New Poly(N-isopropylacrylamide-butylacrylate) Copolymer Biointerfaces and Their Characteristic Influence on Cell Behavior In Vitro.

Designing and obtaining new synthetic smart biointerfaces with specific and controlled characteristics relevant for applications in biomedical and bioengineering domains represents one of the main challenges in these fields. In this work, Matrix-Assisted Pulsed Laser Evaporation (MAPLE) is used to obtain synthetic biointerfaces of poly(N-isopropyl acrylamide-butyl acrylate) p(NIPAM-BA) copolymer with different characteristics (i.e., roughness, porosity, wettability), and their effect on normal HEK 293 T and murine melanoma B16-F1 cells is studied. For this, the influence of various solvents (chloroform, dimethylsulfoxide, water) and fluence variation (250-450 mJ/cm2) on the morphological, roughness, wettability, and physico-chemical characteristics of the coatings are evaluated by atomic force microscopy, scanning electron microscopy, contact angle measurements, Fourier-transform-IR spectroscopy, and X-ray photoelectron spectroscopy. Coatings obtained by the spin coating method are used for reference. No significant alteration in the chemistry of the surfaces is observed for the coatings obtained by both methods. All p(NIPAM-BA) coatings show hydrophilic character, with the exception of those obtained with chloroform at 250 mJ/cm2. The surface morphology is shown to depend on both solvent type and laser fluence and it ranges from smooth surfaces to rough and porous ones. Physico-chemical and biological analysis reveal that the MAPLE deposition method with fluences of 350-450 mJ/cm2 when using DMSO solvent is more appropriate for bioengineering applications due to the surface characteristics (i.e., pore presence) and to the good compatibility with normal cells and cytotoxicity against melanoma cells.

Mitigation of Cellular and Bacterial Adhesion on Laser Modified Poly (2-Methacryloyloxyethyl Phosphorylcholine)/Polydimethylsiloxane Surface.

Nowadays, using polymers with specific characteristics to coat the surface of a device to prevent undesired biological responses can represent an optimal strategy for developing new and more efficient implants for biomedical applications. Among them, zwitterionic phosphorylcholine-based polymers are of interest due to their properties to resist cell and bacterial adhesion. In this work, the Matrix-Assisted Laser Evaporation (MAPLE) technique was investigated as a new approach for functionalising Polydimethylsiloxane (PDMS) surfaces with zwitterionic poly(2-Methacryloyloxyethyl-Phosphorylcholine) (pMPC) polymer. Evaluation of the physical-chemical properties of the new coatings revealed that the technique proposed has the advantage of achieving uniform and homogeneous stable moderate hydrophilic pMPC thin layers onto hydrophobic PDMS without any pre-treatment, therefore avoiding the major disadvantage of hydrophobicity recovery. The capacity of modified PDMS surfaces to reduce bacterial adhesion and biofilm formation was tested for Gram-positive bacteria, Staphylococcus aureus (S. aureus), and Gram-negative bacteria, Escherichia coli (E. coli). Cell adhesion, proliferation and morphology of human THP-1 differentiated macrophages and human normal CCD-1070Sk fibroblasts on the different surfaces were also assessed. Biological in vitro investigation revealed a significantly reduced adherence on PDMS-pMPC of both E. coli (from 29 × 10 6 to 3 × 102 CFU/mL) and S. aureus (from 29 × 106 to 3 × 102 CFU/mL) bacterial strains. Additionally, coated surfaces induced a significant inhibition of biofilm formation, an effect observed mainly for E. coli. Moreover, the pMPC coatings improved the capacity of PDMS to reduce the adhesion and proliferation of human macrophages by 50% and of human fibroblast by 40% compared to unmodified scaffold, circumventing undesired cell responses such as inflammation and fibrosis. All these highlighted the potential for the new PDMS-pMPC interfaces obtained by MAPLE to be used in the biomedical field to design new PDMS-based implants exhibiting long-term hydrophilic profile stability and better mitigating foreign body response and microbial infection.

Correlations between histological subtypes and neurocognitive assessment of language area tumors. Our 43 case series and review of the literature.

