Morphological Aspects of the Aberrant Right Subclavian Artery-A Systematic Review of the Literature

BACKGROUND

The aberrant origin of the right subclavian artery (ARSA), also known as the lusoria artery, is a congenital malformation with an incidence of 0.5-4.4%. Most cases are incidental due to minimal clinical manifestations. Computer tomography (CT) is important in diagnosing and evaluating these patients.

MATERIALS AND METHODS

We conduct a computerized search in two databases, PubMed and EMBASE, for articles published between 1 January 2022 and 31 December 2023, PROSPERO code: CRD42024511791. Eligible for inclusion were case reports and case series that presented the aberrant origin of the right subclavian artery. The main outcome was the highlighting of the morphological types of ARSA. In this context, we proposed a new classification system of this anomaly. The secondary outcome was the evaluation of the demographic distribution of the lusoria artery.

RESULTS

Our search identified 47 articles describing 51 patients with ARSA. The typical course for ARSA is retroesophageal, being registered in 49 out of 51 patients. This malformation is frequently associated with Kommerell diverticulum (15 out of 51), troncus bicaroticus (7 out of 51), and aberrant origins of the right vertebral artery (7 out of 51). We observed a higher incidence of the condition among women (32 out of 51) compared to men (19 out of 51). From a demographic point of view, ARSA is more frequent in the "44 to 57 years" and "58 to 71 years" age ranges.

CONCLUSIONS

ARSA is a congenital malformation resulting from a defect in the development of the aortic arches. The imaging studies such as computer tomography play a defined diagnostic role.

Histological findings for the absorption of small and large liposomes - the basis of future drug delivery and contrast media systems

BACKGROUND AND OBJECTIVES

The purpose of our study was to obtain and characterize carrier systems in different sizes that can affect oral absorption, since the mechanisms of liposome absorption are not yet fully understood. From stomach to the small intestine, liposomes can be gradually destroyed. Understanding the factors that affect oral absorption leads to developing safe and effective nanosystems to improve the oral delivery of therapeutics.

MATERIALS AND METHODS

We determined the efficiency of the absorption of small and large liposomes at the level of gingival mucosa, heart, liver, testicles, kidneys, and lungs, using frozen-section fluorescence microscopy, on rat tissues after liposomes administration. A number of 36 male rats were divided in four groups: control groups, A and C, consisted of six rats each and did not receive liposomes; two other groups, B and D, were the experimental ones, and consisted of 12 male rats each. The animals received small liposomes (75-76 nm) and large liposomes (80-87 nm), respectively, administered either by endogastric tube or intraperitoneal injection. After 24 hours, the animals were sacrificed, and we harvested the organs. We performed frozen sections and analyzed them with fluorescence microscopy.

RESULTS

The frozen sections obtained from all organs revealed a higher absorption level of small liposomes in the testicles, liver, and gum, while the large liposomes had a greater affinity for the liver, with variations dependent on the route of administration.

CONCLUSIONS

Frozen-section fluorescence microscopy is a reliable technique for visualization of liposome absorption. Based on the size of these nanosystems, we revealed significant absorption for small liposomes in testicles, liver, heart, and gum, and for large liposomes mainly in the liver, compared with the control groups. The study advocates for the usage of liposomes for medical purposes, based on their absorption proprieties.

Sexual Dimorphism in the Buccolingual Dimensions of Permanent Anterior Teeth in the Young Iranian Population

Objective: Evaluation of sexual dimorphism is a crucial concern for anthropologists, forensic scientists, and archaeologists. Teeth have been used as an alternative tool to determine sex in forensic anthropology. However, it is necessary to use data specific to a particular population, as different populations exhibit varying degrees of sexual dimorphism. This study aimed to determine the sexual dimorphism in the buccolingual dimensions of permanent anterior teeth in the young Iranian population. Materials and methods:A total of 100 students (50 females and 50 males) participated in the current study. A total of 1200 permanent anterior teeth were examined. The buccolingual dimension of all anterior teeth was measured using Vernier Calipers with a calibration of 0.01 mm. Data were analyzed using an independent sample T-test and paired sample T-test, and a P-value of less than 0.05 was considered statistically significant. Results:The mean values of the buccolingual dimension of the maxillary canines on the right and left sides (13, 23) were statistically greater in males than females (P=0.04, P=0.03) and had the greatest percentage of sexual dimorphism (4.08% and 5.26%, respectively). Conclusion:The buccolingual dimension of Iranian canines could be used as a reliable material to identify gender in forensic studies, and the degree of sexual dimorphism varies among different populations. Therefore, it is essential to use the relevant data samples for each population. It was concluded that Europeans had the greatest amount of sexual differences in the anterior teeth, while Iranians had the least amount of sexual dimorphism in the anterior teeth.

