Evaluation of Eustachian tube function with perfect sequences: technical realization and first clinical results

The aim of this study was the introduction of a specific class of signals, the so-called perfect sequences (PSEQ), in a novel approach for sonotubometry of the Eustachian tube (ET). Sonotubometry using PSEQ stimuli was performed on 20 healthy subjects in order to gauge its potential for clinical applications. In a series of 320 measurements ET opening was probed, which was induced by dry and water swallowing, Toynbee maneuver, and yawning. All sonotubograms were analyzed with respect to their shape, increase of sound intensity, and opening duration. In 298/320 measurements (>93%) the subjects reported subjective ET openings. The evaluation of the recorded sonotubograms showed good detection of ET opening for the inducing maneuvers of swallowing (dry and water swallowing) and the Toynbee maneuver, with 90, 86, and 80% valid sonotubograms, respectively. Yawning led to only 40% valid sonotubograms. In total, 237/320 (~74%) sonotubograms were classified as valid. The evaluation of the sound level increase during ET openings showed that it was significantly higher in measurements with dry and water swallowing, as well as Toynbee maneuvers (mean 17.1, 19.0 and 17.2 dB, respectively), than with yawning (mean 10.17 dB; P < 0.0001). Nasal decongestion was found to have little influence on the results (P > 0.05). Sonotubometry using PSEQ stimuli is a novel sonotubometry methodology that provides valuable information regarding the auditory tube patency. By further technical refinements of the method, a diagnostic tool with high sensitivity and specificity could be developed.     

Curcumin and a Morus alba extract reduce pro-inflammatory effects of resistin in human endothelial cells

Resistin is a cytokine which plays an important role in cardiovascular disease by influencing systemic inflammation and endothelial activation. In human endothelial cells (HEC) it increases the expression of P‐selectin and fractalkine, and enhances monocyte adhesion by antioxidant mechanisms. This study investigated whether the natural antioxidants curcumin (CC) and an extract of Morus alba leaves (MA) have protective effects in resistin‐activated HEC. HEC were exposed to 100 ng/mL resistin for 6 and 18 h in the absence or presence of MA or CC and the expression of fractalkine and P‐selectin was determined by RT‐PCR and western blot. Intracellular accumulation of reactive oxygen species (ROS) was monitored by fluorimetry and NADPH oxidase activity by a lucigenin‐enhanced chemiluminescence assay. In addition, adhesion assays using the monocytic U937 cells were performed. The results showed that treatment of HEC exposed to resistin with MA and CC: (1) inhibited significantly P‐selectin and fractalkine expression, (2) inhibited the increase in the intracellular ROS level, (3) reduced NADPH activation and (4) reduced monocytes adhesion to HEC. The results indicate that MA and curcumin target resistin‐induced human endothelial activation partly via antioxidant mechanisms and suggest that they may represent therapeutic agents in vascular disease mediated by resistin. Copyright © 2011 John Wiley & Sons, Ltd.     

Our experience in the surgical treatment of the arterial hypertension due to endocrine disturbances

This study is trying to expose our experience in the surgical treatment for adrenal tumors which produce arterial hypertension, experience gained over a period of 25 years. There were 93 adrenalcctomies carried out for these kinds of lesions, out of a total of 125 surgical procedures on the adrenal glands. Best results were obtained for phaeochromocytomas and also for tumors that produce primary hyperaldosteronism. Real advances have been done in the field of adrenal glands diseases by diagnosis and treatment but minimal invasive surgery is best used for all adrenal lesions but phaeochromocytomas in which this approach has to be very well judged.     

Synchronous colonic cancers

The aim of this study is to present the difficulty of an accurate preoperative diagnostic for synchronous colonic cancers and to sustain the necessity of total colectomy. A retrospective study was carried out on 16 patients hospitalized in the IIIrd Surgical Unit, St. Spiridon Hospital, U.M.Ph. "Gr.T.Popa" Iasi between 1990-1999. The surgical procedures were: extensive colectomy with ileo-sigmoid anastomosis, segmentary colectomy, total colectomy with ileo-rectal anastomosis. RESULTS: Perioperative mortality: zero; uneventfully recovery for all patients. A metachronous lesion 3 years after the first operation was detected in one patient; postoperatively, one patient developed occlussion 3 months after, requiring re-operation. CONCLUSIONS: 1. synchronous colonic cancers are closely related with a genetic instability of the colonic mucosa; 2. total colectomy is a safe manner to prevent metachronous lesions.     

