Surgical Treatment with Radiofrequencies for Outpatients with Surgical Benign Ano-Perianal Diseases.

INTRODUCTION: Nowadays, the occurrence of surgical benign ano-perianal diseases (SBAPD) is raising. Radiofrequency (RF) represents a surgical therapeutic method using high frequency radio waves to perform incisions, excisions and tissue coagulation. The main purpose of the study is to validate the possibility to use RF within the surgical treatment for outpatients with SBAPD; at the same time, a special consideration has been given to appreciate the efficiency of RF compared with other surgical methods. MATERIAL AND METHOD: The study presents the results accumulated in 11 years (December 2003 - December 2014) in "PROCTOLINE" International Medical Center; also, we have taken into account the accomplishments on 783 outpatients, submitted to RF surgery for 10 different types of SBAPD. Various RF surgeries (cuttings, excisions, coagulations, curettages etc.) have been performed under local anesthesia. RESULTS: The necessary time was usually less than 45 minutes, while the post-operatory duration for a total healing was in the range of 7 to 45 days. The percentage of minor complications was quite a small one (8,3%). Also, we might appreciate excellent post-treatment results (maximum value of 11 years); Typically, the patients return for periodic postoperative examination at first and fourth week after surgery. CONCLUSIONS: RF represents an efficient, rapid and secure method for the treatment of SBAPD; it may be used in ambulatory, only under local anesthesia, offering to the patient a minimal post-operatory discomfort, as well as a rapid, esthetic and functional recovery of wound. By comparison with "classical surgery", the complications are rather minor ones and their percentage occurs in a lesser one.

Rate and Predictors of Satisfaction after Noninvasive Facial Cosmetic Procedures: A National Study in Saudi Arabia.

Background: In response to the growing popularity of noninvasive facial cosmetic procedures, this study assessed the rate and predictors of satisfaction with such procedures in Saudi Arabia, filling a research gap and emphasizing the role of patient satisfaction in optimizing care and understanding the economic implications for healthcare. Methods: This cross-sectional study was conducted from May to June 2023 using an online self-administered questionnaire distributed across all regions of Saudi Arabia. Eligible participants were Saudi adults aged 18 years and older who had undergone noninvasive facial cosmetic procedures. Patients who underwent surgical/invasive cosmetic procedures, nonfacial interventions, or interventions performed by doctors other than plastic surgeons or dermatologists were excluded. Results: Most participants reported satisfaction with their procedures. Significant predictors of satisfaction included sex, income, and residential area. Women, higher-income individuals, and residents of certain areas were more likely to report satisfaction. Participants also expressed a high level of satisfaction with the friendly and polite treatment they received from their doctors but showed dissatisfaction with the difficulty they faced in securing immediate postprocedure appointments. Conclusions: This study provides valuable insights into the rate and predictors of satisfaction after noninvasive facial cosmetic procedures in Saudi Arabia. These findings underscore the importance of considering sociodemographic factors in patient satisfaction and suggest areas for improvement in patient care, particularly in facilitating immediate postprocedure appointments. Future research should continue to explore these and other potential predictors to further improve patient outcomes in the field of noninvasive facial cosmetic procedures.

Staged surgical management of the sequelae of neonatal septic hip arthritis: a case report and review of the literature.

Total necrosis of the femoral head is a common sequelae after septic hip arthritis in infancy. Septic hip dislocation may develop, with severe functional consequences on the growing child: limping and limb length discrepancy. We present our staged surgical treatment of Choi's type IV A sequelae of septic hip arthritis in a 2-year old boy. Open reduction, followed by various reconstructive procedures, were performed. After 8 years of follow-up, the child has a stable, mobile hip, with good functional outcomes. Close follow-up is mandatory to ensure a good long-term outcome. Our technique proved to be successful in the achievement of a functional hip by maintaining the remnants of the femoral head and creating the conditions to remodel them quasi-normal.

Descriptive epidemiology of clubfoot in Romania: a clinic-based study.