Cervico-Dorsal Intramedullary Spinal Cord Abscess with Aspergillus fumigates following Pulmonary Infection in an Immunocompetent Patient

Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7-D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient's initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality.

Epidemiological and pathological characteristics of spinal metastases from gastrointestinal cancers - a series of 40 cases

Spinal metastases from gastrointestinal (GI) cancer are rare and as a result there are only case reports or small series in the literature. The aim of our work was to identify the demographic aspects, the location, and the histopathological aspects of spinal metastases from GI cancers diagnosed and treated in a reference Hospital in Romania over a period of nine years, and comparing the data obtained with those from the recent literature. This is a retrospective case series study on spinal metastases from GI cancers, developed in patients older than 18 years that were surgically treated between January 2013 and December 2021 within three Neurosurgery Clinics from Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iaşi, Romania, which is a tertiary Hospital in Romania regarding the surgical treatment of spinal metastases. We included in our study the patient's demographic data (age and gender), clinical data (location of spinal metastases), radiological investigations and pathological features of the lesions. Regarding the immunohistochemical stainings, the following antibodies were used: anti-cytokeratin (CK)7, anti-CK20, anti-CK19, anti-caudal-type homeobox 2 (CDX2), anti-human epidermal growth factor receptor 2 (HER2), and anti-Ki67. Our series included 40 adult patients (≥18 years old) with a male:female ratio of 3:1, in favor of male patients. The mean age of all patients was 66.42 years. The primary sites of spinal metastases from GI cancers were from all segments of the GI system: the most frequent, however, was from the colorectal level (40%) and the least from the oral cavity level (2.5%). The most common site of spinal metastases from GI cancer was predominantly lumbar region (47.5%), and the most frequent histological type was adenocarcinoma (57.5%), followed by hepatocellular carcinoma (27.5%), pancreatic ductal carcinoma (5%) and squamous cell carcinoma (2.5%). Our results have important clinical implications because they suggest that there are certain subsets of patients with certain types of GI cancers that cause metastases in certain regions of the spine.

Death-causing cardiac injuries after chronic alcohol intake identified by forensic medicine

Ethyl alcohol is the most consumed drug, worldwide, with frequent consequences on the individual’s health and lifestyle. Chronic alcoholism is a pathological state occurring after an excessive alcohol intake and may be observed in teenagers or very old individuals. The study performed by us investigated the changes caused by alcohol intake in the left ventricle myocardium in 77 bodies deceased at home under suspect circumstances and sent to the Institute of Forensic Medicine for establishing the cause of death. In all the individuals, there was determined high levels of blood Ethyl glucuronide, thus showing the alcohol intake up to 96 hours before death. The lesions present in the heart were represented by dilated cardiomyopathy, myocardial fibrosis, and myocardial infarction.

Brain metastases originating in breast cancer: clinical-pathological analysis and immunohistochemical profile

