The value of ultrasounds exam correlated with frozen section diagnosis in the breast tumors.

UNLABELLED: The paper represents a parallel study regarding the harmony between the ultrasounds and the frozen section diagnosis in the breast cancer. PATIENTS AND METHODS: We examined at an ultrasounds machine a group of 146 women aged between 16-73-year-old, which came presenting palpable formations at the level of breasts, in the Pelican Medical Centre from Oradea. The suspect lesions were subject to excisional biopsy or surgical intervention. RESULTS: The elements followed at the ultrasounds exam were: echogenicity, echostructure, contour, presence and absence of posterior shadowing, microcalcifiation, orientation of lesion, compressibility, aspect of adjacent structures. Histopathological diagnosis of suspect lesions emphasized malignant lesions in a percentage of 64.86% of cases; the frozen section exam diagnosed invasive ductal carcinoma in 86% of the cases, invasive lobular carcinoma 8%, medullar carcinoma 2%, and benign lesions 4%. CONCLUSIONS: The clinical-anatomopathological collaboration is absolutely compulsory for a correct microscopic diagnosis. The ultrasounds modifications separated after the criteria taken into account allow the orientation of diagnosis to malignant-benign. At 14% of the women examined, additional lesions were identified in comparison to those palpated, the ultrasounds having a role in detecting the multifocality and muticentricity of lesions. At 29.05% from the identified lesions, malignant lesions were histopathologically identified. The frozen section diagnosis in the breast cancer allows a rapid diagnosis, correct in high percentage of cases, allowing taking an intra-surgery therapeutic attitude in only one surgical intervention, thus reducing the costs. The anatomopathologist's experience reduces the diagnosis risk in excess and÷or in minus.

Eyelid tumors: histopathological and clinical study performed in County Hospital of Oradea between 2000-2007.

The work assessment is to analyze eyelid tumors diagnosed in the last years in our hospital. We found 471 tumoral and pseudotumoral cases, in which malignant tumors predominated, with 255 cases. The most affected age range was the sixth decade and the majority of tumors were located to lower eyelid. The histopathological study allowed us to establish the lesions type and subtype. The Meibomian gland cysts, squamous papillomas and basal cell carcinomas were the most frequent related with this three of category lesions represented by pseudotumors, benign tumors and malignant tumors. Early diagnosis of these lesions can determine a favorable prognosis, especially in cases of malignant tumors.

Intradiploic epidermoid cysts - a series of three cases and our experience with literature data.

Intracranial epidermoid cysts are rare, representing almost 1% of all primary tumors and when are located in the diploe result from entrapped ectodermal embryonic remnants. Because of frequent complications, imaging studies are mandatory for highlighting erosions of both outer and inner table of the calvaria and treatment preparation. We enlisted three female patients within our study, comparing imaging with histopathology aspects. Even though the bone destruction was evident, no atypia or malignant signs were highlighted in serial sections. The interesting fact that we present is that our patients are all females, opposed to what is written in literature. Although the positive diagnosis can be made by imaging, histopathological examination of these cysts is mandatory for identifying malignant behavior.

Correlations between the changes in patients' dental-facial morphology at the end of the orthodontic treatment and the psychological variables.

The purpose of this research was to assess the impact that the improvement of patients' dental-facial morphology has at the end of the orthodontic treatment upon the following psychological variables: self-esteem, current self-related thoughts as well as upon the variables of social self-esteem and performance. The number of patients included in the study was of 168 (82 children and 86 adolescents) who carried out the orthodontic treatment. At the end of the active treatment, we applied to all patients the assessment instruments for the level of self- esteem and self-related current thoughts: the Rosenberg's Self-Esteem Scale and the Heatherton & Polivy Current Thoughts Scale. As far as the patients in the study are concerned, the improvement of their facial aspect at the end of the treatment showed a significantly positive correlation with the variables of global self-esteem, self-related current thoughts, social self-esteem and performance, with the exception of the girls in children study group who showed no correlations between physical aspect and the performance variable.

Ultrastructural modifications at the level of marginal periodontium in the case of incorrect dental reconstruction.

