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Munteanu G, Munteanu M, Zolog I, Giuri S. [Idiopatic parafoveolar telangiectasia associated with pseudoviteliform lesion, basal laminar drusen and optic nerve head drusen]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2010; 54:79-82. [PMID: 20827916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND We present a case with bilateral optic disc drusen, associated in one eye with idiopathic parafoveal telangiectasis (Group 1B), basal laminar drusen, and foveal pseudovitelliform lesion. PATIENT A 45-years old female patient, which complained about a deterioration of vision at the right eye, was ophthalmologically examined. RESULTS The examination revealed a bilateral optic disc drusen, and on the right eye a macular haemorrhage. An examination after 2 months revealed a good vision, the resorption of the macular haemorrhage, idiopathic parafoveal telangiectasis, basal laminal drusen, and a foveal pseudovitelliform lesion. CONCLUSIONS The association is of importance because of the rarity of the haemorrhagic complication in the idiopathic parafoveal telangiectasis (Group IB), the possibility of a pathogenic correlation, and the difficulty of differential diagnosis with the optic disc drusen complicated with retinal haemorrhages. This association was not found in the literature we consulted.
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Munteanu M, Munteanu G, Giuri S. [Multiple optic disc--myth or reality]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2010; 54:41-43. [PMID: 20540368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To study the clinical aspects of multiple optic papilla. CLINICAL OBSERVATION We present 2 cases with multiple optic papilla. First case, with an aspect of duplicated double papilla, where at the supranumerary papilla we noticed a cilioretinal artery. The second case, with pseudo-double papilla, in context of a medium myopia, with visualization of the choroidal circulation. DISCUSSIONS AND CONCLUSIONS The diagnosis of multiple optic papilla is difficult. Its support requires the presence of multiple conditions: double papillary margins, central vascularization with separate emergence, synchronous vascular pulsation, imagistic and morphopathologic arguments. So far no clinical case with those required conditions was ever published.
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Poynard T, Munteanu M, Ngo Y, Ratziu V. Appropriate evidence-based data overviews demonstrate the diagnostic and prognostic performances of FibroTest in patients with chronic hepatitis C. Aliment Pharmacol Ther 2009; 30:1183-5; author reply 1185-6. [PMID: 19888919 DOI: 10.1111/j.1365-2036.2009.04115.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Iliescu D, Cernea N, Novac L, Tudorache S, Cornitescu F, Comanescu A, Capitanescu R, Munteanu M. O403 Outcome of fetuses depending of nuchal translucency values and subsequent tricuspid flow evaluation. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60776-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Poynard T, Massard J, Rudler M, Varaud A, Lebray P, Moussalli J, Munteanu M, Ngo Y, Thabut D, Benhamou Y, Ratziu V. Impact of interferon-alpha treatment on liver fibrosis in patients with chronic hepatitis B: An overview of published trials. ACTA ACUST UNITED AC 2009; 33:916-22. [DOI: 10.1016/j.gcb.2009.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Hermeziu B, Messous D, Fabre M, Munteanu M, Baussan C, Bernard O, Poynard T, Jacquemin E. Evaluation of FibroTest-ActiTest in children with chronic hepatitis C virus infection. ACTA ACUST UNITED AC 2009; 34:16-22. [PMID: 19726147 DOI: 10.1016/j.gcb.2009.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/14/2009] [Accepted: 06/03/2009] [Indexed: 12/13/2022]
Abstract
FibroTest-ActiTest (FT-AT) has been validated in adults with chronic hepatitis C virus (HCV) infection as a noninvasive alternative to liver biopsy (LB), but there are few data of its use in children. The objective of the present study was to evaluate FT-AT in children with HCV infection and to compare FT-AT analysis with liver histology. A total of 43 serum samples from 38 children with chronic HCV infection were analyzed retrospectively. Histological evaluation was performed according to the METAVIR scoring system. In 16 of the children, 21 serum samples were tested with FT-AT and compared to 21 LB (serum/LB pairs) in nontransplanted and liver-transplanted children. FT-AT was also measured in 22 infected children without LB and in 50 healthy controls. FT-AT values in controls were comparable to those of healthy adults, validating the adult FT-AT parameters in children. In most infected children (74%), the FT-AT score was <or = A1-F1. Concordance between FT-AT and METAVIR scores was found in 10 pairs and discordance in 11. FT-AT/METAVIR concordance was better in non-transplanted (8/13 pairs, 62%) than in transplanted (2/8 pairs, 25%) children. A prospective evaluation of FT-AT in non-transplanted children with chronic HCV infection would be worthwhile in future.