The incidence of brain metastases (BMs) originating in breast cancer (BC) is increasing due to advances in imaging techniques, which can detect such events early, and due to new therapies that can ensure longer survival. We performed a retrospective study on patients with BMs originating in BC and receiving surgical treatment in Neurosurgery Clinics of Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iaşi, Romania, from January 2018 to December 2019. We identified 10 consecutive patients who underwent a craniotomy for a BMs originating in a BC (either for diagnostic purpose or with therapeutic intent). Clinicopathological data were collected from the electronic medical record and included the patient demographics (age at diagnosis of their BM), morphological characteristics of BM [location, cytopathological features, histopathological (HP) subtype, and immunohistochemical features, i.e., cytokeratin 5/6 (CK5/6), mammaglobin, estrogen receptor (ER), progesterone receptor (PR), and Ki67 labeling index (LI)], and time from BC diagnosis to BM diagnosis. Ninety percent of patients were in their sixth and seventh decades of life, with a median age of 57.9 years (47–65 years). Median time from BC diagnosis to BM was 34.42 months. Fifty percent of BMs were located in the parietal lobes, and 70% of all cases have multiple (≥2) BMs. All cases (100%) had a cytopathological examination, showing a hypercellular pattern, with poorly cohesive clusters of mild or pleomorphic cells, with nuclei with homogeneously distributed fine granular chromatin membrane, and with small or enlarged and irregular nucleoli. The dominant histopathology was invasive breast carcinoma of no special type (IBC-NST) (70%), but we also identified specific subtypes, i.e., tubular carcinoma (TC) (20%) and invasive micropapillary carcinoma (IMPC) (10%). Correlating location with HP subtypes of BMs from BC, IBC-NST and IMPC were located mostly in parietal lobes, and TC developed only in the occipital lobe. We found three patterns of immunostaining: (i) CK5/6 +/-, mammaglobin+, ER+, PR-, which was much more characteristic for IBC-NST; (ii) CK5/6-, mammaglobin+, ER-, PR-, being identified in tubular breast carcinoma; (iii) CK5/6 +/-, mammaglobin-, ER-, PR-, which were revealed by invasive micropapillary breast carcinoma. Our study revealed the fact that BMs originating in BC show heterogeneity of hormone receptor status, although morphologically there is not so much diversity. We also found a very variable Ki67 LI, which correlated especially with the morphological subtype.

Hepatic injuries resulting from chronic alcohol abuse identified by forensics

Alcohol intake is largely spread all over the world, although it is well-known that it causes important changes of the liver, from liver steatosis, hepatitis to liver cirrhosis. The study we performed on 93 patients deceased in suspicious circumstances and brought to the Institute of Forensic Medicine, Iaşi, Romania, confirmed through the determination of Ethyl glucuronide, that these were alcohol consumers. The macroscopic analysis during necropsy highlighted the presence of alcoholic liver disease (ALD), while microscopy studies confirmed the macroscopic observations. The immunohistochemical studies showed the existence of a chronic liver inflammation, the transdifferentiation of stellate hepatic cells, the activation of Kupffer cells, important changes of the hepatic vascular network, hepatocyte necrosis, lipid loadings and the progression of liver fibrosis process.

Anatomical and Immunohistochemical Evaluation of Colorectal Cancer

Colorectal cancer is a malignant disease with high morbidity and mortality. Ki-67 is a marker of cell proliferation associated with a low survival in colorectal cancer patients. Its expression is increased in patients with Dukes C or D colorectal cancer versus those in stage A or B. The purpose of the study is to evaluate the immunohistochemical expression of the Ki-67 marker in colorectal adenocarcinomas. The study was performed on a group of 28 patients diagnosed with rectal cancer. We made the histopathological and immunohistochemical evaluation of patients in the study group. The evaluation was performed on the sections stained with hematoxylin-eosin, and for mucinous forms, on sections stained with alcian blue. The topography of the Ki-67 reaction is strictly nuclear, evident in areas with intense proliferative activity. In cases with a strong positive response to Ki-67, the prognosis is worse, with invasion of the perirectal tissues and metastases. The lack of Ki-67 expression in nearby neoplastic tissues suggests that cancerous tissue proliferates in a pathway that it is not correlated with adjacent tissues. The Ki-67 could be useful in the prognosis of patients with colorectal cancer.

Management of Collapse Tibial Plateau Fractures Using a Hydroxyapatite-Tricalcium Phosphate Ceramic(ATLANTIK�) and Plate Osteosynthesis

The treatment of bone defects in complex proximal tibial plateau fractures is a challenging situation and biphasic tricalcium phosphate (BCP) ceramics are considered the most promising alternative to autologous bone graft. The aim of the experimental part was to retrospectively asses the use of Atlantik� BCP (a mixture of 70% Hydroxyapatite and 30% beta-tricalcium phosphate) combined with plate osteosynthesis for management of 27 collapse tibial plateau fractures. All fractures healed after a mean time 2.8 months, while the mean time for disappearance the radiolucent zones between the implanted ceramic and receiving tissue was 15 weeks. We noticed a Neer score of 85 points with no reaction to bone substitute or evidence of biomaterial degradation. The study demonstrated that biphasic ceramic biomaterial Atlantik�, combined with supportive plate osteosynthesis, is an effective synthetic bone substitute due to a fast healing and good quality osseointegration.

