[Peritoneal metastasis of breast cancer]. / Carcinomatoza peritoneala in cancerul mamar.

By this paper we present a clinical case of a multiple abdominal metastasing, occuring after 5 years fom a right mamary neoplasm, diagnosed at c-level T2N1M0 treated multidisciplinarily, conservatively operated, sector with axilar ganglionar evidation. Histopathological type of the tumour was invasive lobular mamary carcinoma, weakly differentiated (G3). The prognosis factors for the 2nd generation were negative: the receptors Her2-neu-negative, EGFR negative. The main factors of unfavourable prognosis, in this case, were the differentiating grading G3, the metastasis of the regional limphatic ganglions (2 out of 10 axilary ganglions invaded) knowing that the prognosis would worsen if the number of the axilary ganglions positive was over 3. The peculiarity of the case lies in locating the metastasis at the level of peritoneum with secondary intestinal interest, at a distance of 5 years without the illness. In the mamary cancer, the secondary lesions manifests itself at the osseous, pulmonary, hepatic and cerebral levels.

[Malignant peritoneal mesothelioma]. / Mezoteliom malign peritoneal.

This work presents the case of a hemorrhagic, necrotized peritoneal malignant mesothelioma in a 46-year old man, discovered during the emergency surgery, performed for an acute surgical abdomen/hemoperitoneum. Mesotheliomas are rare neoplasms of the pleura, peritoneum or pericardium, which are frequently associated with exposure to asbestos. The paraclinical investigations (echography) were not able to specify the diagnosis before the operation. The surgical intervention--tumorectomy, electrocoagulation, hemostasis with Gelaspon sponges-- had favourable results.

Mast cells and dendritic cells in basal cell carcinoma.

Basal cell carcinoma (BCC) is a very frequent skin malignancy, with slow evolution and rare metastases. Host tissues react to tumor invasion through complex inflammatory response, comprising varied inflammatory cells. We assessed the expression of mast cells and dendritic cells in 37 archived formalin-fixed paraffin-embedded tissue samples of BCC from the oral and maxillofacial region by means of immunohistochemical (IHC) method, using the SABC (Streptavidin-Biotin Complex) indirect tristadial technique for CD117 and S100 markers. Undetermined cases were eliminated. Mast cells were found in great number at the periphery and in between the tumor islands, the positivity to CD117 being high in three cases, moderate in 11 cases and low in 16 cases. Dendritic cells were also found within the tumor stroma, but they penetrated deep inside the tumor nests. The positivity to S100 was high in one of the 20 conclusive BCC cases, moderate in seven cases and low in nine cases. Three cases were negative to S100. The characteristic location of dendritic cells prove their role as antigen-receptor cells while mast cells might play dual roles in tumor biology.

Simultaneous immunophenotypical assessment of troponin and extracellular matrix molecules in myocardium of patients with sudden cardiac death.

In patients with sudden unexpected cardiac death, there is a relationship between the interstitial fibrosis of the myocardium and matrix molecules with a role in global remodeling of the cardiac stroma. Tissue samples of left ventricular myocardium from 17 middle-aged patients with sudden cardiac death, following acute or chronic ischemic cardio(myo)pathies, were analyzed using standard HE stain and the indirect tristadial ABC peroxidase immunohistochemical method for a panel of four antibodies involved in the dynamic remodeling of extracellular matrix: matrix metalloproteinase 9 (MMP9), tenascin X (Tn-X), TGF-b, CD54 (ICAM-1), together with simultaneously assessment of troponin in myocardic fibers. The most sensitive reaction was noticed for ICAM-1 in 71% of cases, followed by MMP9 in 59% of cases and TGF-b in 47% of cases (with great specificity for capillary vessels), in the extracellular matrix of the residual cardiomyocytes. A direct correlation, statistically significant was recorded between troponin and MMP9 (r = 0.65, p = 0.01), troponin and ICAM-1 (r = 0.31, p = 0.02), respectively ICAM-1 and tenascin (r = 0.72, p = 0.01). The extensive expression of ICAM-1 in the extracellular matrix from the perilesional area probably plays a role in the stimulation of new developing adhesion substrates between residual cells and adjacent stroma, while the over expression of troponin in the residual cardiomyocytes is accompanied by a high expression of MMP9 in the myocardic interstitium, with heterogeneous remodeling of the ventricular stroma. The simultaneous IHC expression of tenascin and ICAM-1 suggests a colocalization required for the nerve sprouting in the residual myocardium and for developing new focal cell-matrix adhesion contacts.