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Munteanu M, Ngo Y, Ratziu V, Poynard T. The risks of changing the rules for previously validated biomarkers and using the same patients several times. Response letter to Calès et al. Gastroenterol Clin Biol 2008;32:1050-60: "Evaluation and improvement of a reliable diagnosis of cirrhosis by blood tests". GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2009; 33:387-389. [PMID: 19372019 DOI: 10.1016/j.gcb.2009.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 02/19/2009] [Indexed: 05/27/2023]
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Munteanu M, Munteanu G, Giuri S, Zolog I. 529 Anomalies pigmentaires papillo-rétiniennes : à propos de 17 cas. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neckell A, Munteanu M. [Diabetus mellitus and pregnancy]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2009; 53:118-122. [PMID: 19899558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The evaluation of diabetic retinopathy during pregnancy. MATERIAL AND METHODS Retrospective study regarding 16 pregnant patients, with type 1 diabetes mellitus and variable retinal changes before the pregnancy: without retinal changes (5 cases), minimal diabetic retinopathy (7 cases), severe diabetic retinopathy (3 cases), proliferative diabetic retinopathy with panphotocoagulation before the pregnancy (1 case). The patients had a complete general and ocular investigation. RESULTS The patients without retinal changes were not influenced by pregnancy; the patients with minimal changes presented an aggravation of the diabetic retinopathy with an amelioration post-partum in 3 from the 7 cases; the patients with severe diabetic retinopathy suffered an aggravation in 1 from the 3 cases; the patients with proliferative diabetic retinopathy with panphotocoagulation before the pregnancy did not present any important changes during pregnancy. CONCLUSIONS The pregnancy represents a risk factor in the evolution of retinal changes in diabetic patients. The monitoring of the retinal changes and of the patients during the pregnancy is strongly recommended.
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Hiastru G, Dimitriu A, Brumariu O, Munteanu M. SFP-P155 – Néphrologie – Les modifications échocardiographiques induites par la séance d’hémodialyse chez les enfants avec insuffisance rénale chronique. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Poynard T, Munteanu M, Ngo Y, Moussalli J, Lebray P, Thabut D, Benhamou Y, Ratziu V. FibroTest is effective in patients with normal transaminases, when accuracy is standardized on fibrosis stage prevalence. J Viral Hepat 2008; 15:472-3; author reply 474. [PMID: 18363670 DOI: 10.1111/j.1365-2893.2008.00986.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Voorhees PM, Manges RF, Sonneveld P, Somlo G, Jagannath S, Zweegman S, Munteanu M, Vermeulen JT, Xie H, Orlowski RZ. Phase II study evaluating the efficacy and safety of CNTO328 in combination with dexamethasone for patients with relapsed/refractory multiple myeloma (MM). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Munteanu M, Munteanu G, Zolog I, Chercota V, Giuri S, Haidu S. [Diffuse choroidal hemangioma associated with serous retinal detachment]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2008; 52:59-63. [PMID: 19065916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 53-years old patient, with the diagnosis of diffuse choroidal hemangioma, partially ossified, associated with serous exudative retinal detachment, secondary to the choroidal neovessels, is presented. Aspects of differential diagnosis with the choroidal osteoma associated with serous exudative retinal detachment are discussed.