Clinical-pathological correlations in Warthin tumors of parotid gland: a series of 10 cases

Warthin tumor is described using various terms, such as papillary cystadenoma lymphomatosum, adenolymphoma or monomorphic adenoma. It is a medical condition related to the salivary glands, namely a benign cystic tumor which contains an epithelial component and an abundant lymphoid stroma. It is also named Warthin tumor after Aldred Scott Warthin, the pathologist who described this entity in 1929 by observing it in two patients. Warthin tumor is a benign one and ranks secondly in terms of the most common not malignant salivary gland tumor located in the parotid gland. Because of its cystic nature, from the clinical point of view, it appears to be a slow-growing tumor often fluctuant on palpation. In terms of the treatment of choice, complete excision with wide tumor-free margins is preferred. The aim of the present article is to evaluate possible correlations between clinical-pathological features and postoperative complications in a target group made up of 10 patients diagnosed with Warthin tumor of the parotid gland admitted for surgery in a period of 21 years and to compare the results with literature.

The Use of Diacrylic Resins in Dental Restorations

The materials as well as the procedures used successfully in modern dental restorations are based on scientific selection criteria, which can predict outstanding results, both in terms of physiological aspects and the durability of the performed maneuvers.The rationale of using certain materials, as the success or failure in using certain techniques, has contributed to the evolution of dental restorations. The optimal way to combine the material with its applicability and finishing technique implies an exhaustive approach to the subject that still requires research, that adress to specialists, in order to improve its refinement and development.Among the restoration materials, those that satisfy the aesthetic requirements of the patients are considered to be composite resins. With all the advantages resulted from their intrinsic characteristics, it should be noted that composite resins still have inconveniences, primarily linked to the polymerization shrinkage, which causes a gap between the obturation and the dental tissue, resulting in the formationof marginal microinfiltrations with all the drawbacks associated with it. The purpose of the experimental research is to evaluate the marginal microinfiltrations at the level of the class II cavities restoration with composite diacrylic resins, according to various techniques of restoration and to establish the optimal technique to minimize side effects.

Anatomical considerations on the masseteric fascia and superficial muscular aponeurotic system

The masseteric region is considered by the most researchers as a subdivision of the parotideomasseteric region. Because of its surgical significance, we emphasize it has distinctive morphofunctional features. The aim of this manuscript is to highlight particular characteristics of the masseteric region and practical applications of this concept. The material used was represented by 12 embalmed cephalic extremities dissected in "Ion Iancu" Institute of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 10 operating specimens from the Clinics of Maxillofacial Surgery and Plastic Surgery of the "St. Spiridon" University Hospital, Iaşi, Romania, and computed tomography (CT) and magnetic resonance (MR) images from the same patients. Our results underline the importance and individual arrangement of the superficial muscular aponeurotic system (SMAS) of the face, at the level of masseteric region. The superficial fascia facilitates adhesion to the dermis of the mimic muscles of the region. This reveals that the masseteric superficial fascia will follow the masticatory movements of the mandible and masseter, but also those of the minor and major zygomaticus muscles. These muscles are the infra-SMAS layer and thus take part in the formation of a unitary complex together with the superficial fascia. The particularities of the SMAS in the masseteric region are especially important in plastic and reconstructive surgery.

The anatomical and functional characteristics of parotid fascia

Parotid superficial and profound fascias are considered to originate from a bifurcation of the profound fascia. Its relations with the facial nerve, the continuity with platysma, temporal and zygomatic fascias suggest it is related to a superficial fascial complex rather with a profound one. The aim of this study is to add clues which sustain the theory of parotid fascia origin from superficial fascia of the face. The study was conducted on 12 cephalic extremities, which were meticulously dissected in the "Ion Iancu" Anatomy Institute of "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania, and on a group of 10 patients admitted to the Clinic of Maxillofacial Surgery, "St. Spiridon" Emergency Clinical Hospital, Iasi, patients which were clinically and imagistically diagnosed [computed tomography (CT), magnetic resonance imaging (MRI)] with parotid tumors and underwent surgical interventions for total or partial parotidectomy. On each stage of dissection mesoscopic images were acquired, examined and further processed to remark the regional stratigraphic differences. Surgical interventions have allowed us segmental anatomical studies, providing in vivo visualization of the fascial and muscular structures, evaluating the possibilities of dissociating the plans and appreciating their vasculature. The collected specimens were processed by paraffin technique and stained with H special techniques for muscular and connective tissue. The results are clearly showing the belonging of parotid fascia to the superficial fascia of face.

