Changes in qualitative and quantitative ultrasound assessment of the gastric antrum before and after elective caesarean section in term pregnant women: a prospective cohort study.

Ultrasound measurement of the antral cross-sectional area allows a quantitative estimate of gastric contents in non-pregnant adults, but this relationship may be affected by compression of the stomach exerted by the gravid uterus during pregnancy. This study aimed to assess differences in quantitative (Perlas score) and qualitative (antral cross-sectional area) ultrasound assessments of the gastric antrum performed immediately before and after caesarean section. Forty-three women having elective caesarean section performed under spinal anaesthesia were studied in the semirecumbent and semirecumbent-right lateral positions. Thirty-nine women showed no change in stomach contents using the Perlas score between the two measurement periods; four women showed a change, but by one grade only. The median (IQR [range]) antral cross-sectional area was 323 (243-495 [103-908]) mm2 before, and 237 (165-377 [112-762]) mm2 after, caesarean section in the semirecumbent position (p = 0.001); the comparable values in the semirecumbent-right lateral position were 418 (310-640 [161-1238]) mm2 and 362 (280-491 [137-1231]) mm2 (p = 0.09). The distance between the skin and the antrum, and the aorta and the antrum, decreased significantly in both positions after surgery. We suggest that our results indicate that stomach contents remain largely unchanged in women having elective caesarean section, but antral cross-sectional area decreases, especially in the semirecumbent position, related to a change in the position of the stomach within the abdomen. This implies that the relationship of antral cross-sectional area to volume of stomach contents, which has been determined for non-pregnant subjects, may not apply in term pregnant women.

[Salvage radical prostatectomy for brachytherapy failure: preliminary results]. / Prostatectomie radicale de sauvetage après échec de curiethérapie: étude préliminaire.

OBJECTIVES: Analysis of preliminary results in six patients operated by second-line (salvage) radical prostatectomy for local recurrence after low-dose brachytherapy. PATIENTS AND METHODS: Since January 2009, six patients had an open salvage radical prostatectomy with a lymph node dissection and without neurovascular bundles preservation for a low-dose I125 brachytherapy failure. Local recurrence was confirmed by trans-rectal biopsy or TURP. All the patients had PSA increase or lower urinary tract symptoms. Bone scan and pelvis MRI were performed to detect a locally advanced disease, a lymph node involvement or the presence of bone metastasis. Pathology reports and PSA level at 1, 3, 6 and 12 months were analyzed. RESULTS: Salvage radical prostatectomy with lymph node dissection was performed in all patients without major complications. The PSA level was below 0.1 ng/mL in five out of six patients at 1 and 3 months. The only case of persistent PSA is treated by androgen deprivation in a pT3b N1 patient. CONCLUSION: Salvage radical prostatectomy after brachytherapy failure was feasible with a limited perioperative morbidity. This second-line curative treatment in a selected group of patients should be kept in mind. Our early results looked promising.

Hepatic trauma management in polytraumatised patients.

UNLABELLED: The specialty literature of the last decade presents the nonoperative management of the closed abdominal trauma as the treatment of choice. The purpose of this study is to highlight the importance of the optimal management of hepatic lesions considering the clinical, paraclinical and therapeutic approach. Our study is based on the analysis of the clinical and paraclinical data and also on the evaluation of the treatment results in 1671 patients with abdominal trauma affecting multiple organs who were treated at the Clinic of Surgery, County Hospital of Oradea from 2008 to 2011. The non-operative approach of the hepatic trauma, applied in 52% of the patients, was indicated in stable hemodynamic status, non-bleeding hepatic lesions on the abdominal CT, and the absence of other significant abdominal lesions. The remaining 48% were treated surgically. The postoperative evolution was free of complications in 72% of the patients while the rest of 28% presented one or more postoperative complications. ABBREVIATIONS: CT = Computer Tomography; ISS= Injury Severity Score; AIS = Abbreviated Index of Severity; AAST = American Association for the Surgery of Trauma; ARDS = Adult Respiratory Distress Syndrome.

Mixture of Graphene Oxide/Phosphoric Acid/Melamine as Coating for Improved Fire Protective Performance and Enhancement of Surface Electrical Properties on Wood Chipboard.

