[Morphopathological changes in glaucoma-induced trabecular meshwork]. / Modificarile morfopatologice ale retelei trabeculare în glaucom.

UNLABELLED: Glaucoma causes trabecular meshwork and Schlemm canal changes, resulting in the obstruction of the aqueous flow at this level. AIM: To show the histological changes in the surgically removed trabecular meshwork tissues. MATERIAL AND METHOD: Trabecular meshwork fragments were histologically processed for histological diagnosis. RESULTS: 29.87% of all patients had ordered structure with high eosinophilia, 20.12% a rare structure with high eosinophilia, 21.34% a voluminous trabecular meshwork with fusiform cells, 21.03% tissue fibrosis and 7.62% had tissue necrosis. CONCLUSIONS: Aqueous flow obstruction in trabecular meshwork is produced by the histological changes at this level, found in all tissue specimens removed during surgery.

Electron microscopy analysis of skin biopsies in CADASIL disease.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is an inherited vascular disorder, non-amyloid and non-atherosclerotic, affecting predominantly the central nervous system. We examined samples of skin biopsies from six patients (men, 43-52-year-old), admitted for treatment in the Neurology Clinic regarding the presence of partial motor impairment on upper and lower right limbs, facial asymmetry and phrasing impairment (three of the patients); These three patients had family history remarkable for early-onset strokes: mother and two brothers deceased by early strokes (40-50-year-old). Skin biopsy samples were fixed in glutaraldehyde and post-fixed in osmium tetroxyde. After dehydration, tissue samples were embedded in Epon. Ultrathin sections were mounted on copper grids and stained with uranyl acetate and lead citrate as usual and examined with a transmission electron microscope Phillips CM100. In all cases ultrastructural study showed granular osmiophilic material (GOM) in extracellular locations, between degenerating smooth muscle cells in dermal arteries or in their indentations. Deposits of GOM varied in size and electron density. Degeneration and loss of smooth muscle cells (SMCs) leads to abnormal enlargement of the space between these cells Ultrastructural analysis in three cases showed chromatin condensation and peripheral aggregation of nuclear material suggesting cells entry to apoptosis. These aspects and the marked destruction of the vascular wall were correlated with MRI findings and the severity of clinical manifestations at these patients. Our study showed that findings of GOM deposits, degeneration and loss of SMCs (probably by apoptosis), cell adhesion elements disturbance are characteristic for CADASIL disease and sufficient for diagnose of certainty. Moreover, electron microscopy analysis of skin biopsies is a useful tool for a differential diagnosis and can be considered as first choice method.

[Anatomical variations of landmarks in endoscopic surgery of the paranasal sinuses revealed by MRI imaging]. / Variante anatomice ale reperelor din chirurgia endoscopica a sinusurilor paranazale evidentiate imagistic prin RMN.

Continue development of endoscopic techniques of rinosinusal approach involves knowledge about the anatomy of this region, with a three-dimensional orientation before surgery, a therapeutic plan well thought, anticipating the gesture controller, taking into account the particularities of each case. Endoscopic surgical anatomic variants parts at this level can be well identified by imaging methods (CT, MRI). CT study of patients who are candidates for surgery Fess is on top, as the technique of choice. MRI is the imaging method to supply the CT data, providing a study carried out the normal anatomy and standard deviation of the numerous variants, single or in combination. This paper aims a randomized retrospective study of 120 MRI of the head and face region, to investigate and highlight the anatomical variations of structures at this level of impact and those with sinusitis etiopatologia, as well as those with operative risk (bleeding complications, ocular, vital risk) to determine the prevalence in the general population and have to compare the data with the literature. Using all sections (axial, sagittal and coronal) with the aid of different sequences (T1, T2, Flair and diffusion) allowed study of three-dimensional images of whole rhino-sinus-related pathology. Anatomic variations of surgical landmarks have investigated a wide range of expression, which are unique or associated with a complex architecture, with sufficient accuracy and visible on MRI. Their prevalence in the group studied was generally consistent with the literature studied.