Long-term survival in a patient with advanced gastric cancer and metachronous right-sided colon cancer

Gastrointestinal carcinomas represent the most common cancers worldwide. The coexistence of gastric cancer with metachronous colon cancer represents a rare phenomenon, and the prognosis of the patient is poor. We present here a case of an elderly patient with primary gastric intestinal type well-differentiated adenocarcinoma (pT3N0, stage IIA) who developed a metachronous right-sided colon cancer diagnosed and treated after 11 years from the first surgical intervention. Histopathological and immunohistochemical examination revealed a well-differentiated adenocarcinoma (strongly positive staining for cytokeratin 20 and CDX2), pT3N0 stage IIA. The patient is still alive and active after 16 years from his first surgical intervention, even though no treatment has done after the removal of his second cancer. In conclusion, in any case of gastric cancer, first the surgeon, and then the general practitioner should be alert to recognize a second primary tumor with different origin and to perform complete postoperative control. The correct diagnosis could lead to the patients' best prognosis.

Morphological changes in support mechanism of superficial face layers in Moebius syndrome

Moebius syndrome, also called congenital facial paralysis is a rare neurological disease, whose etiology is not fully elucidated. It affects especially facial and oculomotor cranial nerves and its clinical feature is peripheral facial paralysis. The objective of the study is to highlight the anatomical and functional changes in the Moebius syndrome and establish certain criteria that should be the basis for reparative surgery in this disease. For this purpose, we used a group of six patients diagnosed with this pathology, in whom we pursued functional anatomical and histological changes of the superficial layers of the face that we have grouped in terms of their clinical impact. All the data obtained were centralized in order to assess anatomical functional changes occurring after evolution in time of lesions caused by Moebius syndrome. The results of the study led us to conclude that the face is made up of three main regions - median, medial and lateral -, which behave differently both in atresia of the facial nerve and in healthy individuals. This has an important echo on the way we emphasized the functional anatomy of superficial layers of the face and in surgery.

CONSIDERATIONS ON ANATOMY AND PHYSIOLOGY OF LYMPH VESSELS OF UPPER AERO DIGESTIVE ORGANS AND CERVICAL SATELLITE LYMPH NODE GROUP

The almost constant local regional development of the cancers of upper aero digestive organs requires the same special attention to cervical lymph node metastases, as well as to the primary neoplastic burning point. The surgical therapy alone or associated has a mutilating, damaging character, resulting in loss of an organ and function, most of the times with social implications, involving physical distortions with aesthetic consequences, which make the reintegration of the individual into society questionable. The problem of cervical lymph node metastases is vast and complex, reason why we approached several anatomical and physiological aspects of lymph vessels of the aero digestive organs. Among the available elements during treatment, the headquarters of the tumour, its histologic degree, and its infiltrative nature, each of them significantly influences the possibility of developing metastases.

Supernumerary fronto-orbital arteries arising from contralateral anterior cerebral artery associated with partially duplicated anterior communicating artery - case study and literature review

The anatomical variations of the fronto-orbital artery are uncommon and rarely described in literature. During the dissection of a 64-year-old female formalized brain, we discovered a particular congenital abnormality regarding the arterial supply of the right fronto-orbital gyrus. We identified three arterial sources: a low caliber ipsilateral fronto-orbital artery that arises from the A2 segment of the right anterior cerebral artery and ends in the posterior part of the fronto-orbital gyrus, a large aberrant contralateral fronto-orbital artery that arises from the A2 segment of the left anterior cerebral artery, supplying most of the right fronto-orbital gyrus and a small accessory branch of the left anterior cerebral artery passing towards the contralateral fronto-orbital gyrus. These abnormalities are associated with a partially duplicated anterior communicating artery. This case shows a unique pattern of congenital brain vascular abnormalities that may have clinical and surgical implications.