Looking for multifunctional materials, an assessment of the performances both as fire retardant and generator of electrically conductive surfaces for a three component mixture of graphene oxide, phosphoric acid and melamine applied on wood chipboard was performed. A simple approach was used to investigate the intumescent char formation and quantify the loss mass during vertical burning tests, in which the prepared samples were exposed for a certain time interval to a flame generated by an ethanol lamp in ambient conditions. Moreover, mass loss evolution and structural changes that occur during the burning process were more comprehensive investigated by differential thermal and thermogravimetric (DTA/TGA) techniques. By comparing the performances between the wood chipboard samples without any coverage and those covered with one or multiple component mixture, an increase of protection against the fire action was noticed when the three component mixture was used. Also, an improvement of the electrical properties was observed, after flame exposure of the samples covered with multiple layers (i.e., two and three), when the three component mixture was used. Morphological and structural investigations by microscopy (optical and electronic-SEMEDX), X-ray diffraction (XRD) and spectral (Raman, FTIR) methods are described. An assessment of market potential is also discussed.

hHR23B is required for genotoxic-specific activation of p53 and apoptosis.

Rad23 proteins function in both DNA repair and protein stability regulation. As ubiquitinated forms of p53 are stabilized after DNA damage in concert with p53 functional activation, and human Rad23 proteins (hHR23A and B) regulate p53 stability in unstressed cells, the role of hHR23B in post-genotoxin regulation of p53 was investigated. Depletion of hHR23B by specific short interfering RNA before genotoxic exposure attenuated p53, p21 and bax induction, abrogated the accumulation of ubiquitinated p53 and suppressed apoptosis. Expression of ubiquitin derivatives with all lysines mutated except K48 or K63 demonstrated that K48-linked p53-ubiquitin conjugates were specifically induced after DNA damage. hHR23B, along with native and ubiquitinated p53, accumulated in chromatin after genotoxic exposure, and the accumulation of ubiquitinated p53 in chromatin was prevented by hHR23B depletion. Chromatin immunoprecipitation analysis demonstrated that hHR23B and p53 both localized to the p21 promoter shortly after DNA damage. hHR23B thus plays a critical role in the activation and function of p53 after specific genotoxic exposures.

[Radiotherapy of bone metastases in France: A descriptive monocentric retrospective study]. / Radiothérapie des métastases osseuses en France : étude descriptive rétrospective monocentrique.

PURPOSE: Bone metastases cause pain and affect patients' quality of life. Radiation therapy is one of the reference analgesic treatments. The objective of this study was to compare the current practices of a French radiotherapy department for the treatment of uncomplicated bone metastases with data from the literature in order to improve and optimize the management of patients. MATERIAL AND METHODS: A retrospective monocentric study of patients who underwent palliative irradiation of uncomplicated bone metastases was performed. RESULTS: Ninety-one patients had 116 treatments of uncomplicated bone metastases between January 2014 and December 2015, including 44 men (48%) and 47 women (52%) with an average age of 63years (25-88years). Primary tumours most commonly found were breast cancer (35%), lung cancer (16%) and prostate cancer (12%). The regimens used were in 29% of cases 30Gy in ten fractions (group 30Gy), in 21% of cases 20Gy in five fractions (group 20Gy), in 22% of cases 8Gy in one fraction (group 8Gy) and in 28% of cases 23.31Gy in three fractions of stereotactic body irradiation (stereotactic group). The general condition of the patient (P<0.001), pain score and analgesic (P<0.001), oligometastatic profile (P=0.003) and practitioner experience (P<0.001) were factors influencing the choice of the regimen irradiation. Age (P=0.46), sex (P=0.14), anticancer treatments (P=0.56), concomitant hospitalization (P=0.14) and the distance between the radiotherapy centre and home (P=0.87) did not influence the decision significantly. A total of three cases of spinal compression and one case of post-therapeutic fracture were observed, occurring between one and 128days and 577days after irradiation, respectively. Eight percent of all irradiated metastases were reirradiated with a delay ranging between 13 and 434days after the first irradiation. The re-irradiation rate was significantly higher after 8Gy (P=0.02). The rate of death was significantly lower in the stereotactic arm (P<0.001) and overall survival was significantly greater in the stereotactic arm (P<0.001). CONCLUSION: This study showed that patients' analysed was comparable to the population of different studies. Predictive factors for the choice of the treatment regimen were identified. Non-fractionnated therapy was underutilised while stereotactic treatment was increasingly prescribed, showing an evolution in the management of patients.

Identification of a novel saturable endoplasmic reticulum localization mechanism mediated by the C-terminus of a Dictyostelium protein disulfide isomerase.

