Correlations between CD34 Immunolabelled Blood Vessels and CD34 mRNA Expression in Colorectal Cancer.

PURPOSE: This study aims to determine the correlation between microvessel density of CD34 immunolabelled blood vessels and CD34 mRNA gene expression in colorectal cancer tissue. MATERIAL/METHODS: Standard immunohistochemistry and gene expression was perform on samples collected from 76 patients with colorectal cancer in order to determinate the number of CD34 immunolabelled blood vessels and the relative quantity of CD34 mRNA. RESULTS: For the study group, the mean CD34 immunolabelled microvascular density (MVD) was of 307/mm2, and the mean CD34 gene expression value for colon cancer was 2.303. The low p value (<0.001) of the Spearman correlation test showed a significant direct correlation between CD34 MVD and CD34 gene expression for the entire study group. CONCLUSIONS: CD34 gene`s expression can be looked at as a prognostic factor in colorectal cancer.

Colorectal Cancer Biomarkers - A New Trend in Early Diagnosis.

Colorectal cancer (CRC) is one of the most widespread malignancy, posing as a great challenge due to its high incidence and mortality in both genders. Yet, it also stands as one of the most preventable diseases because of its known malignant transformation mostly from tubular adenomas or serrated polyps, therefore offering a strong incentive to the screening programs that are being developed for this disease. Current diagnosis of CRC has surely evolved along with the evolutionary step in gastrointestinal technology of flexible endoscopy. These innovations have promoted colonoscopy as a primary choice for screening programs of colonic lesions, proving to be of great benefit for patient's well-being. In this review, we present the current status of CRC screening methods from the non-invasive options to the long developed colonoscopic and imaging techniques. We search through PubMed and Medline databases and chose relevant articles on CRC with focus on blood based biomarkers and stool based tests. Additional relevant publications were also according to the reference lists of firstly identified articles.

Noninvasive Fibrosis Assessment in Chronic Viral Hepatitis C associated with End Stage Renal Disease.

INTRODUCTION: HCV is considered the most encountered viral infection that affect patients after hemodialysis sessions. Even though liver biopsy is considered the golden standard for hepatic diagnosis, additional methods have been used for assessing liver fibrosis. Transient elastography (TE) has evolved as a reference method in some European countries and allows the physician to carry out a fibrosis evaluation in a noninvasive, low-cost and rapid method. Our objective was to assess the efficacy of TE in staging patients with HCV liver disease associated with ESRD, thus choosing the correct moment to perform the procedure. MATERIALS AND METHODS: We included 34 patients known with ESRD within the regional Nephrology Clinic of Olt County Hospital and also having positive hepatitis C viral liver marker. TE was performed before and hemodialysis and data was analyzed. RESULTS: The patients where we have encountered significant changes were especially within the F0 and F1 stage with a decrease of fibrosis after hemodialysis. Thus, 7 patients which had no fibrosis (F0) went from 4,14±0,98kPa to 3,54±0,84 (p<0,05) and 12 patients from the F1 stage went from 6,22±0,39kPa to 5,47±0,58kPa. The other stages had no significant changes with F2 changing after hemodialysis from 8.03±0,62kPa to 7, 76±0,6kPa. CONCLUSIONS: TE represents a valuable tool for stiffness assessment and should be taken into considerations as a major option for ESRD patients with liver disease. However, more patients should be enrolled to strengthen this theory and thus providing more reliable results.

Histochemical and immunohistochemical study of mucinous rectal carcinoma.

