Romanian Journal of Morphology and Embryology最新文献

This paper represents a retrospective study on 252 patients with acute ischemic stroke (AIS), who received thrombolytic therapy between 2019-2023, in the Department of Neurology at the Emergency County Hospital in Craiova, Romania. We aimed to evaluate treatment complications and short-term outcomes of patients with AIS, treated with intravenous (i.v.) recombinant tissue plasminogen activator (rtPA; Alteplase), within 4.5 hours from onset. We also tried to assess the correlations between classical risk factors, such as diabetes, hypertension, atrial fibrillation, smoking and the outcome of these patients. Two hundred and fifty-two patients were treated with i.v. thrombolysis in our Department between October 2019 and December 2023. Out of the total thrombolysed patients, 146 were men and 106 were women. Our focus was on the clinical evolution of our patients and on the complications, especially on hemorrhagic transformation and death, and we tried to see if there were any correlations between gender, age, vascular risk factors such as diabetes, smoke, obesity, hypertension, atrial fibrillation and the outcome of our thrombolysed patients. Out of the total of 252 thrombolysed patients, only 55 (21.83%) had hemorrhagic transformation. Analyzing the differences between the occurrence of hemorrhagic transformation, respectively death, depending on the location and type of stroke, we did not identify statistically significant differences. The only comparison where a difference close to the significance limit is observed is that related to the frequency of deaths depending on the type of stroke - patients with cardioembolic stroke had a higher death rate.

Lower third molars are frequently extracted due to pathologies of the dental follicle, pericoronitis, advanced carious lesions, orthodontic reasons (risk of anterior tooth crowding) or causing periodontal or carious lesions in the distal area of the second molar. The case presented here is of a male patient that came to our Clinic experiencing pain in the distal area of one of his old bridges. The clinical examination revealed a malpositioned, but unusually functional third molar; it is a very rare situation for an initially impacted third molar to erupt in an almost horizontal position and not only to remain on the arch for a very long period of time, but also to contribute to mastication efficiency and occlusion, despite the fact that masticatory forces are distributed at a right angle on its long axis and that mastication takes place on the distal surface of the crown and root, and not on the usually occlusal cusped surface. The horizontal mandibular right third molar contributed to maintaining the vertical dimension of occlusion and the masticatory efficiency for a very long period of time; it also ensured a proper distribution of forces trough the long axis of the second premolar, since the distal contact of the third's molar crown with the second premolar helped it to resist masticatory forces and to remain on the arch, despite the prolonged absence of any mesial contact.

Angiosarcoma represents a group of rare tumors originating from vascular and lymphatic endothelial cells, characterized by marked aggressiveness, rapid growth and poor clinical outcome. The incidence of breast angiosarcoma accounts for approximately 0.05% of all malignant breast tumors and less than 1% of all sarcomas. In this article, we report the case of a 67-year-old female patient who presented to our Clinic due to a rapidly evolving, non-painful, vegetating mass, encompassing almost her entire left breast. Imaging studies revealed diffuse skin thickening in all quadrants and an intensely opaque axillary lymph node (LN). Interestingly, the patient had prior medical history of breast carcinoma treated conservatively in 2007 with limited breast resection and left axillary lymphadenectomy, followed by post-operative chemotherapy and radiotherapy. At the current presentation, we performed a radical mastectomy with ipsilateral lymphadenectomy. The histopathological examination revealed a secondary angiosarcoma with LN involvement mimicking an atypical vascular lesion. In this article, we report the clinicopathological particularities of this case and discuss the challenge of diagnosing LN involvement in angiosarcoma.

The association between different viruses and cancer is well acknowledged in human pathology. However, the precise understanding of how oncogenic viruses intervene in the development of cancer of salivary glands (SGs) remains incomplete. Our review aimed to explore the current literature regarding SGs cancer to evaluate the potential involvement of human papillomaviruses (HPVs) in their development. Our work hypothesis suggests that viruses may be involved in these tumors' immunogenicity. The literature analysis showed HPV-positive detection in different head and neck malignancies, added to variable risk factors and a constant increasing incidence rate. HPV tumorigenesis mechanism is complex, involving E6 and E7 HPV oncoproteins. Additionally, the reported findings generally support the relationship between SGs cancer and high oncogenic subtypes 16 and 18. However, the pathogenic contribution of HPV subtypes 11, 33, 45, 52, 56, and 59 is controversial and further research may clarify their potential involvement in the SG tumor's development. This literature review may enhance the understanding of the role of viral contribution as an etiopathogenic co-factor in SG carcinogenesis. Thus, these data may add value to innovative concepts and treatment strategies development, given that virus-induced tumors can be prevented by targeted immunization, added to oncolytic or viral therapy.

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.

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.