Localization of soluble endoplasmic reticulum (ER) resident proteins is likely achieved by the complementary action of retrieval and retention mechanisms. Whereas the machinery involving the H/KDEL and related retrieval signals in targeting escapees back to the ER is well characterized, other mechanisms including retention are still poorly understood. We have identified a protein disulfide isomerase (Dd-PDI) lacking the HDEL retrieval signal normally found at the C terminus of ER residents in Dictyostelium discoideum. Here we demonstrate that its 57 residue C-terminal domain is necessary for intracellular retention of Dd-PDI and sufficient to localize a green fluorescent protein (GFP) chimera to the ER, especially to the nuclear envelope. Dd-PDI and GFP-PDI57 are recovered in similar cation-dependent complexes. The overexpression of GFP-PDI57 leads to disruption of endogenous PDI complexes and induces the secretion of PDI, whereas overexpression of a GFP-HDEL chimera induces the secretion of endogenous calreticulin, revealing the presence of two independent and saturable mechanisms. Finally, low-level expression of Dd-PDI but not of PDI truncated of its 57 C-terminal residues complements the otherwise lethal yeast TRG1/PDI1 null mutation, demonstrating functional disulfide isomerase activity and ER localization. Altogether, these results indicate that the PDI57 peptide contains ER localization determinants recognized by a conserved machinery present in D. discoideum and Saccharomyces cerevisiae.

New clinical application of amniotic membrane transplant for ocular surface disease.

UNLABELLED: The new defined anatomical and functional complex conjunctiva-limbus-cornea is a new concept, which helps clinicians better understand and treat ocular surface pathologies. The management of the ocular surface disease has changed dramatically over the years, with spectacular improvements of techniques, and of course, results. The amniotic membrane, used as a graft or as a substrate for the cultivation of limbal corneal cells has showed encouraging results. AIM: To investigate the usefulness of amniotic membrane transplantation in ocular surface pathologies. METHOD: The study is retrospective. 28 eyes of 28 patients with ocular surface pathologies (ocular burns, recent and old, symblepharon, pterygium, corneal and conjunctival tumors, persistent epithelial defect) underwent an amniotic membrane transplantation during a 1 year period. The necrotic and the scar tissue were first excised in all the patients and the amniotic membrane was sutured with an epithelial face up. Follow up ranged from 1 to 12 months. RESULTS: Good results were obtained in all 28 eyes. The anatomy of cornea and conjunctiva was improved, with limited benefits only in old ocular burn, symblepharon and in one case of extended tumors of the cornea and conjunctiva. Out of 28 eyes, 23 (82%) also had a visual acuity improvement. CONCLUSION: The amniotic membrane may be considered a good alternative for ocular surface reconstruction especially in acute status. ABBREVIATIONS: AMT = amniotic membrane transplantation, BCVA = best corrected visual acuity, BUT = break up time.

In vitro analysis of the HIV-1 second strand-transfer reaction.

Two strand-transfer reactions are required during the retroviral reverse transcription. The second strand-transfer is believed to occur at the primer binding site (PBS). By using an in vitro model system derived from the human immunodeficiency virus type-1 (HIV-1), molecular events related to the second strand-transfer reaction were examined. The RNA-directed DNA synthesis catalyzed by the HIV-1 reverse transcriptase (RT) appears to pause twice, around the 2nd and the 11th bases downstream into the HIV-1 PBS. In either case, pausing seems to be caused by local sequence effects. From both these pause sites the nascent DNA strands can undergo transfer to PBS-homologous templates. The results confirm that pausing favors the internal strand-transfer. They also indicate that PBS-mediated transfers proceed through displacement of the DNA strands from RNA donor molecules by the acceptor template, as in one of the models proposed by DeStefano et al. (DeStefano, J.J., Bambara, R.A. and Fay, P.J. (1994) J. Biol. Chem. 269, 161-168). Whereas no hydrolysis by the ribonuclease H activity of HIV-1 RT seemed to occur within the HIV-1 PBS, specific cleavage was observed outside of this sequence and noticeably 5 bases upstream from its 3' end relative to the DNA primer growing point. This particular cleavage event remained essentially unchanged when the second pause site downstream into the PBS, located 16 bases beyond, was removed by mutation. The experiments suggest that this prominent RNA degradation event could precede the PBS-mediated strand-transfers.

Incidence of Herpes Simplex Virus Keratitis in HIV/AIDS patients compared with the general population.