Our study focused on the evolution of the marginal periodontium inflammatory process caused by an incorrect dental reconstruction. Our research studied a control group and a group of patients having traumatic and inflammatory lesions in different stages of evolution. A pronounced rarefaction of the junction desmosome structures as well as an inflammatory process pointed out by the presence of macrophages, neutrophils, Langerhans' cells, and mastocytes. The presence of altered fibroblasts and collagen fibers in the electron microscopic sections of vascular lesions represents microscopic signs of the inflammation and support the theory of local immunoglobulin synthesis.

Unusual occurrence of avascular necrosis with bilateral involvement and ankylosing spondylitis, meningioma and Hodgkin lymphoma.

This case report aimed to reveal the multidisciplinary aspect and discuss an association of disorders in a complex case with Hodgkin disease, meningioma, avascular necrosis with bilateral involvement and ankylosing spondylitis. We report the case of a 47-year-old patient, diagnosed with Hodgkin lymphoma at the age of 14. Two decades later, she was diagnosed with frontal chordoid meningioma, which was surgically removed, without radiotherapy. She was re-operated 10 years later for recurrence of meningioma. At the age of 39, she was diagnosed with bilateral avascular necrosis of the humeral head, femoral head and scaphoid bones. In the same year, she was also diagnosed with ankylosing spondylitis. We considered that the occurrence of rare chordoid meningioma, avascular necrosis with multiple locations and bilateral involvement in a patient with a malignancy during childhood and an autoimmune disease was unusual and there may be some common pathways.

The importance of the histopathological examination in establishing the diagnosis of delayed splenic rupture. Report of a case and literature review.

In forensic activity, splenic ruptures occur frequently in cases involving abdominal trauma due to road traffic collision, strokes, falls and work accidents. Splenic lesions can occur either immediately after the trauma or within variable timeframes after it, the last scenario being the case of a delayed splenic rupture. Delayed splenic rupture is ranked third in abdominal traumatology frequency, after liver and intestine rupture. Delayed splenic rupture is more frequently the result of abdominal contusions or compressions, rather than the result of direct wounds located in the left flank. In the first stage, an intraparenchymatous hematoma is formed. The second stage occurs within a variable timeframe (between two days and one month), either spontaneously or following a second trauma, when the capsule ruptures leading to secondary peritoneal hemorrhage. In order to correctly determine the chronology of splenic lesions, histopathological (HP) investigations have an important role to play. The presence of hemosiderin highlighted by Hematoxylin-Eosin (HE) staining or special stainings, confirms the diagnosis of delayed splenic rupture. This study will present the case of a 55-year-old male from the countryside, a chronic alcohol consumer, animal care provider, who suffered multiple traumatic injuries four days prior to his death. He was found lying on the ground, presenting an open craniocerebral trauma (CCT) with a bleeding wound on the scalp. The autopsy showed CCT with meningeal hemorrhage and subdural hematoma, along with a splenic rupture presumably produced in two stages. The HP investigations did not reveal the presence of hemosiderin in the tested specimen samples. Using this scientific diagnostic criterion, it was thus confirmed that the splenic rupture occurred after the aggression, in another traumatic stage, the same one where the other thanatogenerator lesions occurred, as a result of the victim's collapse from the same level and hitting the planes with irregular surfaces.

Morphological study of upper wisdom tooth.

The article presents aspects of crown and root morphology of the superior wisdom teeth, aiming to several parameters: size, shape crown and occlusal surface, number, topography and orientation of the roots in order to determine which the most common morphological types are. For this purpose, the upper wisdom teeth were collected. According to studies, the dominant form of the dental crown is parallelepipedic, the rectangular or parallelogram shape of the occlusal surface has large mesial and distal-oriented sides. The positive occlusal forms are generally poorly demarcated; cusps are less tall and rarely individualized. In half of the cases, the root is unique, voluminous, straight or with a curved distal tip.

The importance of the histopathological examination in lethal acute intoxication with ethylene glycol. Case report.

