Archive issue

Current Health Sciences Journal

vol. 38 no. 4, 2012

1. Molecular mechanisms underlying the anti-cancerous action of flavonoids


Flavonoids are phenol compounds present in the pigments of fruit, vegetables, green tea and red wine. They have anti-allergic, anti-inflammatory, anti-microbial, anti-cancerous, anti-coagulant and anti-cholesterol effects. A few molecular mechanisms through which flavonoids exert their anti-cancer action are presented. One of the molecular mechanisms on which their anti-cancer action is based is their anti-oxidant activity which is exerted through the direct removal of the free radicals, the interaction with cell membranes, or the inhibition of xanthine-oxidase activity, an important source of ROS (radical oxygen species). Another is that by which flavonoids interact with the pathways signaling cell growth and apoptosis. Flavonoids interact with the signaling pathways for PI3-kinase, Akt/Pkb, tyrosine-kinase, P1KC and MAP-kinase. The same flavonoids may alter growth signaling by inhibiting receptor phosphorylation or by arresting growth factors binding to receptors. The activation of apoptosis genes is a characteristic of quercetin (a flavonol) which, in high concentration, induces thymidylate synthase – mediated apoptosis.  In association with other drugs, flavonoids might prove useful in the treatment of cancer

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2. Clinical, histological, immunohistochemical and statistical aspects in malignant nasopharyngeal tumors


Various types of cancer can be found at a nasopharyngeal level, and most of them are carcinomas (NPC=nasopharyngeal carcinoma). The most frequent and clinically important carcinoma is the undifferentiated one, known as UCNT. It is localised form, it is a very radiosensitive and radiocurable type of cancer, but strong emphasis has also been placed on its high chemosensitivity. Actually, its connection to the Epstein Barr virus (EBV) drew numerous researchers’ attention. The use of immunohistochemical markers in the study of malignant nasopharyngeal tumours for diagnosis purposes and in order to determine the exact nature of undifferentiated tumours for scientific purposes and for the assessment of the prognosis thus becomes absolutely imperative.

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3. Histopathological study of sinus mucosa in patients diagnosed with odontogenic maxillary sinusitis


urpose - The aim of the study is to analyze the changes that occur in the mucosa of  ontogenic maxillary sinusitis patients. Material and methods - The study included 127 patients diagnosed with odontogenic maxillary sinusitis admitted to the County Hospital Craiova, ENT Clinic in 2006-2010; out of them there were selected 47 patients who underwent surgery, practising radical Caldwell-Luc sinus cure. Sinus mucosa taken during these inteventions was analysed in terms of histopathological hematoxylin-eosin staining. Results - Histopathological study of sinus mucosa taken during surgery allowed us to observe the presence of the following cellular infiltrates: existence of a microscopic respiratory type epithelium, often ulcerated, subjacent dense collagen stroma with myxoid areas alone or combined with hyalinisation areas; presence of diffuse lymphoplamocitary infiltrate, subepithelial or focal, periglandular; the presence of this lymphoplamocitary infiltrate shows chronic inflammation of sinus mucosa; presence of eosinophilic infiltrate with or without lymphoplasmocitary infiltrate; presence of chronic xantogranulomatous infiltrate. Discussion and conclusion - In odontogenic maxillary sinusitis histopathology of sinus mucosa, performed regularly, confirms the clinical diagnosis. Histopathological examination is necessary to identify a possible malignant lesion. In general, the changes are not characteristic for sinusitis of dental origin but we have to take into consideration the adagium  “if it is important enough to have it removed, it is important enough to have it investigated”

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4. Sedation impact over perioperative endocrine stress response in patients with increased anxiety undergoing total arthroplasty of the inferior limb


Purpose. Decreasing anxiety level through intraoperative sedation and postoperative anxiolysis can modulate perioperative neuroendocrine stress response. Material and Methods. This randomized prospective clinical study includes 48 patients subjected to total articular endoprothesis at hip and knee level, respectively. The patients included in the study were equally divided into 2 groups, each group comprising 24 patients: 12 patients with knee prothesis (TKA), and 12 patients with hip prothesis (THR). All patients benefited from subarachnoid anaesthesy.  In order to evaluate anxiety, there was used a STAI-X2 questionnaire for determining preoperatory anxiety and STAI-X1 questionnaire for determining preoperatory, post-operatory anxiety, immediately and the following day. The numerical scale was used to evaluate preoperatory pain (NRS), while the Wilson  scale was used for quantifying the intraoperatory sedation. Results. The situation anxiety in group As decreases significantly immediately after surgery, (p<0.0001 for TKA, THR respectively), the following day after surgery patients show slightly increased scores (p=0.0002 for TKA, p=0.0004 for THR) in comparison to the end of surgery. In the sedated patients (Group As), both for TKA and for THR, the level of cortisolemia significantly decreases immediately after surgery (p<0.0001 for TKA, THR, respectively). Seric glycemia is maintained relatively stable (even decreasing in the case of THR (p=0,00014) immediately after surgery in the patients in group As.Conclusions. Immediately after surgery, faced with surgery, there is a signficant correlation: situation anxiety-cortisolemia-glycemia. Intraoperatory sedation and postoperatory anxiolysis in patients with high anxiety may indirectly modulate the postoperatory neuroendocrine response.