UNLABELLED: Acquired immune deficiency syndrome (AIDS) is associated with a wide spectrum of systemic and ocular infectious diseases. Little information is known about Herpes Simplex Virus type 1 (HSV-1) keratoconjunctivitis in association with AIDS. Because HSV-1 is becoming, day by day, a common eye disease (nearly 100% patients of over 60 years old harbor HSV in their trigeminal ganglia at autopsy), this article discussing a worldwide public health problem. AIM: The purpose of this paper is to compare the incidence and clinical aspects of HSV-1 Keratitis in HIV/ AIDS patients compared with the general population who develops HSV- 1 Keratitis. METHOD: The study is retrospective and comparative. Each patient was examined thoroughly at the biomicroscope ocular slit after corneal staining with fluorescein or rose bengal. Visual acuity, intraocular pressure and corneal sensitivity were also examined. RESULTS: From 170 patients with HIV and ocular anterior segment disorders, 47 patients had viral etiology. 58 patients had keratitis; 14 of them were HSV-1 keratitis. CONCLUSION: Doctors should be aware of the existence of the ocular damage in HIV/ AIDS and emphasize the importance of regular ophthalmologic examination of patients with HIV/ AIDS as HSV infection is common nowadays among the general population.

Verotoxin targets lymphoma infiltrates of patients with post-transplant lymphoproliferative disease.

Post-transplant lymphoproliferative disease (PTLD) is an invasive, EBV expressing B lymphoma and a major cause of morbidity and mortality following organ transplantation. Presently there is limited therapy available; rather the patient often loses the allograft or succumbs to the malignancy. CD77 (or globotriaosyl ceramide -Gb(3)) is a germinal center B cell marker [Gregory et al. Int J Cancer 1998;42:213-20; Gregory et al., J Immunol 1987;139:313-8; Mangeney et al. Eur J Immunol 1991;21:1131-40], expressed on most EBV infected B cells and is the receptor for the E. coli derived verotoxin (VT) [Lingwood CA. Advances in Lipid Research 1993;25:189-212]. We present the basis of a possible novel approach to PTLD therapy utilizing the specific targeting of VT to the infiltrating lymphoma cells. Biopsies of adenoid, kidney or liver tissue of four PTLD patients were stained with verotoxin to determine expression of CD77. VT is a potent inducer of necrosis/apoptosis of receptor positive cells. In each PTLD case, the infiltrating EBV positive B lymphoma cells were strongly and selectively stained with VT, identifying CD77 as a new marker for these cells. For such individuals, VT might provide the basis of an approach to control their malignancy.

Increased serum gamma-glutamyltransferase in hypertriglyceridemia: comparison with serum pseudocholinesterase.

Both gamma-glutamyltransferase (gammaGT) and pseudocholinesterase (PCE) were found to be increased in hypertriglyceridemic subjects. High values of gammaGT were noted in alcoholic subjects and especially in those with either increased serum triglyceride or alanine aminotransferase higher than 16 mU/ml, while PCE was not significantly changed in alcoholic subjects. Although both enzymes were strongly correlated with the logarithm of serum triglyceride and the prebeta electrophoretic fraction, there were striking differences concerning their behavior in various hypertriglyceridemic subjects. PCE activity was high even in moderate hypertriglyceridemias but its correlation with serum triglyceride had a tendency to flatten with increasing concentration of triglyceride. However, increase of gammaGT was rather characteristic for gross hypetriglyceridemia. Short-term, triglyceride-lowering therapy was accompanied by a tendency to normalization of gammaGT, while PCE values were not influenced. An attempt was made to interpret these changes of serum-enzyme activity in hypertriglyceridemia in connection with mechanisms of lipoprotein synthesis and with the pathogeny of hyperlipemic conditions.

Multipass versus single pass photorefractive keratectomy for high myopia using a scanning laser.