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Morra R, Munteanu M, Bedossa P, Dargere D, Janneau JL, Paradis V, Ratziu V, Charlotte F, Thibault V, Imbert-Bismut F, Poynard T. Diagnostic value of serum protein profiling by SELDI-TOF ProteinChip compared with a biochemical marker, FibroTest, for the diagnosis of advanced fibrosis in patients with chronic hepatitis C. Aliment Pharmacol Ther 2007; 26:847-58. [PMID: 17767469 DOI: 10.1111/j.1365-2036.2007.03427.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND FibroTest has been validated for the diagnosis of liver fibrosis in patients with chronic hepatitis C. AIM To compare FibroTest with a new proteome-based model for the prediction of advanced liver fibrosis. METHODS Sera from 191 consecutive patients with simultaneous liver biopsy and FibroTest on fresh sera were used for retrospective mass spectrometry analysis. A new fibrosis index was constructed combining proteomic peaks, selected on differential expression according to fibrosis stages in logistic regression analyses. The main end point was the diagnosis of advanced fibrosis on liver biopsy. RESULTS Eight out of 1000 peaks were selected for the construction of the proteomic index. The area under the receiver operating curve (AUROC) of the proteomic index was 0.88 (95% CI: 0.82-0.92), significantly greater than the FibroTest AUROC of 0.81 (95% CI: 0.74-0.86; P = 0.04); the AUROC of the proteomic and FibroTest combination was 0.88 (95% CI: 0.83-0.92). Seven of the eight selected peaks were highly associated with the FibroTest score, with different patterns of association with the five components of FibroTest. CONCLUSIONS A proteomic index combining eight peaks had an excellent accuracy value for the diagnosis of advanced fibrosis in patients with chronic hepatitis C. However, despite a statistical significance, the small improvement delivered by proteomics impairs clinical applications because of its cost and its variability compared with the well validated FibroTest.
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Giuri S, Munteanu M, Munteanu G. 397 Étude sur la tolérance oculaire immédiate après l’administration de l’olopatadine 0,1 % et du kétotifène 0,025 %. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Munteanu M, Munteanu G, Giuri S, Zolog I. 419 Dégénérescence maculaire vitelliforme de l’adulte. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80232-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Poynard T, Halfon P, Castera L, Charlotte F, Le Bail B, Munteanu M, Messous D, Ratziu V, Benhamou Y, Bourlière M, De Ledinghen V. Variability of the area under the receiver operating characteristic curves in the diagnostic evaluation of liver fibrosis markers: impact of biopsy length and fragmentation. Aliment Pharmacol Ther 2007; 25:733-9. [PMID: 17311607 DOI: 10.1111/j.1365-2036.2007.03252.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The area under the receiver operating characteristic (ROC) curve is widely used as an estimate of the diagnostic value for fibrosis markers. Biopsy length and fragmentation are known as risk factors of false positive or false negative of biopsy but their quantitative impact on area under the receiver operating characteristic curve variability has not been assessed. AIM To assess these relationships to better compare the fibrosis markers. METHODS The area under the ROC curves of FibroTest for the diagnosis of fibrosis was estimated in patients with chronic hepatitis C using an integrated database including 1312 patients with FibroTest and biopsy. To take into account the biopsy length, we used two adjustment factors: one in which an observed area under the ROC curve could be adjusted according to the relative area under the receiver operating characteristic curve of a biopsy of a given length vs. the entire liver and one taking into account the prevalence of each fibrosis stage defining advanced and non-advanced fibrosis. RESULTS The mean biopsy length was smaller for cirrhosis (F4, 16 mm) vs. F3, (18 mm, P=0.01) and F0 (19 mm, P=0.01). The mean number of fragments was higher for cirrhosis (F4=4.1 fragments) vs. all the other stages (F0=1.9, F1=1.9, F2=1.9, F3=2.3; P<0.001 vs. F4). The FibroTest area under the ROC curves for the diagnosis of advanced fibrosis, adjusted for stages' prevalence, ranged from 0.80 to 0.98 depending on biopsy length and fragmentation, respectively. CONCLUSION The comparison of the area under the ROC curves of fibrosis markers should take into account the biopsy length and fragmentation.
