The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Total Lower Lip Reconstruction - What Techniques Should We Choose

2014-04

N. Calcaianu, S.A. Popescu, Daniela Diveica, I. Lascăr

While the incidence of lip cancers incidence in the central Europe is low 0.7% of all malignant tumors compared to the 1-2% generally considered (2-5), they are extremely important from a clinical and surgical point of view because of the morphological and functional changes involved. More than 90% of these tumours are squamous cell carcinomas (SCCs) and, in lesser numbers, basal-cell tumours (BCCs); however, some adenocarcinomas deriving from the minor salivary glands can be observed and, even more rarely, melanomas, sarcomas and lymphomas. BCCs generally occur in the upper lip and do not usually present lymph node metastases (4, 6). In contrast, SCCs develop most often in the lower lip, with a possibility of neck metastases. Lip carcinomas frequently appear on top of precancerous lesions, such as radiodermitis, chronic chelitis and xeroderma pigmentosum. The diagnosis and treatment of these pre-cancerous lesions, facilitated by a direct view of the lesions, is, therefore, crucially important in order to avoid their evolving into actual tumours. The subjects most at risk of this type of tumour are fair-skinned elderly people who work in the open air. Men are more at risk than women, (1.3% men and 0.3% women) (1) probably because the latter use lipstick or lip-salve (2, 7-9).

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Acute Myocardial Infarction in Youngs: Presentation, Treatment and Outcome

2014-04

Anna-Maria Andronescu, A. Nechita, Eugenia Panaitescu, M. Vintilă, Maria Dorobanțu

Coronary Artery Disease (CAD), the world’s leading cause of death and morbidity, it is not anymore an attribute of old age (1). The increase prevalence of atherosclerotic risk factors among the young and very young population is responsible for more premature CAD cases (2). Prior studies highlighted that AMI in young’s is associated with different clinical features and has a better short-term outcome than in older population (3,4,5). However, long-term follow-up revealed a higher mortality and morbidity in young AMI survivors than in general population (6,7). Also, the conclusion of several studies and "real-world" registries was that patients with STEMI and NSTEMI, regardless of age and despite different management, have similar inhospital outcome and longterm survival (8,9).

In our country, RO-STEMI registry is providing the most extensive information on the profile, treatment and inhospital outcome of the STEMI Romanian patients (10) but only few reports about mid and long-term follow up of young Romanian patients with AMI, especially in case of NSTEMI, are available (11,12,13).

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Intrahepatic Cholangiocarcinoma - the Impact of Pathological Characteristics on the Long-Term Outcome after Resection

2014-04

Zenaida Emilia Ionel, T. Dumitrașcu, V. Brașoveanu, I. Lupescu, R. Anghel, V. Herlea, M. Ionescu, I. Popescu

Intrahepatic cholangiocarcinoma (ICC) is the second as frequency primary liver cancer after hepatocellular carcinoma (HCC), arising from the biliary epithelium of the second branch (segmental branch) or the proximal branch of bile duct (1,2). Recent reports suggest that the incidence of ICC varies considerably according to geographical location, and accounts for about 5-30% of primary liver cancers, with an increasing incidence during the past years all over the world (3-6). Radical resection (R0) remains the only potential curative treatment, but the resectability rate is still low because of late diagnosis. In general, prognosis is poor, with a reported rate of 5-year survival, usually below 20 to 40% for patients with potentially curative resection (7).

However, the recent progress in anesthesiology and intensive care, the development of more effective surgical techniques in hepatobiliary surgery, and the advent of new devices for parenchymal trans-section made more applicable aggressive surgical approaches for ICC, improving the resectability rate in the last two decades (8,9).

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Ontogenesis - Complementarity or Opposition between Materialism and Idealism, between Science and Religion

2014-04

M. Ifrim

The "Albert Schweitzer" International Academy, founded and directed by the academician Kazimierz lmielinski, scientific personality of worldwide renoun, nominalized for the award of the Nobel prize, represents by its prestigious members an international saientific authority in the framework which are debated: medical problems of a fundamental and functional character, as well as philosophical conceptual aspects regarding the materiality and the ideality of the Universe in which we live.

In this context, I present some aspects refering to ontogenesis, which may open interesting perspectives for the medical science.

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THROMBUS FORMATION ON DISRUPTED PLAQUES

2014-03

A. Yamashita and Y. Asada

Acute cardiovascular events that usually involve thrombus formation at sites of disrupted atherosclerotic plaques are currently described as atherothrombosis. Thrombosis is a major complication of atherosclerosis and also a rare but serious complication after stent implantation. However, it does not always result in complete thrombotic occlusion with subsequent acute symptomatic events (1). Therefore, thrombus growth is critical to the onset of clinical events. Thrombus formation is probably modulated by the thrombogenicity of exposed plaque constituents, local hemorheology, systemic thrombogenicity and fibrinolytic activity. Although the mechanisms of thrombus formation have been intensively investigated, little is known about either the mechanisms involved in thrombogenesis or thrombus growth after plaque disruption and stent implantation. This article examines the pathology of atherothrombosis, including late drug-eluting stent (DES) thrombosis, and recent advances in the understanding of thrombogenetic mechanisms and thrombus growth on atherosclerotic lesions, especially coronary atherothrombosis.

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