Advanced molecular approaches in male infertility diagnosis†.

In the recent years a special attention has been given to a major health concern namely to male infertility, defined as the inability to conceive after 12 months of regular unprotected sexual intercourse, taken into account the statistics that highlight that sperm counts have dropped by 50-60% in recent decades. According to the WHO, infertility affects approximately 9% of couples globally, and the male factor is believed to be present in roughly 50% of cases, with exclusive responsibility in 30%. The aim of this article is to present an evidence-based approach for diagnosing male infertility that includes finding new solutions for diagnosis and critical outcomes, retrieving up-to-date studies and existing guidelines. The diverse factors that induce male infertility generated in a vast amount of data that needed to be analyzed by a clinician before a decision could be made for each individual. Modern medicine faces numerous obstacles as a result of the massive amount of data generated by the molecular biology discipline. To address complex clinical problems, vast data must be collected, analyzed, and used, which can be very challenging. The use of artificial intelligence (AI) methods to create a decision support system can help predict the diagnosis and guide treatment for infertile men, based on analysis of different data as environmental and lifestyle, clinical (sperm count, morphology, hormone testing, karyotype, etc.), and "omics" bigdata. Ultimately, the development of AI algorithms will assist clinicians in formulating diagnosis, making treatment decisions, and predicting outcomes for assisted reproduction techniques.

Measurement of Lepton-Jet Correlation in Deep-Inelastic Scattering with the H1 Detector Using Machine Learning for Unfolding.

The first measurement of lepton-jet momentum imbalance and azimuthal correlation in lepton-proton scattering at high momentum transfer is presented. These data, taken with the H1 detector at HERA, are corrected for detector effects using an unbinned machine learning algorithm (multifold), which considers eight observables simultaneously in this first application. The unfolded cross sections are compared with calculations performed within the context of collinear or transverse-momentum-dependent factorization in quantum chromodynamics as well as Monte Carlo event generators.

Plasma CXCL10 correlates with HAND in HIV-infected women.

HIV-associated neurocognitive disorder (HAND) is characterized by chronic immune activation. We aimed to identify biomarkers associated with HAND and to investigate their association with cognitive function and sex, in a homogenous cohort of HIV-infected (HIV+) young adults, parenterally infected during early childhood. One hundred forty-four HIV+ Romanian participants (51% women) without major confounders underwent standardized neurocognitive and medical evaluation in a cross-sectional study. IFN-γ, IL-1ß, IL-6, CCL2, CXCL8, CXCL10, and TNF-α were measured in plasma in all participants and in cerebrospinal fluid (CSF) in a subgroup of 56 study participants. Biomarkers were compared with neurocognitive outcomes, and the influence of sex and HIV disease biomarkers was assessed. In this cohort of young adults (median age of 24 years), the rate of neurocognitive impairment (NCI) was 36.1%. Median current CD4+ count was 479 cells/mm3 and 36.8% had detectable plasma viral load. Women had better HIV-associated overall status. In plasma, controlling for sex, higher levels of IL-6 and TNF-α were associated with NCI (p < 0.05). Plasma CXCL10 showed a significant interaction with sex (p = 0.02); higher values were associated with NCI in women only (p = 0.02). Individuals with undetectable viral load had significantly lower plasma CXCL10 (p < 0.001) and CCL2 (p = 0.02) levels, and CSF CXCL10 (p = 0.01), IL-6 (p = 0.04), and TNF-α (p = 0.04) levels. NCI in young men and women living with HIV was associated with higher IL-6 and TNF-α in plasma, but not in the CSF. CXCL10 was identified as a biomarker of NCI specifically in women with chronic HIV infection.

May inflammatory markers be used for monitoring the continuous positive airway pressure effect in patients with obstructive sleep apnea and arrhythmias?

