[Adult onset Still's disease with normal level of serum ferritin]. / Boala Still a adultului cu manifestari aterosclerotice sistemice severe.

We present a case of an adult onset Still's disease: a 51 year old men presented with one month history of high spiking fever, asymmetric migratory polyarthritis and a previous history of pharyngitis. The diagnostic was based upon clinical criteria and laboratory findings, and necessitated the exclusion of infectious, neoplastic, and other "autoimmune" disease. The systemic involvement in our case induced us to comment therapy with corticosteroid. Patients with systemic disease have a favorable prognosis, with only rare serious complications from the disease (pericarditis, tamponade, diffuse intravascular coagulation, amyloidosis, hepatic disease, and respiratory failure) or the treatment (infections, gastrointestinal bleeding etc.).

[Intercellular communication]. / Comunicarile intercelulare.

There are 3 modalities for intercellular communications: the chemical substances secreted by some cells are transported at distance where they act as signals on other cells; the surface molecules of a group of cells interact with the neighbouring cells; some special junctions or nexus provide direct relations between cells. In the first modality the chemical signals operate in 3 ways: a) many cells secrete one ore more chemical signals which act as local mediators (paracrine model); these mediators act immediately or are destroyed after they influence the neighbouring cells; b) some specialised cells--endocrine cells--secrete hormones, which are liberated in small amounts into the blood and exert their effects on some target cells, able to recognise and to respond to the hormonal signal; c) the neurones secrete chemical mediators--neurotransmitters, which act at the level of some special junctions--the chemical synapses. Most biologic phenomena are under the overlapping control of both systems--thus they are regarded as neuroendocrine system. The nervous cells transmit the informations much more rapidly than the endocrine cells. The chemical signals are various, as regarding the structure and function: they are large polypeptides, small polypeptides, glycoproteins, amino-acids, steroid molecules derived from cholesterol and fatty acids. The ability of the cells to respond to an extracellular signal molecule depends on the existence of some specific proteins, included in the plasma membrane, called receptors. The chemical signals influence the target cells both by altering the properties or the synthesis rate of their own proteins or by initiating the synthesis of new proteins. The chemical signals induce rapid and transient or slow- and long-lasting responses. All the neurotransmitters and the majority of hormones are water-soluble; the steroid and thyroid hormones are relatively water insoluble; the mechanisms of influencing the target cells are dependent of this feature: the water-soluble molecules do not pass through the target cell membrane, they bind to the surface specific receptor while the insoluble molecules cross the plasma membrane of the target cell and bind to the cytoplasmatic receptors. It results that the water-soluble molecules mediate short-time responses while those insoluble--long-lasting responses. As regarding the local chemical mediators they are secreted by mast cells or they are represented by the large category of prostaglandins. They produce a great diversity of biological effects, they are rapidly destroyed, and this way, they don't penetrate into the blood stream in significant amounts. The majority of the receptors from the surface of activated cells generate some intracellular signals both by altering the activity of some membrane enzyme (adenilate cyclase) with the accumulation of cyclic MPA and by modifying the permeability of some membrane channels(Ca2+ channels). The target cell exposed to a signal for a long period of time loose often the ability to respond to this signal. This process called desensibilization is reversible and is explained by endocytosis of surface receptors together with the ligand and by their lysosomal destruction, by the degradation of the receptor molecular conformation which becomes unable to bind the ligand or by the lack of activation of membrane enzymes or the channels. The gap or nexus junctions are composed by some proteic particles which form a hydrophilic channel to assure the communication between 2 neighbouring cells. These junctions allow some molecules (amino-acids, monosaccharides, cAMP, nucleotides) to pass from a cell to another one, facilitating the chemical and electrical coupling. These structures show a low electrical resistance, but they are dynamic, some junctions have the capacity to change from a low resistance to a high resistance state, isolating the cells from communicating with their neighbours. Oxygen deprivation, the increase of intracellul

[Morphological diagnostic problems in a case of peritoneal blastomycosis]. / Probleme de diagnostic morfologic într-un caz de blastomicoza peritoneala.

Blastomycosis is a mycotic disease, caused by a fungal infection. It has a wide spectrum of clinical presentations, and, particularly, can mimic neoplastic disease. Correct diagnosis of the illness requires fungal culture and biopsy. In Romania, mycotic histopathology is insufficiently developed, and morphological tests are recommended to very few people who present this type of pathology. The paper discusses a case of peritoneal blastomycosis found at a patient with an abdominal pseudotumoral mass. The microscopic exam revealed the characteristic histologic features and budding yeast, in specific dyes, typical to the Blastomyces dermatidis (PAS, silver-methenamin). Authors of this paper hereby intend to draw pathologists' attention on the existence and diagnosis of mycotic lesions, whose number is continuously increasing nowadays.