Apelin effects on lipopolysaccharide-increased pulmonary permeability in rats.

MATERIAL AND METHOD: Pretreatment with apelin-13 (AP-13, 2 mg/kg, i.p.), sodium butyrate (BUT, 200 mg/kg, s.c.) and N-acetyl-L-cysteine (NAC, 150 mg/kg, s.c.), all reduced the LPS-induced vascular leak measured as Evans blue extravasation, in rats lung tissue when compared to intranasal LPS (10 mg/100 mL) administered alone. RESULTS: Although there is a significant difference either between AP-13 and BUT on one hand, and NAC and BUT on the other hand pretreatments, there is no significant difference between AP-13 and NAC pretreatments. Firstly, apelin-13 pretreatment might justify its effects through the modulation of endothelial layer functions. We recently demonstrated that AP-13 could diminish the endothelial dysfunction of pulmonary vein from both ovalbumin sensitized rats and rats with pulmonary hypertension. Furthermore, pretreatment with AP-13 + BUT, AP-13+NAC as well as BUT+ NAC reduced the LPS-induced vascular leak when compared to LPS alone. The reduction effects of BUT and NAC association were higher than those of either BUT or NAC alone. These synergistic effects might be associated to different and additive mechanisms of action of BUT and NAC. Thus, BUT might be primarily effective on macrophage migration and secondarily on activation and cytokine secretion by macrophages and NAC might be primarily effective on macrophages activation. Furthermore, since there are no significant effects between AP-13, NAC and AP-13+NAC we can conclude that AP-13 and NAC effects might be mediated through the same mechanisms (with the possible involvement of nuclear transcription factor NF-kB).

A rare case of double recurrent choroidal melanoma, with distinctive immunohistochemical features.

A 57-year-old woman, with left choroidal melanoma treated by laser photocoagulation and a history of repeated vitrectomies, checked for left eye acute pain and foreign body-like sensation, symptoms that occurred after three years since the primary tumor treatment. The left eyeball was enucleated and the tissues were investigated by immunohistochemistry for markers associated with cell differentiation, proliferation and adhesion, cell cycle regulation, apoptosis control, vascularization, invasiveness and local immune response. We identified, in fact, two independent tumors, with different localization and sharing some common features, markers of a highly aggressive potential: loss of cell differentiation markers and cell cycle regulators, ability to avoid death by suppressing Fas antigen expression and important invasive capacity by down regulation of E-cadherin expression. However, only in the posterior tumor, we found cells with high proliferation rate, Fas ligand molecule expression and MMP-9 secretion, acquisitions associated with a much more aggressive behavior. These particular phenotypes allowed the posterior cells to grow and to invade the surrounding tissues more rapidly than the anterior ones, leading to the development of a large size tumoral mass, responsible for the clinical symptoms. Photocoagulation, by destroying the tissues, makes impossible the evaluation of the primary tumor's biological features, important for the tumor evolution. The absence of these data stresses the importance of patient monitoring, eventually addressing a panel of soluble markers associated with recurrence or metastasis development.

[Posterior fossa meningiomas--topographic and anatomopathologic aspects]. / Aspecte topografice si anatomopatologice ale meningioamelor de fosa posterioara.

UNLABELLED: Meningiomas are the most frequent met intracranial tumors. Many authors tried to order them according to location, origin and histopathologic type. MATERIAL AND METHOD: Our study is focused on posterior fosa meningiomas, initially classified according to their origin based on IRM and surgical findings in order to identify correlations between demographic data, topographic tumor origin and anatomopathologic characteristics for each subgroup. 35 posterior fosa meningioma patients that have been subject to neurosurgery in Iasi "Prof.Dr. N. Oblu" Hospital Neurosurgery Clinic between January 1st 2005 and December 1st 2009 were assessed. RESULTS: In our study group the majority of patients were females, with an average age in their early 60's. Benign meningiomas (1st degree) represented the unique subtype in tumors located in cerebellum convexity and foramen magnum. Other locations have different characteristic subtypes (fibrous vs. angiomatous meningioma).