Immunohistochemical study of skeletal muscle in rheumatoid myositis.

INTRODUCTION: Rheumatoid myositis (RM) represents a poorly characterized entity, immune mechanism, assessment and management remaining still unclear. The aim of this study was to investigate endothelial and inflammatory cells activation in RM muscle biopsy. MATERIAL AND METHODS: Prospective study on 23 consecutive rheumatoid arthritis (RA) with muscle involvement as defined by clinical, biological and imagistic parameters. CD4, CD8, CD20, CD3, CD45RO and CD68 markers, HLA-DR, cytokines receptors (IL-2, TNFalpha, TGF alpha), pro-apoptotic (CD95) and adhesion molecules (CD54) were assessed by immunohistochemistry in deltoid muscle samples. RESULTS: (1) endomysial, perivascular and perimysial inflammatory infiltrates and moderate muscle fibers involvement; predominance of activated (HLA-DR+), memory (CD45RO+) CD3+TCD8+ cells and macrophages surrounding and invading non-necrotic muscle fibers (34.78%) and TCD4+ activated cells in perivascular and perifascicular areas (65.22%); (2) up-regulation of HLA-DR, CD54 and IL-2R on both endothelial cells and lymphocytes (85%); (3) aberrant increased CD95 in endothelial cells without any other apoptotic sign (83%) have been described. CONCLUSION: Increased expression of activation markers, adhesion molecules and cytokine receptors may indicate early endothelial activation in RM pathogenesis, while endomysial TCD8+ activation may account for further development and perpetuation of myositis.

P53, p63 and Ki-67 assessment in HPV-induced cervical neoplasia.

Carcinoma of the uterine cervix is the most frequent malignancy in women, with an incidence of approximately 456.000 cases per year, leading to 200.000 deaths per year. Twenty-six archived formalin-fixed paraffin-embedded samples of squamous cell carcinoma, selected from 30 Papanicolaou-positive smears, have been analyzed using standard HE stain and the IHC indirect tristadial ABC peroxidase method for four antibodies: p53, p63, Ki-67, HPV. Statistical analysis has been done using the Student t-test, one-group two tails, "paired two samples for mean" variant. Two thirds of the cases were medium and poor differentiated carcinomas. The expression pattern of the proliferation and prognostic factors was biologically correlated with the histopathological type and HPV-infection. Two statistically significant correlations were found between p63 and Ki-67 and between p63 and p53 (p<0.001). The significant increase of the expression of the analyzed immunomarkers was observed in most of the cases with late stage of cervical neoplasm. P63, followed by Ki-67, showed better correlation with cancer progression than p53. This observation could be used in clinical practice with the purpose of identifying those patients requiring more aggressive treatment.

Malignant fibrous histiocytoma of larynx with giant cell: case report and histological-clinical considerations.

INTRODUCTION: Malignant fibrous histiocytoma (MFH) is a tumor which has a mesenchymal origin, and an uncertain histogenesis. MFH with giant cell accounts for 3-15% of all malignant fibrous histiocytomas. OBJECTIVE: To explore the histopathology, the diagnosis and the treatment of MFH with giant cell of larynx. PATIENT AND METHODS: We report a case of a glottic MFH at a 59-year-old male, who has been smoking for 30 years, and was hospitalized in June 2008 at Emergency County Hospital of Craiova. RESULTS: The largely-sized tumor was originated in glottic area, upper a left vocal cord, with no paresis. The tumor determined respiratory failure and dysphonia. Patient underwent surgical excision of the tumor after an emergency tracheotomy. The immunohistochemical techniques proved positive for vimentin, smooth muscle actin, CD68, CD34, bcl2, EGFR, S100, Ki67, and negative for CD117, NFT, chromogranin, c-erbB2, CK34betaE12, MNF116, and p53. CONCLUSIONS: Malignant fibrous histiocytomas (MFH) with giant cell of larynx are very rare mesenchymal neoplasm (this case seems the first reported). The diagnosis of MFH of larynx was difficult and the immunohistochemistry could have been helpful.

Immunophenotypical pleomorphism expression in sudden cardiac death.