[The role of the endothelium in angiogenesis]. / Rolul endoteliului în angiogeneza.

Angiogenesis, the vessel formation process, happens both in normal and pathological conditions, beginning with embryonic period and continuing throughout the post-natal period during the whole life. The stimulating factors of angiogenesis are enumerated: VEGF (vascular endothelial growth factor), PLGF (placental growth factor), IF (Intherpheron gamma), Il1, Il8 (interleukin 1,8), FGF (fibroblast growth factor), acid and basic, TGF (transforming growth factor), PDGF (platelet derived growth factor), GH (growth hormone). A series of factors act as regulators/modulators: hypoxia, PGE1, (prostaglandin E1), gangliosides, heparin, cell-cell and cell-substrate interactions. The main inhibitors are less numerous: trombospondin1, PF4 (platelet factor 4), TNF (tumor necrosis factor), IF (interferon alpha). The implied mechanism are discussed: the ways, paths and action phases of different stimulating factors, modulating or inhibiting factors. The angiogenesis process is shown for the embryonic period, in the wound healing process and in the development and progression of malignant tumors. The main method employed in the study of the microvasculature are enumerated. Some perspective in the cancer treatment are drafted.

[The anatomicopathological considerations in the clinical study of malignant non-Hodgkin's lymphomas in children]. / Consideratii anatomo-patologice pe marginea studiului clinic al limfoamelor maligne non-hodgkiniene la copil.

There have been studied 78 cases with abdominal LMNH diagnosis, treated at the "Sf. Maria" Hospital of Iasi, during the period 1970-1994. The microscopic exam has placed emphasis on the following two important aspects: (i) morphological diagnosis based on standard morphological methods, using conventional staining; (ii) immunohistochemical diagnosis, using monoclonal antibodies CD20, CD3; CD68, E29--for 18 cases. The cases investigated immunohistochemically permitted the identification of the lymphoid tumoral cells for the B/T line and tumoral macrophages, as well as the differential diagnosis with undifferentiated carcinomas. A direct correlation between a certain symptom and the disease could not be determined, although all the gastro-intestinal symptomatic elements have been taken into account. This fact reconfirmed the important role played by the anatomo-pathological exam in establishing the diagnosis and stage of the disease. Consequently the gastro-intestinal lymphomas are particular clinical entities, the investigation of which requires an interdisciplinary approach.

Influence of cloprostenol in the experimentally induced ulcer in rats.

We have tested the action of cloprostenol a relatively stable analogue of PGF2 alpha in experimentally induced gastric ulcer in rats by contention stress or indomethacin. Our results show that CIPG, administered at higher doses than those inducing an luteolytic effect, has a gastroprotective effect both in the contention stress-induced ulcer (2.30 + 0.26 in series III as compared to 3.80 +/- 0.73 in series III, p < 0.01) and in indomethacin-induced ulcer (2.69 +/- 0.38 in series V as compared to 3.61 +/- 0.34 in series IV, p < 0.01).

[Microcirculation study by video-monitored intravital microscopy]. / Studiul microcirculatiei prin microscopie intravitala monitorizata video.

As a result of a interdisciplinary team's work, the in vivo study of microcirculation by video monitoring systems, adapted to the optic microscopy, opens new perspectives for the fundamental as such for the clinical and pharmacological research. The multiple possibilities of image acquisition on video tapes, as well as on colour films, offers a variety of post processing of the images through dedicated computer based programs, in order to obtain a precise measurement of the changes occurring in the living tissues. Furthermore, this technical devices along with a proper directed health program, may be used as a modern diagnostic tool in populational screening.

[The evaluation of the teratogenesis and embryotoxicity of the pharmaceutical product Boicil tablets. II. The effect of the pharmaceutical product Boicil tablets on early embryogenesis, organogenesis and the fetus in 3 successive generations of rats and mice]. / Evaluarea teratogenezei si embriotoxicitatii la produsul farmaceutic Boicil comprimate. Nota II: Efectul produsului farmaceutic "Boicil comprimate" asupra embriogenezei precoce, organogenezei si asupra fatului, la sobolani si soareci pe trei generatii succesive.

