Influence of montelukast on cisplatin-induced experimental acute renal failure.

AIM: To investigate the influence of Montelukast (MK) in acute renal failure (ARF) experimentally induced by cisplatin (CIS). MATERIAL AND METHODS: The experiment was carried out in male Wistar rats (280-320g), divided into 4 groups of 12 animals each, treated as follows: Group I (Control); Group II (CIS): CIS, 5 mg/kbw, single dose, i.p.; Group III (CISMK): CIS, 5 mg/kbw, single dose, i.p and MK 2 mg/kbw, p.o., 10 days; Group IV (MK): MK 2 mg/kbw, p.o., 10 days. Blood and urine (24 h) samples were taken before the start of experiment (Io) and at 3, 7, 10 and 14 days after CIS administration. The following were determined: urea, creatinine, Ca, Mg serum levels and creatinine, proteins, Ca and Mg urinary levels. For histological evaluation, 3 rats of each group were sacrificed at 3, 7, 10 and 14 days. The severity of histopathological changes was evaluated using scores on a 1-4 point scale. RESULTS: Both in CIS and CISMK group, serum levels of urea and creatinine and urinary protein levels were significantly higher compared with Io values and control group at 3 and 7 days, (p < 0.01 and p < 0.05, respectively). Urinary creatinine levels were significantly decreased at 3 and 7 days, (p < 0.01) and (p < 0.05) in CIS and CISMK group compared to Io and control group. The degree of severity of histopathological changes was similar in CIS and CISMK group. CONCLUSIONS: The obtained results showed that MK at a dose of 2 mg/kbw had no protective effect in CIS-induced experimental acute renal failure.

Vascular endothelial growth factor (VEGF) expression in the lung in toxic septic shock.

INTRODUCTION: The need for reasoning with medical evidence the different types of shock, especially when there are medical and legal implications, has determined the search of biological markers of the shock. In the case of toxic septic shock, the most important markers to be used are: the cytokines, the tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6), procalcitonin, lactoferin and the vascular endothelial growth factor (VEGF). VEGF has an essential role in angiogenesis and vascular permeability. MATERIALS AND METHODS: In our study group, we included 30 cases of different types of shock in which we studied the VEGF expression in the lungs. We added also 10 fragments of lung as control group. According to the etiology, the 30 cases of shock were: 15 with a toxic septic shock and 15 with a hemorrhagic shock. In all these cases we used the classical Hematoxylin and Eosin staining method and the immunohistochemical reactions for VEGF-A. Statistical analysis was performed using SPSS 13.0. RESULTS: The VEGF expression was decreased in all the cases of toxic septic shock, in the endothelium and also in the alveolar epithelium, compared to a high level of expression in other cases of shock and in the control lung. CONCLUSIONS: These data allow us to appreciate that VEGF has a different expression in different types of shock and in the normal lung. We observed a statistically significant difference between VEGF expression in toxic septic shock and hemorrhagic shock (p=0.000001). There is a similarity of VEGF expression between hemorrhagic shock and the control lungs (p=0.00001). An obviously low VEGF expression in the toxic septic shock represents a useful biological marker in the forensic medical cases.

[Children's Langerhans cell histiocytosis, diagnostic problems]. / Probleme de diagnostic în histiocitoza langerhans la copil.

Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the proliferation of cells of the mononuclear phagocyte system and the dendritic cell system. From the clinical point of view there are 3 forms of histiocytosis encountered in child pathology: acute, disseminated called Abt-Letterer-Siwe (it usually affects children under 2 years of age), eosinophilic granuloma and the intermediate clinical form called Hand-Schuller-Christian disease. We present the case of a premature born child that had, even from the day she was born, a rash disseminated on the entire surface of the body associated with enlarged lymph nodes, hepatosplenomegaly and thrombocytopenia. The diagnosis of Langerhans cell Histiocytosis is difficult to establish and this case is an example that confirms it. Therefore, we present the difficulties in diagnosing this case and its particular evolution.

[Epidemiological data on shock in forensic medicine]. / Date epidemiologice asupra socului in cazuistica medico-legala.

