FIRST DAY SERUM CALCIUM AND PARATHYROID HORMONE LEVELS AS PREDICTIVE FACTORS FOR SAFE DISCHARGE AFTER THYROIDECTOMY.

CONTEXT: Permanent hypocalcemia is a rare but significant complication of thyroid surgery. OBJECTIVE: The aim of this study was to identify predictive factors of hypocalcemia and hypoparathyroidism after thyroidectomy. DESIGN: Study included 134 total patients submitted to thyroidectomy from two endocrine units (January 2015 - August 2016). METHODS: We measured total serum calcium (sCa) and intact PTH (iPTH) on postoperative day one and 1 month after surgery. RESULTS: 118 patients were women with F/M ratio of 7.3/1 and a mean age of 51.8 years. 64 patients were included in group A (iPTH <12 pg/mL) and 70 patients in group B (iPTH >12 pg/mL). sCa and hypocalcemia symptoms were correlated with iPTH, measured 24 hours after surgery. The cut-off value was for sCa 8.05 mg/dL with a sensitivity of 85.29% and a specificity of 88.0% and for iPTH 11.2 pg/mL, with a sensitivity of 82.3% and a specificity of 71.0%. SCa (< 8.05 mg/dL) was a predictive factor with a 99 (IC95%:12.86-761.58) and iPTH (<11.2 pg/mL) with a 10.77 higher risk (CI95%: 3.83-30.30) to be associated with symptoms. CONCLUSION: SCa and iPTH represent good predictive factors of early and safe hospital discharge and can predict the risk of prolonged and permanent hypoparathyroidism.

Polycystic liver disease with complications: fenestration by laparoscopic approach.

AIM: Isolated polycystic liver disease is a rare congenital cystic liver disease with autosomal dominant transmission. Its main feature is the presence of a large number of cysts of different sizes in the hepatic parenchyma, which have a benign evolution. METHOD: We present the case of an 80 years old male patient with massive polycystic liver disease, diagnosed three years ago by ultrasound examination and abdominal computed tomography scan. The evolution of the disease had been complicated by compressive symptoms, caused by the large dimensions of the cysts. The patient presented with abdominal pain, nausea, vomiting and lost weight. Cyst fenestration through laparoscopic approach resolved the symptoms. RESULTS: The patient was mobilized on the day of the surgery, and was discharged on the 9th postoperative day, after drainage tube removal. CONCLUSIONS: Isolated polycystic liver disease is rare. Surgical treatment is indicated only if complications occur. The laparoscopic approach is an alternate treatment method, if needed. The patients benefit from the advantages of minimally invasive surgery.

[Gastric stromal tumor with liver and subcutaneus metastasis. Case report]. / Tumora stromala gastrica cu metastaze hepatice si subcutanate. Prezentare de caz.

UNLABELLED: The gastrointestinal stromal tumours expand from the undefine mezenchimal cells of the intestinal wall and the origin is in the Cajal interstitial cells. The agresivity of GIST is difficult to be evaluate. Very importants factors for grading are the tumour localisation, the invasion of serosa or mucosa, the dimensions of tumour and the number of mytosis. We present a case with haemoragic gastric stromal tumour, with small dimensions, which was initially diagnosed as a "benign" tumour. Seven years after the operation, the patient presented voluminous liver metastases. After right hepathectomy and medical treatment with Glivec we followed up the case. Eleven years after the first operation she presented a subcutaneus metastasis in parietal region, which was confirmed with imunohistochemical exam. The patient is still under observation with higher doses of Glivec. CONCLUSIONS: The gastrointestinals stromal tumours represent a very rare group of digestive tract tumors, with malignant potentially evolution; the first choice of treatment is surgery, with complete ablation of the tumour. The medical treatment with Glivec is necessary in case of reccurence or metastases; the stromal tumours present a strange evolution, for this reason all the patients must be under medical observation, for the rest of their life.

[Local recurrence after the sphincter-saving operations and abdominal perineal resection in rectal cancer]. / Recidiva tumorala locala dupa chirurgia conservatoare si rezectia abdominoperineala în cancerul rectal.