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Ratziu V, Giral P, Munteanu M, Messous D, Mercadier A, Bernard M, Morra R, Imbert-Bismut F, Bruckert E, Poynard T. Screening for liver disease using non-invasive biomarkers (FibroTest, SteatoTest and NashTest) in patients with hyperlipidaemia. Aliment Pharmacol Ther 2007; 25:207-18. [PMID: 17229244 DOI: 10.1111/j.1365-2036.2006.03182.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mortality related to complications of cirrhosis is increasing in patients with insulin-resistance factors. Hyperlipidaemic patients have multiple risk factors of insulin resistance. It is impossible to perform liver biopsy in such a large number of hyperlipidaemic patients to identify patients with advanced liver fibrosis or with steatohepatitis (non-alcoholic steatohepatitis, NASH). AIMS To use the non-invasive biomarkers, FibroTest (FT), SteatoTest and NashTest, and to assess the prevalence of advanced liver disease in a large population of hyperlipidaemic patients. METHODS A consecutive cohort of hyperlipidaemic patients was followed prospectively in a lipid centre and the sera were analysed retrospectively. RESULTS A total of 2834 subjects were included: 1909 hyperlipidaemic patients and 925 blood donors (BD). Advanced fibrosis was identified by FT in 53/1909 (2.8%) hyperlipidaemic patients vs. 0/925 BD (0%) (P < 0.0001); advanced steatosis in 569/1893 hyperlipidaemic patients (30.1%) vs. 8/164 (4.9%) BD (P < 0.0001) and NASH in 132/1893 (7%) vs. 0/164 (0%), respectively (P < 0.0001). There was a highly significant and linear association between the number of metabolic syndrome factors and liver disease prevalence - the highest being for type 2 diabetics: advanced steatosis 66%, NASH 24% and advanced fibrosis 6%. CONCLUSIONS The prevalence of fibrosis, steatosis and NASH in hyperlipidaemic patients appears to be high (3%, 30% and 7%, respectively). Biomarkers could be useful for screening of advanced fibrosis and NASH in patients with several metabolic syndrome factors, to prevent liver mortality.
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Munteanu G, Giuri S, Munteanu M. [Wyburn-Mason syndrome]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2007; 51:69-74. [PMID: 18064958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The Wyburn-Mason or Bonnet, Dechaume, and Blanc syndrome is a rare congenital anomaly formed of malformations of the retinal vessels, orbito-cerebral vessels, and, rarely, facial vessels. CASE REPORT Male patient, 19 years old, examined because of a severe visual loss and exophthalmos at the left eye. The ophthalmoscopic examination reveals extensive retinal arterio-venous malformations, also confirmed at orbito-cerebral level by ultrasound and MRI DISCUSSION: The Wyburn-Mason syndrome is due to arterio-venous anastomosis, being included in the phakomatosis group. Clinically we describe 3 groups of severity. Aspects of differential diagnosis, pathogeny, and treatment are discussed. CONCLUSIONS The Wyburn-Mason syndrome can be suspected in cases of facial angioma, exophthalmos, or decreased visual acuity. The diagnosis imposes additional examinations with orbito-cerebral imagery.
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Munteanu M, Zolog I. [Retinal capillary hemangioma]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2007; 51:52-55. [PMID: 17937035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The retinal capillary hemangiomas are evolutive tumors which, solitary or multiple, present a vast clinical appearance, described under generic name of "retinal angiomatosis". We present the case of a young male patient with solitary retinal capillary hemangioma, localized in the interpapilo-macular region. The exofitic tumors were characterized by a particular arrangement of the tumoral vascular network: superficial (in the superior area) and profound (in the inferior area). This double vascular localization explains the spotted aspect of the fluorescent tumor, and also the phenomenon of "choroidal adoption".
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Abstract
INTRODUCTION The hemorrhagic complications of the optic disk drusen are rare and interesting because of their functional implications, the difficulty of the differential diagnosis and the uncertain pathogeny. MATERIAL and methods: Retrospective study of 6 cases with a complete general and ophthalmological examination, followed between 2 and 9 years. RESULTS The average age of the cases was 38.5 years (9-62 years). The visual acuity was slightly affected and reversible in the papillary hemorrhages (1 case), low and partial reversible in the extended hemorrhages (4 cases), severe affected and irreversible in the associations with a choroidal neovascular membrane with macular implications (1 case). We found three types of hemorrhages: papillary (1 case), peripapillary associated with choroidal neovascular membrane in acute (2 cases) and cicatricial stage (1 case), extended subretinal (2 cases). The papillary drusen were profound (4 cases) and superficial (2 cases). Ultrasonography showed the presence of the optic disk drusen in both eyes in all cases. The evolution followed on a period from 2 to 9 years, revealed the resorbtion of the hemorrhages between 3 and 6 months, the reversible visual acuity in the cases without macular implication, and the absence of recidiva or bilateralisation. DISCUSSIONS AND CONCLUSIONS The authors are presenting a number of clinical cases of papillary drusen complicated with hemorrhages, some of the cases being associated with choroidial neovascular membrane. Because of the clinical appearance, aspects of differential diagnosis with papillary edema of other etiologies are discussed. A role in the pathogeny is attributed to the direct or progressive compression of the retinal vascularisation which can provoke the erosion of the vessels and in some cases the appearance of the choroidal neovascular membrane. The suggested therapy is medical, surgical, or by photocoagulation, but the results are contradictory.
