Biomedical subjects

G Dimofte

Publications and source records attributed to G Dimofte.

11 recordsLinked to original sources

PubMed2004

[Changes in contrast sensitivity in glaucoma patients].

OBJECTIVE: To evaluate changes of temporal contrast sensitivity (TCS) in patients with glaucoma. MATERIAL AND METHOD: We measured TCS (for 10, 20 and 30 Hz frequencies) in 57 eyes with glaucoma using a prototype that produces a red colour flicker stimulus (lambda = 626 nm) projected in the central 320 of the visual field. In all patients measurements were undertaken for the visual acuity and intraocular pressure. Also the optic disc was evaluated (including C/D ratio), as well as the visual field using the 24/2 program of the Humphrey automated perimeter. RESULTS: For all tested frequencies we computed sensitivity and specificity of the test S < 0 as diagnostic tool for glaucoma. The sets of determination with 30 Hz flicker stimulus have a validity score of 83.8%. We also evaluated the correlation curves between the S score, C/D ratio and mean deviation from automated perimetry. CONCLUSIONS: Patients with glaucoma present a significant drop of the S score for all three tested frequencies. The S score positively correlates with mean deviation (MD) and negatively with C/D ratio reflecting thus diffuse alterations of the magnocellular system. The decrease of the S score in the 30 Hz set of data is major and S < 0 as a diagnostic test has very good sensitivity and specificity. S score might be used in screening for glaucoma as well as monitoring progression of the disease (rapid test, low cost, good validity).

Analysis of Variance↗

PubMed2003

[Measurement of temporal contrast sensitivity].

OBJECTIVE: The main objective is to present a new prototype designed to test temporal contrast sensitivity, using a flicker stimulus. MATERIAL AND METHOD: We used a radiant surface manufactured with light emitting diode having a dominant wave-length of 626 nm, producing a light spot projected in the central visual field (320). The system uses a flicker stimulus with parameters (light intensity and frequency) that can be varied using a computer. The test group (24 healthy subjects) gave us the possibility to evaluate the test response, to optimise the testing protocol and draw the specific de Lange curve. RESULTS: The test has a very good reproducibility with less then 1% variations between measurements. Distribution of temporal contrast sensitivity follows the de Lange classic curve, the frequencies tested in this experiment being situated on the platou of the curve. We preferred to express the results as minimal light intensity. Within 10 Hz to 30 Hz the results demonstrate little dispersion, with a standard deviation of 0.8% and 2.1% for maximal light intensity of 100% and 50% respectively. CONCLUSIONS: We consider that the prototype can be used for testings of the temporal contrast sensitivity for the central visual field (central 320). The device is simple to use and can well accommodate for outpatient evaluations. We hope that our prototype will be used to monitor minimal changes in the response of the visual system to flicker stimuli.

Adult↗

PubMed2003

[Temporal contrast sensitivity in general population].

OBJECTIVE: To define the normal range of values for temporal contrast sensitivity (TCS) in the general population. MATERIAL AND METHOD: The study group consisted of 140 healthy subjects (280 eyes). Measurements were performed using a prototype designed to produce a red color flicker test (660 nm) with variable frequency and modulation, projected în the central visual field. We conducted test with 10, 20 and 30 Hz with highest illumination level. Subjects have been grouped according to age decades as well as sex. Each group was separately evaluated for distribution type, mean and confidence interval. Statistical differences were assessed using ANOVA with one variable. RESULTS: No significant differences could be found between male and female subjects and the response pattern is very similar în all age groups. Temporal contrast sensitivity presents a normal distribution, with a limited dispersion of data around mean value for the respective decade. TCS slightly decreases with age but correlation parameters do not gain statistical significance. Normal range was defined for age decades using the S score, which quantifies the distance from the mean and as such compensates for the differences generated by the non-linear relationship between age and TCS. The test S < 0 defines pathological circumstances with a specificity of 96.5% at 10 Hz, 99.3% at 20 de Hz and 95.4% at 30 de Hz respectively. CONCLUSIONS: We managed to establish normal TCS range of values for the general population using a test with a very good specificity. These normal values, obtained within a statistically significant group, represent the first step în using TCS în ophthalmologic research. Abnormal TCS changes can now be compared with normal values for each age group.

Adolescent↗

PubMedDate not supplied

TNF alpha and IL-6 involvement in surgical trauma. II. In vitro cytokine production.