Morphological aspects of the rectal neovascularization in colorectal cancer - anatomical-surgical and imaging implications

Colorectal neoplasia has an increasing incidence among the population, and this fact compels in achieving an early diagnosis and treatment protocols. The extramural vascular invasion (EMVI) score is a method used for staging cancer. It defines the presence of malignant cells in the blood vessels, outside its own vascular tunic. The purpose of the study is to evaluate the extramural vascular invasion, and thus the impact of this determination in diagnosis, treatment and prognosis of colorectal neoplasia. This was done using magnetic resonance images (MRI) of colonoscopic diagnosed patients with colorectal cancer and subsequently comparing these results with the control group of patients without malignancy. The EMVI criteria taken into account were correlated with the images obtained in patients in the study group. In each of the evaluated patients, we found both, arterial and venous blood vessels in 0 stage - EMVI correlated with T2 or T3 stage tumor. In T3 B stages, we could objectify suggestive images for stage 4 EMVI near and distant from the tumor. Blood and lymph vessels have a high density to their origin area and it decreases anteriorly. This distribution is consistent with a predisposition to the formation of a vascular rectal cancer, especially on the posterior wall. In conclusion, anatomical-imaging staging of colorectal cancers using EMVI score is very close to the colonoscopic diagnosis and to the accuracy of the classic cancer staging. Corroborating EMVI score with a vascular radiology reference pattern improves the accuracy for determining an appropriate treatment and assessment of prognosis.

Histopathological consequences of hyperzincemia on rat teeth. Experimental study

The aim of this study was to investigate the histopathological features of dental pulp in acute zinc (Zn) intoxication and to identify possible physiopathological mechanisms of the lesions. Twelve adult male Wistar rats were divided into two groups, the control one and the exposed group. Each animal from the experimental group received a single dose of zinc chloride (ZnCl2) by intraperitoneal injection. Blood samples were collected from exposed animals at 2, 4, and 6 hours after the injection and plasma Zn concentrations were determined by spectrophotometry. After six hours of observation, the animals were sacrificed and two teeth from every rat were removed. Twelve teeth were processed by standard histological technique using Hematoxylin-Eosin (HE) and Szekely trichrome stainings, and the other twelve were subjected to Schliff cutting-grinding technique. The experimental group showed increased plasma zinc concentration (0.46±0.06 mg÷L) after two hours and then slightly decreasing values in the next four hours. Undecalcified teeth did not showed any changing into the dentin or enamel structures, but decalcified teeth revealed numerous deposits into the dental pulp, which consisted of red acellular superposed sediments that could be made up of zinc with some plasma protein, or there could be an unknown compound which precipitated under the influence of zinc cation (Zn2+). We can presume that the dental pulp may be an elective place for zinc accretion and so it must be considered a potential target for this metal.

Electron microscopic aspects of the effects of certain prostaglandin analogs on mouse testes

Prostaglandins were highlighted in the seminal plasma and then in the rest of the male and female genital tract. Prostaglandin analogs, firstly used in obstetrics and gynecology, are now widespread in both sexes, especially in the treatment of gastric and duodenal ulcers, glaucoma, etc. Therefore, we tried to highlight the effects of repeated administration of Cloprostenol and CIPG isopropyl ester (both prostaglandin F2α analogs) for the male gonad. In our experiment, we used Cloprostenol and CIPG isopropyl ester. We used three groups of white, male mice, aged 50-80 days, kept in standard laboratory conditions, which received the same feed. Each group included 12 mice. The first batch was the control group and received no substance at all. The second batch received 25 μg/kg of Cloprostenol dose per body per day, intraperitoneal administration (a single dose per day) on a daily basis for a four weeks period of time. The third batch received a 25 μg/kg CIPG isopropyl ester dose per body/day intraperitoneal administration (a single dose per day) on a daily basis for a four weeks period of time. After 7, 14 and 28 days of treatment, we sacrificed four animals in each of the batches by cutting their carotid arteries. The prostanoid analogs we used, Cloprostenol and CIPG isopropyl ester, have similar actions on male gonad in mice. These analogs induced significant changes in the evolution of the spermatogenesis and spermiogenesis. In relation to the treatment duration there were cellular changes suggesting apoptosis in different stages. With regard to spermiogenesis, the ultrastructural aspects indicate a decrease of the sperm structuring processes, especially in the acrosomal apparatus and chromatin.