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Munteanu M, Chercotä V. [Optic nerve drusen and angioid streaks in pseudoxanthoma elasticum]. OFTALMOLOGIA (BUCHAREST, ROMANIA : 1990) 2007; 51:99-102. [PMID: 17605281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The clinical study presents the association between optic disc drusen and angioid streaks in the context of pseudoxanthoma elasticum, in 8.5% (4 from 47) of the cases. The values are significantly higher compared to those from the normal population (0.34%). This result can be the consequence of pathogenic correlations between the two diseases, in which a role is attributed to the metabolic changes within the pseudoxanthoma elasticum. The starting point seems to be the accumulation of polyanions in the elastin of the cribriform plate, followed by disruption of axonal transport, mitochondrial extrusion and subsequent formation of optic disc drusen.
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Munteanu M, Pîrşcoveanu M, Mănescu P, Biciuşci V, Petrescu F, Munteanu MC, Munteanu AC, Tudoraşcu C, Fulger S, Gugilă I. Intussusception of efferent intragastric loop after gastrojejunostomy--an exceptional cause of high occlusion and hematemesis. Chirurgia (Bucur) 2006; 101:525-8. [PMID: 17278647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Jejunogastric intussusception (GI) is an extremely rare complication of gastrojejunostomy (GJS) that may appear any time after surgical intervention. Less than 200 cases have been reported so far, on very small series. Young female, 32, who 12 years ago was operated for a gastroduodenal disease that she doesn't know many details about. She presented severe pain in the superior abdominal segment posteriorly irradiated, incoercible biliary nausea followed by hematemesis. The endoscopic, imaging and biological explorations suggested a huge gastric tumor that occupied the whole stomach and was bleeding diffusely. The rapid acute evolution asked for the urgent laparotomy that emphasized: soft tumour mass, intragastrically mobile without any scar at the stomach or duodenum level; adherent to the posterior of the stomach we discovered a ball of jejunal loops that couldn't be undone. The anterior gastrotomy sets the diagnosis: JGI of the efferent loops of a GJS. We hardly managed to reduce the intussusception, without resection, the loop being absolutely viable. In order to prevent a relapse, and because the anastomosis was not justified it was taken down. JGI in a patient presenting GJS must be taken into consideration in the presence of epigastric pain that would not cease, biliary nausea followed by hematemesis and rapid deterioration of general health status.
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Poynard T, Halfon P, Castera L, Ratziu V, Imbert-Bismut F, Naveau S, Thabut D, Lebrec D, Zoulim F, Munteanu M, Bourlière M, De Lédinghen V. CA 16-Méta-analyses du fibrotest (FT) pour le diagnostic de fibrose dans les 4 maladies du foie les plus fréquentes. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0399-8320(06)73426-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Munteanu M, Pirşcoveanu M, Munteanu AC, Munteanu MC, Săftoiu A, Gugilă I. [Surgical management of acute pancreatitis. One hundred years of evolution]. Chirurgia (Bucur) 2006; 101:229-35. [PMID: 16927911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The aim of the paperwork is to present the evolution of surgical management of acute pancreatitis for a period of more than a century, by using the literature data that reveal the important moments in the knowledge of patho-etiology, in clarifying the definition and classification and, last but not least, in the progress of biological and image exploration, the right timing and the permanent development of surgical procedures so that the general mortality should decrease up to 10-15%, as it nowadays. The need for surgical intervention in acute pancreatitis is the controversy that appeared during this period. Until the mid of the 20th century, mainly on the basis of the clinic diagnosis, only the severe cases were recognized and became subjects of surgical exploration, with disastrous results. A great step forward was the dosage of urinary and serum amylase that allowed the non-surgical diagnosis of the disease, so that some patients could be treated successfully without surgery. Introduction of prognosis criteria by Ranson, the dosage of C-reactive protein together with CT scanning of the injury: interstitial - edematous or necrosis,the fine needle aspiration for bacteriology and the adoption of a definition and unitary classification resulted in a major change in therapy, in general, and in the surgical procedures. Necrosectomy combined with a drainage method, practised and developed by Beger since 1982, becomes a surgical dogma. Minimally invasive procedures became a reliable alternative to classic procedures due to the diversity and permanent development of laparoscopic, endoscopic and radiologic techniques.
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