Micro- and nanoparticles--medical applications.

It is a long-standing need of the pharmaceutical industry, physicians, and patients to improve pharmaceutical formulations by establishing simpler, less expensive preparations and treatments, while reducing toxicity. This need can be met with the know-how of drug delivery science that has already made advance developments in improved delivery of injectibles, oral formulations, drug device implants, as well as topical and transdermal delivery formulations, especially in the case of drug delivery to the brain, an untouchable region by traditional drug delivery systems. The reason behind the failure of conventional delivery systems in reaching the brain is the blood brain barrier (BBB) composed of tight tissues making it impervious to outside agents. Nanotechnology has the potential to address and resolve this challenge and make brain a reachable target for drug delivery systems, by combining unique elements of size, surface activity and charge of nanostructures. Micro and nanoparticles have opened up unexpected ways in diagnostics and therapeutics in medicine. The previous treatment strategies in the fields of autoimmune diseases and cancer involved non-targeted treatment options with extensive "collateral damage." Nanodelivery of drugs is predicted to reduce this collateral damage, extend the drug's availability and effectiveness at the site, and reduce toxicity and cost with a high pay-off load. In this review we present the role of micro and nanoparticles in drug delivery and some applications in the health care fields.

[New tendencies in controlled drug release--liposomes entrapped in polymer matrices]. / Noi tendinte in eliberarea controlata de medicamente--lipozomi imobilizati în matrici polimere.

Liposomes entrapment in different forms of polymers represents in the last few years a method to modify the drug release kinetics in order to attend the specificity of this phenomenon. This will result generally in complex systems in which liposomes are dispersed in polymer matrices like gels, hydrogels and microparticles. As a consequence the drug release will be influenced by both polymer matrix and small carrier entrapped in. The researchers are trying to control the release of drug from such solid complex system by modulating not only the vesicle properties but also those of polymer support. This kind of system is necessary also for the cases when time stable liposomes are desired, being already well known that the major drawback of this type of carrier is the stability in time and in different physiologic conditions.

[The implications of cervical spine degenerative and traumatic diseases in the pathogenesis of cervical vertigo and hearing loss]. / Implicatiile bolilor degenerative si traumatice ale coloanei cervicale in geneza vertijului cervical si a hipoacuziei.

AIM: Cervical spine together with vestibular system,visual system and proprioceptive afferents plays an important role in mentaining balance. Spine damage causes distortions in transmitting informations to the brain,favoring vertigo. MATERIAL AND METHOD: The authors point out the occurrence of positional vertigo on 23 patients (20 patients with cervical spondylosis and 3 patients with cervical spine injury) due to blood flow disturbance through vertebral artery. RESULTS: The mechano-receptors located in intervertebral disks and cervical spine muscles are activated by column movement. Changes of blood flow in the vertebral and basilar arteries are showed up by cervical X-Rays, intracranial Doppler ultrasound or angio-MRI, an audiogram marking out the degree of hearing loss or tinnitus occurence. ENT complex treatment outcomes are analyzed and balneo-physio-therapy performed in order to improve vertigo and hearing loss. CONCLUSIONS: Stress beside muscle overload and cervical spine injures causes alteration in the ear blood-flow circulation that leads to hearing loss, vertigo and tinnitus. It emphasies the need for collaboration between balneologist and ENT specialist in solving balance and hearing disorders with cervicogenic cause.

[Immunohistochemical evaluation of inflammatory reaction in a case of pilomatrixoma]. / Evaluarea prin imunohistochimie a reactiei inflamatorii intr-un caz de pilomatricom.

