Category Archives: Original Research

Cytological, Histological Correlations and Human Papillomavirus Testing in the Diagnosis of Cervical Intraepithelial Neoplasia

Colţescu F1, Hălmaciu Ioana2, Rădulescu Carmen3, Rădulescu C3

1 Department of Obstetrics and Gynecology, County Emergency Clinical Hospital, Târgu Mureş, Romania
2 Department of Anatomy and Embryology, University of Medicine and Pharmacy, Târgu Mureş, Romania
3 Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Târgu Mureş, Romania

Introduction: Persistent infection with high risk Papillomavirus (HR HPV) is the main risk factor for cervical cancer. Usually there is a period of approximately 10 years since someone gets infected with HPV till the incidence of an invasive cancer. The slow evolution of precancerous lesions allows their detection before the invasive stage. The objective of this study is to evaluate correlations among cytology, colposcopically guided biopsy and HPV testing, HR HPV prevalence and the reliability of cervical-uterine smears as screening method.
Material and method: The study comprises a number of 64 patients who underwent colposcopy, cytodiagnosis and biopsy examinations during January 2010 – December 2011 at Saint Die Hospital (France). Testing for HR HPV was performed especially in case of ASCUS Pap smears.
Results: ASCUS results of cervical-uterine smears corresponded to histological diagnosis of normal aspect and benign lesions in 60% of the cases, in 26.66% of cases with low grade malignant lesions and in 13.33% of the cases with high grade malignant lesions. HR HPV testing was positive especially in patients younger than 30 years (93.33% of patients who performed the HR HPV test), for patients between 30 and 50 years HR HPV was present in 80% of tested patients and for patients over 50 years was present only in 20% of the cases. Neither of the patients who tested negative for HR HPV presented high grade malignant lesions as a result of the biopsy test.
Conclusions: There is a direct correlation between the presence of HPV and grade of malignancy, thus all patients presenting high grade malignant lesions tested positive for HR HPV. HPV testing should not be performed in patients with LSIL results when sampling cervical-uterine smears, because the HPV prevalence is highly increased and a positive HR HPV test result would only create panic in young patients.

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Relationship Between Genotypes of Hepatitis C Virus and the Progression to Cirrhosis in Chronic Hepatitis C Patients

Colțescu Camelia1, Doffoel M1, Habersetzer F1, Oltean G2, Copotoiu Ruxandra3, Georgescu D4, Bățagă Simona4

1 Department of Hepato-gastroenterology, Faculty of Medicine, University Louis Pasteur, Strasbourg, France
2 Department of Internal Medicine, Medical Clinic 1, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Anesthesiology, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
4 Department of Gastroenterology, Medical Clinic 1, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

 

Objective: To assess the influence of genotype on the stage of liver fibrosis in case of hepatitis C at the moment of identification and at the 5 years follow-up.
Methods: In our retrospective study we enrolled 126 patients with hepatitis C admitted to the Gastroenterology Unit of the Nouvel Hopital Civil in Strasbourg, France between October 2006 and December 2011. All patients had detectable serum HCV-RNA and had not been transplanted during the 5 years surveillance period. The collected data was analyzed with GraphPad Prism Demo for descriptive and inferential statistics and with StatMate2Demo for power analysis.
Results: Genotype distribution was as follows: genotype 1a, n=23 (18.25%); genotype 1b, n=48 (38.10%); genotype 2, n=17 (13.50%); genotype 3, n=18 (14.29%) and genotype 4, n=20 (15.86%). Fibrosis at diagnosis and follow-up was not influenced by the genotype (odds ratio ranging from 0.395 to 5.147 but with a 95% CI below 1), except genotype 1b (odds ratio 2.093 [1.008; 4.348] at follow-up).
Conclusions: There is no association between a particular HCV genotype and the stage of fibrosis as defined by transient elastography.

