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.

Intermuscular and subcutaneous adipose tissue distributions differ in HIV+ versus HIV-men and women.

BACKGROUND: Loss of subcutaneous (SAT) with sparing of visceral (VAT) adipose tissue (AT) has been documented in HIV + men and women. Intermuscular AT (IMAT) rivals VAT in independent associations with cardiovascular risk. OBJECTIVE: To determine whether the size and distribution of IMAT differs in HIV+ vs. HIV- men and/or women. DESIGN: We used whole-body MRI to measure VAT, IMAT and four SAT compartments and compared them by HIV status using whole-body skeletal muscle (SM) or total AT (TAT) as co-variates in multi-ethnic groups of healthy HIV- (n=86) and stable HIV+ (n=76) men and women. RESULTS: The sizes of AT depots (adjusting for SM) did not differ by HIV status, except for smaller gluteal SAT (lower trunk, between L(4)-L(5) to greater trochanter) in both sexes (P<0.05). The AT distribution (adjusting for TAT) was significantly different, with larger VAT (P<0.05) and smaller gluteal and limb SAT (P<0.05) in both HIV+ sexes; IMAT increased more with TAT in HIV+ vs. HIV- men (P<0.05 for slope interaction) but there were no significant differences in women. There were significant race by HIV interactions in AT distribution with more pronounced VAT differences in non-Hispanic white men and larger trunk SAT in African Americans HIV+ vs. HIV-. CONCLUSION: The AT distribution differed markedly in HIV+ vs. HIV- with limb and lower body SAT representing a smaller proportion of TAT in HIV+ in both sexes and IMAT representing a larger proportion of TAT in HIV+ vs. HIV- men.

[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.

[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.

[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.

Intralesional bleomycin injection (IBI) treatment for haemangiomas and congenital vascular malformations.

Successful treatment of vascular anomalies has eluded the physician until now, despite various treatments utilised. Bleomycin has been successfully used in intralesional injection treatment of cystic hygromas and haemangiomas, based specifically on a high sclerosing effect on vascular endothelium. In a prospective study of 95 patients, the effectiveness of intralesional bleomycin injection (IBI) treatment in haemangiomas and vascular malformations was evaluated and documented. Complete resolution or significant improvement occurred in 80% of all patients treated. Complete resolution occurred in 49% of haemangiomas, 32% of venous malformations, and 80% of cystic hygromas. Significant improvement occurred in 38% of haemangiomas, 52% of venous malformations, 13% of cystic hygromas and 50% of lymphatic malformations. Of the six patients who presented with a painful lesion, four experienced complete resolution and two had significant improvement to treatment. Local complications encountered were superficial ulceration occurring in 2 patients, and cellulitis in 1 of the 95 patients. Systemic complications were flu-like symptoms in three patients and partial, transient hair loss in two patients. None of the patients presented with haematological toxic effects or signs of pulmonary involvement (fibrosis, hypertension). IBI is an effective treatment in haemangiomas and vascular malformation lesions, obviating the need for invasive primary surgery or systemic treatment regimens in 80% of cases, and allowing for limited need of secondary surgical or adjunctive procedures in cases with a moderate result.

[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.

[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.

31P-NMR and 13C-NMR studies of mannose metabolism in Plesiomonas shigelloides. Toxic effect of mannose on growth.

The metabolism of mannose was examined in resting cells in vivo using 13C-NMR and 31P-NMR spectroscopy, in cell-free extracts in vitro using 31P-NMR spectroscopy, and by enzyme assays. Plesiomonas shigelloides was shown to transport mannose by a phosphoenolpyruvate-dependent phosphotransferase system producing mannose 6-phosphate. However, a toxic effect was observed when P. shigelloides was grown in the presence of mannose. Investigation of mannose metabolism using in vivo 13C NMR showed mannose 6-phosphate accumulation without further metabolism. In contrast, glucose was quickly metabolized under the same conditions to lactate, ethanol, acetate and succinate. Extracts of P. shigelloides exhibited no mannose-6-phosphate isomerase activity whereas the key enzyme of the Embden-Meyerhof pathway (6-phosphofructokinase) was found. This result explains the mannose 6-phosphate accumulation observed in cells grown on mannose. The levels of phosphoenolpyruvate and Pi were estimated by in vivo 31P-NMR spectroscopy. The intracellular concentrations of phosphoenolpyruvate and Pi were relatively constant in both starved cells and mannose-metabolizing cells. In glucose-metabolizing cells, the phosphoenolpyruvate concentration was lower, and about 80% of the Pi was used during the first 10 min. It thus appears that the toxic effect of mannose on growth is not due to energy depletion but probably to a toxic effect of mannose 6-phosphate.

Expression of p53 and PCNA in cholangiocarcinoma and primary sclerosing cholangitis.