UNLABELLED: The shock is a relative frequent diagnostic in forensic medicine. MATERIAL AND METHOD: We realized a statistical study, using 323 deaths through diverse shock typology, registered within the Forensic Medicine Institute of Iasi in 2000-2009. The concerned variables were: the spread of cases on years, the clinical forms, age, sex, provenience environment, volemic feature, the survival time from the shock to the death, the spread of complications on the form of the shock and survival, the juridical way of death. Our data were introduced in the EXCEL database and statisticaly analyzed by SPSS program. RESULTS: We obtained statistic data on shock typology, based on the survival time and based on the complications of shock types. CONCLUSION: Relevant statistic data were obtained on the relations between the factors that generated the shock, the complications induced and the shock types, related also to the juridical way of death.

[Posterior fossa meningiomas--topographic and anatomopathologic aspects]. / Aspecte topografice si anatomopatologice ale meningioamelor de fosa posterioara.

UNLABELLED: Meningiomas are the most frequent met intracranial tumors. Many authors tried to order them according to location, origin and histopathologic type. MATERIAL AND METHOD: Our study is focused on posterior fosa meningiomas, initially classified according to their origin based on IRM and surgical findings in order to identify correlations between demographic data, topographic tumor origin and anatomopathologic characteristics for each subgroup. 35 posterior fosa meningioma patients that have been subject to neurosurgery in Iasi "Prof.Dr. N. Oblu" Hospital Neurosurgery Clinic between January 1st 2005 and December 1st 2009 were assessed. RESULTS: In our study group the majority of patients were females, with an average age in their early 60's. Benign meningiomas (1st degree) represented the unique subtype in tumors located in cerebellum convexity and foramen magnum. Other locations have different characteristic subtypes (fibrous vs. angiomatous meningioma).

Immunoproliferative small intestinal disease versus colonic monoblastic sarcoma in a 2-year-old boy.

The authors present a case of colonic monoblastic sarcoma, previously treated for other digestive abnormalities (malabsorbtion, Hirschprung's disease). Important similitudes with immunoproliferative small intestinal disease (IPSID) lymphoma were demonstrated for this patient (male, 2-year-old). His main admission complaints were failure to thrive, recurrent episodes of enterocolitis and malabsorbtion syndrome. Some particularities of this case are the young age and the extremely rapid development of the malignant disease in a patient with no previous signs of acute non-lymphoblastic leukemia. The initial diagnosis was of malabsorbtion syndrome, based on the clinical exam at presentation, and then the patient was thought to have a form of Hirschprung's disease, due to a functional intestinal disorder (slow transit). After the necropsy, pathologists diagnosed an immunoproliferative small intestinal disease, and four years later, they performed a more appropriate pathological exam, which explained better clinical symptoms associated to this complex case.

[Myocardial infarction in children. Case report]. / Infarctul miocardic la copil. Caz clinic.

Myocardial infarction is a rare condition in children. We present the case of a 14-year-old girl with known cardiac abnormalities admitted to our pediatric cardiology department with cough, cyanosis, low level of consciousness, and difficult breathing. Two days after her admission, she developed severe thoracic pain associated with tachycardia and agitation. The electrocardiogram revealed myocardial ischemia and then myocardial infarction with a rapid onset of cardiac arrest not responding to resuscitation techniques. Postmortem examination confirmed the diagnosis.

[New methods in cancer research--tissue microarray]. / Noi metode de cercetare in cancer--tissue microarray.

Cancer research advances imperiously requested for a new reliable method for biomarker tissue localization study, with standardized experimental conditions, reproducible, fast and at low-prices. Tissue Microarrays technique is the most important discovery in histopathology techniques in the last decade. It mainly consists in bringing and precisely organizing in a single paraffin block of hundreds of micro-cylinders from different blocks. Sections from this new block may be processed using almost all analyses (immunohistochemistry, in situ hybridization). The clear sightedness of those who developed this technique is proved by its rapid acceptance and integration in basic research, prognostic factors oncology and drugs discovery, reflected in hundreds of publications.

Histiocytic sarcoma associated with Hodgkin's disease.