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Incidence of Malignant Tumors of the Skin by Anatomic Subsite, Gender and Age

Ciortea Carmen Diana1, Gurzu Simona2, Dorobanţu D3, Jung Ioan2

1 Department of Dermatovenerology, County Emergency Clinical Hospital, Târgu Mureş, Romania
2 Department of Pathology, University of Medicine and Pharmacy, Târgu Mureş, Romania
3 Department of Plastic Surgery, County Emergency Clinical Hospital, Târgu Mureş, Romania

Objective: To analyze the clinico-pathological data of the skin lesions, especially malignant tumors, this study being the first step in a future immunohistochemical and molecular analysis.
Methods: The 3582 cases of benign, malignant, premalignant and tumor-like lesions of the skin, diagnosed during January 2006–December 2010 in the Pathology Department of the County Emergency Clinical Hospital of Târgu Mureş, surgically specimens, were revised and grouped based on histopathological forms.
Results: Epithelial tumors represented 37.32% of all skin tumors. The mesenchymal tumors (30.29%) were followed by melanocytic tumors (12.45%) and lymphomas (0.39%). Synchronous tumors represented 10.24% of cases. 63.5% of epithelial tumors were malignant, in contrast to 4.52% from mesenchymal tumors. Squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) were predominant, both of them affecting the upper half of the face. SCC especially occured in males (60.98%), but BCC were more frequent in females (50.84%).The average age was 71.30±11.92 years in SCC, and 68.15±11.29 years in BCC respectively. Regarding cutaneous melanomas, females (58.09%) were more affected than males (41.09%). The average age was 61.04±14.35 years. The trunk was the most common location in males, and the lower limb in females. Regarding lymphomas, only Mycosis fungoides was diagnosed.
Conclusions: Most tumors of the skin are malignant epithelial tumors, but mesenchymal tumors are rather benign type. Melanomas are mostly related to the sun exposure, the trunk and lower limb being more involved. In a significant percentage of cases synchronous tumors can develop. Further immunohistochemical and molecular studies are necessary to elucidate the differences between single and synchronous tumors and gender-related characteristics.

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Expression of Cyclin D1 in Oral Leukoplakia Compared with Normal Mucosa, Benign and Malignant Tumors of the Oral Cavity

Bögözi B1, Mezei T2, Bocskay I3

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Târgu Mureş, Romania
2 Department of Pathology, Faculty of General Medicine, University of Medicine and Pharmacy, Târgu Mureş, Romania
3 Consultant Professor, Faculty of Dental Medicine, University of Medicine and Pharmacy, Târgu Mureş, Romania

Introduction: Cyclin D1 is a rate-limiting controller of the G1 phase and the G1 to S transition of the cell cycle. It’s overexpression may cause disturbance in the normal cell cycle, which may lead to an increased proliferation and consecutive tumour formation. Our objective was to analyse the expression of Cyclin D1 in oral leukoplakia – the most frequent potentially malignant disorder of the oral mucosa – in comparison with normal mucosa, benign and malignant tumours of the oral cavity.
Material and methods: For this paper 51 consecutive cases of oral leukoplakia – surgically treated at the Oro-Maxillo-Facial Surgery Clinic from Târgu Mureş – and, for comparison 9 benign tumours and 27 oral squamous cell carcinomas (OSCCs) were selected. Eight normal mucosa samples were obtained from the peripheral regions of the benign tumours, excized with safe surgical margins. Histopathologically leukoplakias were graded as: with no, mild, moderate or severe dysplasia (G0-3), and OSCCs as: well-, moderately- or poorly-differentiated (G1-3). After immunohistochemical staining for Cyclin D1, statistical analysis was performed regarding the expression of the studied marker.
Results and conclusions: In our findings the difference between the expression of Cyclin D1 in normal mucosa, benign tumours and leukoplakias with no dysplasia was not significant, but the expression of this marker increased significantly with the increase of the grade of dysplasia in case of leukoplakias. A statistically significant difference was found also between leukoplakias and OSCCs, without any correlation regarding the histopathological grade of OSCCs.

