Biomedical subjects
Publications and source records attributed to D Chirilă.
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.
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.
We studied a group of 162 patients(89 females, 73 males), with ages between 15-30 years, who complained of blurred vision at near work. 98 patients(60.4%) were diagnosed with convergence insufficiency (C.I.), the rest of 64 patients(39.6%) had: low refractive errors, heterophoria and intermittent heterotropia. Patients with convergence insufficiency were divided in 3 groups: group 1(34 patients--34.6%) were treated with orthoptic exercises and near point exercises at home, group 2 (34 patients--34.6%) were treated with only near point exercises at home and control group 3 (30 patients--30.8%) without treatment. The result of the treatment of C.I. was good at 25 patients(73.5%) of group 1, at 8 patients(23.5%) of group 2 while in group 3 at only one patient the symptoms disappeared.
We present the case of patient D. E., 48 years old, whose diagnosis is nonfunctional pituitary adenoma. The diagnosis was revealed by the presence of bitemporal hemianopia. This observation led us to remember the principal neuro-ophthalmological manifestations and to emphasize the part of the ophthalmologist in the diagnosis of this disease.
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.
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.
Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome that affects a significant percentage of the total cancer population but is not easily recognized because of the lack of a distinctive clinical marker such as multiple polyps. The authors present a clinical case of HNPCC sustained by clinical evolution, histologically and therapeutically verified. It has followed for 7 years, and related to the family pathological pedigree covering 3 generations. The case has been identified using the Amsterdam criteria, consisting in: (1) 3 or more relatives with histologically verified colorectal carcinoma, 1 of whom is a first-degree relative of the other two: (2) colorectal carcinoma involving at least two generations; (3) one or more colorectal carcinoma cases diagnosed at less than 50 years of age. The diagnosis of HNPCC requires the demonstration of vertical transmission of the syndrome in the family pedigree.
We have presented two cases of traumatic diaphragmatic hernia which have been diagnosed and operated in late stages, 6 months and 4 years, respectively, after the abdominal and thoracical traumatism causing diaphragmatic injure. The diagnosis was based on clinical and imaging results, while the treatment was meant to reduce the herniated organs in the abdomen and the closing up of the diaphragmatic defect, followed by good postoperative results. We have discussed the peculiarities of both case, the difficulty of early diagnosis and the techniques used to treat these cases. We have also presented data regarding posttraumatic diaphragmatic hernia and their treatment techniques.
The authors present two cases of congenital choledochal cysts treated by cyst excision with Roux-en-Y hepaticojejunostomy, followed by good postoperative results. One of the patients has been treated by early excisional procedure, while the other has initially undergone an enteric drainage by cystoduodenostomy, followed by complications, which required reoperations after 18 months. We have evaluated the peculiarities of both cases, the present data revealed by literature regarding biliary carcinogenesis related to congenital choledochal cysts, their classification according to pancreatobiliary malunion, as well as the treatment of choice in choledochal cysts, meaning excisional procedure with Roux-en-Y hepaticojejunostomy to prevent the risk of postoperatory complications which might appear after plain enteric drainage of the cyst.