Genome-wide profiles indicate wolf population connectivity within the eastern Carpathian Mountains.

The Carpathian Mountains provide critical wildlife habitat in central Europe, and previous genome-wide studies have found western Carpathian Mountain wolves (Canis lupus) to be a separate population. Whereas differentiation to the north may be explained by a lowland-mountain transition and habitat fragmentation, the eastern Carpathian Mountains extending through Romania appear to offer continuous wildlife habitat southward. Our objective was to assess gene flow patterns and population connectivity among wolves in Romania, western Ukraine, and the Republic of Moldova. We sought to determine if the Carpathian Mountain region is best described by a north-south gradient in genetic profiles, or whether Romanian wolves show population structure with northern individuals clustering with western Ukraine. We genotyped 48 individuals with 170 000 single nucleotide polymorphism markers, and successful profiles from Romania (n = 27) and Moldova (n = 2) were merged with existing data from western Ukraine (n = 10). Expected heterozygosity was 0.234 (SE 0.001) for Romania and 0.229 (SE 0.001) for western Ukraine, whereas observed heterozygosity values were 0.230 (SE 0.001) versus 0.231 (SE 0.001). Population structure analyses with a maximum likelihood method supported K = 1 population, followed by K = 2 where Romania formed one cluster, and western Ukraine and Moldova formed another. Principal component analysis results were broadly consistent with K = 2. Pairwise FST between western Ukraine and Romania was 0.042 (p = 0.001). Our findings indicated weak population differentiation, and future research may clarify whether the spatial distribution of genetic diversity in the region is associated with environmental and ecological factors such as terrain ruggedness and the distribution of prey species.

Pre-operative transthoracic real-time three-dimensional echocardiography for a better surgical strategy.

UNLABELLED: In this study we aimed to evaluate the three-dimensional (3D) transthoracic echocardiography (TTE) in the assessment of cardiac valve morphology. METHODS: Bidimensional (2D) and real-time 3D TTE was performed in 104 patients consecutive with cardiac catheterisation, prior to valve surgery. Using surgical findings as the gold standard, 2D and 3D TTE were compared for adequate recognition and accurate detection of morphology. A scoring protocol was used for recognition of the valvular segments (0= inadequate, 1 = adequate). RESULTS: Adequate echographic visualization of the valve segments was more frequently obtained by 3D than 2D TTE imaging (731/770 by 3D TTE vs. 693/770 by 2D TTE, p < 0.01). The valve leaflets segments were more clearly identified by 3D TTE rather than by 2D TTE (502/531 vs. 471/531, p <0.01). The assessment of commissures was similar by both methods (229/239 vs. 222/239, p=0.09). Total 3D TTE scores for mitral and aortic valves were significantly better than 2D ITE scores (mean score 12.91+/-1.62 by 3D vs 11.58+/-1.02 by 2D, p=0.02). This superiority of 3D TTE was irrespective of rhythm (p <0.05 for both sinus rhythm and atrial fibrillation). Using surgical classification of valvular disease as gold standard, the sensibility and specificity were 91% and 84 % for 3D TTE, and 85% and 77% for 2D TTE, respectively. CONCLUSIONS: Real-time 3D was superior to 2D TTE forthe accurate localization and identification of valvular pathology, irrespective of heart rhythm.

[Right exophthalmos to a retro-olivary ischemic stroke]. / Exoftalmie ipsilaterala unui accident ischemic bulbar retrolivar--prezentare de caz.

The author presents the case of a healthy young man with an acute onset of an inferior brainstem symptoms. The clinical examination suggests a right Wallenberg syndrome associated with an unexpected ipsilateral exophthalmos MR Imaging confirms the location of the vascular ischemic lesion and, in addition reveals the cause of the right exophthalmos.

Control of blood-transmitted infections in dentistry.

As knowledge has accumulated on the blood-transmitted pathogenic agents, the contact with biological fluids (blood, plasma, saliva, etc.) from apparently healthy individuals has started to be regarded as a real professional risk for dentists. Theoretically, exposure to a contaminated biological specimen may have as a consequence transmission of infection from patient to dentist, from dentist to patient and from patient to patient via inadequately decontaminated and sterilized dental equipment. The present study is concerned with the analysis of the specific conditions that favor the occurrence of the epidemic process, the estimation of the risk degree of transmission of infections caused by hepatitis B, C viruses as well as of HIV infection in Romania. The data for the study were collected using two processes. First a self reporting survey and secondly an experimental procedure were performed. The testing of dentists' knowledge of blood transmissible diseases and infection control in their offices were performed using a questionnaire with 129 questions. The professional incidents/accidents representing a potential risk were counted using a questionnaire (with 37 questions). Serological markers were tested with ELISA kits. The monitoring of sterilization was accomplished with a questionnaire and biological tests. Many conclusions result from the study. There is an extremely reduced probability and infection transmission from the dentist to the patient. The transmission of infection from the patient to the dentist represents a low risk (for all that, the risk should not be minimized). The rigorous control and observation of infection prevention measures in dental offices is necessary to stop the infection transmission from patient to patient. The dentists' postgraduate training in infection control measures should be completed with knowledge regarding the blood transmissible infections epidemiology. Learning more about the epidemiological process enables the dentists to avoid wrong attitudes and behaviors.