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Increased Carotid Intima-Media Thickness and Retinal Vascular Disorders in Patients with Non-Alcoholic Fatty Liver Disease

Baloșeanu Leonica-Cristina1, Lilea Georgiana-Carmen2, Rogoveanu I2

1 Department of Ophthalmology, University of Medicine and Pharmacy, Craiova, Romania
2 Department of Gastroenterology, University of Medicine and Pharmacy, Craiova, Romania

Introduction: In this study we examined the association between the type of liver histology, value of carotid intima-media thickness and retinal vascular disorders in patients with Non-Alcoholic Fatty Liver Disease (NAFLD).
Material and method: We correlated the type of liver histology in 12 Non-Alcoholic Fatty Liver Disease patients with the measurements of carotid intima-media thickness evaluated by ultrasonography and the retinal vessel changes which were observed on retinal photography.
Results: The incidence of NAFLD was more increased in women (58.33%) than in men (41.66%). Dyslipidemia was detected in all 12 patients. The values of ALT were more increased than the one of ASAT. Moreover, the severity of liver findings and the degree of steatosis, necroinflammation or fibrosis were associated with the increase of carotid IMT and the occurrence of retinal vascular disorders (p<0.001 for all).
Conclusions: The results suggest that the type of liver histology is associated to the value of IMT and moreover to the incidence of retinal vascular disorders. Further controlled studies are needed to confirm the results.

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Differences Between Risk Factors and Impact on Antiviral Therapy of Insulin Resistance in Chronic Hepatitis B and C Patients

Lőrincz Gabriella1, Egyed-Zsigmond I2

1 Department Of Internal Medicine, Odorheiu Secuiesc Hospital, Odorheiu Secuiesc, Romania
2 Department of Pathology, University of Medicine and Pharmacy, Târgu Mureș, Romania

Background: Hepatitis C virus infection seems to induce insulin resistance and type 2 diabetes by direct viral involvement. The prevalence of glucose metabolism disorders is higher in C virus infected non-cirrhotic patients in comparation with patients with other etiology liver diseases.
Material and method: Two-hundred seventy patients with chronic C hepatitis were compared to 163 patients with chronic B hepatitis, regarding glucose metabolism before and after antiviral therapy and regarding the risk factors of diabetes.
Results: The prevalence of insulin resistance was 19% in hepatitis C and 6.7% in hepatitis B patients (p<0.0001). 90.2% of insulin resistant patients with C hepatitis had viraemia ≥800,000UI/ml. After viral eradication plasma glucose and insulin levels decreased significantly (p<0.0001). In this group of patients, eradication was obtained less (66.7%) than in the non-insulin resistent C hepatitis (84.4%) or insulin resistant B hepatitis group (80.0%).
Conclusions: Hepatitis C virus infection increases the risk of diabetes compared with hepatitis B virus, irrespectively of classic diabetes risk factors, but dependent on viraemia. Insulin resistance decreases therapeutic response only in hepatitis C, but viral eradication improves glucose metabolism in these patients.

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Non-alcoholic Fatty Liver Disease, as a Possible Independent Risk Factor for Obliterative Arteriopathy

Szalman Krisztina Borbála, Puskás A

2nd Department of Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: Non-alcoholic fatty liver disease, the hepatic manifestation of metabolic syndrome is the most common liver disease in civilized countries. There are a large number of studies which have demonstrated that cardiovascular diseases have a higher prevalence in those who suffer from non-alcoholic fatty liver disease. Direct causality is still largely debated, most components of metabolic syndrome being present in the case of non-alcoholic fatty liver disease too, which are well known risk factors for atherosclerosis also. The aim of our study was to find out the relations between non-alcoholic fatty liver disease and peripheral arterial disease (PAD).
Material and methods: Our retrospective study included 176 patients with PAD and 175 controls. We recorded the stages of PAD, risk factors and associated cardiovascular conditions.
Results: Our results show a significantly higher prevalence of PAD in patients suffering from non-alcoholic fatty liver disease. We also found that the association of non-alcoholic fatty liver disease and obesity or hypertension or hypertrygliceridaemia increase the risk of symptomatic PAD.
Conclusions: The prevalence of peripheral arterial disease is higher in patients with non-alcoholic fatty liver compared to the control group. Studies demonstrating the role of non-alcoholic fatty liver as an independent risk factor for this particular form of atherosclerosis are needed.