Ethylene glycol is a toxic alcohol that is mainly introduced into an organism through the digestive pathway. Its priority toxic metabolites are glycolic acid and oxalic acid. We present the case of a young person, of the male persuasion, without any personal pathological history, found unconscious and presenting signs of violence. The patient is emergency hospitalized presenting coma, convulsive syndrome, severe metabolic acidosis and a positive result for alcoholism. Anamnestic data is extremely poor. The results of the clinical and paraclinical examinations suggest a possible poisoning with toxic alcohols. Despite the drug treatment and the hemodialysis, the evolution is unfavorable, resulting in death one week after admission. Through the forensic examination, the followings were found: cerebral and leptomeningeal edema, focal cerebral microhemorrhages, bronchopneumonia, septic spleen, shock kidney, hepatic fatty dystrophy, excoriated plaques in the head area. The histopathological (HP) examination confirms the macroscopic diagnosis and identifies the presence of calcium oxalate crystals in the kidney tubules. Subsequently, the toxicological examination of the biological samples taken from the corpse at the forensic examination, confirms the presence of the glycolic acid. Postmortem, the investigation conducted by the criminal investigation authorities confirms the oral ingestion of antifreeze. The absence of a positive history, along with alcohol consumption, nonspecific clinical symptomatology and the absence of calcium oxalate in urine are trap elements in the diagnosis of acute ethylene glycol poisoning. The presence of calcium oxalate in tissues, identified through the HP examination, is an extremely important factor when establishing the cause of death.

[Malignant non-Hodgkin conjunctival-orbital lymphoma in the years 1990-2005 at the Ophthalmology Clinic of Oradea]. / Limfoamele maligne non-hodgkiniene conjunctivo-orbitare internate în perioada 1990-2005 în clinica de oftalmologie oradea.

Non-Hodgkin conjunctival-orbital Malignant Lymphoma, there are rare tumors, difficult to be diagnosed. We've made a clinical and paraclinical retrospective study, along 15 years (1990-2005) period of time, analyzing from the point of view, clinical features and anatomo-pathological results, each of the 11 cases that we found.

Study concerning the histopathological changes in chronic hepatopathies.

Chronic liver diseases represent a public health problem both at global level and in our country. Their significance is due not only to the large number of cases but also to their severe complications and associated diseases, which increase the gravity of prognosis. Hepatopathies generally develop by formation and accumulation of fibrous tissue, which leads to architectural distortions in the structure of the liver. Hepatic fibrosis is the result of chronic injury and plays a direct role in the pathogenesis of the hepatocellular dysfunction and portal hypertension. Histopathological changes depend on the stage of the disease and are an essential factor in the therapeutic options and prognosis of the disease. The analysis of histopathological changes at the level of the liver, in the patients with chronic liver disease evaluated by this study, shows that mesenchymal lesions and dystrophy have been present in more than 90% of the subjects, parenchymal lesions in 85% of the cases and fibrosis in 50% of the patients. In relation to the types of disorders, in chronic hepatitis the most frequent lesions described have been portal inflammation, portal fibrosis, and inflammatory infiltrate. In liver cirrhosis portal inflammation, porto-portal fibrosis and biliary neocanaliculi are also prevalent. The results of this study demonstrate the fact that, with the evolution of the disease, histopathological changes are more numerous and more pronounced.

Acinic cell carcinoma of minor salivary glands - case report.

Salivary gland tumors have a high incidence (90%) within the parotid gland. The acinic cell carcinoma (ACC) represents only 1-3% of the salivary gland tumors, most frequently affecting the parotid. The minor salivary glands rarely develop ACC and when the ACC is localized in these glands, generally, it has a less aggressive evolution. The main criterion in the diagnostic of ACC is the histological examination with the regular Hematoxylin-Eosin (HE) staining and additionally Periodic Acid-Schiff (PAS) special staining. Immunohistochemical (IHC) examination confirms the origin of the tumor cells and the cellular proliferation index. Therapeutic management consists of surgical excision and radiotherapy. Left jugular tumor was the clinical diagnosis in the case we presented. The computed tomography (CT) examination revealed a voluminous expansive process of the left cheek. Surgery was performed with tumor resection and the skin defect was threatened. The histopathological (HP) and IHC exams have established the diagnosis of minor salivary glands adenocarcinoma with increased tumor proliferation index. The evolution was unfavorable to tumor recurrence in a short time of one year.