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is defined by recurrent episodes of significant reduction or absence of the oro-nasal airflow during sleep, in the presence of thorax and abdominal movements and snoring. The pathophysiological consequences of intermittent hypoxia determined by OSAS are represented by systemic inflammation, the release of free oxygen radicals and activation of the sympathetic nervous system. Cardiac arrhythmias are a frequent comorbidity in patients with OSAS. HYPOTHESIS: We hypothesized that the continuous positive airway pressure (CPAP) therapy has an effect on inflammatory markers (erythrocyte sedimentation rate, fibrinogen, and red cell distribution width) in patients with OSAS and cardiac arrhythmias. EVALUATION OF THE HYPOTHESIS: We tested this hypothesis on 52 patients diagnosed with OSAS and cardiac arrhythmias, divided into two groups: group A (patients who received CPAP therapy and pharmacological therapy) and group B (only pharmacological therapy). The patients were evaluated at enrollment (T0), at 3 and 6 months. We did not find a statistically significant difference of erythrocyte sedimentation rate (ESR) and fibrinogen levels between the two groups. Regarding the red cell distribution width (RDW), the CPAP treatment seems to have improved the RDW values in patients who received this treatment. Also, in patients from group A, a significant decrease in the average heart rate was noticed after 3 months. CONSEQUENCES: Fibrinogen and ESR cannot be used for monitoring the CPAP therapy in patients with OSAS and arrhythmias. Instead, the beneficial effect of CPAP in patients with OSAS and cardiac arrhythmias can be monitored with the help of the RDW, which could also be used for evaluating the cardiovascular risk in patients with OSAS and arrhythmias.

Determination of the strong coupling constant α s ( m Z ) in next-to-next-to-leading order QCD using H1 jet cross section measurements: H1 Collaboration.

The strong coupling constant α s is determined from inclusive jet and dijet cross sections in neutral-current deep-inelastic ep scattering (DIS) measured at HERA by the H1 collaboration using next-to-next-to-leading order (NNLO) QCD predictions. The dependence of the NNLO predictions and of the resulting value of α s ( m Z ) at the Z-boson mass m Z are studied as a function of the choice of the renormalisation and factorisation scales. Using inclusive jet and dijet data together, the strong coupling constant is determined to be α s ( m Z ) = 0.1157 ( 20 ) exp ( 29 ) th . Complementary, α s ( m Z ) is determined together with parton distribution functions of the proton (PDFs) from jet and inclusive DIS data measured by the H1 experiment. The value α s ( m Z ) = 0.1142 ( 28 ) tot obtained is consistent with the determination from jet data alone. The impact of the jet data on the PDFs is studied. The running of the strong coupling is tested at different values of the renormalisation scale and the results are found to be in agreement with expectations.

[Platypnea-orthodeoxia syndrome: A case of hypoxemia associated with a patent foramen ovale]. / Platypnée-orthodéoxie: un cas rare d'hypoxémie secondaire d'une réouverture post-traumatique du foramen ovale perméable.

Platypnea-orthodeoxia syndrome is a rare disease characterized by dyspnea and oxygen desaturation in the upright position with improvement in the supine position. We report a case of an 87-year-old woman with a recent history of traumatic hip, spine deformity and vertebral compression fracture, referred due to dyspnea oxygen desaturation. Thoracic tomodensitometry excluded the diagnosis of pulmonary embolism. Transthoracic echocardiography, with intravenous administration of agitated saline contrast solution, revealed the presence of atrial septal defect associated with a right to left shunting and mild enlargement of aortic root. Surgical closure of atrial septal defect resulted in resolution of the syndrome.

NONALCOHOLIC FATTY LIVER DISEASE AND ITS COMPLICATIONS--ASSESSING THE POPULATION AT RISK. A SMALL SERIES REPORT AND LITERATURE REVIEW.

