[Immunohistochemical considerations in local inflammatory response induced by prosthetic materials]. / Consideratii imuno-histochimice asupra reactiei inflamatorii locale induse de materialele protetice.

INTRODUCTION: Even they are considered inert and biocompatible, prosthetic materials induce a local inflammatory response with the host despite of their composition and structure. This reaction is responsible for most of the long-term complications of the prosthetic repair of abdominal wall defects. Unfortunately, most of the published studies are the results of animal experiments. Our study analyses the prosthetic materials extruded from humans for various reasons. MATERIAL AND METHODS: 15 prosthetic samples extruded from human patients for various reasons were analyzed. This were prepared with standard colorations (eosin - hematoxilin), for collagen (rethiculyn, Syrius red) and immunohistochemical in order to count inflammatory cells, fibroblasts, collagen fibers, blood vessels. RESULTS: 10 polypropilene (Prolene) and 5 polyester (Mersilene) samples extruded from 11 male patients and 5 female patients with the age between 36 and 73 years old (average 57.46 +/- 9.7) have been studied. Average implantation period was 15.13 +/- 14.14, larger for the Mersilene samples (p = 0.0149). Inflammatory cells, connective tissue, fibroblasts and the number of blood vessels were significantly higher for Prolene samples (p < 0.05). CONCLUSION: The inflammatory response of the host to the prosthetic material persists years after the repair and is mainly dependent by the textile properties of the mesh. Polyester materials conduct to a minimal inflammatory response with lower levels of collagen deposition. The resulted scar is more supple and does not interfere with the mobility of the abdominal wall.

[Current therapeutic management in retinoblastoma with invasion of the optic nerve--a case report]. / Conduita terapeutica actuala în retinoblastomul cu invadarea nervului optic--prezentare de caz.

INTRODUCTION: Retinoblastoma is the most frequent primitive intraocular tumour in children. The extension of retinoblastoma at the optic nerve level gives a dark prognosis implying a complex treatment and a long period of supervision. OBSERVATION: An eleven-months-old child, female, is taken in the hospital with the suspicion of retinoblastoma left eye. The diagnosis was suspected when the child was six months old within another ophthalmologic department, but the treatment was postponed. Surgical treatment consisted of enucleation with at least a 10 mm resection of the optic nerve. The anatomo-pathologic examination shows a retinoblastoma with the optic nerve invasion (stage II b 2--after Grabowski's classification). Because of the early age of the patient, we are obliged to give up applying radiotherapy (technical reasons) and systemic chemotherapy is recommended, in six cycles, under very severe clinic and paraclinic control. CONCLUSIONS: The extension of retinoblastoma at the optic nerve level indicates a severe prognosis with high lethal risk. The correct treatment during thus phase implies the association of radiotherapy (40-45 Gy) and chemotherapy. After 24 months from the finishing of the treatment the patient is in total remission (clinic and paraclinic), but the supervision is going on for at least another 3 years. The early enucleation as well as its appliance with the removal of a large part of the optic nerve represents a therapeutical manner and leads to an important prognosis.