BACKGROUND: Brain tumor location is related with specific, focal neurological impairment, but also with more diffuse, generalized and subtitle neurocognitive dysfunctions. For a better evaluation of these cases, we need a specific battery of tests. Beside the impact of preoperative status on surgical decision, the quantification of postoperative function alteration is essential in neurorehabilitation. PATIENTS, MATERIALS AND METHODS: We proposed a battery of tests to assess the neurocognitive function, with an accent on language adapted to Romanian population. The 43 cases included in the study were tested preoperatively, seven days postoperatively and at one month, and correlated with the images and histological results. RESULTS: At admission, from all participants, 11.6% were affected across all measured items and 6.9% on none of them. A rate of impairment significantly higher, four or more items, was observed in glioblastoma (GB) cases (23.3%) in contrast with low-grade glioma (LGG) (0%), meningioma (0%) and metastases (6.9%). From all cases, we performed seven awake craniotomies. At one-month evaluation, general decrease in neurocognitive function was observed in 20.93% cases, among them 88.88% being GB and favorable outcome in 32.55% patients with dominance of LGG and meningioma cases. CONCLUSIONS: A neurocognitive assessment of brain tumor patients is important for preoperative and postoperative evaluation and secondary adjustment of the surgical resection in order to improve or, at list, meantime the initial status. The role and the link between the histological type and tests alteration were observed. The results can be used for a better understanding and management of language area tumors.

Morphological and functional renovascular changes as cause of resistant arterial hypertension - case report and literature review.

Resistant hypertension is defined by the inability to maintain within normal limits the blood pressure values of an individual, while he is under treatment with maximal tolerated doses of three antihypertensive agents. One of the most common types of resistant hypertension is renovascular hypertension (RVH), which is caused by the narrowing of the renal arteries, in the context of existing atherosclerotic plaques at that level. We are presenting the case of a hypertensive 56-year-old man admitted in the Clinic of Cardiology for a sudden rise of his blood pressure values, despite undergoing the scheduled treatment. The abdominal bruit discovered at the clinical examination and the hypokalemia, together with the mild impairment of the renal function raised the suspicion of an existing stenosis of the main renal blood vessels. Simple grey scale kidney ultrasound, Doppler ultrasound of the renal arteries, abdominal computed tomography and magnetic resonance angiography of the renal arteries, along with invasive renal angiography demonstrated a smaller right kidney, adrenal incidentalomas, reduced vascular diameter of renal arteries due to atheromatous lesions, thrombosis of the infrarenal segment of the abdominal aorta, and reduced vascular hemodynamics in the same territories. After the renal arteries revascularization and with minimal antihypertensive treatment, the patient had a favorable outcome, with normalization of blood pressure and renal function. Atherosclerotic disease causing renal artery stenosis is essential to be taken into consideration in the etiopathogenesis of resistant hypertension especially because RVH is a potentially curable disease.

A novel combination of double primary malignancies: penile carcinoma and glioblastoma. A series of two cases.

AIM: Penile squamous cell carcinoma (pSCC) and glioblastoma (GB) are rare malignant tumors that develop especially in the elderly. The aim of our paper is to present two patients diagnosed and treated for a cerebral GB developed after a prior pSCC and to discuss the possible mechanism of their association. PATIENTS, MATERIALS, AND METHODS: The medical records of 632 patients admitted for a GB in the Department of Neurosurgery, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iasi, Romania, between April 2010 and April 2018, were retrospectively searched for those having a prior histological proven cancer. The review found only two patients (0.31% of all cases with GB) and their demographics, clinical presentation, medical history, treatment and pathological diagnosis were reviewed and discussed. RESULTS: Both patients were 65-year-old on their admission in the Department of Neurosurgery. Their prior penile tumors were both located at the penis glans. In both cases, the histopathological exam revealed a penile keratinized squamous cell carcinoma stage T1aN0M0 at the moment of their first urological diagnosis. At the time of the neurosurgical evaluation, brain radiological investigations demonstrated right frontal cystic neoformation in the first case, and a right frontal-parietal solid, expansive lesion for the second patient. The patients underwent subtotal surgical excision of their brain masses. The histopathological exam revealed in both cases a World Health Organization (WHO) grade IV GB. CONCLUSIONS: This is the first clinical report of a new association between pSCC and subsequent development of GB in a series of two patients. Both our patients developed a prior pSCC without any lymph node and distant metastasis at their first diagnosis and this situation reinforces the idea that this type of cancer has a good prognosis and that the patient can develop a second cancer during his post-penectomy life, probably due to a genetic predisposition, post-therapeutic effects, life style factors (smoke effects), sporadic association, or due to the common embryological origin of the nervous and skin tissues.