OBJECTIVES: To identify the types of the cells in a case of pilomatricoma and to evaluate the lesion's stage, the cells' proliferating rate and the associated inflammatory reaction. MATERIAL AND METHODS: The paraffin-embedded tissue was investigated by histological examination and by immunohistochemistry for the expression of some markers such as: cytokeratins, CD3, CD20, CD68, PCNA, CD34 II. RESULTS: The lesion presented the characteristic epithelial cells of a classical pilomatricoma: bazaloid cells, ghost cells and transitional cells. 10-15% of the bazaloid cells were PCNA+. The MNF 116 antibody labeled only some of the transitional and of the ghost cells. We found no CD3-positive cells and few CD20-positive cells. A marked inflammatory reaction was noticed, dominated by giant multinucleated cells, positive for CD68 and PCNA and a rich network of blood vessels with a high vascular density. CONCLUSION: The histological pilomatricoma diagnosis was straightforward on the basis of the bazaloid and ghost cells presence. Immunohistochemistry brought additional data regarding the cells proliferation rate, the stage of the lesion and the intensity of the associated inflammation.

[Ultrastructural aspects in the development of the human nephron--electron microscopy study]. / Aspecte ultrastructurale în dezvoltarea nefronului uman. Studiu de microscopie electronica.

UNLABELLED: We have looked for electron microscopy aspects tissue fragments of human nephrons harvested from fetuses of 7,5-19 weeks to show ultrastructure aspects of the nephron during development. MATERIAL AND METHODS: We have used 9 fragments from human embryos; Four cases were aged of 7,5, 8, 12 and 17 weeks. The other 5 cases were between 18 and 19 weeks. Tissue fragments were fixed in glutaraldehyde at 4 degrees C and processed by the classic technique. RESULTS: The electron microscopy study shows the evolutive steps of the human nephron (stages I-IV), stages met for the 12-19 weeks embryo. For the cases under this age the meta-nephrogenic blastema was dominant. In the IVth development stage, the cells in the proximal tubule show a higher development degree than the distal segments. CONCLUSION: These observations indicate that during early development the proximal segment is better developed and probably more functional than the distal segments.

[Anatomo-clinical considerations regarding the celiac-mesenteric junction]. / Consideratii anatomo-clinice asupra butonului celio-mezenteric.

AIM: This work points out the access ways - both the classical ones and the ones less known and used - to the origin and the first centimeters of the superior mesenteric artery (SMA), underlining the advantages and disadvantages of each of them. MATERIAL AND METHOD: Our work is based on dissection of 30 human bodies and 200 selective arteriographies. RESULTS: There are two classical ways to access the first part of SMA: inter-duodeno-pancreatic and the left thoraco-abdominal ways. CONCLUSIONS: An access way to the origin of the SMA is necessary for the revascularisation through different techniques of the visceral territory depending on the SMA, taking into account the fact that at this level we have the most frequent localization of the atheroma plaques, which leads to acute or chronic intestinal ischemia (manifest in the form of postprandial abdominal 'angor').

[Clinical, computerized tomography and pathological findings of lesions in the parapharyngeal space]. / Aspecte clinice, computertomografice si anatomopatologice intâlnite in leziunile spatiului parafaringian.

UNLABELLED: We present the clinical, computer tomografic and patological findings of current lesion of the parapharyngial space. MATERIAL AND METHOD: We retrospectivly analised the clinical, cross-sectional imaging files and the patological results for 33 patients explored during January 2006-March 2008 by a medical team at the "Prof. Dr. N. Oblu" Clinical Hospital. RESULTS: In our study we didn't find primitive lesions in the parapharyngial space but, we explored 33 lesions extended in the parapharyngial space with origins around the parapharyngial space. The most frequent hystological types of tumor were represented by squamous cell carcinoma of nasopharyngs (n = 22), followed by primitive lesions in to the infratemporal phosa (n = 5). We had also 2 tumoral cases of the parotyd gland, one of the skull base and 3 facial fractures with involvement in to the parapharyngial space. CONCLUSION: The infiltrations of parapharyngial space by different lesions require Computer tomographic exams for a precise evaluation of the extension of the lesions, evenetual lymph node metastasis, the presence of tumoral recidive and the orientation to a imagistic diagnosis which will be confirmated by a patological exam. The multidisciplinary approach of these lesions will permit a proper terapeutical management to each case.