This study was undertaken to assess several histopathological and immunohistochemical markers regarding some lesional aspects of ischemically and hypoxically damaged myocardium in sudden cardiac death. Tissue samples of myocardium from 17 middle age and young patients with sudden cardiac death, following acute or chronic cardio(myo)pathies, were analyzed using standard HE stain and indirect tristadial ABC peroxidase immunohistochemical method, for a panel of 12 antibodies grouped in three categories: antibodies involved in programmed cell death (bcl-2, p53, Fas/CD95, Fas-L, bax, caspase 9), muscular markers (Myo-D1, myogenin, desmin, actin) and growth factor receptors (b-FGF, VEGF, NGF). Myogenin was more sensitive in identifying the ischemic perilesional myocardic fibers than Myo-D1, but less specific, while desmin had a greater sensitivity than myogenin and Myo-D1 taken separately, but with no specificity for myocardic fibers. Fas-L, caspase 9 and bax were expressed in more than 75% of cases in perilesional residual cardiomyocytes, correlating to each other (r = 0.45, respectively r = 0.6, p<0.05). b-FGF, VEGF and NGF had a focally variable expression in subendocardial and subepicardial cardiomyocytes and were statistically independent. Even if there was a polymorphic expression of antibodies in the studied batch, our findings indicate that some parameters (Fas-L, b-FGF, Myo-D1) might be independent markers for predicting sudden cardiac death in patients with previously damaged myocardium.

The usefulness of immunohistochemistry in sporadic colorectal cancer.

BACKGROUND: Colorectal cancer is an important disease with a large morbidity and mortality and also with increasing health care costs because of widespread of the multi-modal therapy and of the new drugs that continue to appear. There are 678.000 colorectal cancer cases and 400.000 deaths from the disease worldwide. It is the second commonest cause of cancer death in the European Union but, unlike the commonest cause of cancer related death that is lung cancer, the basis of the disease initiation is currently not understood. At the same time, the incidence increases with age, the carcinomas being rare before the age of 40 years, excepting individuals with genetic predisposition or predisposing conditions such as inflammatory bowel diseases. The early detection of colorectal cancer is potential associated with an important decrease of the cancer related mortality. AIM: Our study proposes to find out the significance of some immunohistochemical markers (VEGF, p53, CK20 and CEA) in sporadic colorectal carcinoma cases and to establish the statistical correlations between molecular markers and tumor grade and stage. MATERIAL AND METHODS: We investigated histopathological 40 inpatients (19 female and 21 males) who undergone surgery for colorectal carcinomas in "Sf. Ioan" Emergency Hospital, Bucharest, between September 2005-September 2006. We proceeded the histopathological examination to establish the grade, stage and the main features of the tumors, and then we analyzed using ABC method for immunohistochemistry the following markers for 20 selected cases: vascular endothelial growth factor (VEGF), carcinoembrionic antigen (CEA), cytokeratin 20 (CK20), and p53 oncoprotein. Finally, we analyzed statistical the results using t-Student test. RESULTS: The distribution of colorectal cancer cases (n = 40) regarding the age has showed the preponderance of patients older than 70 years (22/55%) and a small percentage of younger adults (2/5%). The repartition of colorectal tumors of sex ratio outlines a small difference between males (21/52.5%), and females (19/47.5%). The histopathological analysis of tumor grade in the 40 cases has revealed a high percent of moderate grade tumors (23/57.5%), in comparison with the poor differentiated tumors (11/27.5%) and the well-differentiated cancers (6/15%). The neovascularity within the stroma, the main features of tumor growth, has been noticed in 15 cases (3.75%), and also an important inflammatory lymphocyte infiltrate in nine cases (22.5%). We have noticed positive correlation between VEGF1 and CK20 (r = 0.4, p = 0.05), and between VEGF1 and CEA (r = 0.88, p = 0.001). In addition, our results demonstrate a positive correlation between tumor grade and CEA (r = 0.43, p = 0.009), and no relation among the other markers. CONCLUSIONS: Our present study shows that CK20 and CEA are positive immunostaining markers no matter the stage (100%). The oncoprotein p53 has been negative in T1 and T2 stages, but in advanced stages has been positive in a half of cases (50%). Regarding the location, p53 and VEGF showed positively results whatever the topography. We have noticed a direct proportional relation in VEGF expression and CEA, and CEA and tumor grade (r = 0.88, p<0.001).