Histiocytic sarcoma is a rare malignant neoplasm. It is well-known the association of Langerhans' cell histiocytosis with Hodgkin's disease but only few cases of histiocytic sarcoma associated with Hodgkin's disease was reported. We present the case of 20-years-old female patient with Hodgkin's disease with a sternal tumor mass which was diagnosed as histiocytic sarcoma. The diagnostic was established immunohistochemically, using a large battery of antibodies (S-100, CD 68, CD 34, CD 15, CD 30, Vim, NFAP) and by electron microscopy which revealed the lack of the Birbeck granules in the malignant proliferated histiocytes.

[Urokinase-type plasminogen activator (uPA) and its inhibitor--new prognostic factors in oral squamous cell carcinoma]. / Activatorul plasminogenului tip urokinaza (uPA) si inhibitorul sau (PAI1), factori noi de prognostic în carcinomul scuamocelular al cavitatii orale.

Several cell biological studies have shown that the invasiveness of different malignant tumors (breast, renal, prostate, gastric, ovarian cancers) depends at least in part on the urokinase type plasminogen activator (uPA) and its inhibitor PAI1. uPA converts plasminogen into plasmin. Plasmin degrades tumor matrix components and starts invasion and metastasis. Our target was to see the possible prognostic relevance of the tumor-associated proteolytic factors and to compare with tumor size, nodal status and grading. Our results suggest that the invasive and metastatic potential of squamous cell carcinoma is correlated with overexpression of uPA and PAI1.

[Prognostic markers in gastric neuro-endocrine carcinoma]. / Semnificatia prognostica a carcinomului gastric neuro-endocrin.

UNLABELLED: Gastric endocrine tumors show a wide spectrum of clinical pathologic features. Behaviour prognostic evaluation of these tumors is difficult. The aim of this report is to present a rare case of a neuroendocrine carcinoma with multiple locations in stomach. METHODS: A 62 years female patient underwent a resection of stomach for a tumor. The paraffin-embedded sections of 12 blocks were studied by histological and immunohistochemical methods including HE, van Gieson, Grimelius, chromogranin A, cytokeratin, neuron-specific enolase, vimentin, desmin, smooth muscle actin, Ki-67 antigen, protein S-100. RESULTS: Histological pattern was similar in primary tumor (mucosa and submucosa) and sessile lesion at distance, where it affected only mucosa. Histopathologically, these tumors show a sheet of round to spindle and polyhedral neoplastic cells with hyperchromatic nuclei, considerable mitotic activity. Immunohistochemically, the neoplastic cells were positive for cytokeratin and neuron-specific enolase and a high Ki-67 labelling index. The three lymph nodes from five had metastasis. CONCLUSION: The IHC reactions were needed for diagnosis of multiple neuroendocrine carcinomas with lymph node metastasis. These histological and immunohistochemical criteria were very important for the identification of tumors with the aggressive evolution.

[Limitations in the histopathologic diagnosis and prognosis of neuroblastoma]. / Limite în diagnosticul histopatologic si prognosticul neuroblastoamelor.

Neuroblastoma is the most common nonhematopoietic solid tumor of childhood and has been intensively studied for at least 4 decades. Despite this, few predictive histopathologic clues to its behavior exist. Ages, anatomic sites of occurrence, histopathology of the tumor and clinical stage have traditionally been the only reliable prognostic factors in this disease. In the present study we analyzed these prognostic factors in 72 neuroblastic tumors and our histopathological possibilities of diagnosis.

[Relevance of histopathologic diagnosis in amelogenesis imperfecta]. / Relevanta diagnosticului histopatologic in amelogeneza imperfecta.

The aim of the study was the determination of the correlation between the morphostructural aspects of the enamel defects and the clinical diagnostic and the nosologic kinds of these diseases. The research was made on 600 children from Iassy between 7-11 years old, who were examined in natural light. The index used for the systematization of the data was EDS. We used 21 temporary teeth and we examined these teeth on an optic microscope. The study show that there is no absolute correlation between the morphostructural aspects of the enamel defects and the clinical aspects of the lesions, and the clinical defect may not be always associate to the dysplasia from the imperfect amelogenesis.

[Endometrial carcinoma in situ. Morphological and immunohistochemical aspects]. / Carcinom endometrial in situ. Aspecte morfologice si imunohistochemice.