PURPOSE: To study photorefractive keratectomy (PRK) for high myopia using the Nidek EC-5000 slit scanning laser and to compare a single pass versus a multipass ablation approach. METHODS: We retrospectively studied 95 eyes (64 patients; range -10.00 to -27.00 D; mean -12.00 D) treated for high myopia using PRK with a single or multipass technique. Forty-two eyes were treated with the single pass technique and 53 eyes were treated with the multipass technique. RESULTS: Twelve months after PRK, 79.4% (27 eyes) of the multipass group and 48.1% (13 eyes) of the single pass group were within +/-1.00 D of emmetropia; 32.4% (11 eyes) of multipass eyes and 29.6% (8 eyes) of single pass eyes were within +/-0.50 D of emmetropia. Uncorrected visual acuity of 20/40 or better was reached by 85.3% (29 eyes) and 20/20 or better was reached by 55.9% (19 eyes) in the multipass group at 12 months postoperatively. For the single pass group, 74.1% (20 eyes) achieved 20/40 uncorrected and 18.5% (5 eyes) achieved 20/20 uncorrected visual acuity. No multipass-treated eyes lost 2 lines of spectacle-corrected visual acuity at 6 or 12 months postoperatively. Mean regression between 1 to 12 months after PRK was 0.46 D for the multipass group and 1.45 D for the single pass group. Most of the regression occurred within the first 6 months after surgery in both techniques. CONCLUSION: These PRK results showed that treating high myopia using the Nidek EC-5000 excimer laser combined with a multipass approach generated good refractive outcomes with no complications. Undercorrections with the single pass technique could be compensated for with new nomograms. The multipass technique resulted in less regression and better refractive outcomes.

Ultrasound biomicroscopy of the iris-claw phakic intraocular lens for high myopia.

PURPOSE: To study the in situ relative intraocular position of the Ophtec Artisan iris-claw phakic intraocular lens (PIOL) for high myopia using ultrasound biomicroscopy. METHODS: Three PIOLs (13.00, 17.00 and 18.00 D lens powers) were implanted in phakic myopic eyes. Using ultrasound biomicroscopy, echograms were taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens. RESULTS: Preoperative anterior chamber depth ranged from 3.10 to 3.40 mm and the postoperative endothelial-optic distance measured 2.11 to 2.44 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.78 to 0.93 mm. Several echograms revealed the position of the PIOL on the iris. The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL. CONCLUSION: The original anterior chamber depths were reduced by 28% to 34% after implantation. The PIOL-crystalline lens distance ranged from 0.78 to 0.93 mm. This study of 3 eyes revealed that echograms taken by ultrasound biomicroscopy are useful in verifying the intraocular position of the PIOL within the anterior chamber.

Prompt re-treatment after photorefractive keratectomy.

PURPOSE: To study eyes that received a photorefractive keratectomy (PRK) retreatment 1 to 4 months after the first treatment and describe refractive stability and complications. SETTING: Michael Pop CLinics, Montreal, Canada. METHODS: Twenty-six eyes of 20 patients were re-treated for undercorrection and, regression with or without haze. Postoperative refractions were performed at 1, 2, 3, and 6 months. Haze was evaluated on a scale of 0 to 4. RESULTS: Ninety percent of the 21 eyes followed for 6 months after re-treatment achieved an uncorrected visual acuity of 20/40. At 6 months, 67 and 95% of eyes were within +/- 0.50 diopter (D) and +/- 1.00 D, respectively. Regression between 1 and 6 months after re-treatment was 0.71 D, which represented less than one half that observed after the initial treatment. Six months after re-treatment, haze decreased by half, and no eye had haze above 1. Best corrected visual acuity (BCVA) before treatment was well correlated with values 6 months after re-treatment (P < .001). At 6 months, 1 eye lost two lines of BCVA but had an acuity of 20/30 and 2 eyes lost one line of BCVA. CONCLUSION: Prompt re-treatment after PRK for myopia allowed management of undercorrections and regressions with low morbidity and high refractive stability. By re-treating promptly, no additional complications were created and patients avoided long periods of unsatisfactory vision.

Multizone/multipass photorefractive keratectomy: six month results.

A multizone/multipass photorefractive keratectomy (MP-PRK) technique was used to treat 315 eyes with the 193 nm VISX 20/20 excimer laser. Algorithms were developed to treat the full range of myopia, including 170 low myopic eyes (-1.0 to -6.0 diopters [D]), 105 moderately myopic eyes (-6.0 to -10.0 D), and 40 highly myopic eyes (-10.0 to -27.0 D). Preoperative mean myopia was -6.69 D; astigmatism equal to or greater than -0.5 D (mean -1.18 D) was present in 193 eyes. At one month postoperatively, most eyes were slightly hyperopic (mean +0.8 D); this regressed to a mean of -0.16 D. At six months, 95.5% of low myopes, 84.8% of moderate myopes, and 59.5% of high myopes were within 1.0 D of emmetropia; 78.4% of high myopes were within 2.0 D of the intended correction. There was no loss of 20/40 best corrected visual acuity (BCVA) at six months; a significant gain in 20/25 BCVA was seen in the moderate and high myopia groups (P < .05). At six months, uncorrected visual acuity was 20/25 in 89.4% of low myopes, 75.0% of moderate myopes, and 25.7% of high myopes. Mean haze value was 0.48 at one month and was not significantly different among the three groups (0.44, 0.52, 0.51, respectively). A control group treated with the one-pass multizone technique had a significantly higher amount of haze: 1.05 (P < .01). The data presented compare favorably with those obtained from other centers. Based on these results, we believe that MP-PRK is a safe, reliable technique to correct most low, moderate, and high myopia.