UNLABELLED: The aim of the study was to highlight correlations between serum biochemical markers and different degrees of liver inflammation or fibrosis revealed by liver biopsy in morbidly obese patients. We also wanted to emphasize that the occurrence of hepatocellular carcinoma (HCC) is increasingly associated with obesity, metabolic syndrome and nonalcoholic fatty liver disease. MATERIAL AND METHODS: A clinical retrospective study was carried out on a series of 13 patients operated for morbid obesity in our surgical unit. Included in this study were only the obese patients referred for bariatric surgery without other risk factors for liver disease and in whom a liver biopsy was taken during metabolic surgery. RESULTS: The pathology report revealed different stages of nonalcoholic fatty liver disease in all 13 patients: pathological features of steatohepatitis (7 patients), hepatic steatosis (5 patients) and lesions specific for evolving cirrhosis (1 patient). Regardless of the pathological changes of the liver, except the patient with evolving cirrhosis, none of these patients showed changes in classical liver function blood tests. DISCUSSIONS: Hepatic alteration in obese patients, ranging from simple steatosis to steatohepatitis or even cirrhosis, is not always correlated with the values of classical biological liver function tests. Literature data suggest the involvement of adipokines in the development and progression of steatosis as the hepatic expression of metabolic and chronic inflammation syndrome occurring in obese patients. Furthermore, these proteins secreted by adipose tissue seem to be related to the HCC occurrence. However, none of these studies show the exact pathway followed by the hepatic cell from simple fatty liver to hepatocellular carcinoma. CONCLUSIONS: finding and selecting the population at risk for fatty liver disease progression and for HCC development among obese patients is mandatory.

MANAGEMENT OF TRAUMATIC LIVER LESIONS.

AIM: To determine the correct therapeutic approach to the different grades of liver trauma. MATERIAL AND METHODS: The study is based on a retrospective analysis of treatment outcomes in 56 patients with abdominal trauma admitted over a 9-year period to in the IIIrd Surgical Clinic of the Iasi "Sf. Spiridon" Hospital. It is focused on operative or non-operative management of liver trauma, surgical technique used, morbidity and postoperative mortality. Data were collected from electronic medical records and observation sheets and processed and interpreted using Microsoft Excel statistical functions. RESULTS: In the interval May 26, 2005-April 19, 2013 56 cases of abdominal trauma were recorded, 31 (55.35%) residing in urban areas, and 25 (44.64%) in rural areas. The mean age was 39 years, range 18-83 years old. The male/female ratio was 2.5/1 and the group consisted of 40 (71.42%) male patients and 16 (28.57%) female patients. The causes of abdominal trauma were: car accident in 29 (51%) cases, fall from different heights in 6 (10%) patients, workplace-related accidents in 8 patients (14%) and direct hit injury in 12 patients (12%). In our cohort, 51 (91%) patients with abdominal trauma have been emergency admitted, 3 patients (5%) were transferred from different medical units, and 2 patients (4%) were referred by a specialist doctor. Two or more simultaneous lesions were diagnosed in 53 (96%) cases. Of the 45 patients with traumatic liver injuries diagnosed on admission, 32 (71%) required surgical intervention. In the remaining 13 (29%) patients, the therapeutic management was conservative. CONCLUSIONS: Hepatic traumas are often severe, and frequently associated with multiple injuries. The non-operative management is indicated in liver lesions grade I, II and III according to the American Association for the Surgery of Trauma (AAST), if abdominal cavity organs are not injured. Higher grade liver lesions (over IV) in which the hemorrhagic risk persists or reappears require surgical intervention as soon as possible, and according to the type of lesion, the right procedure should be chosen.

Pain-associated biomarkers in breast cancer.

Breast cancer represents a major public health problem, being the highest incidence neoplasia in females in Romania. The most important step in the treatment of this neoplasia is the surgical procedure; the biggest problem associated with this form of treatment in these patients is pain-related. Pain is a complex symptom with an impact on quality of life and psychology of cancer patient and can only be monitored verbally and subjectively. Consequently, the purpose of our work is to identify some biochemical parameters involved in the events cascade associated with inflammation and pain in breast cancer female patients, monitored in dynamics of anesthesia and surgical procedure. Measurements of lipid peroxides, ceruloplasmin and immune circulating complexes in mentioned dynamics have been performed. The recorded values are in concordance with the inflammatory processes and pain intensity, thus we can allege that these measurements can complete the pain-associated clinical picture in female breast cancer patients.

