The current aspects of food quality

Foods may become damaging factors to the human body, both by inadequate intake (over- and sub-nutrition), and by the accidental presence of biological agents (bacteria, viruses, parasites), and the toxic chemical substances, which may be normal compounds of a given product (alkaloids, antivitamins, goitrogen substances), or may come from food altering (toxic amines, peroxide fat compounds), may be produced by certain contaminant microorganisms (mycotoxins), may pollute the food product (toxic metals, pesticides), or may be added willingly (adjuvants) in higher concentrations than allowed by sanitary legislation. Changes in of a food's quality, as long as the food may become improper for consumption, therefore damaging to the consumer's health, is called alteration. Altering processes are different, according to the chemical composition of the food product and to the factors that act upon it. National and international organisms for the safeguard of population's health are permanently monitoring food quality and give normatives and rules that will be imposed to the products offered for human consumption.     

Neck dissections: Its anatomy,indications, history and current terminology

This paper provides an overview of the anatomy of the neck lymph node distribution; indications, history and current terminology of various types of neck dissections and the therapeutic applications for different primary head and neck malignancy.     

Perinephric phlegmon. Current aspects of diagnosis and treatment. Apropos of 20 cases

The authors report a series of twenty patients presenting with perinephric abscess. Percutaneous management was performed in 4 cases. Considering the benefit of the modern imaging techniques, the authors discuss the current diagnostic, therapeutic and prognostic modalities of this disease.     

Cardiac wounds. Experience from 10 years of war. Apropos of 32 cases treated surgically

Thirty-two patients with cardiac wounds from high velocity firearms (bullets or shrapnel) were operated. Seven of these patients who had no cardiac activity on arrival underwent emergency thoracotomy with a mortality of 85%. The other twenty-five patients underwent planned sternotomy with a mortality of 12%. The authors analyse these case with emphasis on the diagnostic and therapeutic management.     

Emergency vascular access in patients with renal failure. Apropos of 32 implantations of permcath

Central venous catheters allow for the most rapid hemodialysis procedure with sparing of peripheral blood vessels. 32 flexible, double-lumen "permcath" catheters were implanted to 27 patients over a period spanning 42 months (February 86-August 89). Catheter placement was definitive in 2 cases while another 30 provided previsory intravenous access for plasmapheresis (25 cases), acute renal insufficiency (7 cases), and chronic renal failure (17 cases). The mean utilization time per patient was 10.7 +/- 8.01 (SE) weeks. As respects chronic renal failure, this provided a time-opportunity for prospective maturation of conventional venous routes of access or transplantation. Permcath thrombosis occurred in 6 instances (18.75%), 5 times unremittingly (15.4%). Infection occurred in 6 patients (18.75%), leading to ablation of the permcath only once. Thus, permcath ensures safe, effective access for hemodialysis and enables maturation of a conventional venous cutdown. It may be used directly as a permanent vascular approach in case of limited life expectancy or of an extremely precarious vascular bed.     

Adenocarcinoma of the kidney with invasion of the inferior vena cava. Apropos of 32 cases

The authors present 32 cases of renal cell carcinoma with inferior vena cava involvement. Three sub-groups of patients can be distinguished on the basis of the level of this involvement: A (24 patients) with infra-hepatic involvement, B (6 patients) with retro-hepatic involvement and C (2 patients) with supra-hepatic involvement. The surgical tactics and results are analysed for each of these 3 sub-groups. The prognosis is relatively good in sub-group A, but is increasingly less favourable in groups B and C.     

The current and future aspects of liver cell transplantation

Our previous experiment presented that isolated adult rat hepatocytes survived and proliferated markedly and they reconfigured macroscopic hepatic tissue occupying more than 50% of the spleen 27 months after transplantation. On the basis of the results, we have emphasized that the hepatized spleen provides many fundamental and clinical interests on hepatology. The morphlogical studies of the recomposed hepatic tissue revealed almost normal architecture of the liver except the lack of bile duct system. Prolongation of the survival time was obtained in rats with hepatized spleen which underwent a portacaval shunt several months earlier compared with animals without hepatized spleen, when the rats were completely devascularized. That means that the hepatized spleen can act as an auxillary liver. For the purpose of applying this experimental model clinically, liver cell autotransplantation was performed using dog and monkey. These resulted in recomposed hepatic tissue in the monkey's spleen 15 months after transplantation, but no survival of the transplanted hepatocytes in dogs. In human, we have been developed a new hepatocyte isolation technique and we can obtain approximately 10(6) isolated human hepatocytes (viability 55-86%) from the partially resected liver with the hand-made multiperfusion system. Finally, future problems of clinical application of the intrasplenic hepatocyte transplant were mentioned especially about the idea of the liver cell bank.