Cytological, histopathological and immunological aspects of autoimmune thyroiditis: a review.

Autoimmune thyroiditis (AT) is a disease that may be associated with many other autoimmune endocrine and non-endocrine disorders. This disease is mediated by both humoral and cellular mechanisms and it is the result of combined effects of human leukocyte antigen (HLA) class II genes and non-HLA genes polymorphisms. The clinical course of AT is variable and may be characterized by spontaneous remission and by irreversible thyroid insufficiency as the consequence of atrophic and fibrous transformation of the thyroid gland in other cases. In this paper, the AT's etiology and immunological mechanism along with its cytological and histopathological features are reviewed in order to increase our understanding about the mechanism involved in pathogenesis of this disease and to open new directions of investigations that will be useful in a better clinical practice.

Inflammatory juvenile compound conjunctival nevi. A clinicopathological study and literature review.

AIM: The conjunctival nevus affecting children and adolescents is a rare condition and the literature showed only few reports on this issue. The aim of this article is to determine the histopathological features for the correct diagnosis of an inflammatory juvenile compound nevus of the conjunctiva (IJCNC) in order to make the difference between this tumor and other lesions, like conjunctival melanoma or lymphoma, very similar from a gross point of view. This article is a clinical pathological study of two cases of IJCNC with particular histopathological characteristics, who were admitted at the 2nd Ophthalmology Clinic, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iasi, Romania, over a period of five years (from July 1, 2012 to June 30, 2017). Both patients were adolescents, a boy (13-year-old) and a girl (12-year-old). Both lesions were bulbar juxtalimbal located and grew in size over one year. Seen at slit-lamp biomicroscopy, the first one presented as a non-pigmented lesion, while the second was a pigmented nevus, but their dimensions did not exceed 10 mm in diameter. From a histopathological point of view, both of them showed a nested junctional growth pattern, along with intra- and subepithelial location, of the nevomelanocytes. Tumoral cells demonstrated different degrees of atypical cytology, but in the second case, it was more obvious. Microscopic examination also revealed epithelial cystic inclusions, and prominent inflammation in the stroma of these two nevi. One of the cases presented heavy inflammation that took the form of lymphoid follicles and sheets of eosinophils, but the other showed only diffuse inflammation with lymphocytes plasma cells, and eosinophils within its stroma. The immunohistochemical characterization (anti-melan A, anti-S100 protein and anti-cytokeratin AE1÷AE3 antibodies) of the tumoral cells helped to the diagnosis. CONCLUSIONS: IJCNC represent a small group of nevi that develop in adolescents and have some particular histopathological features. The pathological diagnosis is difficult as the microscopic features are very similar to a conjunctival melanoma, but a detailed microscopic examination, immunohistochemical stainings and the young age of the patient could help in establishing the benign nature of these lesions.

A 16-year retrospective study of dacryocystitis in adult patients in the Moldavia Region, Romania.

PURPOSE: Chronic dacryocystitis (CD) is an inflammation of the lacrimal sac and nasolacrimal duct with a long-standing evolution. The aims of this study were to analyze the epidemiology and to evaluate the histopathological features and the chronic inflammation score (CIS) system of chronic dacryocystitis in the region of Moldavia, Romania, over a period of 16 years. METHODS: We conducted a retrospective descriptive analysis of all pathological reports of chronic dacryocystitis from the Department of Pathology, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iasi, Romania, between January 1, 1999 and December 31, 2015, with the final application of CIS. We also recorded the demographic information of patients and lesion localizations. RESULTS: Eighteen cases of CD were identified, with a female:male ratio of 8:1. Patient median age was 66.27 years (range 33-83 years), 55.55% being in their eighth and ninth decade of life. A non-systemized growth trend starting with 2002 could be identified. Microscopically, several histopathological features were identified, some of them being associated: epithelial lining hyperplasia with pseudopapillary folds (77.77% of the cases), epithelial invaginations in the submucosa (11.11%), squamous metaplasia (16.66%) or partial denudation (33.33%). The sac wall revealed chronic diffusion (88.88%) or nodular lymphocytic inflammation (11.11%). 5.55% of cases presented fibrosis in the lacrimal sac wall with few lymphocytes. Applying CIS system, the majority of cases (13 patients, 72.22%) were identified with moderate chronic inflammation, only one case (5.55%) pointed out a mild degree of inflammation with a CIS<3, but four (22.22%) cases showed severe inflammatory changes with a CIS>6. CONCLUSIONS: In our region, CD is more frequent in senior women, probably due to their deficient immune system. Histological specimens of CD are not commonly found in practice of pathologists, but when the histological sections are analyzed they reflect a multitude of aspects that need to be known in order to guide ophthalmologists in their practice. In our region, CD is more frequent in senior women, probably due to their deficient immune system and to the specific anatomy of their nasolacrimal duct. The histological appearances varied from patient to patient and even in the same patient varied from one area to another. There were histopathological changes indicating adaptive changes, which could lead to the development of malignant tumors at this level. Therefore, there is a need for patient education with CD both in terms of ophthalmic hygiene and in what regards possible complications in the absence of a regular presentation to the ophthalmologist.