The aim of this study was to identify the pattern and significance of expression of p53 and PCNA in cholangiocarcinoma and primary sclerosing cholangitis. Histological sections from 18 patients with cholangiocarcinoma (3 of the cases were associated with primary sclerosing cholangitis), 10 patients with primary sclerosing cholangitis without cholangiocarcinoma, and 7 patients with cirrhosis without cholangiocarcinoma or primary sclerosing cholangitis were stained immunohistochemically for p53 and PCNA. Samples from 17 patients with cholangiocarcinoma (94%) stained positively for p53. Among these 17 cases, nontumorous bile duct epithelium was positive in 7 (including 3 cases with primary sclerosing cholangitis and 2 with carcinoma in situ), and were positive proliferating bile ductules in 4 cases. The single p53-negative cholangiocarcinoma did not show p53 positivity in either the bile duct epithelium or the proliferating bile ductules. Bile ductal and ductular cells in all 10 patients with primary sclerosing cholangitis without cholangiocarcinoma and in the 7 controls were not reactive for p53. All 18 samples from patients with cholangiocarcinoma (100%) were positive for PCNA protein. Bile duct epithelium was positive for PCNA in nine cases (90%) of primary sclerosing cholangitis without cholangiocarcinoma and in six (85%) controls. Our study showed a high rate of p53 expression (94%) in cholangiocarcinoma. The adjacent uninvolved bile duct epithelium was also immunoreactive for p53 in 7 of 17 patients (41%). These findings suggest an early p53 mutation in bile ductal cells in cholangiocarcinogenesis. Expression of p53 may potentially be used to identify or screen, by bile duct brushings, cases of primary sclerosing cholangitis suspected of harboring cholangiocarcinoma. Expression of PCNA was a universal feature in cholangiocarcinoma.

Simple chemiluminescence assays for free radicals in venous blood and serum samples: results in atopic, psoriasis, MCS and cancer patients.

OBJECTIVE: To investigate the generation of reactive oxygen species (ROS) in serum and venous blood as well as the serum antioxidative activity (AOA) in patients and healthy controls by means of a simplified chemiluminescence (CL) methodology. STUDY PARTICIPANTS: 48 Atopic eczema, 23 psoriasis, 15 multiple chemical sensitivity (MCS) and 35 cancer patients together with 22 healthy volunteers. METHODS: ROS generation/photon emission in blood and serum samples under basal conditions and after light exposure as well as the AOA of the serum samples was investigated at room temperature (22 degrees C) in all 143 fasted subjects. The 3-step methodology resumes in adding a constant amount of blood or serum to a constant amount of CL substrate (or to an ROS-generating mixture for the AOA test), followed by a short preincubation and registration of the photon counts over a 600-second time interval. RESULTS: In the basal and light exposure tests significantly higher photon counts (> 14, 000 counts/600 s) were registered in venous blood in all patient groups when compared to healthy controls (p < 0.001), suggesting increased amounts of activated leukocytes and light-sensitizing compounds, respectively. By contrast, most patient sera showed in all three CL tests a strongly inhibited light emission (p < 0.005), suggesting an adaptive antioxidative response to oxidant stress factors. CONCLUSIONS: Atopic, psoriasis, MCS and cancer patients are exhibiting significantly changed blood and serum CL patterns when compared to healthy controls. The described assays are simple, well reproducible and enable a fast assessment of ROS generation and AOA in biological samples at low operational costs.

[Remodelling of the crown for occlusal equilibration in partially edentulous patients]. / Remodelarea coronara în cadrul echilibrarii ocluzale în edentatia partiala.

Two clinical cases of partial edentulous patients with irregular occlusal plane and their treatment are presented. The authors emphasize the role of occlusal rehabilitation before any prosthetic treatment. Gingivectomy, osteoplastic surgery and crown reshaping are used. Occlusal relationships before fixed or removable prosthodontics is applied, are essential to insure correct mandibular movements and the dento-maxillary system homeostasis. Two clinical cases of patients with irregular occlusal plane because of teeth migrations (horizontal or vertical) after long-term edentation are presented. Both cases were by crown reshaping after pulpectomy and gingivectomy to obtain a regular occlusal plane. Prosthetic treatment was applied only after these preparations. We achieved good results concerning the dento-maxillary functions.

[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.

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.

[The induction current, an ideal resource for the smelting of dental alloys]. / Curentul de inductie, sursa de fuziune ideala a aliajelor de uz stomatologic.

The authors present an electrical furnace for melting dental alloys, made by the German company BEGO. This furnace uses electrical current of high frequency. The advantages of this melting method are the possibility of controlling the adequate melting temperature for a specific type of alloy, the fusion in a protective environment of rare gas and casting by associating the centrifugation with the vacuum. This leads to exact castings without any defects. The authors describe as a personal contribution an external cooling system capable of maintaining the furnace's parameters even when the water pressure is low.