OBJECTIVE: Congenital clubfoot affects 1 per 1000 live births per year in Romania. To date, no epidemiological studies have been conducted in this country to assess risk factors associated with the deformity. The aim of this study was to evaluate specific environmental and socio-demographic factors that may increase the risk of an infant to be born with clubfoot. PATIENTS AND METHODS: A descriptive clinic-based study over a twelve-week period was conducted using structured questionnaires given to biological parents of clinically confirmed clubfoot and control subjects. 62 parents of probands and 66 parents of control patients were enrolled for risk factor questionnaires. Phenotypic data from clubfoot children was also collected. RESULTS: We found that males were twice as likely to have clubfoot and half of clubfoot subjects were affected bilaterally. There was no significant difference in the rate of left versus right clubfoot. Infant and maternal characteristics showing a strong association with clubfoot included breech presentation and old maternal age at conception. CONCLUSIONS: Our results support reported literature data that males are two times as likely to have clubfoot which indicates a genetic influence. Previous reports suggest clubfoot babies are born to young mothers but in Romania advanced maternal age (≥ 35 years) was an indicator which may suggest genetic influence. This clinic-based study does not support previously recorded data of a positive association for maternal or household smoking. Data from this Romanian population also does not support previous data suggesting strong associations with maternal diabetes.

A molecular orbital investigation of the conformation of transfer RNA.

The PCILO method has been used for a theoretical exploration of the conformational properties of tRNAPhe with respect to the phosphodiester torsion angles. The computations were based on the utilisation of the dinucleoside triphosphate model and took into account the different combinations of sugar puckers and different conformations about the C4'-C5' bond. The dependence of the (omega'-omega) conformational energy maps upon these factors was specified. A detailed comparison is carried out between the theoretical results and experimental data on the crystal structure of tRNAPhe produced by four different groups of investigators.

[Typical tripeptide sequences of collagen: quantitative conformation study]. / Séquences tripeptidiques typiques du collagène: étude conformationnelle quantique.

Theoretical and experimental investigations on the conformations of synthetic polytripeptides, with Gly-R2-R3 general repetitive sequence, are of great interest for the comprehension of the factors which contribute to the triple helix stabilization. Using appropriate molecules as models, we have investigated by the PCILO method the intrinsic conformational possibilities of each "in situ" residue for the following cases : Gly-imino-imino, Gly-amino-imino and Gly-imino-amino which represent the most important sequences occurring in the primary structure of collagen. The computations were carried out taking into account the two pyrrolidine ring puckerings and the preferential side-chains orientations. Extending our previous work concerning the isomeric polytripripeptides Gly-X-Pro and Gly-Pro-X with X epsilon (Pro, Phe) we have studied the cases of X epsilon (Ala, Ser). In this brief communication, we present a preliminary synthesis of these recent results.

Sensitization to doxorubicin resistance in breast cancer cell lines by tamoxifen and megestrol acetate.

Acquired drug resistance is a major factor in the failure of doxorubicin-based chemotherapy in breast cancer. We determined the ability of megestrol acetate and/or tamoxifen to reverse doxorubicin drug resistance in a doxorubicin-resistant breast cancer line (the human MCF-7/ADR). The cytotoxicity of doxorubicin, megestrol acetate, and/or tamoxifen was determined in the sensitive and resistant cell lines utilizing the sulphorhodamine B assay. Tamoxifen alone produced an IC50 (concentration resulting in 50% inhibition of control growth) of 10.6 microM, whereas megestrol acetate alone resulted in an IC50 of 48.7 microM in the MCF-7/ADR cell line. The IC50 of doxorubicin in MCF-7/ADR was 1.9 microM. Neither megestrol acetate alone nor tamoxifen alone at 1 or 5 microM altered the IC50 of doxorubicin. However, the combination of tamoxifen (1 or 5 microM) and megestrol acetate (1 or 5 microM) synergistically sensitized MCF-7/ADR cells. Additionally, megestrol acetate and tamoxifen inhibited iodoarylazidoprazosin binding to P-glycoprotein, and, in their presence, there was an increased doxorubicin accumulation in the MCF-7/ADR cells. Furthermore, the combination of tamoxifen and megestrol acetate had much less effect on the cytotoxicity of doxorubicin in MCF-7 wild-type cells. Clinically achievable concentrations of tamoxifen and megestrol acetate can largely sensitize MCF-7/ADR to doxorubicin. The combination of these three drugs in a clinical trial may be informative.