The effect of Boicil tablets on early embryogenesis (the first 3 gestational days), organogenesis (the 10th, 11th and 12th gestational days) and fetus (the 18th and 19th gestational days) by its intraamniotic administration was followed up in three successive generations of mice and rats. Two doses were used (2 mg/kg body weight and 20 mg/kg body weight), estimated in relation with the maximum therapeutic daily dose in man, being administered in a single dose, per os. No inborn malformations or somatic abnormalities were recorded both in mothers and in their descendents for three successive generations. It is concluded that Boicil tablets is not teratogenic.

[Metabolic and cardiovascular changes in experimental diabetes, stress and orchiectomy]. / Modificari metabolice si cardiovasculare in conditii de diabet experimental, stres si orhiectomie.

When Aloran (Al) was administered to normal or orchiectomized animals, the adult ones proved to be more sensitive, most normal animals (77.7%) developing a DAla and the remainder (22.3%) a DAlc, while of the orchiectomized animals 66.6 developed a DAlc and 33.4% presented a decreased glucose tolerance. 33.4% of the young normal developed a DAla and 66.7% a DAlc, while of the young orchiectomized ones 33.4% presented a DAlc and 66.7% a STG. No matter of age, orchiectomy induced an increased resistance to the various action of Al. Glycemia and lipid fractions, especially LT and TG were significantly elevated in the normal animals with DAla and in the young orchiectomized animals with DAlc. Insulinemia was elevated in most young animals, except for the orchiectomized ones with DAlc, in which it decreased. Serum cholesterol was the most markedly elevated in the adult animals belonging to the group ACTH + D2 + Al, form DAlc. Histopathologically, in this last group degenerative lesions and microcalcifications in aorta and interstitial infiltrate and homogenization of myocardial fibres in the myocardium were found.

[The evaluation of the teratogenesis and embryotoxicity of the pharmaceutical product Boicil tablets. I. The effect of the pharmaceutical product Boicil tablets on fertilization and implantation in rats and mice]. / Evaluarea teratogenezei si embriotoxicitatii la produsul farmaceutic Boicil-comprimate. Nota I: Efectul produsului farmaceutic Boicil-comprimate asupra fertilizarii si implantarii la sobolani si soareci.

The teratogen action of Boicil tablets was studied in two animal species, rats and mice, the prefertilization and implantation stages being the main interest. Three generations of animals were followed up. The active powder suspended in distilled water (0.1 ml/10 g for mice and 1 ml/100 g for rats) was administered per os in a single dose, prepared on spot and in two doses, 2 mg/kg body weight and 20 mg kg body weight, respectively. The administered doses were equivalent to the daily maximum therapeutic dose prescribed in humans (110 mg active principle). The first gestational day was determined differently in the two species. For estimating the effect on prefertilization, Boicil tablets was administered for 5 days before making and for its effects on the number of implantations during the first 3 gestational days. The two parameters under investigation were within normal limits and all newborn animals followed up for three generations did not present pathological microscopic and gross alterations or somatic malformations. It was concluded that Boicil tablets is not teratogenic.

[Further comment on the importance of microscopy in clinical microbiology. The argument for the diagnosis of the skin manifestations of histoplasmosis and coccidioidomycosis]. / Inca o data despre importanta microscopiei în microbiologia clinica. Argumentum dupa diagnosticarea unor manifestari cutanate ale histoplasmozei si coccidioidomicozei.

This paper presents two interesting cases: a patient with cutaneous coccidioidomycosis, the first case in Romania, and a female patient with latent histoplasmosis with cutaneous manifestations, periodically reactivated during her pregnancies. The etiological diagnosis problems of these affections in relation with the degrees of competence of the clinical laboratories is discussed. The role of direct microscopic examination in the early and more rapid diagnosis of deep mycoses is underlined.

[Differentiated thyroid cancer]. / Cancerul tiroidian diferentiat.

In the interval 1979-1988, out of 1070 operated goiters 77 malignant thyroid tumors were recorded, 60 of them being differentiated: papillary--32 (53.4%), vesicular--12 (20%), mixed forms--16 (26.7%). The differentiated thyroid carcinomas had peculiar clinical biological and prognostic features and were framed: stage I--60%, stage II--23.4% and state III-IV--16.6%. Only 15 cases presented lymph node metastases. In 16 cases the thyroid tumor was associated with another thyropathy: Hashimoto's thyroiditis--5 cases, Basedow's disease--1 case. The surgical intervention was performed in two times: first total lobectomy or total lobo-isthmectomy [correction of lobioistectomy] with contralateral subtotal exeresis, then total thyroidectomy. It is insisted upon a careful surveillance of postoperative evolution (clinical, biological, scintigraphy) in order to detect the recurrence and apply a proper treatment.