Split-thickness skin grafting in oncologic surgery of the limb--a case report.

Large excision of tumor soft tissues is often complicated by infections, seriously undermined blood supply and venous drainage, tendon exposure, functional impairment. We report the case of a 67 years old woman admitted for a sarcoma of the right forearm occurring 14 years after a modified radical mastectomy and adjuvant chemotherapy for carcinoma of the right breast. A wide excision of the lesion and split-thickness skin graft was performed with uneventful recovery and satisfactory healing of the graft tissue and functional aspect of the arm. In the last few decades, there has been a search for solutions in tissue repair without need for auto grafts, such as biological substitutes that could repair or improve the function of tissue. In case none of these products are available, auto graft is a good choice and it may be commonly used in the surgical treatment of postoperative soft tissues defects after oncologic surgery.

Metabolic disorders in patients operated for pancreatic cancer.

Adenocarcinoma of the pancreas presents a major threat with a 5-years survival rate of 5%. Whipple pancreaticoduodenectomy (PD) is the standard procedure for cephalo-pancreatic neoplasm. After an extended resection and reconstruction of superior gastrointestinal tract the digestive physiology might be heavily disrupted. A literature review of metabolic alterations of patients who suffered a major pancreatic resection is performed, regarding micronutrients, lipid absorption and pancreatogenic diabetes. Long-term survivors following PD generally have a satisfactory nutritional status although with subclinical iron, vitamin D and selenium deficiency. These patients should be followed-up also regarding these micronutrients and properly dietary supplemented when necessary, also considering the increased life expectancy. Approximately 17-25% of patients will develop insulin-dependent diabetes but pancreatogenic diabetics have elevated levels of serum insulin and minimal or absent response to food intake, as opposed to a type I diabetics, where insulin serum is normal or elevated and there is an exaggerated response to ingestion of sugar.

Perioperatory pain in oncological patient - physiopathological and therapeutical implications.

Perioperatory pain in oncological patients represents a witness of anesthetic-surgical aggression, frequently exacerbated by the complementary radio-chemotherapy and also a predictive factor for postoperatory evolution. The objectivation of perioperative pain by scales of clinical evaluation does not offer a certain and objective quantification; so, the dosing of some hormonal and acute phase inflammation mediators could realize a more realistic projection. Clinical and biological correlation can offer a support for an adequate and well-balanced treatment.

[Treatment of peritoneal carcinomatosis of gastro-intestinal origin--a retrospective study of 203 cases]. / Tratamentul carcinomatozei peritoneale de etiologie digestiva--studiu retrospectiv pe un lot de 203 pacienti.

UNLABELLED: Peritoneal carcinomatosis of gastrointestinal origin (PC-GI) is an advanced digestive tumor and is found in 10-30% of patients (P) with primary surgery for cancer (C) and up to 50% of C recurrences. AIM: To evaluate the main characteristics, ethio-pathogenesis, prognosis and imaging to track of P with PC-GI admitted to the Third Surgical Clinic, "St. Spiridon" Hospital, Iasi. MATERIAL AND METHODS: A retrospective study was carried out on series of 203 patients admitted in the period June 2006 - March 2011. The patients were aged between 27-80 years (average 62), with a women/men ratio of 95/108. The duration of hospitalization was between 1 and 61 days, with an average of 13.5 days for emergency cases and 15 days for elective cases. The data from observation files, the operating protocols, pathology reports and follow-up files were collected and analyzed. RESULTS: 136 patients were hospitalized with synchronous PC (the most common gastric N = 60) and 67 with metachronous PC (the most common colon N = 29). Imaging investigations consisted of ultrasound and computer tomography that showed a sensibility and specificity of 80% and 73% respectively, mainly in regard to ascites but less in assessing the presence of peritoneal deposits. The most common complication was septic shock and mortality was 9.5% (17 patients). Average survival was 5.7 months. CONCLUSION: PC-GI is a disease with a poor prognosis, posing difficulties in early diagnosis, establishing the surgical indication and protocol. Consistent advances in systemic and locoregional chemotherapy, surgical techniques, intraoperative radiotherapy, as well as immunotherapy are expected to improve prognosis.