Colorectal cancer (CRC) is a major health problem worldwide. The objective of our study was to assess the histopathological (HP) and immunohistochemical (IHC) profile of mucins from signet ring (SR) and mucinous rectal carcinoma, while evaluating their value as a prognostic factor and muco-secretive ability. The HP study (76 cases) included 4 categories of patients: pure mucinous (PM), mixed mucinous components (MM) (50-80% of the tumor cells), mixed mucinous components (Mm) (< 50% of the tumor cells) and signet ring (SR). The IHC study consisted of a total of 30 cases of MRC and was processed by the ABC/ HRP technique. The antibodies used have addressed their muco-secretive capacity: MUC1, 2 and MUC5AC. MRC cases were more frequent in the sixth decade, with a median age of 57.3 years. It could be noted that MRC tended to develop at younger ages. For the MP variant, the gender ratio was 1.37 in favor of men, while for the MM variant it was 1.16, 1.31 for the Mm and 1.6 in the case of signet ring type. Most of the MRC were moderately differentiated forms, except for the SR form, poorly differentiated forms predominating. Well-differentiated forms were the most underrepresented, being more common in the Mm version. Regarding the biochemical type of mucin, MP and SR were characterized by acid mucins and sialomucin, while in the Mm type, there was a balance of acidic and neutral mucins. The prevalence of mucin acids, respectively sulfomucin, was characteristic to younger ages and poor prognosis.

Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods.

Non-alcoholic fatty liver disease (NAFLD) is an ailment affecting and increasing a number of people worldwide diagnosed via non-invasive imaging techniques, at a time when a minimum harm caused by medical procedures is rightfully emphasized, more sought after, than ever before. Liver steatosis should not be taken lightly even if its evolution is largely benign as it has the potential to develop into non-alcoholic steatohepatitis (NASH) or even more concerning, hepatic cirrhosis, and hepatocellular carcinoma (HCC). Traditionally, liver biopsy has been the standard for diagnosing this particular liver disease, but nowadays, a consistent number of imagistic methods are available for diagnosing hepatosteatosis and choosing the one appropriate to the clinical context is the key. Although different in sensitivity and specificity when it comes to determining the hepatic fat fraction (FF), these imaging techniques possessing a diverse availability, operating difficulty, cost, and reproducibility are invaluable to any modern physician. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), elastography, and spectroscopy will be discussed in order to lay out the advantages and disadvantages of their diagnostic potential and application. Although imagistics has given physicians a valuable insight into the means of managing NAFLD, the current methods are far from perfect, but given the time, they will surely be improved and the use of liver biopsy will be completely removed.

In Vivo Experimental Study of an Endoscopic Ultrasound Multifunctional Radiofrequency Ablation Probe.

The aim of our study was to test the feasibility of a new developed RFA probe made especially for EUS use and also capable of injecting iron oxide nanoparticles within the targeted liver area. The procedures were performed on domestic pigs, divided in groups: A.liver RFA was performed; B -IONs were injected in the liver followed by EUS-RFA in the same area; C.local EUS-guided liver IONs injection were performed. After EUS measurements for the ablation areas, group A had a mean of 4.9 cm, while group B had a mean of 5.2 cm (Fig.3, 4). IONs exposure was on a median area of 3.1 cm. EUS imaging pointed out a regular oval shape in group A, and a slightly irregular outline on group B, with more echo bubbles around. MRI sections revealed different patterns for each group separately. In group A and B, RFA lesions were easily identified with specific liver parenchyma changes. Group B revealed few deposits of nanoparticles further away from the targeted point. The last group pointed out a large amount of IONs within the injection region and a larger amount of dispersed IONs within the liver than group B.

Quantification of liver fibrosis in chronic hepatitis B virus infection.

Chronic hepatitis B virus infection (HBV) is considered a global public issue with more than 78.000 people per year dying of its evolution. With liver transplantation as the only viable therapeutic option but only in end-stage disease, hepatitis B progression may generally be influenced by various factors. Assessing fibrosis stage plays an important part in future decisions on the patients' wealth with available antiviral agents capable of preventing fibrosis passing to an end-stage liver disease. Several methods have been taken into consideration as an alternative for HBV quantification status, such as imaging techniques and serum based biomarkers. Magnetic resonance imaging, ultrasound, and elastography are considered non-invasive imaging techniques frequently used to quantify disease progression as well as patients future prognostic. Consequently, both direct and indirect biomarkers have been studied for differentiating between fibrosis stages. This paper reviews the current standings in HBV non-invasive liver fibrosis quantification, presenting the prognostic factors and available assessment procedures that might eventually replace liver biopsy.

