Heterogeneity of Cervical Cancer-Associated Tertiary Lymphoid Structures (TLSs) and Their Specific Interrelation With Clinicopathological Parameters.

OBJECTIVE: The study investigates morphological variants of tertiary lymphoid structures (TLSs) in relation to cervical cancer development, from intraepithelial neoplastic lesions to invasive carcinomas with locoregional lymph node metastases. MATERIALS AND METHODS: This retrospective analysis comprised 100 cervical cancer cases who had had total hysterectomy with lymphadenectomy in the Obstetrics and Gynecology Clinic of the Municipal Emergency Clinical Hospital of Timisoara, Romania, from 2020 to 2023. Bilateral ilio obturator lymphadenectomy and total hysterectomy were used to acquire biopsy samples. The presence of germinal centers, other stromal structures, TLS density, topography relative to the tumor lesion, and malignant cell islets are used to evaluate and classify TLS. RESULTS: We first globally evaluated the total number of TLSs (TLS.T). We observed topographically two places in the cervical stroma: TLS immediately peritumorally positioned and TLS away from tumor lesions. Invasive carcinomas have bigger superficial TLSs with a well-defined germinal center. As they approached the tumor, TLSs increased in size and density. We also detected a special type of TLS associated with nerve fibers, which we named tertiary lymphoid structures associated with nerves (TLS.N). The total number of TLSs did not correlate with age, but 85.71% of patients presenting TLS.N were aged between 59 and 72 years old. Our findings showed a strong correlation between age (postmenopausal, p = 0.005) and TLS-N presence. Similarly, TLS parameters evolved with tumor differentiation. Only in the TLS.N group did the tumoral grading (G) 3 correlate with TLS (p = 0.041), while TLS.T did not correlate with G. All TLS.N. patients, except one, had lymphovascular invasion and massive histiocytosis. On the first point, TLS.N correlated with lymphovascular invasion (p = 0.032). CONCLUSION: Tertiary lymphoid structures associated with nerves have not been previously reported in cervical cancer, and their effects on prognosis and aggression are unknown. There was a substantial association between TLSs.N presence and age over 60, suggesting it is exclusive to menopausal women. They were also substantially connected with lymphovascular invasion and G3, suggesting they may be a poor cervical cancer prognostic factor.

Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model.

(1) Background: This study aimed to assess the pulpal response of primary teeth by pulse-oximetry (PO) in a canine model, following direct pulp capping (DPC). (2) Methods: Forty-eight primary teeth from eight canine subjects were divided into three treatment groups, based on the DPC material­calcium hydroxide (CH), MTA, BiodentineTM)­and three corresponding control groups. Data from PO pulp testing were correlated with laser Doppler flowmetry (LDF) testing, computer tomographic (CT) densitometry and histological analysis; the experiment lasted 14 days. (3) Results: SpO2 recordings revealed statistically significant differences (p = 0.002, <0.05) between the treatment and control groups, and no significant differences (p = 0.257, >0.05) were observed between treatment groups. LDF recordings showed significant differences (p = 0.002, <0.05) between the treatment and control groups and identified significant differences between materials (p = 0.001, <0.05). CT densitometry indicated vital pulps in all teeth, with pulpal inflammation detected in 6/8 CH-capped teeth and 2/8 MTA-capped teeth. Histologic evaluation confirmed vital pulp in all specimens, with different degrees of inflammation. (4) Conclusions: Within its limitations, the present study confirms the diagnostic value of PO evaluation of pulpal status in primary teeth with histologic means after pulp-capping procedures in a canine model. However, various degrees of pulpal inflammation elicited by different pulp-capping materials seem not to correlate with the obtained PO values.

Antimicrobial Meshes for Hernia Repair: Current Progress and Perspectives.

Recent advances in the development of biomaterials have given rise to new options for surgery. New-generation medical devices can control chemical breakdown and resorption, prevent post-operative adhesion, and stimulate tissue regeneration. For the fabrication of medical devices, numerous biomaterials can be employed, including non-degradable biomaterials (silicone, polypropylene, expanded polytetrafluoroethylene) or biodegradable polymers, including implants and three-dimensional scaffolds for tissue engineering, which require particular physicochemical and biological properties. Based on the combination of new generation technologies and cell-based therapies, the biocompatible and bioactive properties of some of these medical products can lead to progress in the repair of injured or harmed tissue and in tissue regeneration. An important aspect in the use of these prosthetic devices is the associated infection risk, due to the medical complications and socio-economic impact. This paper provides the latest achievements in the field of antimicrobial surgical meshes for hernia repair and discusses the perspectives in the development of these innovative biomaterials.

