Category Archives: Original Research

Subject Specific Modeling of the Forefoot Based on CT 3D Reconstruction

Incze Bartha S, Nagy Ö, Incze Bartha Zsuzsánna

Clinic of Orthopedics and Traumatology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: Developing new surgical procedures and prototyping implants requires a real or adequate virtual testing environment to work in. Due to the unique architecture of the human foot interventions and implants can be tested only on patients and cadavers. We present our own approach for creating the geometrical model based on 3D CT reconstruction.
Material and methods: For the model construction we used the CT data from the foot of a healthy, young patient. The input data consisted from 56 sections from the talar dome to the plantar surface. The slices were segmented, boundary detection was performed, the boundaries were smoothed, NURBS interpolation was performed to obtain 3D surface. The surfaces were closed to solids and the solids edited to obtain the virtual anatomical structures.
Results: Our model is geometrically accurate in the limits of resolution that were given by the CT examination.
Conclusions: Now that we have an available model construction method we can begin enclosing the geometrical model into mathematical environments for finite element analysis. Also, scanning and reconstructing multiple feet with different conditions will help us to understand illnesses and develop new operative techniques and implants.

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Outside over Inside Analysis of Medical Students’ Education Efficacy in Cognitive Domain over a given Physiology Curricula

Gliga M, Sabău M

Department of Physiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Aim: We tried to correlate, in cognitive domain, the second year medical students’ oral evaluation results to the efficacy of education they were provided, over our medical physiology curricula between 2004 and 2011.
Material and methods: We used the fact that during the mentioned period the curricula configuration for the two semesters of the second year was identical. We also used the fact that, for a given group of students and curricula, education and evaluation were performed by the same teacher. We compared three existing and unmodified configurations: 1. different groups of students, same curricula, different teachers, 2. same group of students, different curricula, same teacher and 3. same group of students, different curricula, different teachers. We also took an inside brief evaluation of students’ skills in cognitive domain at the beginning of the second year and tried to correlate it with final results.
Results: We couldn’t make any correlations because of logical contradictions of the configurations we compared. We couldn’t obtain, as an outside observer, concise information of what levels in cognitive domain students were evaluated on by different teachers. Merely we can say that education of the second year medical students over our physiology curricula cannot be efficient for a large amount of students who do not possess those compulsory cognitive skills that are required to study physiology.
Conclusions: The protocols used between 2004 and 2011 for evaluating medical students’ skills in cognitive domain over second year medical curricula cannot give accurate information for an outside evaluator.

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Antimicrobial Activity of 2% Chlorhexidine

Ghiga Dana1, Bacârea V1, Petrişor M2, Haifa B2, Şchiopu A3

1 Department of Research Methodology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Physiopathology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: A great interest regarding 2% chlorhexidine solution is over its efficiency on gram-negative bacteria, but chlorhexidine sensitive microorganisms include gram-positive bacteria, gram-negative bacteria and fungi. The aim of the study was to analyze the antimicrobial and antifungal action of 2% chlorhexidine solution against the microorganisms isolated from infected root canals before and after irrigation. Material and method: Clinical material. We took samples from 20 incisors of 20 patients. Sampling procedure. We followed all the rules necessary for sampling under sterile conditions. Three microorganisms: Enterococcus faecalis, Staphylococcus aureus and Candida albicans were identified from infected root canals, based on culture, and biochemical characteristics and pathogenicity tests. The statistical analysis was performed using a statistical analysis program (SPSS Statistics 16.0). A log10 transformation of the CFU (colony forming units) values was performed to normalize the data.
Results: The frequency of the isolated microorganisms before irrigation with 2% chlorhexidine solution were: Enterococcus faecalis – 3.18±1.84 CFU, Staphylococcus aureus – 1.92±0.79 CFU, Candida albicans – 2.12±1.10 CFU and after irrigation were: Enterococcus faecalis – 0.67±0.20 CFU, Staphylococcus aureus – 0.95±0.26 CFU, Candida albicans – 1.02±0.35 CFU. The difference between the means of isolated germs’ CFU before and after irrigation with 2% chlorhexidine solution is statistically significant (p<0.05).
Conclusions: The use of 2% chlorhexidine solution as endodontic irrigant reduces the number of the studied microorganisms’ colony forming units.

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Influence of Some Flavoring Substances on the Hematological Parameters of Rats

Duca Alina1, Mihele Dana2

1 Department of Clinical Laboratory and Alimentation Hygiene, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2 “Prof. Dr. Scarlat Longhin” Clinical Hospital of Dermatovenerology, Bucharest, Romania

Introduction: Given the risk of side effects of flavoring substances used in the food industry, their cytotoxic effect on mouse fibroblast cell cultures and the risk of malignant degeneration, in this paper we observed eventual changes to hematological parameters of rats under the influence of flavorings: (±) – limonene p-methyl-1,8-diene (orange flavoring substance), (±) -3,7-dimethyl-6-octenal (lemon flavoring substance), ethyl format (rum flavoring substance) and 4-hydroxy-3-methoxybenzaldehyde (vanilla flavoring substance).
Materials and methods: The changes were followed in red blood cell counts, red cell indices, hemoglobin in erythrocytes, leukocytes, differential blood count, platelet count and platelet indices. For measurements we used white Wistar rats, weighing 240±10g. The flavoring substances were administered in doses of 25 mg/kg orally for 7 days compared to a control group treated with saline solution at a dose of 10 mg/kg orally. Blood was collected after 7 days of treatment in tubes with EDTA-Na 1 mg/2 ml blood and measurements were made with an automated hematology analyzer.
Results: After 7 days of treatment we found the orange and lemon flavoring substances determined a significant decrease in the number of erythrocytes, hematocrit and hemoglobin values, mean corpuscular volume, mean erythrocyte hemoglobin, mean erythrocyte hemoglobin concentration, but the number of leukocytes and platelet count did not change significantly. The vanilla and rum flavoring produced no statistically significant changes in hematological parameters.
Conclusions: The orange and lemon flavoring substances studied after statistical processing of experimental data by Student t-tests and ANOVA has modified significant the hematological parameters (number of erythrocytes, hemoglobin and hematocrit value).

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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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