Primary malignant melanoma of the bladder - case report and literature overview.

Malignant melanoma is one of the common skin cancers but as a primary cancer localized in urinary bladder is a very rare clinical entity, 0.2% of all melanomas. We report the very rare case of primary malignant melanoma of the bladder in an 80-year-old man. According with our knowledge is the first case of primary malignant melanoma reported in Romania. Only a few percent of malignant melanoma have origin outside the skin. Less than 30 cases of primary bladder melanoma have been reported in the literature. The most common metastasis in urinary bladder comes from breast carcinoma and skin melanoma The tissue examination presents the same futures does not matter if is a primary or secondary malignant melanoma. The ancillary tests like immunohistochemistry help us to do an accurate diagnostic but to discriminate primary vs. metastatic tumor remain an important issue. Usually, the bladder melanoma has an aggressive lethal behavior. Histopathological examination, immunohistochemistry, clinical history, and endoscopic evaluation can provide certain diagnostic features.

The urologist and child hydronephrosis caused by ureteral anomalies.

Congenital hydronephrosis caused by ureteral anomalies, like ureteral duplicity, megaureter, ureteral ectopy and ureterocele, must be differentiated from ureteropelvic junction obstruction (UJO) hydronephrosis and from the hydronephrosis caused by vesicoureteral reflux. These represent a differentiated branch of congenital abnormalities in children even if not so common, but this fact should not be disconsidered. Over a five years period, from 111 operated children in our Clinic, we performed 13 interventions for congenital hydronephrosis, 11 (84.61%) being caused by ureteral abnormalities. Here, there were described particular cases, with diagnosis steps and treatment decisions. Ureteral ectopy can be manifested by loss of urine drops in cases where ureteral holes are located in the vagina, septum or urethra, inferior to the sphincter mechanism. Incontinence in boys never occurs because the ectopic ureter never opens under the sphincter mechanism. If the ureter opens in the genital tract, patients may clinically present with the epididymitis symptom. From autopsy statistics in the US, the incidence of ureteral duplex is estimated to be less than 1%. When the duplex is associated with urinary infection, the incidence of ureteral duplex increases up to 8%.

A micro-computed tomography study of morphological aspect of root canal instrumentation with ProTaper Next and One Shape New Generation in mandibular molars.

ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) (PTN) and One Shape New Generation (MicroMéga, Besançon, France) (OSNG) belong to a relatively new generation of rotary nickel-titanium (NiTi) files. Scientists keep improving features of endodontic files in order to obtain anatomically shaped and cleaned root canals and avoid canal transportation, for a better outcome of the endodontic treatment. For the current study, the aim was to evaluate and assess the changes in root canal morphology after instrumentation with PTN and OSNG by using micro-computed tomography (CT). This high-tech resolution tomography allows a much more detailed analysis of the root canal anatomy and its transformation after rotary instrumentation. We have selected 10 mandibular molars; before and after canal preparation, the samples were distributed in two homogeneous groups (PTN and OSNG groups) and submitted to standardized radiographs and micro-CT (SkyScan1172, Kontich, Belgium). From the three-dimensional (3D) images obtained from the scanning, we were able to perform a two-dimensional (2D) (perimeter, area and roundness), respectively a 3D (volume, surface area, structure model index) analysis, before and after root canal instrumentation. Results did not revealed important statistical differences among the two groups in relation to the curvature and volume of the root canals before instrumentation; after rotary instrumentation, there was a substantially increase of volume and surface area for all the samples (p<0.05). The two types of instruments preserved the original canal path, maintaining a continuous, safe and adequate shape and taper of the root canals.

Osseointegration of zirconium dental implants three months after insertion in rabbit femur. Histopathological study.

Implantology is a highly researched field with a constant concern in finding and studying new implant materials. Lately, zirconium has become a very attractive alternative to the detriment of titanium, but the research results were sometimes contradictory. Thus, we considered as opportune to study the osseointegration of zirconium dental implants in rabbit femur, three months after insertion. The biological material was represented by five rabbits and the experimental protocol was approved by the Ethics Committee of the University of Oradea, Romania. The implants (zirconium ceramic dental implants: 5 mm length, 2.6 mm diameter) were inserted in the femur under controlled conditions, after creating a bone defect. The animals received the appropriate postoperative care. Three months later, the implantation area was harvested and processed for histological examination. The assessment of the osseointegration process of the zirconium implants showed that they were very well tolerated by the host organism that did not trigger any rejection processes. Approximately 80% of the compromised bone was replaced with newly formed bone in advanced stages of remodeling and consolidation. The proliferated bone near the implants acquired a structure similar to the rabbit diaphyseal bone, but with higher density and size of the osteons. The stage reached by the osseointegration process three months after the insertion of the implants, ensures a good consolidation of the implants that supports the prosthetic structures, which are to be built on them.

Clinical, surgical and morphological assessment of the pyeloureteral syndrome.

Obstruction of the pyeloureteral junction (PUJ) is by far the most common cause of hydronephrosis in children, with an incidence of one in 1000-2000 newborns. Also, the obstruction of the PUJ is the most common cause of prenatal hydronephrosis, accounting for 80% of the cases. The aim of this study is to observe and discuss first the efficacy of described surgery procedures and second the microscopic modifications of the PUJ (abnormalities of smooth muscle tissue, inflammation and fibrosis). One hundred and eleven children with a diverse urological pathology with an average age of 11.57 years were operated between 2011 and 2015 in Urology Clinic of Oradea, Romania. Of these, 20 children (11 boys and nine girls) with congenital hydronephrosis by junction syndrome required surgical correction. The surgical techniques used were Anderson-Hynes dismembered pyeloplasty, non-dismembered Scardino procedure and the Hellström procedure. Operator interventions were performed by subcostal lombotomy with or without partial XII rib resection. The average operator time was between 40 and 50 minutes. None of the patients required blood transfusions. Average hospitalization was seven days. All patients were monitored through the Ambulatory Pediatric and Urological Service. Anderson-Hynes operation is the main procedure to solve the obstructive syndromes of the PUJ. It can be performed without stentings of the ureter as originally described by the author, but also by protecting anastomosis with a urinary diversion, such as JJ catheter, ureteronephrostomy or ureteropyelostomy. Even though clinical and imaging studies are sufficient for diagnose of PUJ syndromes, morphology and histology bring essential data regarding the age of the lesions.