Cytokinetics of a novel 1,2,3-triazene-containing heterocycle, 8-nitro-3-methyl-benzo-1,2,3,5-tetrazepin-4(3H)-one (NIME), in the human epithelial ovarian cancer cell line OVCAR-3.

The mechanism of action of the novel tetrazepinone 8-nitro-3-methyl-benzo-1,2,3,5-tetrazepin-4(3H)-one (NIME), structurally related to the antitumour drug temozolomide, was studied in the human ovarian tumour cell line OVCAR-3. NIME preferentially inhibited DNA synthesis over protein and RNA syntheses at 3 and 24 hr post-treatment. A Maxam-Gilbert sequencing assay showed that NIME induced barely detectable levels of guanine N7 alkylation in an isolated DNA strand, in contrast to temozolomide, a strong alkylating agent containing, like NIME, a cyclic 3-methyl-1,2,3-triazene moiety. Alkaline sucrose density-gradient sedimentation, at concentrations 2- to 10-fold lower than the ones used in the DNA sequencing assay, showed significant DNA damage in OVCAR-3 cells 24 hr after treatment with NIME. This was accompanied by a significant accumulation of cells in late S and G2M. Cell cycle arrest was transient and was reversed after 2-3 days following drug treatment. This was in agreement with bivariate bromodeoxyuridine/propidium iodide analysis, which showed that at 100 microM, a concentration at which the majority of the cells arrested in late S and G2M, a significant fraction of bromodeoxyuridine positive (S-phase) cells escaped the block. In an attempt to elucidate the mechanism underlying these effects, the degradation of NIME in cell culture medium was analyzed by GC-MS (gas chromatography coupled with mass spectrometry). The results showed that, in contrast to temozolomide, NIME did not convert to an open-chain alkyltriazene in cell culture medium, but to a major benzimidazole product, which exerted a minor effect on the cell cycle. This suggests that NIME, despite containing a 3-(alkyl)-1,2,3-triazene moiety, does not act by DNA alkylation but probably by generating a short-lived genotoxic species during its degradation to 6,5-benzofused derivatives.

Comparative studies between the effects of mitozolomide and two novel tetrazepinones PYRCL and QUINCL on NIH:OVCAR-3 cells.

UNLABELLED: Cytotoxicity, reduction of macromolecule synthesis and cell cycle perturbations by two novel 3-(2-chloroethyl)-tetrazepinones, PYRCL and QUINCL were compared with those produced by the structurally related 3-(2-chloroethyl)-tetrazinone, mitozolomide, in the OVCAR-3 cell line. METHODS: Macromolecule synthesis was determined by incorporation of 3H-thymidine, 3H-uridine and 3H-leucine into acid-precipitable fractions of OVCAR-3 cell extracts. Maxam-Gilbert sequencing was used to compare the DNA alkylating sites induced by the tetrazepinones, with those created by mitozolomide. Alkaline sucrose-density sedimentation was employed to detect genomic DNA damage. Also, the effects of the tetrazepinones on the cell cycle were determined by univariate flow cytometry. RESULTS: At 3 h post-treatment, mitozolomide appeared as a selective inhibitor of DNA synthesis, while both tetrazepinones inhibited the synthesis of all three macromolecules. At 24 h post-treatment, the inhibition of DNA synthesis was observed to increase in cells treated with mitozolomide, while it decreased in those previously exposed to the tetrazepinones. Also at 24 h post-treatment, mitozolomide induced accumulation of cells in S(late)/G2M at low concentrations and in S-middle at high concentrations. In contrast, at the same recovery time, cells treated with the tetrazepinones accumulated specifically in G2M, the strength of the block being dose-dependent. At an equimolar concentration, the tetrazepinones induced weaker guanine N-7 alkylation than mitozolomide. By 24 h after treatment, cells exposed to the tetrazepinones showed significantly greater DNA fragmentation than those previously treated with mitozolomide. CONCLUSION: In summary, based on (a) their effects on DNA, RNA, protein synthesis and on the cell cycle, (b) their alkylating power and (c) their interactions with DNA, the 3-(2-chloroethyl)tetrazepinones appeared to kill tumor cells by a novel mechanism which may significantly differ from that of their 3-(2-chloroethyl)-tetrazinone counterpart, mitozolomide.

