Romanian Journal of Morphology and Embryology最新文献

The study presents a novel approach to bone regeneration using bioactive nanocomposites. The research focuses on creating hydroxyapatite (HAp) and zinc oxide (ZnO) nanocomposites functionalized with rosemary and thyme essential oils (EOs) to enhance osteogenic and antimicrobial properties. The findings reveal that the incorporation of EOs not only improves biocompatibility by reducing Zn-induced cytotoxicity but also enhances antimicrobial activity, particularly against Gram-negative and Gram-positive bacteria. Additionally, thyme EO exhibits a more potent effect in enhancing cell viability and antibacterial efficacy compared to rosemary EO. Structural analyses through X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier-transform infrared (FT-IR) spectroscopy confirm the successful synthesis of well-integrated HAp-ZnO structures with the EOs. This study offers promising insights into the potential of functionalized nanocomposites for biomedical applications, especially in bone regeneration and infection prevention.

Orthopedic screws are subjected to high mechanical stress, corrosive environment, and microbial colonization, which may cumulatively lead to implant failure and periprosthetic joint infections. To overcome these issues, this study has focused on modifying the surface chemistry and topography of screws utilized in knee intervention toward enhancing their mechanical and biological behaviors. Specifically, this study has explored the optimization of composite coatings made of polycaprolactone (PCL), graphene oxide (GO), and Meropenem (MRP) via the matrix-assisted pulsed laser evaporation (MAPLE) technique. The PCL∕GO∕MRP coatings aimed to upgrade the surfaces of the implantable fixation devices, offering superior antimicrobial properties, reduced biofilm formation, and better mechanical characteristics. Comprehensive physicochemical analyses, including Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Raman microscopy, confirmed uniform deposition, efficient material transfer, and preservation of functional groups. The developed coatings displayed significant antibacterial activity against Staphylococcus aureus and Escherichia coli, with a marked reduction in biofilm formation compared to uncoated surfaces. Thus, this work highlights the potential of the designed PCL∕GO∕MRP coatings as a strategy to enhance the biocompatibility and longevity of orthopedic screws, minimize complications related to implant-associated infections in knee surgeries, and ultimately improve post-surgical outcomes to increase patients' quality of life.

Aim: In this secondary analysis, we aimed to characterize the lymphocytes population and placental inflammation in pregnant women with moderate and severe coronavirus disease 2019 (COVID-19) forms.

Patients, materials and methods: In the analysis of this prospective evaluation, we included 26 pregnant women at term with moderate and severe COVID-19 forms that were evaluated in a tertiary maternity center in a one-year timeframe. Clinical data, along with blood immunophenotyping results and placental histopathological examinations were comparatively evaluated between two study groups depending on the COVID-19 severity: Group 1 (moderate COVID-19, n=14 patients) and Group 2 (severe COVID-19, n=12 patients).

Results: Pregnant patients with severe COVID-19 presented significantly lower total amount of lymphocytes (p<0.001), T-lymphocytes (p=0.009), cluster of differentiation (CD)4+ T-cells (p=0.002), B-lymphocytes (p=0.001). Also, the number of CD4+ T-cells (p=0.01), CD8+ T-cells (p=0.02) and B-lymphocytes (p=0.002) was lower enough for cases with severe COVID-19.

Conclusions: Lymphocytopenia could be a useful hematological marker for risk stratification of COVID-19 in pregnant women at term. A vertical transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cannot be confirmed in this study, mainly because of the limited sample size and short timeframe between infection and birth.

Metastases are the most common tumors of the spine. As an important increase in the annual incidence of spinal metastases (SMs) has been observed in the last decade, the aim of this study was to describe the epidemiology and histopathological types of SMs surgically treated in the Neurosurgery Clinics of a Regional Hospital in North-Eastern Romania over a period of five years, in order to define a certain tumor profile that would benefit from an early screening. We retrospectively evaluated 115 adult patients, searching for demographic data (gender and age of the patients), primary tumor characteristics (location and histological type), topography of the SMs, and the time interval between the diagnosis of the primary tumor and the surgery for the SMs. The patients were elderly (average age: 58.96 years), with a male predominance (67.82%). Main location of SMs was in thoracic region (44.34%), with multiple vertebral metastases in 30.43% of patients. Only 33.04% of the patients had a known cancer at the time of admission. Primary tumor was located mainly in lung (47.82%), gastrointestinal tract (15.65%), breast (11.30%), prostate (10.43%) and kidney (9.56%). SMs from lung cancer (LC) mostly expressed squamous cell carcinoma (19.13%), probably due to patients' smoking habits, and those from the digestive system mostly exhibited a moderately/poor colorectal adenocarcinoma (8.69%). Our data suggest the need for close surveillance of patients diagnosed with LC and colorectal cancer because these malignancies most frequently develop SMs. Smoking prevention actions and screening programs for the detection and removal of precancerous colorectal lesions must be developed and expanded.