[Psychocognitive impairment evaluation in early post-stroke period]. / Evaluarea afectarii psiho-cognitive in perioada precoce post-stroke (AVC).

UNLABELLED: There are many interconnections between pathological mechanism involved in production of dementia and cognitive impairment even in stroke patients. Early detection and management of these disorders provide better prevention of possible dementia. AIM: To explore the factors which can affect psychocognitive impairment of poststroke patients. METHOD: using the MMSE (mini-mental state examination), GDS (Geriatric Depression Scale), NIH (National Institute of Health) Stroke Scale we evaluated 47 consecutive patients with ischemic stroke, admitted in I Neurological Clinic of "N. Oblu" Hospital from Iassy. RESULTS: Our patients had relative important cognitive impairment (11 individuals--MMSE < 20, but only 4 below 10) and important depression (GDS > 10 in 35 cases and > 20 in 7 cases). We found correlation between some risk factors and cognitive impairment / depression (hypertension, overweight, dyslipidemia, diabetes, arrhythmia, carotid system lesion). CONCLUSION: Cerebrovascular disease can produce important cognitive and psychological impairment, which we can easily evaluate using some "bedside" tools MMSE, GDS.

[Evaluation of oral injuries in experimental induced diabetes mellitus by analysis of some gingival fluid markers]. / Evaluarea afectarii teritoriilor orale in diabetul indus experimental prin analiza unor markeri in fluidul gingival.

AIM: The objective of this study was to determine the relationship between the activity of the enzyme aspartate aminotransferase (AST) and IL1-beta in gingival crevicular fluid (GCF) on animal model with experimentally induced diabetes mellitus and periodontal disease. MATERIAL AND METHOD: During our study we used 15 Wistar rats, divided into three groups: I--control, II--with experimental model of periodontal disease, III--with experimental model of periodontal disease and diabetes. The sampling of GCF was realized using Whatman no. 1 paper strips introduced in the gingival sulci from mandibular left and right molars. For the determination of AST in GCF we used a spectrophotometric method while gingival fluid IL-1beta determinations were realized through immune enzymatic methods, using an ELISA kit (rlL-1beta). RESULTS: The results displayed 3.47 times increased gingival fluid AST values in the stimulated experimental model (with periodontal alteration) when compared to control values (without periodontal disease), while in diabetes an increase of 6.139 times higher compared to control (without periodontal disease) were recorded. Moreover, the levels of periodontal disorder-induced IL-1beta were 3.54 times higher compared to control (group II--218.490 pg/mL vs group I--61.691 pg/mL), the most significant increase being recorded for the group with diabetes associated to periodontitis (492.129 pg/mL). CONCLUSION: The present study found a high level of agreement between the presence of AST and IL-1beta in GCF in the experimental model of diabetes associated to periodontal disease, elevated when compared with the periodontal disease only model, and both higher when compared to control group.

[CT and anatomo-pathologic examination in the diagnosis of cavernous sinus lesions]. / Aportul examenului CT si al examenului anatomo-patologic in diagnosticul leziunilor sinusului cavernos.

UNLABELLED: This study presents the CT imaging and histological aspects of a lot of cavernous sinus disease that include primary and secondary neoplastic processes, congenital lesions, infectious and inflammatory processes, and vascular abnormalities. MATERIAL AND METHODS: All 47 patients were CT explored with and without intravenous contrast, using specific protocols for orbit and brain. We studied the topography of the tumors, their impact to neighborhood regions and post-treatment results. For all patients we performed histological examination. RESULTS: We found 26 cases with sellar origin of the tumor and 21 cases of para-sellar origin, with a significant extension in 22 cases. The most frequent histologic type of tumors were represented by hypophyseal adenoma (17 cases), followed by meningiomas (9 cases) and cranio-pharyngiomas (5 cases). CONCLUSIONS: CT imaging allows a fast and accurate analysis of sellar and para-sellar tumors, with a tumor extension assessment. The clinical and imaging diagnosis is confirmed by histological examination.