By local recurrence we define the appearance of the same anatomopathological type of cancer like the one initially described in the primary tumor, limited at the rectum or pelvis.The study is based on the analysis of all the cases with rectal cancer who undergone surgical procedures in Surgical Clinic No.2 Tg. Mures in the last 5 years. Using the most important parameters for each patient we identified some risk factors for the recurrence of the rectal cancer: surgical procedures--there were no major variations in the local recurrence between the sphincter-saving operations and abdominal perineal resections. The most frequent recurrence tumors appeared after Hartmann I operation; the moderate aggressive adenocarcinomas at the old patients and high aggressive adenocarcinomas in young patients, T3, T4 stages. The recurrent rectal cancer is more frequent in aged patients with high aggressive adenocarcinomas. There were no major differences in recurrence rate between the sphincter-saving operations and abdominal perineal procedures.

Two-step hepatectomy with right portal branch ligature for a right lobe metastasis.

AIMS/BACKGROUND: Hepatic resection is the only treatment with possible curative effect both for primary and secondary tumors. An increase of the rate of resectability for tumors considered inoperable at first and a decrease of the postoperative morbidity and mortality can be realized by right portal branch ligature and two-step hepatectomy. METHODOLOGY: This paper presents the case of a patient with left bowel cancer with a hepatic metastasis. A right portal branch ligature was performed followed by systemic postoperative chemotherapy. RESULTS: The right portal branch occlusion was followed by right lobe atrophy and left lobe hypertrophy, confirmed by CT scan. Three months after the portal occlusion a right lobe hepatectomy was performed. The postoperative evolution was favorable; eight days of hospitalization were necessary. CONCLUSIONS: Portal branch ligature can be performed in certain cases of hepatic tumors to increase the resectability rate.

[Controversy about the term inflammatory orbital pseudotumor]. / Controverse asupra termenului de pseudotumora inflamatorie orbitara.

The term of "inflammatory orbital pseudotumor" is met in the inflammatory pathology of the orbit and it has been modified through the time both in its frequency of usage and in its meaning. The authors make a review of the evolution of in the term usage and especially in its importance as a partial diagnosis and also as an attitude towards the paraclinical investigations. The goal of this work is to present the evolution of the problems implied by the term "orbital pseudotumor" that even today rises controversies.

Interaction of beta-lactoglobulin with small hydrophobic ligands as monitored by fluorometry and equilibrium dialysis: nonlinear quenching effects related to protein--protein association.

Although a thorough characterization of binding parameters is essential for application of beta-lactoglobulin as a carrier for a variety of small hydrophobic ligands, the binding parameters derived in various studies using various techniques are inconsistent. The bindings of several small ligands as detected by fluorometry and equilibrium dialysis were compared. Fluorescence spectroscopy showed that beta-ionone, retinol, and fatty acid lactones all bound in the vicinity of a tryptophan residue. Retinol and fatty acid lactone competed for the same binding site. Exclusively for ligands that quench the beta-lactoglobulin fluorescence through a resonance energy transfer mechanism, fluorometry yielded a systematically higher binding affinity than equilibrium dialysis. The binding overestimation in fluorometric measurements can be explained by oligomer formation of protein, together with an underestimation of the limiting quenching level at saturating ligand concentrations due to the use of a limited set of data points.

Evaluation of the DEFINDER system for fully automatic glossary construction.

In this paper we present a quantitative and qualitative evaluation of DEFINDER, a rule-based system that mines consumer-oriented full text articles in order to extract definitions and the terms they define. The quantitative evaluation shows that in terms of precision and recall as measured against human performance, DEFINDER obtained 87% and 75% respectively, thereby revealing the incompleteness of existing resources and the ability of DEFINDER to address these gaps. Our basis for comparison is definitions from on-line dictionaries, including the UMLS Metathesaurus. Qualitative evaluation shows that the definitions extracted by our system are ranked higher in terms of user-centered criteria of usability and readability than are definitions from on-line specialized dictionaries. The output of DEFINDER can be used to enhance these dictionaries. DEFINDER output is being incorporated in a system to clarify technical terms for non-specialist users in understandable non-technical language.

Controlling Maillard reactions in the heating process of blockmilk using an electronic nose.

An electronic nose has been used to classify blockmilk products subjected to various heating processes based on their volatile composition. Multivariate analyses of electronic nose and GC/MS data are highly comparable with respect to relative changes in aroma profile going from raw to final product. Predictive properties of various neural networks based on the raw sensor output were moderate to good.