The odontogenic maxillary sinus disease (endo-antral syndrome; EAS) is directly related to the spread of endodontic infections from upper premolars and molars with necrotic pulp. Cone-beam computed tomography (CBCT) images proved to be a reference diagnostic aid for detecting the etiological relationship between chronic apical periodontitis and maxillary sinusitis. There were retrospectively evaluated a total of 109 CBCT images (47 males and 62 females) from a pool of CBCT scans taken for routine diagnosis and treatment planning in consecutive 353 patients. The CBCT images were acquired with Veraviewepocs 3D P (R100) equipment (J. Morita MFG Corp., Kyoto, Japan). The scan parameters were 90 kV, 5 mA, 9.4 s exposure time, 125 μm spatial resolution and 40×40 mm field of view (FoV). The aim of this CBCT study was to find out the influence of space separating apical lesions and sinus floor on subsequent EAS. There were observed four categories of anatomical rapports, such as tangent contact, protruding contact, 1-2 mm separating interval, and over 2 mm separating interval. The highest incidence was recorded in molars for tangent contact (47.69%) and in premolars when the apical lesions were situated at 1-2 mm distance from sinus floor (7.69%). The abnormalities revealed on CBCT scans of maxillary sinus have been mucosal hyperplasia, dome-shaped opacification, periostitis, and sinus opacification with air-bubbles. A four class classification related to the anatomical distance between the chronic apical lesions and sinus floor was suggested.

During the coronavirus disease 2019 (COVID-19) pandemic, the infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presented quite a diverse symptomatology, in addition to respiratory symptoms, while other clinical signs such as thrombosis, postoperative hemorrhages, acute kidney or liver failure, digestive disorders (vomiting and diarrheal stools) were also reported. We present the case of a patient diagnosed with transverse colon neoplasm and asymptomatic SARS-CoV-2 infection, who presented to the Emergency Room (ER) of the Emergency County Clinical Hospital, Craiova, Romania, with a clinical picture of low intestinal occlusion. Surgery was decided and a right hemicolectomy extended to the left, with terminal ileostomy performed. The postoperative evolution was favorable, with the resumption of intestinal transit and discharge on the third postoperative day. The patient returned to the ER Department on the fifth day after surgery, with diffuse abdominal pain, absence of intestinal transit and flatulence. Clinical examination of the abdomen revealed the presence of bloating sounds on palpation. Emergency laparotomy was again performed with the suspicion of postoperative occlusion and five perforations were found in the small bowel, associated with fecaloid peritonitis and mechanic-inflammatory occlusion. The perforations were without any obvious lesion substrate, four of them being located on the jejunum and one on the terminal ileum. The histopathological examination revealed hemorrhage and recent transmural thrombosis on the intestinal wall, most likely caused by COVID-19. Without any respiratory symptoms, the COVID-19 infection caused multiple intestinal lesions, leading to peritonitis and septic shock, followed by the patient's death.

Aim: Cervical intraepithelial neoplasia 2 (CIN2) evolution is controversial, and some of them regress spontaneously in a two-year follow-up. The purpose of this work was to evaluate the percentage of CIN2 progression or persistence during a 24-month follow-up, using clinical predictors such as human papillomavirus (HPV) genotype and cytology results.

Patients, materials and methods: This is a retrospective case-control study and included patients of reproductive age who had a new diagnosis of CIN2 who were monitored for lesion regression (Group 1, n=72 patients), and progression or persistence (Group 2, n=36 patients). A multinominal logistic regression was preferred to evaluate the impact that various categorical risk elements can lead to outcomes of persistence or progression of CIN2. We also performed a linear regression to assess the risk of CIN2 progression or persistence using the interaction between clinical predictors.

Results: A previous cervical cytology indicative of high-grade squamous intraepithelial lesion (HSIL) [relative risk ratio (RRR): 3.85, 95% confidence interval (CI): 1.66-8.90] or atypical squamous cells, cannot exclude HSIL (ASC-H) can highly raise the probability of a CIN2 progression or persistence. The presence of HPV16 increased the risk of CIN2+ with 3.77 (95% CI: 0.78-5.00), the presence of HPV18 increased the probability of CIN2+ with 4.39 (95% CI: 1.35-14.33), and other high-risk HPV (HR-HPV) strains increased the probability of CIN2+ with 3.62. The highest risk issue was produced by the interaction between HSIL* HPV16, ASC-H* HPV16, and ASC-H* HPV18.

Conclusions: When discussing follow-up for CIN2 lesions, it is important to offer careful consideration and monitoring of patients with a previous HSIL or ASC-H cytology, with or without HPV 16, 18 or other HR-HPV strains, as their presence significantly increased the risk of CIN2 progression and persistence.