Transitional cell tumors of the ovary: a compact group with a heterogeneous histological and immunophenotypical pattern.

A small percentage of ovarian neoplasms are transitional cell tumors, which proves to be a distinct group with various histological and immunohistochemical patterns. In this study, 13 archived formalin-fixed paraffin-embedded samples of transitional cell tumors of the ovary have been assessed using standard HE stain and the indirect tristadial ABC peroxidase IHC method for 11 antibodies (CA125, CK7, CEA, EMA, MNF116, CK20, Vim, ER, PgR, PCNA, Ki-67). More than 50% were malignant Brenner tumors. CA125 was positive in all malignant tumors (of Brenner type and transitional cell carcinomas), but not in benign and borderline tumors, while CK7 was positive in approximately 70% of all cases. These two antibodies have shown a high sensitivity and low specificity, but do not correlate to each other. PCNA was positive in the study batch with a mean value of 40% and Ki-67 with a mean value under 25%. A direct correlation statistically significant has been noted between the aforementioned proliferation factors and the tumor grade (r = 0.4, p = 0.05). The other markers were unspecific, with low sensitivity and independently of the histopathological type.

[The Krukenberg tumor caused by an adenocarcinoma of the gallbladder]. / Tumora Krukenberg secundara unui adenocarcinom al veziculei biliare.

This work presents the case of a 62 year-old woman's Krukenberg tumor caused by an adenocarcinoma of the gallbladder. This was the presumptive diagnosis that was confirmed during the operation. The characteristic feature of this case consists of the rarity of the Krukenberg tumors caused by a cancer of the gallbladder, the paraneoplastic pleurisy and the presence of the cells with "a ring with a seal" in the pleural liquid and in the ascites liquid. The paraclinical investigations (echography, computerised tomography) were not able to specify the diagnosis before the operation. The surgical intervention (cholecystectomy and total hysterectomy with bilateral adnexectomy) has had favourable consequences. Nevertheless, the woman died 5 months after the operation.

Quantification of apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT).

AIM: To quantify the apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT). MATERIAL AND METHODS: The study lot consisted of 30 endometrial biopsies on which we studied the apoptotic phenomenon through morphological and molecular biology techniques (TUNEL reaction). Examination of endometrial biopsies before and post-therapeutically has been made. RESULTS AND DISCUSSIONS: From morphological point of view, pre-therapeutically, endometrial biopsies presented apoptotic changes in about 1-3% of cells and under TSH there have been observed apoptotic changes in about 1-2% of cells. In female reproductive system, we found out a raised rate of cellular proliferation and concurrently a raised rate of apoptosis. Apoptotic phenomenon can be observed in endometrium at every menstrual cycle. In proliferative endometrium apoptosis rate is low, but in endometrial carcinoma apoptosis rate grow up. Bcl2 and Bax are expressing in normal and hyperplastic endometrium, but in endometrial carcinoma Bcl2/Bax ratio decline. CONCLUSIONS: Quantification of apoptosis, using morphological and TUNEL reaction methods, on endometrial biopsies in postmenopausal patients before and after therapy indicate a low rate of apoptotic phenomenon.

Ultrastructural analysis of the endometrial mucosa of female patients at menopause with hormonal substitutive therapy (TSH).

The objective of the paper was to observe the ultrastructural aspects of the endometrial biopsies taken from female patients at post-menopause with substitutive hormonal therapy (TSH). Material and methods. A number of three endometrial biopsies were taken from female patients at post-menopause with TSH. The ultrastructural analysis was carried out with the help of the electronic microscope Philips ME 301 using classical electronic microscopy methods. Results and discussions. The ultrastructural analysis has highlighted the presence of cuboidal and columnar epithelial cells, with basally situated nuclei, well represented cellular organelles, some cells having at the apical pole microvilli. At the electronic microscope, three types of epithelial cells are described, at the level of the endometrial mucosa of the woman who is in a fertile period: secretory cells (cells with an average electronic density with microvilli on the luminal surface), ciliated cells and clear cells (cells with a low electronic density). These cells have certain ultrastructural characteristics and of receptivity towards the steroid hormones. The stroma is axial with elongated cells with oval nuclei, with nucleoli and with smooth or undulated membrane. Conclusions. The ultrastructural aspects suggest the presence at endometrial level of epithelial active glandular cells, secretory cells and stromal active cells at female patients at post-menopause with TSH.