Anatomic variants in Dandy-Walker complex.

Dandy-Walker complex (DWC) is a malformative association of the central nervous system. DWC includes four different types: Dandy-Walker malformation (vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa); Dandy-Walker variant (vermis hypoplasia, cystic dilatation of the fourth ventricle, normal posterior fossa); mega cysterna magna (large posterior fossa, normal vermis and fourth ventricle) and posterior fossa arachnoid cyst. We present and discuss four cases with different morphological and clinical forms of the Dandy-Walker complex. In all four cases, diagnosis was reached by incorporation of clinical (macrocephaly, seizures) and imaging [X-ray, computed tomography (CT), magnetic resonance imaging (MRI)] data. Two patients were diagnosed with Dandy-Walker complex, one patient was diagnosed with Dandy-Walker variant in a rare association with neurofibromatosis and one patient was diagnosed with a posterior fossa arachnoid cyst associated with left-sided Claude Bernard-Horner syndrome, congenital heart disease (coarctation of the aorta, mitral stenosis) and gastroesophageal reflux. In all forms of DWC, the clinical, radiological and functional manifestations are variable and require adequate diagnostic and therapeutic measures.

Carcinogenic uterine risk of repeated abortions: hormone receptors tumoral expression.

The main objective of this study is to draw the attention that repeated induced abortions in the women's physiological history are very dangerous and could lead to developing uterine cancer. The legislation regarding this practice is variable in different countries. Relevant information in the field concerning the numerous risk factors that appear with abortions must be taught in schools before girls start their sexual life and can help avoiding the complications that may follow. Also, the abortion should be an extreme measure that must be used only in extreme cases that threaten the mother's life or imply the health of the future child. The study comprised 258 women diagnosed with endometrial carcinoma, without any risks factors for this type of cancer, which were questioned regarding the abortions in previous history. The results show that the age when the uterine carcinoma appears is even lower as the number of abortions is higher and the number of this type of cancer cases is directly proportional with the number of abortions suffered. In order to avoid this fact we have to pay more attention to the legislation and education of the patients. Also, we followed the expression of both estrogen and progesterone hormone receptors, in the case of uterine cancer that occurred in women who had abortions in history compared to the expression of hormone receptors in the case of patients who did not have abortions.

Choroidal melanocytes and associated pathology.

The embryologic origins of choroidal and cutanoeus melanocytes, also of the genes involved in cutaneous and choroidal melanoma, are identical, even the two kinds of tumors are different entities. This is a general scientific report, which stretches the molecular mechanisms, as basement of choroidal melanocytes proliferation.

Non-Hodgkin Malignant Lymphoma Study--admitted cases during 1990-2005 in Ophthalmologic Clinical Department, Oradea.

Non-Hodgkin Malignant Lymphomas are rare tumors, difficult to be diagnosed. We've made a clinical and paraclinical retrospective study, along 15 years (1990-2005), estimating the moment of onset, clinical and anatomo-pathological features, in each of the 11 cases.

Atypical case of Sjögren's syndrome with psychiatric and peripheral neurological disorder.

Sjögren's syndrome is a rare disorder of the immune system characterized by the chronic lymphocytic infiltration of the organs with exocrine secretion (lachrymal, salivary glands), but also of other tissues of the body, that can be primary or secondary and can appear alone or in association with other systemic diseases: rheumatic arthritis, systemic erythematous lupus, scleroderma or polymyositis÷dermatomyositis. The case that we are presenting is that of a 40-year-old man, who came to the Department of Rheumatology with articular, muscular, ocular, psychological and neurological symptoms. After multiple biological, immunological, histological, neurological, psychiatric, ophthalmological, digestive investigations, it was reached the conclusion that the patient presents a rare autoimmune disease (primary Sjögren's syndrome) involving mainly peripheral neuromuscular and psychological (small frequency) and the patient was given specific immunomodulatory, anti-inflammatory and anti-depressive treatment, to which he responded well. Thus, after 18 months of investigation, severe depressive episodes and difficult collaboration of the patient with the medical team, it was possible to reach the definitive diagnosis and to perform the appropriate treatment.

