Histological diagnosis and risk of renal vein thrombosis, and other thrombotic complications in primitive nephrotic syndrome.

BACKGROUND: The risk of thromboembolic events is increased in patients with nephrotic syndrome (NS) as compared with other medical conditions and is a severe complication associated with significant morbidity and mortality. We aimed to assess the risk of renal vein thrombosis, and other venous thromboembolic events (VTE) in a large cohort of patients with NS and to identify the disease-specific risk for VTE. PATIENTS AND METHODS: We performed a prospective observational study including consecutive adult patients with primitive NS admitted to our department. Clinical and biological data were obtained every six months during follow-up. Occurrence of VTE confirmed by imaging techniques was the primary study outcome. RESULTS: We enrolled 191 patients (47±15 years, 53% men) with a median follow-up of 24 [IQR:12,36] months. During follow-up, 23 VTE occurred, of which 65.2% in the first six months. The disease-specific risk of VTE during the follow-up period was different across the histological groups, with the lowest risk in minimal change disease and IgA nephropathy and the highest in membranous nephropathy and membranoproliferative glomerulonephritis patients. In the subgroup of membranous, the severity of the subepithelial electron dense deposits did not correlate with the risk for VTE (p=0.5). CONCLUSIONS: In this prospective study, the risk of VTE was higher in the first six months of follow-up in NS patients. The histological pattern seems to influence the risk of VTE in this setting.

Expression pattern of CK7 and CK20 in nasal polyps, at patients with chronic rhinosinusitis with nasal polyposis.

We investigated the expression of cytokeratins 7 (CK7) and 20 (CK20) in nasal polyps on a group of 106 patients with chronic rhinosinusitis with nasal polyposis (45 women - 42% and 61 men - 58%) who benefited from surgical procedures. Harvested biological material was analyzed in the pathology laboratory through two methods: histopathological and immunohistochemical analysis. Classical histopathological method of processing the tissues initially fixed in 10% formalin was used. The tissues were then processed by paraffin impregnation, sectioned and stained with Hematoxylin-Eosin. The immunohistochemical method was based on soluble immunoenzymatic complexes - LSAB/HRP (labeled Streptavidin Biotin) method. We used DAKO LSAB 2 System HRP (Universal DAKO Labeled Streptavidin Biotin 2 System Horseradish Peroxidase). The expressions of CK7 and CK20 in nasal polyps were analyzed.

Laryngocele associated with laryngeal carcinoma.

Laryngocele is an abnormal dilatation of Morgagni ventricle (saccule) in direct communication with the laryngeal lumen. Symptoms are not characteristic: hoarseness, dyspnea, foreign body sensation and cough. Sometimes it is presented as cervical swelling causing airway obstruction and need an emergency tracheotomy. In this paper, we report a case of upper airway obstruction due to laryngocele associated with a laryngeal carcinoma who was treated by emergency tracheotomy and, finally by total laryngectomy. A review of the literature is also presented.

Assessment of Extracorporeal Shock Wave Lithotripsy (ESWL) Therapeutic Efficiency in Urolithiasis.

Extracorporeal shock wave lithotripsy (ESWL) revolutionized the treatment of urolithiasis and gradually became the favorite treatment option so that today it is considered to be the first line of treatment for more than 75% of the patients with urolithiasis. The purpose of this study was the assessment of the therapeutic efficiency, complications and limitations of ESWL in urolithiasis in the initial experience using a third generation electromagnetic lithotripter.  Between 2007 and 2008 we performed ESWL for 167 patients with urolithiasis. We recorded 92 patients with single stone (55.1%) and 72 with multiple lithiasis (44.9%). Stone size varied between 7 and 24 mm with an average of 12.3±7.1 mm. Radioopac stones were found in 104 patients (62.3%) while radiolucent stones in 63 only (37.6%).    Complete stone disintegration and clearance was achieved in most cases (86.2%). Complications were mostly minor and rare (transitory haematuria, renal colic). Severe complications (renal hematoma, steinstrasse) were diagnosed for a limited number of patients (3.6%) and their management was mostly nonsurgical or minimally invasive (retrograde ureteroscopy). ESWL is therefore the first line of treatment for urolithiasis with stone size smaller than 2.5 cm. It has an efficiency rate above 85%, low procedure time, high safety and good tolerability (new generation lithotripters do not require anesthesia) and minimal complications.

Assessment of Gleason system use on different types of prostatic tissue samples.

One of the well-known and accepted methods of prostatic adenocarcinoma grading is Gleason system. The authors made a retrospective analysis of 221 prostatic adenocarcinomas divided into three groups (transvesical prostatectomies, transurethral resections and needle biopsies) following the type of surgical procedure used for drawing the tissue. Gleason scores and comparison between odd and even Gleason scores were assessed in the entire group and in each subgroup. High scores prevailed, meaning a tendency towards a low grade of differentiation. Even scores also prevailed meaning, on one hand, that, often, the examined specimen reveals only one pattern and, on the other hand, that surgical procedures as transurethral resections and unique needle biopsies cannot offer a sufficient material for examination, the multicentricity of prostatic carcinoma being well known.