Longer survival of a patient with glioblastoma resected with 5-aminolevulinic acid (5-ALA)-guided surgery and foreign body reaction to polyglycolic acid (PGA) suture.

In recent years, there is a growing evidence that using 5-aminolevulinic acid (5-ALA)-guided resection of a cerebral glioblastoma, associated with chemoradiotherapy determine a prolonged survival of these patients, even though this period do not exceed 15 months. 5-ALA is a natural biochemical precursor of heme that is metabolized to fluorescent porphyrins, particularly protoporphyrin IX (PPIX) and no foreign reaction were noted until now. However, foreign body reaction developing in neurosurgery is documented in a few number of cases to suture material, surgical hemostatic material, or surgical glove starch, but up to now we could not find any article about granulomatous inflammation to polyglycolic acid (PGA) suture after brain tumor resection. Here we present a case of a delayed foreign body granuloma to PGA suture diagnosed after 10 months following fluorescence-guided surgery with 5-ALA for resection of a cerebral glioblastoma that was difficult to diagnosis both clinically and on magnetic resonance imaging (MRI). Moreover, the survival time was longer. We correlate the appearance of foreign body granuloma with the patient's persistent pre- and postoperative lymphocytosis. We also suggest that the chronic inflammation inhibited the proliferation of any tumoral cells which could remain in the tumor bed because we did not noticed on serial MRI scans a rapidly tumor growth during the first 10 months after the initial surgery as we have expected to be for a glioblastoma.

One-year evaluation of two hybrid composites placed in a randomized-controlled clinical trial.

OBJECTIVE: The aim of this prospective randomized-controlled clinical trial is to assess the long-term performance of two direct composite resins in posterior teeth. This study provides a survey of the one-year results. MATERIALS AND METHODS: A total of 1805 restorations were placed by students in stress-bearing Class I/II cavities (including cuspal-coverage) in molars and premolars in 456 patients. Clinical evaluation was performed at baseline and after one year using modified USPHS criteria. The restorations in each patient were performed either with Ceram X/Prime&Bond NT or Tetric Ceram/Optibond Solo Plus. RESULTS: After one year 528 fillings with Ceram X and 580 with Tetric Ceram were available for evaluation of substance loss, contact point, color match, marginal staining, marginal adaptation, secondary caries and radiographic examination (if necessary). This represents a recall rate of 61.18% (279 patients). The failure rate per material was 5.3% in the Ceram X group and 6.1% in the Tetric Ceram group. Most of the failures were associated with marginal adaptation/integrity of the filling. A significant influence on the occurrence of a failure was observed for the number of treated teeth per patient, the age of the patient, the mesio-distal extension of the restoration and the tooth position. Gender, material, a previous root canal treatment, the bucco-lingual extension of the filling or cuspal-coverage did not significantly influence the failure rate. Patients attending the first recall were significantly older and had more fillings than patients not attending. CONCLUSIONS: In a group of Class I/II restorations (including cuspal-coverage), there was no significant difference in failure rates between ormocer-based and bis-GMA-based restorative systems after one year. A previous root canal treatment had no negative influence on the failure rate. A longer observation period is indicated to get clear evidence of the long-term performance of these composite resin systems.