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5. Correlations between scleroderma renal crisis and videocapillaroscopic patterns in patients with systemic sclerosis


Introduction - Scleroderma renal crisis is one of the major complications of ScS, being the main cause of mortality in patients with systemic sclerosis. Objectives - to establish the correlations between scleroderma renal crisis, the subsets of the disease, videocapillaroscopic patterns and modified Rodnan skin score in patients with ScS. Methods: a number of 35 patients with ScS have been included in the study, 23 with lcScS and 12 from dcScS. Scleroderma renal crisis has been studied in comparison with the two subsets of the disease, capillary nailfold changes and modified Rodnan skin score. Results - scleroderma renal crisis was more frequent in diffuse cutaneous form (25%) than in the limited one (8,70%),  occuring with the same frequency in the first 5 years and after an evolution longer than 10 years (40%). In 60% of the patients with SRC, an “active” type scleroderma-like pattern was observed and in 40% a “late” pattern was described, and mRSS recorded an average value of 35,97 ± 9,02. Conclusions - During the last two decades, the outcome of scleroderma renal crisis has improved dramatically with the use of angiotensin-converting enzyme (ACE) inhibitors. Prompt diagnosis and early, aggressive initiation of therapy with ACE inhibitors will result in the most optimal outcome.

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6. The importance of analgosedation in postoperative periode


 We observed and noted clinical  symptoms,.and  used screenig tests as tools for evaluating the values of pain and neuropsychiatric changes . We introduced as instrument of measurements: rating numerologic scale of pain, Ramsay Sedation Scale (RSS), criteria of  delirium diagnose , applied  in early period of arrousal (20 minutes- 4 hours) at the moment T1, at 4-7 hours : complete arrousal (T2) and at 72 hours (T3). Our pathophysiological, prospective randomised, clinical study, was approved by Ethic Commission of UMF and of Hospital nr.1 Craiova. We selected 100 patients from Plastic and Recontructive Surgery Department , with the aggrement of head of this section and having the patient accord. The most important conclusion of our study was that: appropriate information of patients about surgery and anesthesia, reduces preoperative anxiety, post-operative pain and hospital stay length.

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7. Assessment of bone involvement and malignancy in sinonasal inverted papillomas


Introduction - Sinonasal inverted papilloma (IP) is a rare benign epithelial neoplasm of unknown etiology characterized by destructive pattern of local growth, tendency to recur after surgery and associated squamous cell carcinoma. The aim of this study was to evaluate the bone erosions and the malignant transformation in sinonasal inverted papilloma. Material and methods - The presence of bone erosions and the association to squamos cell carcinoma, were analysed in 43 patients with histologically proven inverted sinonasal papilloma. All patient data were retrospectively staged using the staging system for inverted papilloma proposed by Krouse. Results - The study group consisted of 28 men and 15 women, confirming the male predominance. 25 patients (58.2%) were admitted with a stage II inverted papilloma. Eight patients (18.6%) were admitted with extranasal inverted papilloma, extension beyond the sinuses or even malignant transformation, representing stage IV inverted papillomas. In ten cases (23.2%) localized bone defects were found on the preoperative CT scans as well as intraoperatively. Histological examination revealed inverted papilloma with focal transformation to squamous cell carcinoma in five cases (11.6%). Discussion and Conclusions - Although benign, inverted papilloma has an aggressive clinical behavior. Even in the absence of malignancy, the adjacent bone destructions are not uncommon. Close follow-up after surgical removal is necessary and extremely important to detect early recurrence or possible transformation to malignancy

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8. Characterization of a tosylated cholesteryl derivative


Purpose. This study presents the synthesis of 11-cholesteryloxy-3,6,9-trioxaundecyl-1-p-toluenesulfonate and its detailed structural characterization. Bearing a p-toluenesulfonyl group, it is a very versatile compound that can be used in the synthesis of a wide variety of derivatives that can be incorporated in liposomes, with various applications in modern drug delivery systems. Material/Methods.  The compound has been prepared in a sequence of three reactions, using cholesterol as starting compound. After purification, the tosylated product has been analysed by 1H, 13C NMR and mass spectrometry.  Results. The performed analysis confirmed the structure of the desired derivative. Conclusions.11-cholesteryloxy-3,6,9-trioxaundecyl-1-p-toluenesulfonate has been successfully obtained as a pure compound in 58.26 % overall yield  starting from cholesterol.

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9. Considerations on dental bridges` stability and balance for mandibulary teeth with coronary-root amputation


Dental occlusion represent the function of dentomaxillary system at which realization participate all the components of that system holding the equilibrium between them. Setting up the treatment with dental bridges in partial edentuluous is rule by some principles that have aims like restore the morphology and functions change by edentuluous condition and also prevention disorders of remaining teeth and other structures and functions of dentomaxillary system. During the prosthetic treatment with fixed bridgeworks in clinical cases presents in this study , we used also terapeutical techniques specifically other dental domains like endodontology and oral surgery. For avoid the appearance of occlusal dysfunction is necessary a good knowledge and respecting the biomorphocinematic behaviour of dentomaxillary system structure under action of occlusal force during mastication and also biomechanical rules that influence the functional equilibrium of teeth and dental bridg

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10. Emphysematous Cystitis. Case report and imaging features


Emphysematous cystitis is a rare bacterial infection of the bladder which results in presence of gas in the bladder wall, lumen, and surrounding tissues. The most important factors involved in this disease are diabetes mellitus, dysuria and neurogenic bladder, with predominance of female gender.           We present a case of a 64 years old female patient, with diabetes mellitus tip 2, who presented in our emergency department with fever, abdominal complaint, olyguria for the last one month. Abdominal CT (computer tomography) revealed gas in the bladder with thickening of bladder wall and formation of an air-fluid level. Laboratory test showed anemia and leukocytosis. Urine culture showed elevated growth of Escherichia coli (E. coli). The diagnosis was emphysematous cystitis and patient started the antibiotic specific therapy.

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