arteries were found. The mesorectum was also highlighted in fetuses as a real mesentery. As a result, the mesorectum was clearly identified as an individualized structure in the pelvis. Dissection in the "holy plane" was successfully accomplished without damaging the important vascular-nervous structures. [ABSTRACT FROM AUTHOR]

We present a case of complete unilateral absence of the trapezius muscle associated with the presence of the cleidocervical muscle found in a female cadaver during routine dissection in our University. Complete unilateral absence of the trapezius muscle is a very rare variation and to our knowledge there were only few other cases reported. The cleidocervical muscle is a rare supernumerary muscle that occurs in the posterior triangle of the neck. This muscle appears regularly in anthropoid apes and most mammals, but rarely appears in modern man. We consider that the absence of the trapezius and the presence of the cleidocervical muscle on the same side are probably related. [ABSTRACT FROM AUTHOR]

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The ethmoid sinuses are pneumatic cavities situated in the lateral masses of the ethmoid bone. High variability of ethmoid development, often creates confusion and uncertainty among sinus surgeons. The objective of this study was to measure different important ethmoid mass dimensions using computed-tomography on 192 ethmoid lateral masses. We measured the anterior- posterior dimensions of the ethmoid lateral mass and of the anterior ethmoid, and also the height of the ethmoid mass in relation to the lamina cribrosa and skull base. No significant differences were observed between dimensions on the right and left sides. [ABSTRACT FROM AUTHOR]

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ovarian cysts are one of the most common conditions in females. However due to appropriate screening programs giant serous ovarian cysts are rare. We report the pre-, intra- and postoperative management of 52-year-old patient diagnosed with a giant pelvic-abdominal mass. With high risk consent, a voluminous ovarian cyst of approximately 16 kg was resected without severe complications. The management of patients with giant ovarian cysts requires a multidisciplinary approach in order to decrease the risk of multiple complications that can appear during the ablation of such a tumor. [ABSTRACT FROM AUTHOR]

Introduction: There are currently two theories regarding the origin of the transverse humeral ligament . the classic theory sustains that transverse humeral ligament is a distinct structure that acts as a retinaculum, maintaining the long head of biceps within intertubercular groove. However recent macroscopic studies concluded that no distinct transverse humeral ligament could be identified and hypothesized that is actually a fibrous expansion originating from the tendon of subscapularis muscle. Materials and methods: In this study, we dissected twelve formalin-fixed cadavers and highlighted the transverse humeral ligament, analyzing its origin and insertion. Conclusion: due to both macroscopic, but especially microscopic examination, we concluded that transverse humeral ligament does not exist as a distinct structure. [ABSTRACT FROM AUTHOR]