Predicting sulcus size using ocular measurements.

PURPOSE: To predict sulcus size using ocular measurements. SETTING: Michel Pop Clinics, Montreal, Quebec, Canada. METHODS: Forty-three eyes were evaluated using several techniques. Ultrasound biomicroscopy (UBM) echograms were taken to measure the anterior chamber depth (ACD), sulcus size, and central corneal thickness. The limbus size was measured with a caliper. Axial length, ACD, and pachymetry were measured by contact ultrasonography. Refraction and corneal power were also evaluated. RESULTS: The coefficient of linear regression was 0.05 between the limbus and the sulcus size (P =.78), 0.76 between ultrasonography and UBM ACD measurements (P <.001), and 0.69 between ultrasonography and UBM pachymetry (P <.001). Paired t tests showed that ultrasound and UBM ACD measurements were not statistically different (P =.70) but that ultrasound and UBM pachymetry measurements were (P <.001). The sulcus versus limbus difference was 0.6 mm for myopia and 0.3 mm for hyperopia. A backward elimination multiple regression performed with all measures to predict sulcus size resulted in the following formula: Sulcus size = 18.9 - 0.023 x sphere + 0.15 x mean keratometry (R = 0.49; P =.005; statistical power = 0.89; standard error of estimate = 0.5 mm). CONCLUSION: Traditional estimation of sulcus size through limbal measurement is inadequate because limbus size alone cannot predict sulcus size. A general formula using the sphere and the mean corneal power can help predict sulcus size. Corneal power was significantly and negatively correlated with sulcus and limbus size as well as sphere. The standard error of sulcus measurement by UBM was 0.4 mm.

Oral health status among schoolchildren in Romania, 1992.

In Romania, systematic information on the occurrence of oral diseases in children is scarce. The purpose of the present study was to describe the prevalence and the pattern of dental caries in schoolchildren, and to use the data to provide a baseline for planning and evaluation of oral health care. A national sample of children at grade 1 (n = 729) and grade 6 (n = 660) was chosen consistent with the WHO pathfinder principle. Clinical examinations were carried out according to the recording system for the Danish Municipal Dental Service and the following results were obtained. In children of grade 1 (7-yr-olds) the prevalence proportion of caries in primary teeth was 86% and in permanent teeth 39%. The mean caries indices were 11.4 defs and 1.3 DMFS. At grade 6 (12-yr-olds) the prevalence proportion of caries in primary teeth was 17% and in permanent teeth 90%. The mean caries experience was 0.8 defs and 6.5 DMFS, and a mean of 4.1 DMFT was observed. In both groups, the D-component of the caries index was dominant. The children were also classified by caries severity zone. At grade 1, 61% had a very severe pattern of caries in the primary teeth, i.e. caries in pits/fissures, proximal surfaces, smooth surfaces, and incisors. Forty-three percent of the children at grade 6 showed this pattern in permanent teeth. In Romanian schoolchildren the present level and pattern of dental caries are most severe and the implementation of oral health promotion and prevention at the community level is urgently needed.

The Panisset-Pop syndrome.

The authors describe a syndrome occurring in people learning fundus photography. This entity comprises the following: decrease of vision due to accomodative spasm, signs of anxiety and the finding of an improperly set ocular on the instrument used by the trainee.

[Terson's syndrome. Its surgical resolution]. / Sindromul Terson. Rezolvare chirurgicala.

The observation of 50-year-old patient is presented. Following a traffic crash, he had suffered a left cranial fracture, right subdural hematoma, cranial base fracture and vitreous hemorrhages at the both eyes. Right ocular vision was 1/500, left ocular vision was 1/200. The vitrectomy through pars plana with Tollentino lens at the right eye, without scleral indentation, is made. The postoperative evolution was good, 21 days after the intervention the visual acuity of the right eye reaching 16/20. The role of vitrectomy in vitreous hemorrhages of Terson syndrome is emphasized.