[Early results of the surgical management of gastrointestinal stromal tumors (gist)--the experience of the 3rd surgical unit]. / Rezultate imediate in managementul chirurgical al tumorilor stromale gastrointestinale primare (gist)-- experienta clinicii a III-A chirurgicale.

UNLABELLED: This study provides a clinical and paraclinical algorithm of assessment of gastrointestinal stromal tumors (GIST), with the possibilities and limits of their current management. It is focused on defining an optimal imaging and anatomoclinic diagnosis protocol. In the absence of specific algorithm of surgical management, the study proposes an evaluation of possible histologic diagnosis and the indication for surgery, and the assessing the immediate results of thesurgical treatment. MATERIALS AND METHODS: A retrospective analysis was carried out over a period of 8 years (2004-2011), including patients with pathologic results of resection specimens revealing the stromal nature. There were analyzed the tumor characteri stics, the association with other digestive tumors, the biologic behavior, clinical manifestations and the comorbidities of the patient, the indication for surgery, and also, the surgical morbidity and mortality. From 2004 to 2011 there have been operated 24 cases of GIST diagnosed histologically by common stains. Among them, a total of 16 patients (beginning with 2007) were confirmed immunohistochemicaly. RESULTS: During the study, each clinical suspicion of GIST was an opportunity for thorough assessment of the clinical picture, imaging studies or anatomoclinical aspects (intraoperative macroscopical aspects, pathological and immunhistochemical examination). We have tried a standardization of diagnostic and therapeutic algorithm. Positive diagnosis of GIST was clinicaly suspected in patients with digestive tract tumors (22 cases out of 24) without mucosal involvement, or based on intraoperative macroscopic appearance. The lesions were confirmed by the pathologist. The surgical morbidity (4 cases--16.6%), was to the surgery (a single case of anastomotic leakage) or due to patient's comorbidities (diabetus, chronic renal failure, etc), and has been framed to acceptable extent. No deaths occurred in relation to the surgery. CONCLUSIONS: The diagnostic difficulties are overcome in terms of a positive laboratory features revealed by immunhistochemical examination. The surgical approach of GIST is different from that of a carcinoma. The postoperative immunhistochemical confirmation of GIST, leads the patient to a specific adjuvant treatment.

The risk of lymphedema after breast cancer surgical treatment.

UNLABELLED: The aim of this study is to emphasize the importance of knowing the predisposing factors of the occurrence of homolateral upper limb lymphedema after breast cancer surgery. MATERIAL AND METHODS: The study included 1104 patients with breast cancer, who were hospitalized in the IIIrd Surgical Clinic, lasi, between 2000 and 2010, for surgical treatment followed by oncological adjuvant therapy. The surgical intervention was conservative in 228 cases and modified radical mastectomy - Madden type - in 876 patients. Periodic clinical follow-ups were done every 3 months during the first postoperative year, every 6 months during the second year and annually thereafter. RESULTS: Early lymphedema occurring in the first 14 postoperative days or between day 14 and day 21 was found in 8 patients. Late lymphedema, occurring up to 12 months or more after surgery, was diagnosed in 41 patients. Medium and severe lymphedema occurred at 42 patients. We evaluated the preexisting risk factors, the risk factors related to the type of surgery and those related to the cancer staging. CONCLUSIONS: It's ideal to identify predisposing factors of developing lymphedema related to breast cancer surgery before applying any type of treatment, There are therapeutic methods (general, drug therapy, physiotherapy) and methods related to the surgical act that influences the prophylaxis of lymphedema or have an amazing effect on already occurred lymphedema.