The study aimed to correlate TNF alpha and IL-6 dynamics during surgical trauma as well as the changes which appear in the circulating monocytes' response after LPS stimulation in vitro. Three patients with major abdominal operations were chosen and serial blood samples were taken before, during and after the operation. Normal unmatched individuals were used as control group during a two hours bed resting period. Both TNF alpha and IL-6 in vitro production showed similar patterns with an initial drop and almost full recovery 24 hours after the operation. We propose a model for TNF alpha and IL-6 role in trauma induced inflammation.

Abdominal Cavity↗

PubMedDate not supplied

[Efficiency criteria for endoscopic diagnostic in upper gastrointestinal bleeding].

Endoscopy plays a major role in the evaluation of upper digestive haemorrhage. We evaluate the difficulties in the introduction of emergency endoscopy in a period of transition, regarding mentalities and errors generated by the learning curve. The study includes 512 consecutive patients admitted with upper gastrointestinal haemorrhage. We retrospectively evaluate some proposed efficiency criteria for the diagnostic endoscopy: the frequency of incomplete endoscopic evaluation (14%), frequency and causes of endoscopic diagnostic errors (3%), frequency of upper digestive haemorrhages with no detectable source (24.2%) and the indication of multiple endoscopic examination. We discuss the causes responsible for the generation of such problems as well as the dynamics of those during the evaluated period.

Adult↗

PubMedDate not supplied

[Congenital cystic disease of the biliary system in adults].

Congenital cystic disease of the biliary system is a complex syndrome of ectasies of the intra-, extra- or both situation of biliary tree. This disease has an unsure etiopathogeny. It is uncommon through the third age, with a greater incidence in child, teen-ager and young adult. The goal of our study is to evaluate the symptoms, diagnosis, treatment and histological aspects of the congenital biliary cysts. We performed a retrospective study from March 1988 to July 2003 about 11 patients with this disease treated in our surgical clinic. Clinical features, methods of diagnosis and surgical treatment were assessed. All patients were females with mean age 51 years (extreme 26-77 years). The symptoms were: right upper quadrant pain--11 cases (100%), jaundice--6 cases (54.5%), fever--3 cases (27%), palpable abdominal mass--2 cases (18%), weight loss--1 case (9%). The imaging diagnosis was helpful (ultrasonography, CT, ERCP, percutaneous cholangiography and preoperative cholangiography). In concordance with Todani classification the patients were included in the following types: Ia--3 cases (27%), I b--1 case (9%), I c--3 cases (27%), IV a--2 cases (18%), IV b--1 case (9%), V--1 case (9%). All patients were operated on: after cholecystectomy and transcystic cholangiography (11 cases--100%) we performed the total excision of the cyst--9 cases (82%) with choledochal jejunostomy (Roux-en-Y)--6 cases (54.5%), choledochal jejunostomy (omega)--1 case (9%) and choledochal duodenostomy--2 cases (18%). In one case of neoplasic cyst with portal invasion we performed a cyst-jejunostomy (omega) and in one case of Caroli disease with total obstruction of the distal choledoc, the solution of choice was choledocal-duodenostomy. The microscopic pathology of the cyst wall showed: chronic intramural inflammation--9 cases (82%) and the absence of the nervous intramural terminations--1 case (9%). The additional lesions was: hepatic cirrhosis--1 case (9%) and hepatic fibrosis--3 cases (27%). We found three cases with neoplasia: malign cyst with advanced local invasion--1 case (9%), pancreatic carcinoma--1 case (9%) and gallbladder carcinoma (microscopic finding)--1 case (9%). The postoperative morbidity includes biliary fistula--2 cases (18%) and wound infection--2 cases (18%). Long-term follow-up revealed cholangitis in one case--9%. The cystic dilatations of the common bile duct is an exclusive indication for surgery as soon as it was discovered.

Adult↗

PubMedDate not supplied

[Meckel's diverticulum in laparoscopic era].

A recent case of a Meckel's diverticulum diagnosed and successfully laparoscopically treated, triggered off a retrospective study on a series of 34 cases with Meckel's diverticulum admitted to the First Surgical Clinic between 1990-2003. We encountered 12 uncomplicated cases and 22 cases with a large panel of complications: 11 intestinal obstructions (volvulus 9, intussusceptions on a tumor-2), 9 cases with diverticulitis, 1 gastrointestinal bleeding and 1 case with Littre's inguinal hernia. Positive diagnosis was established intraoperatively and the surgical treatment was adapted according to the local situation (excision of the diverticulum or enterectomy). Out of 12 patients with uncomplicated Meckel's diverticulum 8 were subjected to prophylactic excision of the diverticulum. In 6 of these microscopic examinations were inclusions of gastric mucosa. Laparoscopy is safe, relatively inexpensive and efficient in the diagnosis and treatment of Meckel's diverticulum.