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Separation by Capillary Electrophoresis of Six Extensively Used Antibacterial Compounds

Simon Brigitta1, Hancu G2, Gyéresi Á2

1 Pharmafarm, Tîrgu Mureş, Romania
2 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Background: Penicillins and fluoroquinolones are two of the most extensively utilized class of antibacterial substances. Taking into account the importance of these compounds in the human and veterinary antibacterial therapy, identification and separation of these compounds in different complex matrices represent a necessity and also a challenge.
Objective: The aim of our study was to elaborate an alternative separation technique, suitable for the identification and separation of four penicillin derivatives – amoxicillin, ampicillin, benzylpenicillin and oxacillin – and two fluoroquinolones: ciprofloxacin and norfloxacin, and to optimize the analytical conditions.
Material and methods: MEKC proved to be the appropriate method of analysis for the separation of the studied compounds. The CE experiments were conducted on the Agilent 6100 CE System; the data were recorded and processed with Agilent Chemstation software.
Results: An optimum separation was achieved using a buffer solution containing 25 mM sodium tetraborate, 100 mM sodium dodecyl sulfate and 100 mM boric acid. The migration order of the six compounds was: amoxicillin, ampicillin, benzylpenicillin, oxacillin, ciprofloxacin and norfloxacin. The analytical performance of the method was evaluated by calculating the standard deviation for the peak area and also by checking the linearity of the determination.
Conclusions: The proposed method proved to be an efficient and useful tool in the separation of the studied substances and can find useful applications in the analysis of the studied substances from environmental samples.

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Allogenic Corneal Stem Cell Transplantation in Rabbits

Samoilă O1, Șoritău Olga2, Totu Lăcrămioara1, Cristian Cristina3, Călugăru M1

1 Ophthalmology Clinic, University of Medicine and Pharmacy, Cluj-Napoca, Romania
2 Oncology Institute, University of Medicine and Pharmacy Cluj-Napoca, Romania
3 University of Medicine and Pharmacy, Cluj-Napoca, Romania

Background: This is the first study regarding corneal stem cells cultivation in Romania. Our objective is to find a way to cultivate corneal stem cell into tissue that can be used to repair ocular surface.
Material and methods: We have conducted a study using an animal model (rabbit). Corneal fragments were cultivated on amniotic membrane substrate (intact or denuded).
Results: Cultures using denuded AM substrate showed high replication rates, especially after week 2, whereas cultures using intact AM showed little progression. After 1 month, 8 mm fragments trephined from cultivated tissues were used as allografts and transplanted on 8 rabbit eyes. All grafts integrated well, but with loss of transparency and corneal vascularization.
Conclusions: We have demonstrated the technique of cultivating limbal stem cells in vitro, on amniotic membrane substrate. We have also proved that surgical technique of transplantation is straightforward. Allograft use of cultivated stem cells was not efficient in this study.

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Bevacizumab for Macular Edema in Branch and Central Retinal Vein Occlusion

Rusu Monica-Blanka1, Egyed ZsI2, Maki Cristina1

1 Ophthalmology Clinic, Tîrgu Mureș, Romania
2 Department of Pathology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Purpose: To assess the efficacy and safety of intravitreal bevacizumab in central and branch retinal vein occlusion.
Methods: Prospective study, 18 patients, 19 eyes in branch retinal vein occlusion, and 37 patients and 37 eyes in central retinal vein occlusion; preoperative and postoperative assessment: visual acuity, fundus biomicroscopy, optical coherence tomography (OCT).
Results: Visual acuity improves in 84% in central retinal vein occlusion (OVCR) and 73.33% in branch retinal vein occlusion (BRVO) at 1 month after the third injection.
Conclusions: Bevacizumab may play a role in the treatment of central and branch retinal vein occlusion.

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