A possible precursor for invasive endometrial carcinoma is an in situ stage, but this notion is very much debated. We present a case of endometrial carcinoma diagnosed in a patient with post-menopausal bleeding. The morphological examination of the hysterectomy specimen, processed by routine technique, put in evidence focal atypias of the glandular epithelium in a group of few endometrial glands, on a background of atrophy without a desmoplastic stromal reaction. The immunohistochemical investigation of the steroid receptors and p53 protein, using monoclonal antibodies in the ABC technique, revealed the p53 positivity and the absence of the receptors in the focal malignant areas. The surface epithelium had the same immunohistochemical aspect. These aspects were decisive in precising that the malignant change was primarily in the surface epithelium with secondary extension in some glands, the final diagnosis being in situ serous papillary carcinoma.

Sequential phenotype changes in progressive lesions of breast carcinoma.

Malignant transformation is the result of genetic events, translated into sequential acquisitions of multiple abnormalities in the control of cellular growth and cell cycle regulation. We determined the expression of the estrogen receptor (ER), progesterone receptor (PR), c-erbB-2 and p53 gene products in a patient with mixed (ductal and lobular) invasive breast carcinoma bearing different coexisting lesions. The purpose of the study was to establish a possible correlation between the expression pattern for these molecules and the histological appearance of the breast tumor. Our results showed no positivity for ER. PR expression was restricted to normal epithelium, simple hyperplasia and in situ carcinoma. c-erbB-2 was detected in all lesions with the exception of normal epithelium and immunostaining for p53 was found positive only in in situ and invasive carcinoma. These findings support the hypothesis of tumorigenesis as a multistep process and as a sum of changes, each representing an advantageous acquisition for the malignant cells' behavior. The loss of hormone receptors' expression occurred as an early event in this case, while the p53 mutations were found only in more advanced neoplastic lesions.

[Cyst duplication of the colon in an adult. Case report]. / Chist de duplicatie enterala--tip colon la un adult. Prezentare de caz clinic.

The cystic type of the enteric duplication has the same histological structure as the digestive tract and the same mucosal lining as the segment to which is attached. These are rare pathological conditions especially in an adult as they usually are diagnosed and treated in childhood. A 39 year-old women has been elective admitted in our unit complaining of upper abdominal pain and a palpable abdominal mass in epigastrium and left upper quadrant. The imagistic findings (abdominal ultrasound and CT scan) raise the suspicion of a pancreatic cystic lesion. Intraoperative we found a large cystic lesion localized in the transverse mezocolon close to the transverse colon. The resected specimen was examined histopatologically and found to be a cystic duplication of the colon. The patient made an uneventful postoperative recovery.

[Morphological study of osteosarcomas in children]. / Studiu morfologic privind osteosarcoamele la copil.

Osteosarcoma is the most frequent primary osteal tumor in children. Our study evaluates morphological aspects of osteosarcomas during last 20 years. We present the results of study that includes 32 cases of classical osteosarcomas that had been diagnosed and treated at the "Sf. Maria" Hospital from Iasi (Romania). The diagnosis is based on usually histopathological methods applied to bioptic and surgical exeresis pieces. Male sex is most involved (56%). Patients' age is between 12-15 years in 68% of total cases. In 50% cases the tumour was localized in distal femoral metaphysis. Histological forms were: osteoblastic (66%), chondroblastic (18%), fibroblastic (16%). Enneking's staging was: II A (6.25%), II B (81.25%), and III (12.5%). Metastasis appeared in 75% cases' evolution. Concluding, 25% of studied patients had a favourable evolution during a 5 years period. Survival rate at 2 years was 39%.

[The causes of gingival overgrowth]. / Cauzele hipercresterii gingivale.

Gingival overgrowth includes a series of diseases with many clinical appearances. The pathological mechanisms being obscure there were used many terms for defining it. Thus, "gingival hyperplasia" and "gingival hypertrophy" were the definitions used to define this pathology. Therefore, the term of "gingival overgrowth" replaced in last decades the above two terms. This article have the goal of trying a classification of the entities forming the large family of gingival overgrowth.