Comparative efficacy of oral contraceptive versus local treatment versus intense pulsed light combined with vacuum in endocrine acne in women.

Acne is the most common affection of adolescents, although it can be also found in adult women. Our study was aimed at the comparative assessment of three different therapies over a three-month period, applied to women with moderate comedogenic and papulo-pustular endocrine acne. In the study 116 female patients with endocrine localized face acne were included and divided into three groups: group I with 42 patients was treated with a combination of contraceptive pill + local treatment + pulsed-vacuum light; group II with 38 patients was treated with contraceptives and pulsed-vacuum light and group III with 36 patients was treated only with local treatment. The acne evaluation was made using the Global Acne Grading System (GAGS). Statistical data processing was carried out using the STATA software. For the comedogenic form of acne, the good and very good results were superior in group I vs group II and III (83.33% vs 31.58% vs 5.56%) at the end of the three months of treatment. For the papulo-pustulous form of acne, good and very good results were similar in groups I and II (92.86% vs 73.68%) both after the first month of treatment and at the end of the study, well above the local treatment group (13.99%). Our study highlighted the superiority of laser treatment combined with hormonal treatment, compared to hormonal and local treatment in the comedogenic form of acne, and the superiority of hormonal treatment combined (or not) with laser treatment in the papulo-pustular form compared to local treatment.

Histopathological factors as predictors for survival in colon and rectal cancers.

Colorectal cancer is one of the most frequent malignant diseases with a raising incidence in Romania. Survival at 5-years even was improved in the last decade, remains low especially because of delayed diagnosis. Many clinical-biological and pathological factors have demonstrate a good prognostic value over the time but there are not a wide consensus in this field. The aim of our study is to evaluate the accepted pathological prognostic factors of survival for colorectal cancer in relation to management adopted in a general surgical clinic. We included in our study 273 patients with colon and rectal cancers admitted in Surgical Clinic of Military Hospital of Craiova in which we evaluate the clinical-pathological features, location of the distant metastasis, postoperative staging, curability and survival. We established correlations, inside of a same stage of the disease, for pathological features (characters of the tumors, differentiation grade and location) and survival rate. Our results showed that curative resection is one of the most important factors that could improve survival. Tumor differentiation is correlated with survival only for the patients with stage II and III of the disease, perineural invasion and pathologic N stage representing important predicting factors for a shorter survival. Peritoneal washing for cytology prior to surgery is correlated with the stage of the disease and not with tumor differentiation.

The study of CD20 and CD45.Ro antibodies in the inflammatory infiltrate involved in acne and seborrheic dermatitis.

The aim of our study was to evaluate the role of CD20 and CD45.Ro antibodies in acne and seborrheic dermatitis. A number of 20 patients with papular, pustular or nodular acne and another 20 patients with seborrheic dermatitis were available for our study. We removed bioptic material from all of them and we perform histochemical and immunohistochemical processing within the Laboratory of Histology, Histopathology and Immunohistochemistry of the University of Medicine and Pharmacy of Craiova. In acne, we could reveal a positive CD45.Ro immunomarking in rare lymphoid cells situated in the middle derma at a distance from the affected pilosebaceous follicle and in the inflammatory infiltrate subepidermically, and also a negative immunomarking in the inflammatory cells from the proximity of the affected pilosebaceous follicle. In patients with seborrheic dermatitis we noticed a positive immunomarking infiltrate of the papillary derma and a positive immunomarking of membrane for CD45.Ro in many lymphoid cells of the inflammatory infiltrate situated in the papillary derma predominantly disposed perivasculary. Conclusions. The absence of the cells marked with CD45.Ro in the proximity of the pilosebaceous follicle interested in acne excludes the direct participation of B- and T-lymphocytes in the perifollicular inflammatory process, though the T-lymphocytes can be revealed in a small number at a distance from the affected follicle. The inflammatory infiltrate from the seborrheic dermatitis proved to be rich in positive CD45.Ro cells and poorer in positive CD20 cells.

Giant retroperitoneal sarcomas.