Quantum molecular modeling of the interaction between guanine and alkylating agents--1--sulfur mustard.

Interaction between Guanine and the episulfonium form of Sulfur mustard (HD) was studied using the ab initio LCAO-MO method at the HF/6-31G level. The alkylation mechanism on guanine-N7 was analyzed by using a supermolecular modeling. Our stereostructural results associated with the molecular electrostatic potentials and HOMO-LUMO properties, show that in vacuum the alkylation of the N7 of guanine by HD in the aggressive episulfonium form is a direct process without transition state and of which the pathway is determined.

Quantum molecular modeling of the interaction between guanine and alkylating agents--2--nitrogen mustard.

The alkylation mechanism of guanine by nitrogen mustard (HN2) was studied by using a supermolecular modeling at the ab initio 6-31G level. Our computations show that interaction of guanine with the aziridinium form of HN2 necessitates a transition state for the N7 alkylation route. The pathway of N7-guanine alkylation by nitrogen and sulfur mustards is discussed on the basis of the Molecular Electrostatic Potential and HOMO-LUMO properties of these molecules.

23Na NMR study of the interaction between DNA and the platinum (II) compounds: cis-DDP, trans-DDP and TDP.

The interaction of calf thymus DNA with cis-DDP, trans-DDP and TDP was studied by 23Na NMR in aqueous solutions at pH=7.0, with Pt(II) compounds/DNA(P) (P=Phosphate) molar ratios r increasing from 0 till to 1P. 23Na NMR results are interpreted on one hand, with the help of a " two states model " with R(F) and R(B) relaxation rates, and, on the other hand, using the " entropy of fluctuations " concept developed by Lenk. We have established that, for the studied platinum compounds, the preference to interact with DNA phosphate sites -interpreted as a perturbation of the counterions environment- is in a decreasing order: TDP >> cis-DDP > trans-DDP. These results are discussed with regard to the interaction of DNA with the hard bication Mg++ and the soft bication Cu++.

Quantum molecular modeling of the elastinic tetrapeptide Val-Pro-Gly-Gly.

The free Val-Pro-Gly-Gly tetrapeptide belonging to the Proline-rich sequences of elastin has been studied both theoretically and experimentally. The molecular modelisation was carried out using AM1 and ab initio quantum computations while the conformation in solution was ascertained by circular dichroism spectroscopy performed on the synthesized tetrapeptide. Experimental and theoretical investigations lead to the conclusion that the most probable structure is constituted by a type II beta-turn.

23Na NMR study of the interaction between hyaluronan and the bications Ca(++), Mg(++) and Cu(++).

The relaxation rate R = pi Delta nu(1/2) of the quadrupolar (23)Na nucleus was measured at pH approximately 7 using a 200 MHz NMR spectrometer with a view to observe the interaction between hyaluronan and its natural counterion Na(+) and the bications Ca(++), Mg(++) and Cu(++). An interpretation of our results, by means of the "entropy of fluctuations" concept of Na(+), is presented. We show that Cu(++) ions are more effective than Ca(++) and Mg(++). A possible model of complexation of Cu(++) in a cage formed by the 1-4 glycosidic bond, the carboxylate side-chain and the acetoamide side-chain is proposed, according to electrostatic potential computations using the ZINDO1 quantum semi empirical method.