[Biosafety and biosecurity in the medical laboratory. Update and trends]. / Biosiguranta si biosecuritatea în laboratorul medical. Actualitati si tendinte.

Biosafety includes the protective measures against the risks of contamination with pathogen germs in the laboratories that handle pathogens, or stock or manipulate potentially contaminated products, or perform microbiological tests for medical or scientific research purposes, as well as the means of protecting the environment and the human collectivities against hazard contaminations that have as starting point these laboratories. Besides, lately, a new notion emerged, that of biosecurity, which refers to the sum of measures designed to protect workers, environment and population against the loss, theft, use and release in the environment of pathogenic biological agents. The work overviews the present concerns for the regulation of these two notions and the way in which a system for the management of the biological risks in a laboratory that handles pathogens should be documented and implemented. The need for the continuous professional training of the staff and for the establishment of individual and collective responsibilities for preventing biosafety incidents and trespassing biosecurity rules are as well emphasized. The main biosafety measures are pointed out and a series of considerations regarding biosafety and bioterrorism in correlation with the medical laboratory are as well mentioned.

[Phenotype characterisation of Enterococcus spp. strains isolated from urocultures]. / Caracterizarea fenotipica a unor tulpini de Enterococcus spp. izolate din uroculturi.

OBJECTIVES: Our aim is to comparatively study the susceptibility to antibiotics of Enterococcus spp. strains isolated from urocultures of patients admitted in the urology department, as well as from ambulatory patients, and also to establish the resistance phenotypes of these strains. MATERIALS AND METHODS: We studied 33 strains of Enterococcus spp.: 10 isolated from a total of 1889 urocultures from ambulatory patients (of which 431 positive) and 23 isolated from 1871 urocultures from patients admitted in the urology department (of which 462 positive). The antibiotic susceptibility was realised by Kirby-Bauer disk-diffusion tests. Statistical analysis of the antibiograms and determining of the resistance phenotypes were performed with automatic reading methods (Osiris--Bio Rad Laboratories), according to the CLSI/NCCLS standard. RESULTS: The wild phenotype was present in 60% of the strains isolated from ambulatory patients, and only in 39.13% in patients admitted in the urology department. In the urology department a multiresistant strain was isolated, displaying Van A (VRE) phenotype, to which was added resistance to beta-lactams, aminoglycosides, macrolides, tetracycline and nitrofurans. CONCLUSIONS: In the past decades urinary tract infections with Enterococcus spp., especially the nosocomial ones, have become serious health issues because of the increasing number of cases and the difficulty of treatment of infections caused by multi-resistant strains. In order to limit the spread of these strains, especially VRE strains, in the hospital environment, efficient measures must be instituted for the control of nosocomial infections, accompanied by policies for the rational use of antibiotics.

A new indicator reaction for kinetic determination of traces of cobalt.

The reduction of dissolved oxygen by SO(2-)(3) in feebly alkaline media is catalysed by Co(2+) ions. By use of an electrochemical sensor for oxygen, the optimum analytical conditions for determining traces of the catalyst have been established. At 25 degrees the optimum conditions are pH = 8.25 and [SO(2-)(3)] 1.25 x 10(-3)M. Under these conditions cobalt may be determined in the range 1-7 x 10(-7)M.

Design and preliminary evaluation of a portable instrument for assisting physiotherapists and occupational therapists in the rehabilitation of the hand.

This paper describes a portable instrument designed to monitor progress accomplished by patients participating in a hand rehabilitation program. The instrument is driven by a microcontroller and features signal conditioning circuits to measure and record the strength and duration of hand contractions. An alphanumeric display provides the patient with performance indications to allow biofeedback reinforcement, and clear instructions on how to perform the prescribed exercises. Exercise data acquired by the portable instrument can be transferred to a host computer for analysis and archival storage. Results of a preliminary clinical evaluation in 14 patients are presented.

Gastric lipoma and mucocele of appendix. Case history.

An interesting coexistence of two rare diseases in the same patient is presented. A 51 year old female was operated for a benign tumor of the stomach, a lipoma of about 5 cm of the gastric antrum. After the tumor removal, a mucocele of the appendix was surprisingly found, for which an appendectomy was necessary. The clinical course was uneventful and one year after the operation the patient is in a good state of health. A short review of the literature accompanies the description of the case.

Noma (Cancrum Oris) associated with Kwashiorkor: a case report and review of the literature.

Noma (Cancrum Oris/Ulcerogingivostomstitis) is a rare devastating grangrenous orofacial disease. It may lead to severe facial mutilation and deformities with dysfunctional effects. This disease primarily affects malnourished children from underdeveloped countries. It has recently been associated with AIDS in North America and Western Europe. We will be reporting and discussing the pathogenesis, bacteriological complications and treatments according to the literature.

A complication of mesenteric lymphangioma: case report and brief review of literature.