Evaluation of circulating tumor cells in colorectal cancer using flow cytometry

ObjectiveWe aimed to evaluate the prognostic value of circulating tumor cells (CTCs) and the impact of intraoperative tumor manipulation on CTCs in colorectal cancer (CRC) patients.MethodsWe performed a prospective study on 40 patients with CRC stages I to IV who received curative surgery using the no-touch technique. Flow cytometry was used to identify CTCs in peripheral blood samples (4 mL/sample) collected at two surgical moments: skin incision (T1) and after surgical resection (T2). A threshold of ≥4 CTCs/4 mL blood was established for considering patients CTC positive.ResultsIn the univariate analysis, CTC evaluation at T2 was correlated with female sex, vascular invasion, tumor localization in the colon and metastatic lymph nodes. In the multivariate analysis, only female sex and colon cancer maintained statistical significance. At a medium follow-up of 15 months (1–25 months), the mortality rate was 10% (n = 4), with no significant differences between the overall survival of T1 or T2 CTC-positive and CTC-negative patients.ConclusionsFlow cytometry is a feasible CTC identification technique in CRC, and although surgical manipulation has no influence on CTC numbers, CTCs may serve as a prognostic and predictive factor.     

Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors

ABSTRACT: BACKGROUND: Many trafficked people suffer high levels of physical, sexual and psychological abuse. Yet, there has been limited research on the physical health problems associated with human trafficking or how the health needs of women in post-trafficking support settings vary according to socio-demographic or trafficking characteristics. METHODS: We analysed the prevalence and severity of 15 health symptoms reported by 120 trafficked women who had returned to Moldova between December 2007 and December 2008 and were registered with the International Organisation for Migration Assistance and Protection Programme. Women had returned to Moldova an average of 5.9 months prior to interview (range 2-12 months). RESULTS: Headaches (61.7%), stomach pain (60.9%), memory problems (44.2%), back pain (42.5%), loss of appetite (35%), and tooth pain (35%) were amongst the most commonly reported symptoms amongst both women trafficked for sexual exploitation and women trafficked for labour exploitation. The prevalence of headache and memory problems was strongly associated with duration of exploitation. CONCLUSIONS: Trafficked women who register for post-trafficking support services after returning to their country of origin are likely to have long-term physical and dental health needs and should be provided with access to comprehensive medical services. Health problems among women who register for post-trafficking support services after returning to their country of origin are not limited to women trafficked for sexual exploitation but are also experienced by victims of labour exploitation.     

Women in post-trafficking services in moldova: diagnostic interviews over two time periods to assess returning women's mental health

Background  

Trafficking in women is a widespread human rights violation commonly associated with poor mental health. Yet, to date, no studies have used psychiatric diagnostic assessment to identify common forms of mental distress among survivors returning to their home country.     

Optical techniques for the noninvasive diagnosis of skin cancer

Purpose

The aim of this paper is to provide an overview of the most investigated optical diagnostic techniques: optical coherence tomography, fluorescence spectrometry, reflectance spectrometry, Raman spectroscopy, and confocal microscopy.

Methods

A search of three databases was conducted using specific keywords and explicit inclusion and exclusion criteria for the analysis of the performances of these techniques in the pre- and postoperative diagnosis of skin cancers.

Results

Optical coherence tomography has shown promising results in the assessment of deep margins of skin tumors and inflammatory skin diseases, but differentiating premalignant from malignant lesions proved to be less effective. Fluorescence spectroscopy proved to be effective in revealing the biochemical composition of tissue; early detection of malignant melanoma was reliable only with stepwise two-photon excitation of melanin, while tumoral margin assessment and differential diagnosis between malignant and non-malignant lesions showed some conflicting results. Characterization of the structural properties of tissue can be made using diffuse reflectance spectrometry, and the values of the specificity and sensitivity of this method are ranging between 72–92 % and 64–92 %, respectively. Raman spectroscopy proved to have better results both in carcinoma and melanoma diagnosis with sensitivities and specificities above 90 % and high above 50 %, respectively. Confocal microscopy is the closest technique to pathological examination and has gained the most clinical acceptance, despite the need for a standardization of the interpretation algorithm.

Conclusions

In conclusion, these optical techniques proved to be effective in the diagnosis of skin cancer, but further studies are needed in finding the appropriate method or combination of methods that can have wide clinical applications.