Morphometric findings in avascular necrosis of the femoral head.

Avascular necrosis of the femoral head is an illness with a controversial etiology, the trigger event being the suppression of blood flow to the femoral head. The disease affects mostly young adults within their third and fifth decade, the majority of the patients being men. The main risk factors are trauma, chronic alcohol consumption, smoking, corticotherapy. The main goal of our study is to describe the morphometric changes found in the bone tissue of patients diagnosed with avascular necrosis of the femoral head, with different risk factors, by comparing the area of bone trabeculae inside the area of necrosis with that from the adjacent viable tissue. The morphometric study used biological material from 16 patients with ages between 29 and 57 years, who underwent surgery for avascular necrosis of the femoral head. They were admitted in the Orthopedics Department at the Emergency County Hospital in Craiova between 2010 and 2011 and were split into four groups. Group I presented trauma as the main risk factor, Group II had corticotherapy as the defining risk factor, Group III presented chronic alcohol consumption and Group IV was represented by the patients who smoked and exhibited chronic alcohol consumption. There was not a significant statistical difference between the areas of bone trabeculae of the four groups when we compared viable bone tissue to the necrotized one. Knowing the risk factors of the avascular necrosis of the femoral head is critical to the management of the disease, because diagnosing it in an early stage is a necessity for obtaining a good result for conservative treatment.

Histological and immunohistochemical changes of the myocardium in dilated cardiomyopathy.

Dilated cardiomyopathy is a major cause of heart failure and a major cause of morbidity and mortality. It is a multifactorial disease that includes both hereditary and acquired forms. It is estimated that around 20-35% of patients with dilated cardiomyopathy have hereditary forms. It is the third most common cause of heart failure and the most common cause of heart transplant. Dilated cardiomyopathy can be a secondary condition of many diseases such as coronary heart disease, diabetes, pheochromocytoma, infections, malnutrition, ingestion of toxic substances (alcohol, cocaine), ingestion of chemotherapeutic drugs, autoimmune diseases. In our study, we aimed to describe the changes of myocardial cells and interstitial connective tissue in patients clinically diagnosed with alcoholic dilated cardiomyopathy. The material studied consisted of heart fragments sampled from the left ventricle (LV) during necropsy from a total of 28 patients, aged between 58 and 73 years, with a clinical and laboratory diagnosis of dilated cardiomyopathy, hospitalized in the Cardiology Center of the Emergency County Hospital of Craiova in 2009 and 2010. In dilated cardiomyopathy, myocardial muscle fibers appeared slightly elongated or wavy, with hypochromatic, heterogeneous, vacuolar sarcoplasm, by a decrease of myofibril numbers. Lipofuscin granules were frequently seen in the sarcoplasm. Nuclear changes were consistent with sarcoplasmic alterations. Changes of the interstitial connective tissue were sometimes extensive and sometimes barely noticeable. The most common alteration of this structure was the onset and development of a mainly perivascular collagen fibrillogenetic process.

Chronic gastritis with intestinal metaplasia: clinico-statistical, histological and immunohistochemical study.

Chronic gastritis has a high incidence in adults, causing progressive destruction of glandular structures, favoring the development of gastric atrophy. The association of chronic gastritis with intestinal type metaplasia of gastric mucosa has a poor outcome as intestinal metaplasia is regarded as a precancerous lesion. Metaplasia is common in patients with Helicobacter pylori infection and also heavy smokers. The aim of our study was to evaluate the relationship between chronic gastritis and intestinal metaplasia. The study was conducted on a total of 1218 patients, aged between 5 and 90 years, who presented for dyspeptic disorders in the period 2007-2010 and were examined clinically and endoscopically. During the gastroscopic examination, fragments of gastric mucosa were collected for the histopathological study and for highlighting the H. pylori infection. For the histopathological study, the Hematoxylin-Eosin and PAS-Alcian Blue stains were performed, while for the immunohistochemical study the anti-TAG72 and anti-PCNA antibodies were used. A diagnosis of gastritis was established in 615 patients, representing approximately 50.5% of all cases. Most cases with gastritis were found in people of middle age. Gastritis was present in almost all age groups, from teenagers to the elders. Of the 615 cases of gastritis, urease test was positive in 353 patients, representing approximately 57.40% of all patients with gastritis. Histopathological examination identified the presence of intestinal metaplasia in 61.60% of patients with chronic gastritis, mostly complete metaplasia. PCNA immunohistochemistry revealed that cell proliferation processes are intensified in intestinal metaplasia. This study highlights the importance of chronic gastritis, intestinal metaplasia, and H. pylori infection in the etiopathogeny of gastric cancer.