Polyploidy in First and Second Trimester Pregnancies in Romania - a Retrospective Study.

BACKGROUND: Polyploidy is a rare lethal cytogenetic anomaly in pregnancies, generally leading to pregnancy termination. This study aims to compare first and second trimester polyploidy in pregnancies and describe the underlying mechanisms. METHODS: A retrospective study was conducted in three medical genetics laboratories, collecting cases from Eastern, Southern, and Western Romania. The period of interest was January 2008 to December 2018. Prenatal samples (chorionic villi and amniotic fluid) and miscarriage samples were tested by standard karyotyping, as well as QF-PCR or FISH as complementary or alternative techniques. RESULTS: In first trimester pregnancies, we report cytogenetic results of chorionic villi samples from miscarriages: 25 triploid cases and 13 tetraploid cases. In second trimester samples obtained by amniocentesis, cytogenetic findings were positive for 17 triploid cases. Maternal age, age of the pregnancy, and fetal gender identified by ultrasound were recorded in all cases and, additionally, data on biochemical risk and ultrasonographic findings for second trimester pregnancies. CONCLUSIONS: Cytogenetic investigations of spontaneous abortions provide valuable information on the cause of abortion. This information is crucial for genetic counseling and may also contribute to prenatal diagnosis in subsequent pregnancies.

Reversible arterial redistribution in a fetus with true umbilical cord knot: case report and review of literature.

Umbilical cord knot (UCK) affects around 1% of pregnancies and tightening of UCK is a very rare and highly unpredictable complication of pregnancy that can lead to fetal demise or neonatal death. The majority of authors agree that very little could be done to prevent fetal deaths in pregnancies with undiagnosed tight UCK. We herein report the case of a 39-year-old, gravidity five, parity three, pregnant woman at 40 weeks and five days age of pregnancy, whose pregnancy evolved without complications and who was admitted to hospital for the management of the birth. Although the last ultrasound examination before birth showed a reversible arterial redistribution in the fetus dependent on the postural status of the pregnant women and other factors associated with umbilical cord knot were present, the diagnosis was missed because of the factors' non-specificity. After a spontaneous labor without complications a dead male fetus, weight 3300 g, without heartbeat, Apgar score 0 was delivered. Macroscopic and microscopic findings confirmed that the cause of neonatal death was asphyxia caused by a tight UCK. The aim of our paper is to present the dramatic outcome of a pregnancy with a fetus with a tight umbilical cord knot (UCK), to bring to attention the signs that suggested the diagnosis, and to review the literature on this subject.

Utero-adnexal damage in septic abortion. Histopathological study on 91 cases.

Septic abortion represents the main causes of abortion-induced maternal death. Hysterectomy may represent a beneficial therapeutic solution for septic abortion, nevertheless with irreversible effects on a woman's reproductive condition. The study analyzes the anatomopathological damage found in ninety-one patients hospitalized for septic abortion. The patients were admitted to the "Dr. D. Popescu" Clinical Hospital, Timisoara, between 1980-1989 and 1999-2008; hysterectomy was performed in all the cases to eliminate uterine sepsis responsible for the emerging complications.

[Aspects of Bcl-2 proto-oncogene expression in dysplastic and malignant lesions of the uterine cervix]. / Aspecte ale expresiei proto-oncogenei Bcl-2 în leziunile displazice si maligne ale colului uterin.

We studied Bcl-2 proto-oncogene expression in dysplastic and malignant lesions of the uterine cervix and looked for a relation between its incidence and tumor histopathologic type and tumor differentiation grade. We used immunohistochemical reaction with a Bcl-2 specific monoclonal antibody in order to identify this protein in 40 patients' biopsies. We noticed a Bcl-2 nuclear immunoreaction in high differentiated squamous carcinomas, whereas a positive cytoplasmic reaction of a granular pattern was registered in low differentiated types. Distribution and intensity of Bcl-2 reaction final product was correlated with tumor differentiation grade in 29 of all studied cases (72.5%). Immunostaining technique may be an important adjuvant factor for a more accurate prognosis.