Introduction: Gonadal pediatric tumors are rare, ranking fourth (6%) among pediatric tumors, by Surveillance, Epidemiology, and End Results Program (https:∕∕seer.cancer.gov∕). They have vague symptoms, leading to late discovery, but early detection and identifying its risk factors result in favorable prognosis and reduction of its incidence respectively.

Patients, material and methods: A 10-year retrospective study identified peculiarities and risk factors in 210 children till age 17 with (para)gonadal tumors.

Results: Stress, pollution (agricultural chemicals, insecticides and metal mine), obesity, breastfeeding ≤5 months, malformations [mainly non-genetic related 67∕87 (77%), especially eye malformation - 64%], hormone, smoking, positive heredo-genetic history, rural residence area, abnormal birth weight, and menstruation disorders showed an increased gonadal malignancy risk; relative risk ratio (RR): 1.33, 1.30, 1.34, 1.11, 1.65, 1.16, 1.36, 1.10, 1.00, 1.08 and 1.15 folds, respectively. RR for histopathological subtypes: immature teratoma (IT) (pollution - 1.75, Rhesus positive - 3.41), dysgerminoma (menstruation disorders - 2.80), granulosa cell tumor (stress - 2.10, menstruation disorders - 2.80), mucinous cystadenomas (obesity - 2.84, no postnatal vaccine - 3.71), mature teratomas (stress - 2.35, malformations - 2.18) and serous cystadenomas (breastfeeding ≤5 months - 2.53), dependent variables being mixed germ cell tumors (GCTs) and cysts. Children presenting with bleeding (73%), abdominal distention (62%), elevated tumor markers (91%), (multilocular) solid tumor (88% and 100%), tumor size >10 cm (65%), GCTs (74%), death (100%), metastases (100%), viruses (77%), loss of appetite (68%), and weight (85%), had gonadal malignant tumors, especially mixed GCTs and IT.

Conclusions: Avoiding these risk factors will prevent and reduce gonadal pediatric tumors. Investigating children presenting with the listed peculiarities, especially if exposed to the mentioned risk factors, will enable early gonadal tumor identification, successful patient management, and favorable prognosis.

Breast cancer is one of the more frequently diagnosed cancers leading to death in women, and, like other tumor types, it is heterogeneous in its immunophenotype. It harbors mutations that modify tumor aggressiveness, therapy responses, residual disease, drug resistance, and relapse rates in advanced stages. This study aims to assess the mutational status of G2 and G3 tumors using next-generation sequencing (NGS) on initial tissue biopsies, liquid biopsies, and mastectomy specimens. The histopathological (HP) diagnosis for the 32 selected cases was established via Hematoxylin-Eosin (HE) staining by two observers. For the immunohistochemical (IHC) testing of estrogen receptor (ER), progesterone receptor (PGR) and human epidermal growth factor receptor 2 (HER2), we used the Ventana BenchMark Ultra. Ki67 testing was conducted using Bond-III from Leica. For cases with a score of 2+, gene amplification was assessed by silver-enhanced in situ hybridization (ISH) (SISH; Inform HER2 Dual ISH) on Ventana BenchMark Ultra. NGS analysis was initially performed on biopsies and plasma, and later on mastectomy specimens. After automated deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) extraction, concentrations were measured using the Invitrogen Qubit system. Libraries were created using Oncomine systems, and sequencing and analysis were done with the Ion Torrent system. Most tumors were graded as G3 (19 cases), with Luminal A being the predominant molecular subtype, and a significant number displayed HER2∕HER2-low characteristics (24 out of 32 cases). The NGS assessment showed that phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutations were the most frequent across all sample types. A significant limitation was the high number of invalid plasma tests due to pre-analytical handling errors or transport issues. Nonetheless, plasma testing (liquid biopsy) proved useful for monitoring tumor evolution and assessing residual disease.

Over the last decades, silica nanoparticles (SiNPs) have been studied for their applications in biomedicine as an alternative used for conventional diagnostics and treatments. Since their properties can be modified and adjusted for the desired use, they have many different potential applications in medicine: they can be used in diagnosis because of their ability to be loaded with dyes and their increased selectivity and sensitivity, which can improve the quality of the diagnostic process. SiNPs can be functionalized by targeting ligands or molecules to detect certain cellular processes or biomarkers with better precision. Targeted delivery is another fundamental use of SiNPs. They could be used as drug delivery systems (DDS) since their structure allows the loading of therapeutic agents or other compounds, and studies have demonstrated their biocompatibility. When SiNPs are used as DDS, the drug's toxicity and the off-target effects are reduced significantly, and they can be used to treat conditions like cancer and neurological diseases and even aid in regenerative processes, such as wound healing or bone repair. However, safety concerns must be considered before SiNPs can be used extensively in clinical practice because NPs can cause toxicity in certain conditions and accumulate at undesired locations. Therefore, an overview of the potential applications that SiNPs could have in medicine, as well as their safety concerns, will be covered in this review paper.