In vitro evaluation of laser fluorescence devices for caries detection through stereomicroscopic imaging.

The aims of this study were to determine the diagnostic accuracy and reproducibility of the laser fluorescence device (LF), and the relationship between laser fluorescence readings taken at the entrance of the fissure, ICDAS visual examination caries detection system and the histological depth of the lesion. Two hundred and forty teeth (122 human third molars and 118 bicuspids) were selected from 62 patients enrolled in the study. Visual and LF examinations (Diagnodent, Kavo, Biberach, Germany) of the occlusal surfaces were performed in vivo. After tooth extraction, histological sections were evaluated by stereomicroscopy in vitro. Statistical analysis was performed using multiple statistical methods (SPSS ver. 17). Intra-examiner reproducibility for the LF measurements was excellent: intra-class-correlation coefficient (ICC) for LF was 0.957. Kappa values for each examiner's reproducibility were 0.74-0.82. The diagnostic performance of the LF device gave a good overall diagnostic accuracy according to ICDAS II codes and histological values as indicated by the area under the ROC curve of 0.707 and 0.709 respectively. The results of the study showed acceptable diagnostic accuracy for the laser fluorescence device. This supports the view that dentists can be site specific in applying fluorescence-based devices to multiple discrete sites within the same surface. In conclusion, these diagnostic methods have different characteristics, indications and limitations for use. In order to detect caries on occlusal surfaces thoroughly, a combination of methods would be the best practice moderated by clinical knowledge and experience.

Imagistic and histopathologic concordances in degenerative lesions of intervertebral disks.

Lumbar disk lesions in 47 cases were initially diagnosed using MRI investigation, then, after surgery, biological and histopathological aspects of intervertebral disks were revealed. Pieces from intervertebral disks were used for electron microscopy studies in order to determine collagen in the components of the intervertebral disk. The aim of the present study was to highlight the correspondence between the MRI aspect in cases with clinically manifest lumbar hernia, staged according to MRI Modic classification, and the histopathological aspect in patients with surgical interventions on the intervertebral disks. 4/5 of the analyzed disks had advanced forms of degenerescence of the intervertebral disks: hyalinized disk cartilage ± intradiskal calcification or ossification zones, chronic inflammatory infiltrate at the disk cartilage level. Electron microscopy studies made on disk fragments obtained by discectomy revealed quantitative and qualitative changes of all types of collagen at the level of the three anatomical structures of the intervertebral disks, which correspond to the MRI changes.

[Some aspects of pulmonary vascular remodelling in smokers and patients with mild COPD]. / Aspecte de remodelare vasculara pulmonara prezente la fumatori si pacientii cu BPOC usor.

An important feature of the pathophysiology of COPD patients is represented by the remodelling of pulmonary vasculature. Within this process, a pathogenic element might be the endothelial dysfunction induced by the combined effect of several factors such as: cigarette smoke, inflammatory mediators, hypoxia, mechanical stress, whose contribution differs according to the stage of the disease. The aims of our study were to characterize the structural pulmonary vascular abnormalities present in smokers and patients with mild COPD and to assess their pathophysiological importance. Serial tissue sections from fragments of pulmonary exeresis have been subjected to both morphometric analysis and histochemical examination of muscular pulmonary arteries. Our results have shown a process of arteriolar muscularization and intimal thickening of small muscular arteries in both smokers (intimal index 23.11% +/- 3.04%) and patients with mild COPD (25.62% +/- 3.06%) as compared to controls (17.86% +/- 2.96%). Correlation analysis has demonstrated that intimal thickening is significantly associated with cigarette consumption expressed as packs-years (r = 0.65, p = 0.04) whereas univariate regression has shown a moderate causal relation between the intimal collagen deposits and the degree of vascular thickening (r2=0,53 and p=0,002). In conclusion, cigarette smoking may play a central role within the pathogenesis of vascular abnormalities in patients with mild COPD.