Blood Clearance of Citric Acid-Coated Superparamagnetic Iron Oxide Nanoparticles in Rats - a Pilot Study.

Superparamagnetic iron oxide nanoparticles are primarily utilized for different biomedical applications such as magnetic resonance imaging (MRI), hyperthermia, cancer treatment, targeted delivery of drugs or genes and biosensors. Nanoparticles are interesting due to their unique proprieties together with minor side effects. It is essential to determine the blood clearance of superparamagnetic nanoparticles (SPIONs) for in vivo biomedical applications, to ensure their optimum clinical use. The purpose of this study was to evaluate the elimination kinetic of citric-acid iron oxide nanoparticles in blood via intravenous injection in rats. Animals were blood sampled at different time intervals, ranging from 30 minutes to 24 hours after injection. The decay of SPIONs in blood was analyzed using electron paramagnetic resonance (EPR) technique. The results suggest that the injected iron oxide nanoparticles are rapidly cleared from circulation, with half-life of elimination process from the bloodstream about 14.06 minutes.

Real Time Elastography Assessment of Fibrosis In Chronic Viral Hepatitis.

Fibrosis assessment is a necessary component of liver disease evaluation not only for prognosis but also for future therapeutic management. Our study objective was to evaluate the accuracy of quantitative assessment of liver fibrosis in patients with chronic viral hepatitis B or C, relying on RTSE results, a method approved and acknowledged in Europe. MATERIAL AND METHODS: Sixty-three consecutive patients diagnosed with chronic viral hepatitis B or C between January 2014 and December 2014 at the Emergency County Hospital of Craiova were enrolled in the study. Patients underwent both TE and RTSE. RESULTS: The reference method used for staging liver fibrosis was TE, based on its recognition and validation by the European guidelines. Fibrosis was classified as follows: 17.47% of patients were staged as F0, 11.11% of patients staged as F1, 14.28% as F2, 17.47% as F3, and 39.68% as F4. Correlation coefficients between measurements for each parameter was done with ANOVA test, in order to identify any differences, according to the fibrosis stage. Valuable information was obtained suggesting that MEAN, SD, %AREA, COMP, Skewness, IDM and Contrast had highly significant differences when related to the Fibrosis Stage (FS) (p<0,001) and ASM had significant differences (p<0,05). As for Kurtosis, ENT and Correlation parameters no significant differences with the FS was found. CONCLUSIONS: Imaging methods of assessing liver fibrosis are of special interest in chronic liver fibrosis assessment. RTSE comes as a potential new technology based on elastogram evaluation which may prove to be more efficient along with larger prospective studies.

Iron Oxide Nanoparticles Biodistribution in an Experimental Pig Model - A New Approach for Delivery and Imaging.

Iron oxide nanoparticles (IONs) are of great interest in medicine, with great potential for imaging diagnostics, as well as therapeutic. Biomedical applications of IONs have been suggested for magnetic resonance imaging (MRI), with two available contrast agents on the market. However, new developments in biocompatibility and biodistribution are necessary as many new physiochemical features of coatings have been proposed for a good safety profile. MATERIALS AND METHODS: Our study objective was to assess a different setting in terms of biodistribution of IONs coated with citric acid on an experimental pig model, based on EUS-guided portal vein (PV) injection. Four pigs were subjected to EUS procedures and portal vein injection of an IONs solution. All animals were kept under surveillance for the next 24 hours and euthanized. Necropsy was performed and their organs were harvested, visualized with a 3T MRI scanner and sent to pathological examination. RESULTS: All pigs had no change in their behavior and no signs of complications were encountered. There were no problems in identifying the pig's PV under EUS-guidance. The IONs solution was clearly visualized on ultrasound live imaging, during EUS-injection. MRI and histopathological data confirmed all the deposits using Prussian Blue staining. CONCLUSIONS: This paper comes forward as a first phase of assessing new future therapeutic options and their distribution within the main organs depending on their characteristics. In our opinion this new distribution option has a strong incentive to the research of therapeutic and imaging areas and is worthy of further appraisal.