Adolescent↗

PubMedDate not supplied

[Abdominal pain in liver cirrhosis patient--an unusual case].

We present the case of a 62 years male subjects, known with liver cirrhosis diagnosed in 2000 during a laparoscopy. The subject presented with important atypical abdominal pain, leucocytosis, thrombocytosis, small ascites; pneumatosis and hydro-aeric images of small intestine at abdominal X Ray, thickened bowel wall at CT-scan. Laparoscopy revealed mesenteric venous thrombosis, intestinal infarction and the standard surgical treatment was enterectomy. Mesenteric thrombosis may rarely occur in liver cirrhosis due to portal hypertension. This rare but severe complication is usually difficult to diagnose..

Abdominal Pain↗

PubMedDate not supplied

[Pancreatic endocrine tumors].

Incidence of the endocrine tumors of the pancreas is about 4 to 10/1.000.000 peoples. We present 10 cases of endocrine pancreatic tumors which were operated in the First Surgical Clinic Iaşi in the last 20 years (1984-2003); these cases represent about 2.21% from all the pancreatic tumors (454 cases). It was 4 insulinoma, 2 gastrinoma, 2 gastrinoma associated with other endocrine neoplasia (Wermer syndrome) and 2 non-functioning endocrine pancreatic tumors. Female/men ratio was 9/1 and median age was about 41.9 yo (27-67 yo). In the four cases of insulinoma (all females) the diagnosis was delayed by two to five years due to misinterpretation of neurological symptoms generated by hypoglycemia. The diagnosis of insulinoma was based on Whipple triad, high plasma insulin levels associated with low plasma glucose levels, as well as the symptomatic relief after intravenous glucose injection. The surgical option was based on biological data, ultrasonography, computed tomography and arteriography. In two cases the localization of the insulinoma was established only by intraoperative ultrasonography. All tumors were localized in the tail of pancreas. In three cases we decided for a distal pancreatic resection with splenectomy and in one case for spleen preserving left pancreatectomy. Postoperative course was uneventful and all the symptoms disappeared. The diagnosis was confirmed on pathological examination in all cases. We also present two cases of gastrinoma with multiple ulcers and multiple surgical interventions for haemorrhage and perforation with peritonitis. Both patients died and diagnosis of pancreatic endocrine tumors was post-mortem. The two patients with Wermer syndrome also had ulcers complicated with haemorrhage and peritonitis and parathyroid adenoma. One case also had ante-hypophyseal and pituitary adenoma and the other had thyroid colloid hypertrophy. We performed left pancreatectomy with spleen preservation in one case and enucleation associated with total gastrectomy in the second case. The two cases of non-functioning pancreatic endocrine tumors had a non-specific symptoms. Diagnostic was established by abdominal ultrasound exam. We performed spleno-pancreatectomy in one case and pancreatectomy with spleen preservation in the other patient. Postoperative course was un-eventful.

Adult↗

PubMedDate not supplied

[Incidence and management of the ovarian fibroma and thecoma. Experience of The First Surgical Clinic Iaşi].

The ovarian fibroma, thecoma and fibro-thecoma are a rare benign tumors growing from the connective tissue of the ovarian cortex. The general surgeon may confront in his practice solid ovarian mass, sometimes in emergency. Between 1995 and 2005, we report thirteen cases of ovarian fibroma (two bilateral) and two ovarian thecoma with mean age 53 years operated in First Surgical Clinic Iasi. Four of them were operated on as emergencies. Clinical ascites are found in three patients with large tumors. The early symptoms were pelvic pain and abnormal uterine bleeding. Patients with large tumors or ascites were admitted with compression symptoms or abdominal distension. Ultrasonography showed a solid uniformly hypo-echogenic mass, with very marked sound attenuation. We performed oophorectomy in six cases (laparoscopic approach in four cases) and salpingo-oophorectomy in nine cases (using laparoscopic stapler in three cases). There were no conversions to laparotomy. In all cases the diagnosis was established by histological examination. Laparoscopic approach is associated with significantly less operative morbidity, less postoperative pain, shorter hospital stays and shorter recovery periods, best cosmetic results.

Adult↗

PubMedDate not supplied

Laparoscopic wedge resection of gastric leiomyoma.

Gastric leiomyoma is a rare gastric neoplasia. The laparoscopic method may treat various gastric tumors, including benign leiomyoma by wedge resection without opening the gastric cavity. The laparoscopic approach to submucosal tumors of the stomach is technically feasible, is safe, and has good postoperative results. It should be considered a viable alternative to open surgery. Herein, we describe a case of laparoscopic wedge resection of gastric leiomyoma.

Aged↗