Mesenteric lymphangioma (ML) has only rarely been reported in the literature. These cases are rare enough to arouse interest when encountered. Usually, the cases are asymptomatic but may present with acute or chronic intestinal obstruction. We report an additional case of ML associated with intermittent intestinal volvulus in a 5 years old boy.

Experimental preparation of deantigenized vascular heterografts and study of tolerance after transplantation.

A new technique in preparing a heterograft is presented. Deantigenized calf carotid arteries are obtained by papain digestion and formol tanning. The biochemical determinations show a pronounced reduction in total protein content after papain digestion. The formol tanning gives a good rigidity and elasticity in adapting to different blood volumes without aneurysmal dilatation. Eight dogs were grafted : two died after surgery, two were killed after 35 days and two others 60 days after transplantation, one died after 8 months and one is alive 30 months after transplantation. The good in vivo tolerability has been appreciated. There have been no haemodynamic troubles and no cell changes of rejection. An insignificant quantity of immunoglobulins G has been found in the sera of the animals with heterografts. These data draw attention on the possibility of the use, in clinical practice, of the deantigenized calf arteries.

Characterization of the epidemiological process of HIV infection using some immunological markers.

In an attempt to elucidate the causes which led to the high percentage of HIV infection in the infantile population in Romania, the paper deals with the study of the evolution of the infection process, in the 0-6 years age group; the process was separately studied in children from closed collectivities (5,318 sera) and children living with their families (2,462). The study of the various patterns obtained with sera analysed by western-blot allowed of concluding that the massive spreading of the infection in both types of infantile population occurred in 1991-1992, the most intense process being reported in the 0-2 years age group (children from closed collectivities). The differences between the evolution of HIV infection epidemic in the above mentioned infantile populations and that noticed in adults are shown.

Serological diagnosis in human Yersinia infections.

Serological examinations revealed Y. enterocolitica 0:3 specific antibodies in 34% of 80 children affected by a yersiniosis epidemic at titres of 1/40-1/640 and in all sporadic Yersinia enteritis cases. Similarly, agglutinins were identified for Y. enterocolitica 0:3 and 0:9 in 3.4% of 430 appendectomized children hospitalized with painful syndrome in the right iliac fossa. In 10% of 101 patients hospitalized with arthritis and Reiter's syndrome antibodies to Y. enterocolitica 0:3 (8 cases) and Y. pseudotuberculosis (3 cases) were detected at titres of 1/80-1/640. Our results stress the importance of serological examinations in diagnosing human infections with Yersinia.

[Delayed rupture of the spleen in a multiply injured patient]. / Ruptura întârziata a splinei la un politraumatizat.

The authors present a case of delayed rupture of the spleen in a polytraumatised patient. This entity was defined as a late occurrence of signs and symptoms attributed to splenic injury not detected by diagnostic computed tomographic scanning during the initial examination. The mechanisms in which the delayed rupture of the spleen occurs are discussed and the conclusion is that the delayed rupture of the spleen represent a real clinical entity.

[Laparoscopy in abdominal trauma. Preliminary report in 37 cases]. / Laparoscopia diagnostica si terapeutica în traumatismele abdominale. Studiu preliminar pe 37 cazuri.

The role of diagnostic laparoscopy (DL) and therapeutic laparoscopy (TL) in abdominal trauma is not clear. Even after diagnostic punction lavage (DPL), ultrasonography (US), and CT scan (CT), in some cases is difficult to decide between laparotomy and observation. In 37 cases of abdominal trauma, a laparoscopic evaluation was done; 28 abdominal blunt trauma (22 associated with multiple trauma), and 9 abdominal wounds (8 stab wounds). In blunt abdominal trauma, DL was done for haemoperitoneum (26 cases), after DPL, US or CT. In three cases, with equivocal diagnosis, an extra abdominal operation in general anaesthesia was necessary. In abdominal wounds a DL was done for suspicion of penetration. All the patients were haemodynamic stable, TS > or = 12. A laparotomy was necessary in 12 cases (32.43%), a LT was possible in 5 cases (13.51%). In the rest of cases, a DL with or without lavage-drenage enough.

[Laparoscopic suture or open suture in perforated duodenal ulcer]. / Sutura laparoscopica sau sutura deschisa în ulcerul duodenal recent perforat la tineri.

Between Nov. 1994-Jan. 2001 we performed laparoscopic suture with omentoplasty of perforated duodenal ulcer (PDU) in 51 patients out of 56 it was intended (this constituted the laparoscopic group--LG). The selection criteria were young patients, age < 40 years, no associated diseases, onset of the operation under 12 hours from the occurrence of the perforation, absence of clear ulcer history. In the same period, we performed an open suture based on the same criteria in 105 patients (open group--OP). The results showed a difference between needed analgesia (2.8 days for LG vs. 5.2 days for OG) and a hospital stay of 6.1 days in LG vs. 7.7 days in OG. The incidence of postoperative complications was 5.88% in the LG and 7.61% in the OG with 1.96% and respective 1.90% reoperation rate. In conclusion laparoscopic suture of PDU with associated postoperative modern therapy of ulcer disease could be the treatment of choice in young patients.