p53 protein and bcl-2 expression in glioblastomas. Pathological correlations in a comprehensive series.

p53 and bcl-2 are two well-known antiapoptotic factors associated with gliomas, and mostly astrocytic tumors. In the present study we assessed, by immunohistochemistry, the expression of these two factors in a series of 50 glioblastomas. The correlations between their expression and several tumor-related factors (age, location, recurrence, proliferating potential) were investigated. Our results suggest that a valuable correlation between these factors cannot be found. This is in discrepancy with some literature data, which emphasize strong relations of p53 and bcl-2 in oncogenesis spreading or final prognosis. Further studies are needed, with unique, standard procedures for these evaluations.

[Surgically treated malignant melanoma. The long-term results]. / Melanom malign operat. Rezultat de la distanta.

It is presented the case of a 37-year-old man with diagnosis of junctional nevus malignant with aspect of nodular melanotic melanoma level V Clark with regional lymph node invasion who would be classified as III stage in T.N.M. classification. Remark on importance for diagnosis of malignancy the history of recently modification of congenital tumor and the local examination. Also, on remark the favourable evolution after an oncologic surgical treatment--wide surgical excision of lesion completely (in condition of negatives histopathologic tumor markers of prognostic) with prophylactic regional lymphadenectomy with curative intention. The excellent result 7 years after the surgical treatment determined us to present this case.

Cellular immune response in atypical tuberculosis diagnosed by PCR in paraffin embedded material.

The aim was to evaluate the cellular immune response in atypical tuberculosis and granulomatous inflammation consistent with tuberculosis (TBC), negative histochemically for acid-fast bacilli and analysed by PCR for Mycobacterium tuberculosis (MT) detection in paraffin-embedded tissue. Thirty six samples of differently localized atypical tuberculous lesions and granulomatous tuberculoid lesions negative for acid fast bacilli and 4 positive cases on Ziehl-Nielsen stain were analysed by PCR for MT detection and were tested immunohistochemically (IHC) for the cellular immune response in the granulomas and perigranulomatous tissue. The samples selected were: 7 pulmonary and 33 extrapulmonary specimens, especially lymph nodes. Histologically, the atypical tuberculous lesions contained supurative necrosis, defective granulomas and cellular polymorphism. The epithelioid cells showed frequent mitoses. The immunoprofile of cells was polymorphous. L26 positive small lymphocytes were found in nodular lymphoid aggregates surrounding granulomas. A significantly increased number of positive UCHL1 cells were found in 33 out of the 40 analysed cases, with a larger percentage of CD4 positive T cells (81.8% of cases). CD44 was positive in multinucleated giant cells (17.5% of cases), epithelioid cells (60% of cases) and lymphocytes (30% of cases). CD68 was localized in multinucleated giant cells and epithelioid cells, in a 4%, respectively 62.5% of cases. The PCR was performed in all 40 cases; the tissue samples were heterogeneous (lung, lymph nodes, lever, nasopharynx, etc.) and needed a good quality extraction of DNA. Performing a control PCR for Beta Globin tested the extraction; a good result was obtained in 31 cases (77.5%); from these, 19 cases had amplification for IS 6110. The cellular immune response in the atypical tuberculous lesions was similar in cases with and without acid-fast bacilli, but positive for PCR. In the most cases with negative PCR reaction, it was due to a deficient fixation of the material. The T lymphocytes were numerous in all types of tuberculous granulomas, with the prominence of CD4 positive subtype. The immunoprofile of the epithelioid cells, positive for CD44 and CD68, presenting frequently mitoses suggests an activate state in a possible relationship to the T-cell-mediated immune response in tuberculosis.

Immunofluorescence expression of Ki-67, p53 and cyclin inhibitors (p16ink4a, p21 and p27) in low-grade cervical lesions versus high-grade cervical lesions. Research study on cell cultures.