[Rare clinical situatons of the diverticuli of the colon]. / Situatii clinice rare ale diverticulilor colonului.

UNLABELLED: It is well known that the diverticuli of the colon gets inflamed in 10-15% of cases, thus becoming clinical symptomatic as a diverticulitis, while in other 15% they will bleed, with the clinical aspect of an inferior digestive bleeding. Our study presents some clinical observations with diverticuli of the colon, that raised diagnostic and therapeutic problems. MATERIAL AND METHOD: Between 2001-2010, 17 patients were admitted in the 3rd Surgery Clinic, University Hospital "St.Spiridon", Iasi, with asymptomatic diverticuli of the colon, that were put in evidence imagistically, intraoperative or on specimens after removal of the colon for other conditions;meanwhile, there were 15 patients admitted with complications of the diverticuli:5 patients had perforated diverticulitis (4-pericolic abscesses and one with peritonitis in the lower abdomen), 4 had rectal bleeding and the other 6 raised particular problems of diagnostic and treatment, being included in the present study. RESULTS: Five out of six underwent operation. One patient refused the surgical treatment. Postoperative evolution was favorable in 4 out of the 5 operated patients. CONCLUSIONS: The complications of colonic diverticuli present on admission under clinical aspects that usually mimic a colonic cancer. In these situations the imagistic examinations do not offer enough details to elucidate the diagnosis. Our six particular observations strengthen the dictum of avoiding the "mirage" of the first lesion. The extent of the surgical procedure in the case of patients with colonic diverticuli admitted under the clinical aspect of a complication is sometimes disproportionate and encumbered of increased mortality and complication rate.

[The influence of stress factors on liver function and lipid metabolism in an animal model of arterial hypertension]. / Influenta factorilor de stres asupra functiei hepatice si metabolismului lipidic pe un model de hipertensiune arteriala la animale de laborator.

AIM: to investigate the influence of some stress factors on hepatic function and lipid metabolism in an experimental-induced hypertension. MATERIAL AND METHODS: The experiment was carried out on Wistar rats, treated intraperitoneally, for 4 weeks, as follows: Group 1: saline solution (0.5ml/100g weight); Group 2: saline solution + stress; Group 3: Endotelin-1; Group 4: Endotelin-1 + stress; Group 5: Endotelin-1 + cholesterol diet (0.2g/kbw/day); Group 6: Endotelin-1 + cholesterol diet + stress. Endotelin-1 0.25nmol/kbw was initially administered, followed by 0.5nmol/kbw 15 min later, 2 times/week. Stress-inducing factors were immobilization and water immersion. In the 28th day of the experiment blood pressure was measured and blood samples were taken from retro-orbitary plexus to assess glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT) and lactic dehydrogenase (LDH) activity, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides levels. RESULTS: Using immobilization and water immersion as chronic stress, our study proved an increase of GOT, GTP and total and LDL cholesterol in rats with endotelin-1-induced hypertension. CONCLUSIONS: In this animal model of endothelin-1-induced hypertension the blood pressure increased significantly under chronic exposure to stress, reaching the highest values when associating stress and experimentally induced dyslipidemia.

[Experimental research regarding the influence of the stress factors in an animal model of HELLP syndrome]. / Cercetarea experimentala a influentei factorilor de stres pe un model animal de sindrom HELLP.