Molecular modeling of a Leishmania antigen eIF-4A: identification of a potential epitope implicated in the adjuvant effect.

In leishmaniasis, the development of an effective vaccine depends on its capacity to elicit Th1 immune responses. Despite many approaches, recent vaccines do not induce sufficient levels of protection and long-term memory. To overcome this problem, vaccines are used with adjuvants that drive immunity towards Th1 and enhance endogenous production of IL-12, a Th1-promoting cytokine. Although exogenous IL-12 may act as an effective adjuvant, it has an elevated cost and toxic effects. Therefore, it is important to develop cheap and safer adjuvants that trigger endogenous IL-12. Of particular interest is LmeIF a unique Leishmania protein that provides significant adjuvant effects by stimulating high IL-12 production. This investigation was designed to identify the structural factors responsible for the adjuvant effects of LmeIF by establishing the 3D models of LmeIF and MueIF (mouse) by homology modeling based on the X-ray structure of their homologs in yeast and comparing their stereo-electronic properties. The molecular electrostatic potential was computed around each model and used to localize the active site and the most different amino acids between LmeIF and MueIF. Sequence alignment of LmeIF with eIF-4 from other species showed three residues (Q186, A189, E214) in the active site which were peculiar to the Leishmania protein. Long MD simulation was carried out on LmeIF fragment 129-261 to compare its folding with the native protein. Despite a high degree of sequence similarity with different species, we have identified in LmeIF a set of residues unique to the protozoan parasite Leishmania which may be potentially responsible for its adjuvant property. Using LmeIF model, a plausible surface region for binding with its receptor was also identified.

23Na NMR study of DNA thermal transconformation in presence of cysteamine radioprotector.

DNA thermal transconformation is studied in absence and in presence of the cysteamine radioprotector, by observing the delta nu 1/2 variation of 23Na NMR peaks. The sodium state (Free or Bound) is discussed with the help of a two states model with RF and RB relaxation rates. The delta nu 1/2 behaviour during the DNA transconformation shows clearly the electrostatic interaction with cysteamine which is accompanied by an Na+ ejection out of phosphate sites. The temperature dependence of delta nu 1/2 in all cases leads to the conclusion that RBc (the average relaxation rate of sodium nuclei that remain bound in the coil state of DNA) tends to zero.

[Paget's disease of breast--a special form of breast cancer]. / Boala Paget sânului--forma particulara de neoplasm mamar.

The incidence of Paget's disease of the breasts (15 cases) among 701 operated breast cancer was 2.1%. All studied cases were women. Over two-thirds of the patients were at menopause at the time of diagnosis. The interval between the clinical onset of disease and the histological diagnosis was approximately of 21.4 month. The clinical diagnosis was based on the presence of the characteristic erythemato-squamous lesion. In five cases a palpable mass was found. We registered one case of bilateral metachronous Paget's disease. Four patients had axillary lymphadenopathy: three of them presented with palpable mass. Mammography, cytology and histological examination from biopsy were the principal means of diagnosis. There were 10 women in stage, two women in stage II, and three women in stage III. The surgical treatment was the major component of treatment. The best prognosis was registered in the cases without a palpable mass in the breast and axillary lymphadenopathy with 5-year survival in four of five cases.

Surgical treatment of parietal defects with "da Vinci" surgical robot.

The robotic surgery has come through the development of telemedicine and minimally invasive surgery concepts, being developed in the military medicine by NASA during the years 1970-1980. The purpose of this paper is to briefly present our experience in the new field of the robotic surgery, by analyzing the results obtained over a lot of 20 patients operated with the "da Vinci" robot within the last 5 years in the Clinical Emergency Hospital Bucharest for various abdominal defects.