Technical performance of colonoscopy -- multicenter study in university and non-university centers of Romania.

UNLABELLED: The aim of the paper was to evaluate the national availability of colonoscopy and the quality parameters of this procedure in our country. MATERIAL AND METHOD: During a 6 months period (01.07- 31.12.2009), we performed a prospective multicenter study in which 76 centers were invited to respond to a questionnaire regarding colonoscopy, 39 centers agreeing to participate. We assessed: the number of colonoscopies, the number of total colonoscopies and the causes of incomplete colonoscopies. RESULTS: During the study period, 16,083 colonoscopies were performed, 12,294 (76.4%) of them total colonoscopies. In 1,191 cases, stenosis was the cause of incomplete colonoscopy. If we consider this an objective reason for an incomplete colonoscopy, there were 12,294 total colonoscopies (82.4%). Comparing university centers with non-university ones, the proportion of total colonoscopies was 10,400/12,475 (83.4%) vs. 1,894/2,417 (78.4%) (p less then 0.0001). However, comparing the present study with previous ones, performed in 2003 and 2007, the proportion of total colonoscopies increased from 70.5% to 76.9% and 82.4% respectively (2003 vs. 2007 p less then 0.0001; 2007 vs. 2009 p less then 0.0001), while the quality difference between university and non-university hospitals persisted. CONCLUSIONS: the quality of colonoscopy in Romania increased in the last 5 years, while the quality difference between university and non-university hospitals persisted.

COX-2 and Ki-67 immunohistochemical markers in the assessment of long-standing ulcerative colitis associated dysplasia.

INTRODUCTION: Malignancy in LUC (long-standing ulcerative colitis) presumably evolves through a chronic inflammation-dysplasia-adeno-carcinoma sequence in which a multitude of yet not fully understood factors takes part. AIM: To assess ulcerative colitis (UC) associated dysplasia and to distinguish regenerative changes from premalignant ones using immunohistochemical (IHC) markers. MATERIALS AND METHODS: We studied 80 LUC biopsy specimens: 20 high-grade dysplasia (HGD), 20 low-grade dysplasia (LGD), 20 indefinite for dysplasia, 20 regenerative atypia. We used anti-COX-2 and Ki-67 antisera (Dako, Carpinteria, USA) to perform immunohistochemical staining by the labeled Streptavidin-Biotin method, and then assessed and graded staining intensity and distribution using previously described scoring systems. Statistical analysis was made using chi-square test and SPSS application. A p-value <0.05 was considered significant. RESULTS: In LGD, most of the cases had middle and top Ki-67 localization of the staining. For HGD, we found to be characteristic the top and surface staining of the crypts and no case of basal immunostaining. COX-2 immunostaining was positive (total score >=3) in 72.5% of all the UC cases studied. In non-dysplastic lesions (regenerative atypia), COX-2 expression was negative and as the pathologic process progressed towards dysplasia/malignant transformation, COX-2 expression became positive with a progressive increase of the total score. CONCLUSIONS: A combination of enhanced colonoscopic surveillance and IHC markers those are more sensitive for dysplasia might be the optimal way to manage the increased colorectal cancer (CRC) risk in LUC patients. Further studies to find additional prognostic parameters will provide valuable insights into the behavior of LUC.

Attempts to identify the active factor of reticulin-M by high voltage electrophoresis and by acetone precipitation.

The reticulin-M forte (R forte), an antianaphylactic peptide, extracted from organs rich in RES, previously stimulated with India ink, was analysed after acetone precipitation by paper high voltage electrophoresis. Finally the biological activity remains concentrated in the second, arbitrary group of basic peptides, fractions 1 and 3.