Sialic Acid, possible marker of angiopathic complications at diabetics type 2.

Studies from the last decade emphasize the importance of sialic acid (SA) in general pathology (neoplasic disease, colagenosis), and its implication in appearance and aggravation of atherosclerosis (e.g. appearance of angyopathy like chronic complication in diabetes mellitus). Diabetes is known as a major risk factor for atherosclerosis and has a high incidence in general population. The incidence of diabetes increases from year to year, especially type II of diabetes, the most common type (more than 90% from diabetics are type II). Diabetes mellitus with its chronic degenerative complications like micro and macrovascular angyopathy (coronary disease, nephropathy, retinopathy, arteriopathy) represents a major health and social problem (more than 80% of the mortality to type II diabetics is the result of coronarian and cerebral vascular complications). The early discovery of chronic angyopathic complications to diabetics is a major objective in increasing the hope of life to diabetics. Determination and monitorization of SA could be useful in the early discovering of chronic degenerative complications to patients with diabetes mellitus.

Monitoring the effects of treatment in colon cancer cells using immunohistochemical and histoenzymatic techniques.

BACKGROUND: Monitoring the effects of treatment in malignant diseases is very important in study of the influence on the cell metabolism. Energy production in cancer cells is abnormally dependent on aerobic glycolysis. In addition to the dependency on glycolysis, cancer cells have other atypical metabolic characteristics. The purpose of the present study is to evaluation and analysis of the colon cancer cells under anti-angiogenic treatment, to establish the changes in the cellular energy metabolism and apoptotic potential. Anti-angiogenic drugs block the vascular endothelial growth factors, preventing the formation of new vessels. MATERIALS AND METHODS: We use immunohistochemical analysis of cytochrome c release and histoenzymatic analysis of adenosine triphosphatase (ATP-ase), succinate dehydrogenase (SDH), lactate dehydrogenase (LDH) enzymes. Colorectal tumor tissue samples were obtained by biopsy following the surgical procedures at the County Clinical Hospital of Oradea (Romania). RESULTS: The obtained results show that the apoptotic potential of malignant cells increases during the anti-angiogenic treatment, in the same time the rate of glycolysis increases, due to installed hypoxia and reduced ATP synthesis. Our results have been confirmed by international studies too. CONCLUSIONS: It was been demonstrated that the apoptotic potential of malignant cells increases significantly during anti-angiogenic treatment. There is growing evidence that cancer's "Achilles' heel" is tumor cell metabolism.

Phyllodes tumor: diagnostic imaging and histopathology findings.

Phyllodes tumors are rare breast tumors, accounting for less than 1% of all primary tumors of the breast. Histologically, phyllodes tumors can be divided into benign (60%), borderline (20%) and malignant (20%). The mammography examination was performed by means of a digital mammography system Giotto 3D Images; the ultrasound examination was performed through a GE Logiq P6 device and histological confirmation was possible after surgery or following the histological biopsy. We grouped the nine patients who presented clinically palpable nodules into two groups, namely: the six patients presenting histological benign results into Group I, and Group II where we included those with borderline and malignant histological results. Mammography performed in 77.7% revealed a well-circumscribed round or oval opacity or with contour lobules. Ultrasound examination was performed in all patients. Mammography and ultrasound have limitation in differentiating between benign lesion and phyllodes tumor. In the nine analyzed cases, mammographic and ultrasound examinations did not allow the differentiation into the three groups of phyllodes tumor. Histopathological examination is considered the golden standard for their diagnosis. Correlations between mammographic and microscopic aspects were inconclusive for determining the degree of differentiation, ultrasound changes could be correlated with the histopathological aspects.