Retroperitoneal sarcomas are rare malignant tumors, which are developing from mesenchymal stem cells residing in muscle, fat, and connective tissues. Underlying the rarity of this kind of tumors in general population, the aim of this paper is to present three cases of retroperitoneal sarcomas operated in Surgical Department of Military Hospital of Craiova (a retroperitoneal liposarcoma, a dedifferentiated liposarcoma and a malignant fibrous histiocytoma). From clinical point of view, we note the poverty of symptoms and non-specificity of these and a great tolerability of retroperitoneal space that offers the possibility for a great development of the tumor. CT-scan and MRI are the best investigations for diagnosis but surgical exploration is the best way for a good evaluation of these tumors. From histological point of view, we try to present new features about these kinds of tumors in order to classify them. Results of surgery correlated with complementary therapies were good without per-operative mortality or postoperative morbidity but we noted a recidive of one tumor (with different histological pattern) 21 months after the surgical intervention. The rarity of retroperitoneal sarcomas, combined with the vast array of histologic subtypes, has complicated our understanding of these tumors and impeded the development of effective therapies.

[Primary anastomosis in perforated Crohn disease]. / Restabilirea primara a continuitatii digestive în boala Crohn perforata, neglijata.

Inflammatory bowel disease (IBD) comprises a group of diseases of intestine characterized by chronic inflammation of the bowel with periods of exacerbation and remission. The evolution of the disease needs, in some therapeutic moments, surgeon's intervention. We described the case of a patient hospitalized through emergency service of Military Hospital of Craiova which presented multiple ileo-cecal perforations, histological examination proving clinical supposition of Crohn's disease. The authors achieved, on the other hand, some considerations about etiopathogenical, clinical and therapeutic aspects of this disease.

[Madura's foot (mycetoma)]. / Piciorul de Madura (micetomul).

Mycetoma is a chronic disorder involving the skin, bones and soft tissues and is characterized by multiple discharge sinuses, nodules and swelling of the affected part. It may be caused by actinomycetes or eumycetes. It most commonly involves the foot but occasionally involve the hands, back or shoulders. We describe a 66-year-old male agricultural worker, hospitalized in Military Hospital of Craiova, for leg amputation caused by the disease evolution without response at treatment that was initiated 20 years ago.

[Hydatid cyst--rare presentations]. / Chistul hidatic. Forme rare de prezentare.

Hydatid disease is an parasitic infestation due to germens from Echinococcus family, principal localizations of the disease being hepatic and pulmonary. We present two cases of disease, first localized primary on the buttock and second with multiple organ involving. We consider these cases interesting because of rarity and complexity of lesions.

Steatosis and serum lipid patterns in patients with chronic viral hepatitis: differences related to viral etiology.

Lipid metabolism disorders related to viral etiology are described in chronic viral hepatitis, independent of age, gender and liver synthetic function. Steatosis is present, especially in chronic hepatitis C but also in chronic hepatitis B. Although liver biopsy is the gold standard in determining presence of steatosis, its presence can be determined by ultrasonographic examination as an initial screening test. Our aim in this study was to evaluate the presence of steatosis in chronic hepatitis B and C, to determine its frequency in both hepatitis type, and to explore possible relationships between presence of steatosis, lipid metabolism disorders and viral etiology. Our study lot included 66 patients, 36 subjects with chronic hepatitis C, and 30 with chronic hepatitis B. We only encountered significant levels of steatosis in the chronic hepatitis B sub-group. We found the average age, cholesterol, triglyceride, HDL-C, VLDL-C levels in the group with steatosis to be significantly higher than those in the group without steatosis (p < 0.05). Ultrasound reports of hepatic steatosis were particularly associated with histological inflammation, as well as fibrosis; however, the sensitivity and specificity of steatosis on ultrasound was poor when compared to steatosis on biopsy. Hepatic steatosis was significantly more frequent in chronic hepatitis C than in chronic hepatitis B. Severe inflammation and advanced fibrosis were more frequently found in HCV-infected patients with steatosis than in patients without steatosis.