Immunoexpression of alpha-SMA and CD68 in native kidney biopsies.

INTRODUCTION: The role for inflammation and fibrosis as predictive histopathological markers for renal function has been discussed in several studies. Aim of our investigation was to evaluate the clinico-pathological correlation of myofibroblasts expression as markers for initial development of fibrotic processes and macrophagic infiltration in a population with impaired renal function, in order to better understand their value in diagnostic biopsies. MATERIALS, METHODS AND RESULTS: We evaluated 20 consecutive native kidney biopsies performed for diagnostic purposes. Material remaining after routine light microscopy and immunofluorescence, was stained for α-SMA as myofibroblast marker and CD68 as macrophage infiltration marker. Quantitative evaluation was conducted by electronic image analysis on consecutive low power fields, avoiding glomeruli, and estimated as percentage of the total area or as number of positive cells/field for macrophage infiltration. The renal biopsies were also evaluated for histological characteristics such as percentual area of inflammation infiltration and fibrosis. Clinical and laboratory data were recorded at biopsy moment and followed-up on a period of 17 ± 11 months after the renal biopsy. Interstitial α-SMA immunoexpression proved to be related with interstitial fibrosis (r=-0.47, p<0.001) and macrophage infiltration (r=0.21, p=0.03). Higher immunoexpression of α-SMA was related with renal function assessed by creatinine level at biopsy moment (r=0.32, p=0.002). CONCLUSIONS: In this study, detection of myofibroblast infiltration using α-smooth-muscle actin (α-SMA) proved to be a good marker in describing the initial phases of interstitial fibrosis development in early stages of chronic kidney dysfunction.

Microscopic aspects of macrophage system cells in hemorrhagic stroke in humans.

Stroke is an important public health issue because it has high morbidity and mortality rates. In addition, it has one of the highest rates of disability in adults. Recent data show that macrophage system cells, especially microglial cells, are involved both in neuroprotective processes and in the neurotoxicity, depending on the type and extent of the brain damage. In our study, using histology and immunohistochemistry techniques, we evaluated the macrophage-type cell reaction in cerebral hemorrhage. We found that the number of CD68-positive cells increased 7-8 folds per square millimeter of cortical surface in the cerebral parenchyma adjacent to the hemorrhage. We identified a large number of perivascular-activated macrophages, in areas distant to the hemorrhage, showing that individuals with hemorrhagic stroke have profound and extensive alterations of the blood-brain barrier.

Histopathologic and immunohistochemical aspects of the renal parenchyma in patients with glomerulonephritis developed in locked-up spaces.

A number of 38 renal biopsies and 13 necroptic pieces removed from 51 prisoners were available for our study. From 51 cases, 21 patients were diagnosed with actual chronic glomerulonephritis, 19 patients with non-specific chronic glomerulonephritis, four patients with renal amyloidosis, and seven patients with glomerulonephritis lesions associated to pielonephritis.

Glomerulopathies in locked-up persons. Histopathologic and clinic study.

The diseases of the urinary apparatus are frequently-enough inside the locked-up spaces of the penitentiaries. Among them, glomerulonephritis and pyelonephritis take a special place, by their late diagnosis and their lasting evolution. The authors clinically and paraclinically investigated a number of 214 locked-up male persons aged between 18-57 years, presenting various clinical forms of glomerulonephritis. Histopathological exams performed in 51 patients confirmed the diagnosis.