Echinocandins--new antifungal agents

Over the past 10-15 years, the number of clinically available antifungal agents has increased substantially, due to rise in the number of invasive fungal infections, which are a real problem for specialists. Echinocandins are the new class of antifungal agents available for clinical use. This class comprises over 20 natural echinocandins and several semisynthetic ones. Natural echinocandins are not of clinical utility due to their toxicity and low water-solubility (which does not allow obtaining parenteral pharmaceutical forms), although they have good antifungal activity against Candida species. Consequently, semisynthetic echinocandins with minimal toxicity, good antifungal activity and high water-solubility were obtained. All echinocandins inhibit beta-1,3-glucan-synthase, an essential component of the fungal cell wall. Echinocandins exhibit potent antifungal activity against key pathogenic fungi, including Candida species, Aspergillus species and Pneumocystis carinii. The available echinocandins lack in vitro activity against Cryptococcus neoformans. The semisynthetic echinocandins have great advantages, among which low toxicity, fast antifungal activity, favorable pharmacokinetics that allow once-daily administration. The echinocandins recently available for clinical use are: caspofungin, micafungin and anidulafungin.

Early onset of podocytes apoptosis - a TEM study in streptozotocin-induced diabetic rats

Cell death types are usually defined by morphological criteria. Even though podocyte loss is associated with various cell death mechanisms, podocyte apoptosis is rarely detected. The purpose of this study is to evaluate whether morphological signs of apoptotic cell death could be detected in early streptozotocin-induced diabetes in rats kidneys. There were used five Wistar rats, and renal tissue samples were drawn after three weeks of disease and further evaluated in transmission electron microscopy (TEM). Podocytes damage was indicated by two major findings: foot processes effacement, viewed as loss of cell processes, and chromatin condensation and margination (partial karyopyknosis: peculiar nuclear morphologies - partly normal, euchromatic, and partly positive for karyopyknosis and nuclear shrinkage). Mitotic glomerular endotheliocytes were also encountered. Podocytes cell death commitment and detachment appeared as concomitant events. However, karyopyknosis is not a specific feature of apoptosis. Thus, further biochemical evaluations are needed to distinguish between different pathways of podocytes death.

Morphological changes of the peritoneal membrane in patients with long-term dialysis

Morphological alterations of peritoneum in chronically dialyzed patients involve fibrosis and angiogenesis as pathogenic mechanisms. The aim of this retrospective study was to evaluate morphological changes of peritoneum in chronic peritoneal dialysis (PD) at 4, 8, 12, and 14 years. Peritoneal changes were investigated in 110 patients with end stage renal failure, which were included in a PD program. Intraoperative biopsies were grouped in four study Groups (A: 1-48 months, B: 49-96 months, C: 97-144 months, and D: 145-168 months), and were processed histologically and stereologically. Mesothelial denudation was found in percentage volumes of 5.49% - Group A, 16.10% - Group B, 16.68% - Group C and 19.88% - Group D. Reduplication of the basement membrane was observed in patients with over five years of PD. Interstitial stromal fibrosis recorded percentage volumes of 25.49% (Group A), 26.10% (Group B), 35.85% (Group C) and 56.63% for the patient with 14 years of PD. Subendothelial hyalinizing vasculopathy was recorded in percentage volumes of 2.22%, 6.63%, 9.16% up to 9.20%. Vascular permeability reduction was recorded as decreasing percentage volumes from 22.59% to 12.81%, 7.77% and 7.37%. Perivascular inflammation was marked in the serosa of the patients in Group A (4.55%). Calcifications recorded percentage volumes of 1.63% at eight years, 3.74% at 12 years and 4.03% at 14 years of PD. Peritoneal morphological changes appear at 3-4 years of PD and progressively aggravate with long-term PD.

[Anatomo-clinical considerations regarding the celiac-mesenteric junction]

AIM

This work points out the access ways - both the classical ones and the ones less known and used - to the origin and the first centimeters of the superior mesenteric artery (SMA), underlining the advantages and disadvantages of each of them.

MATERIAL AND METHOD

Our work is based on dissection of 30 human bodies and 200 selective arteriographies.

RESULTS

There are two classical ways to access the first part of SMA: inter-duodeno-pancreatic and the left thoraco-abdominal ways.

CONCLUSIONS

An access way to the origin of the SMA is necessary for the revascularisation through different techniques of the visceral territory depending on the SMA, taking into account the fact that at this level we have the most frequent localization of the atheroma plaques, which leads to acute or chronic intestinal ischemia (manifest in the form of postprandial abdominal 'angor').