AIM: to study the effects of licht/dark induced-stress in an animal model of HELLP syndrome. MATERIAL AND METHODS: The experiment was carried out on white female Wistar rats treated intraperitoneally, for 4 weeks, as follows: Group 1: saline solution 0.5ml/100g weight; Group 2: saline solution + dark induced-stress, continuously, 28 days; Group 3: saline solution + light induced-stress, continuously, 28 days; Group 4: endotelin-l; Group 5: endotelin-1 + dark induced-stress, continuously, 28 days; Group 6: endotelin-1 + light induced-stress, continuously, 28 days. Endotelin-1 0.125nmol/kbw was initially administered, followed by 0.25nmol/kbw 30 min later, 2 times/week. RESULTS: At the end of the experiment blood pressure was measured and blood samples were taken to assess: leukocyte formula, phagocytic capacity of peripheral neutrophils and serum complement activity, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and lactic dehydrogenase (LDH) activity, total bilirubin and lipid profile. CONCLUSIONS: In these experimental conditions we obtained an animal model of partial HELLP syndrome (elevated liver enzyme levels and a low platelet count, values emphasized by light induced-stress, without hemolysis). In chronically stressed animals we found the highest levels of blood pressure, a decrease of plasmatic cortisol level and of phagocytic capacity of peripheral neutrophils and an increase of total cholesterol.

[Radiofrequency ablation for liver metastases--mini invasive therapeutic option for patients with unresecable tumors]. / Distructia prin radiofrecventa a metastazelor hepatice--optiune terapeutica miniinvazia optimala la pacientii non-rezecabili chirurgical.

UNLABELLED: Radiofrequency ablations (RFA), a new therapeutic option for liver metastases, proceeded by open surgery or laparoscopic approach, provide an acceptable control of local tumor process, involved lower risks than resection surgery. OBJECTIVES: We analyzed this procedure, for classic indication in hepatic metastatic tumors, based on four years experience, focused on perioperative complications, recurrence rate and long distant evolution. METHOD: Between December 2006 and December 2010, 61 patients with liver metastases underwent RFA; 46 cases had metastatic lesions from colo-rectal cancer, 9 cases from breast cancer, 4 cases from gastric cancer and 2 cases from ovarian cancer. RFA was performed in 55 patients via open surgery and laparoscopic approach in 6 patients. Postoperative course was followed with CT scan at 1 month, and then at 3 month interval, in correlation with tumor markers level. RESULTS: Perioperative complications occurred in 8 cases, consist of prolonged fever, severe hepatic cytolysis, without other complications such, biliary tract injury, hemorrhage, and peritonitis; no mortality caused by RFA procedure. 10 cases had local recurrence, at 6 and 25 month after post RFA procedure. CONCLUSIONS: Initial experience shows that RFA is a safe procedure for treatment of liver metastases, with low rate of morbidity and local recurrence, indicated for patients with unresecable lesions or high risks for surgical resection.

[Experimental research on the influence of stress factors in an animal model of hypertension]. / Cercetari experimentale privind influenta factorilor de stres pe un model animal de hipertensiune arteriala.

AIM: to investigate the influence of some stress factors in endothelin-1-induced hypertension. MATERIAL AND METHODS: The experiment was carried out on Wistar rats, treated intraperitoneally, for 4 weeks, as follows: Group 1: saline solution (0.5 ml/100 g weight); Group 2: saline solution + stress; Group 3: Endotelin-1; Group 4: Endotelin-l + stress; Group 5: Endotelin-1 + cholesterol diet (0.2 g/kbw/day); Group 6: Endotelin-1 + cholesterol diet + stress. Endotelin-1 0.25 nmol/kbw was initially administered, followed by 0.5 nmol/kbw 15 min later, 2 times/week. Stress-inducing factors were immobilization and water immersion. In the 28th day of the experiment blood pressure was measured and blood samples were taken from the retro-orbitary plexus to assess plasma cortisol, blood count, phagocytic capacity of peripheral neutrophils, and serum complement activity. RESULTS AND DISCUSSIONS: Repeated administration of endotelin-1 determined an increase in blood pressure, statistically significant in stress conditions comparing to non-stressed animals. Our study proved a decrease of plasma cortisol, total leukocyte count, phagocytic capacity of peripheral neutrophils, without significant alterations in serum complement activity. CONCLUSIONS: Chronic exposure to complex stress conditions in rats with endothelin-1-induced hypertension determined a decrease of plasma cortisol levels, effect correlated with elevated blood pressure and decrease in the number and phagocytic function of peripheral neutrophils.