[CT exam and 2D and 3D reconstructions in facial tumors diagnosis]. / Aportul examenului CT si al reconstructiilor 2D si 3D in diagnosticul tumorilor masivului facial.

UNLABELLED: This study presents the CT imaging of a group of maxillofacial tumors that include benign tumors and primary and secondary malignant processes. MATERIAL AND METHOD: All patients were CT explored with and without intravenous contrast, using specific head and neck protocols. RESULTS: We studied the topography of the tumors, their impact on neighborhood regions and post-treatment results. The diagnostic of all patients had histological confirmation. In maxillofacial tumors and tumor-like diseases, 3D imaging was significantly superior to 2D axial imaging in showing the tumor shape and spatial relationships between tumors and surrounding structures. Two dimensional imaging and MPR imaging were excellent to reveal internal structure and pathological changes of tumors. 2D imaging and MPR imaging also achieved better results in showing tumors extended to soft tissues.

[Neurosurgeon-neuropathologist collaboration in cerebral tumors diagnosis]. / Colaborarea neurochirurg--neuropatolog în diagnosticarea tumorilor cerebrale.

The aim of the neurosurgical treatment in neuro-oncology is multiple: diagnostic (obtaining of a precise histopathological diagnosis to improve the treatment and the further prognosis), symptomatic (the improvement of the neurological clinical features by decreasing intracranial pressure) and therapeutic (to obtain a cytoreductive treatment, by complete or partial exeresis of the tumoural mass). To establish a precise histopathological diagnosis, during the intervention and latter, on the paraffin sections, the neuropathologist must examine the neurosurgical drawings knowing the history of the illness, the clinical and radiological aspects of the case in study, which complains a good cooperation between neurosurgeon and neuropathologist. To initiate the procedures of histopathological processing of various neurosurgical drawings, the neuropathologist must understand very well the surgical procedure. This is the reason of this study: to present different neurosurgical technics; the choose of one of these essentially depends on the location and size of the cerebral tumour, on neuroradiological characteristics and presumptive histopathological diagnosis and on the neurological status, the age and the general condition of the patient.

[The influence of the dihydroxamic compounds on the rat lung]. / Influenta unor compusi dihidroxamici asupra plamanului de sobolan.

The role of the dihydroxamic compounds in the human and animal organism are little known. This is the reason they the experiment studies the effect of these compounds on the rat lung. 3 lots of Wistar adult male rats were used. The first lot was the witness lot and did not receive any substance. The second lot received Dihydroxamic adipoil acid, 0.5 mg/kg weight/ day, intraperitoneal administration in a unique daily dose, for 3 weeks. The third lot received Dihydroxamic terephtaloyl acid, 0.5 mg/kg weight/day, intraperitoneal administration in a unique daily dose. After 14 and 21 days the animals of each lot were euthanised by sectioning carotid arteries. The authors collected the lungs, prepared the histological sections, stained in HE and Szekely. The witness lot presented normal rat lung structure. After 2 and 3 weeks of treatment, the second lot presented distended blood vessels. After 2 and 3 weeks of treatment, the third lot presented very severe alterations of the lung tissue at all levels.

[Temporo-mandibular joint. Morpho-functional considerations]. / Consideratii morfo-functionale asupra articulatiei temporo-mandibulare.

The temporo-mandibular joint is distinguished from most other synovial joints of the body by two features: 1. the two jointed components carry teeth whose position and occlusion introduce a very strong influence on the movements of the temporo-mandibular joint and 2. its articular surfaces are not covered by hyaline cartilage, but by a dense, fibrous tissue. This paper describes the parts of the temporo-mandibular joint: the articular surfaces (the condylar process of the mandible and the glenoid part of the temporal bone), the fibrocartilaginous disc which is interposed between the mandibular and the temporal surface, the fibrous capsule of the temporo-mandibular joint and the ligaments of this joint. All these parts present a very strong adaptation at the important functions of the temporo-mandibular joint.