OBJECTIVE: The aim of this research was to assess the immunofluorescence expression (IFE) of cell cycle regulators p16ink4a, p21, p27, in association with proliferation and prognosis factors Ki-67, p53 respectively, in cell cultures, obtained from different types of cervical intra-epithelial lesions. The final purpose was to distinguish a best marker able to identify with high accuracy the high-grade squamous intra-epithelial lesion. MATERIALS AND METHODS: The study was carried out on 68 epithelial cell cultures. Three senior specialists have analyzed 500 cells/case individually. The statistic analysis for correlation between used markers has been performed. RESULTS: The study batch revealed a very low expression of investigated parameters (<1%) in negative cases for malignancy and intraepithelial lesion (NMIL), a progressive exponential expression in low-grade squamous intraepithelial lesion (LSIL), and a very high expression in high-grade squamous intra-epithelial lesion (HSIL) and invasive squamous cervical carcinoma (ISCC). Ki-67 and p53 were overexpressed in nuclei both in LSIL and HSIL. A slightly direct correlation between p21 and Ki-67 (r=0.35, p<0.001) was observed in HSIL. Statistically significant correlations were noticed between some markers: p16ink4a and p27 (r=0.4, p=0.03), p16ink4a and Ki-67 (r=-0.4, p=0.002). CONCLUSIONS: The most reliable parameters for assessing HSIL and ISCC proved to be Ki-67 and p16ink4a. Both were with percentages and intensity of IFE around 100% and higher immunoexpression within the nucleus of cell cultures. Our study reveals that p27 cyclin inhibitor was not reliable in differentiating between LSIL and HSIL.

Sudden cardiac death due to triple myocardial bridging associated with atypical coronary topography.

Myocardial bridging (MB) is defined as the presence of an intramural course of a coronary artery, most likely caused by a defect in resorption of the musculature that encircles the epicardial arteries during morphogenesis. We present a case of the young man who died suddenly while playing professional football and whose cause of death was acute myocardial infarction associated with multiple myocardial bridges (1.8 cm on the anterior interventricular artery, 1.3 cm on the circumflex artery, and an intramyocardial trajectory of the posterior interventricular artery), and discuss the causes of death and possible consequences of this pathology.

Cellular immunophenotypes in human embryonic, fetal and adult heart.

The cellular immunoprofile of cardiac dysfunctions and lesions of ischemic etiology are insufficiently studied to date, especially regarding the contribution of non-cardiomyocytic structures. Aiming to explore this immunoprofile, we used immunohistochemistry applied on embryonic, fetal and adult normal or ischemic myocardium. We observed a decrease of smooth muscle alpha-actin expression in fetal vs. embryonic cardiomyocytes, its absence in normal adult myocardium and its intense expression in the fibrotic scars of ischemic myocardium. DDR2 and vimentin, which are present in the interstitial cells and cardiomyocytes of the embryo, fetus and normal adult heart, are absent in the fibrotic scar tissue and cicatricial infarction, the latter expressing smooth muscle alpha-actin and CD34. This suggested that myofibroblasts and not local fibroblasts that participate in ischemic remodeling. An EGFR-positive vascular network was better represented in the ischemic heart than in the adult normal one, a fact possibly related to EGFR implication in cardiac ischemic pre- and post-conditioning. Therefore, cardiomyocytes and non-cardiomyocytic cells have an undulating immunoprofile according to the intrauterine life stage or age after birth, and a variable contribution in cardiac lesions, mostly in ischemic ones.

Georges Marinesco and the early research in neuropathology.

OBJECTIVE: To present the scientific contributions of Georges Marinesco (1863-1938) and place his achievements within the context of early neuropathology research. BACKGROUND: Neuropathology is a relatively recent medical field, its origins dating to the late 19th century. RESULTS: One of the most important neuroscientists of that period was the Romanian-born Georges Marinesco. He became a neurologist under Charcot's guidance at the Salpêtrière Hospital, in Paris. In 1892, Paul Blocq and Marinesco gave a first account of senile plaques, having used their pathologic skills in the examination of nine deceased epileptic patients. They did not, however, relate the plaques to dementia. Marinesco made discoveries in neuropathology which he described from a histopathologic perspective, and introduced new medical terms such as neuronophagia, chromatolysis, and medullomyoblastoma. He also drew correlations between clinical neurologic findings and morphology, for example in congenital cerebellar ataxia, syringomyelia, and parkinsonism. From 1899 he used cinematography as a medical research tool. CONCLUSION: Marinesco was a prolific researcher in the field of neuropathology, especially neurodegeneration but also in clinical neurology. He is now considered the founder of the modern Romanian school of neurology.