The influence of the tumoral cell proliferation rate in pituitary adenoma on expressing other factors with a prognostic role and therapeutic potential

Department of Morphopathology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: This article describes the growth rate of pituitary adenomas, their invasion and potential recurrence. Some of them grow rapidly while others remain in a dormant condition for a long time. The recurrence rate is also very hard to forecast. The pituitary adenomas that initially reduced their proliferation rate now acquire a rapid one, producing aggressive recurrences. Materials and methods: Eighty two cases of pituitary adenomas were studied. The classification of human pituitary adenomas has been profoundly assisted by immunohistochemistry. Ki-67 antibody was used to assess the proliferative index of pituitary adenomas. Results: Acidophil type adenomas or acidophil cells areas within mixed pituitary adenomas had the highest proliferation rate. Chromophobe pituitary adenomas were Ki67 negative in 90%, as well as the ones that presented the basophilic cells. The pituitary adenomas with a trabecular growth pattern had the lowest rate of proliferation, in about 50% of the cases being zero. The heterogeneity expression of growth factors and corresponding receptors is dependent on hormonal profile of pituitary adenomas. Conclusion: The pituitary adenomas proliferation rate depends on the type of secreted hormone as well as on the hormonal associations met in some cases of pituitary adenomas

Colorectal polypoidal formations: prevalence and therapeutic approach

Scopul lucrării. Datele GLOBOCAN 2021 arată o creștere esențială a ratei morbidității, cancerul colorectal (CCR) ocupând al doilea loc după mortalitate. Cunoașterea detaliată a caracteristicilor leziunilor premaligne este foarte importantă, întrucât rezolvarea acestora conduce la diminuarea semnificativă a riscului de apariție a CCR. Scopul studiului este evidențierea numărului și tipului formațiunilor protruzive descoperite la nivelul unui eșantion de populație. Materiale și metode. Studiu prospectiv pe 85 pacienți cu leziuni precursoare maligne (polipi), depistate la colonoscopia diagnostică în 2018-2022 în cadrul IMU (Chișinău). Indiferent de gen sau vârstă, pacienții incluși în studiu au necesitat colonoscopie pentru stabilirea diagnosticului, fără a fi examinați colonoscopic anterior. Au fost analizate variabilele: date demografice, localizarea și morfologia formațiunilor, precum și atitudinea terapeutică. Rezultate. Dimensiunile polipilor au variat între 2 și 40mm, fără semnificație statistică între genuri (p>0.05); localizare: hemicolonul stâng – 66(76.6%), drept – 12(14.1%), transversul – 7(8.3%); histologic: 95% polipi de tip neoplazic, predominând cei tubuloadenomatoși – 37(43.5%), tubulo-viloși – 29(34.1%). Examenul anatomo-patologic a relevat: displazie ușoară – 68(80%), moderată – 14(16.5%), severă – 3(3.5%). În toate cazurile cu displazie ușoară/moderată s-a practicat polipectomie endoscopică, suficientă ca act terapeutic. În displazia severă – atitudine oncologică: rezecție recto-sigmoidiană cu ileostomie (n=1) și rezecție colonică cu anastomoză primară (n=2). Follow-up postpolipectomie la fiecare 6 luni – fără recidivă. Concluzii. CCR, fiind în majoritatea cazurilor o consecință evoluției polipilor adenomatoși maligni, diagnosticul precoce a acestora urmat de polipectomie, reduc considerabil riscul de dezvoltare a neoplaziilor colorectale.Aim of study. Data provided by GLOBOCAN 2021 show a significant increase in the morbidity rate, with colorectal cancer (CRC) taking second place in terms of mortality. Detailed knowledge of premalignant lesions, as their removal leads to decrease in the risk of developing CRC. The aim is to analyze the number and type of protrusive formations discovered globally, at the level of a sample population. Materials and methods. Prospective study on 85 patients with malignant precursor lesions (polyps), detected after diagnostic colonoscopies, performed at Emergency Hospital (Chișinău), during 2018-2022. Regardless of gender or age, the patients included in the study required colonoscopy for diagnosis, without having previously been colonoscopically examined. The variables were analyzed: demographic data, location and morphology of formations, as well as therapeutic attitude. Results. The size of the polyps varied between 2 and 40 mm, without statistically variations between sexes (p>0.05). Location: left colon – 66(76.6%), right – 12(14.1%), transverse colon – 7(8.3%). Histologically, 95% of polyps – neoplastic type, predominating tubulo-adenomatous – 37(43.5%), tubulovillous – 29(34.1%). Anatomical-pathological examination: low dysplasia – 68(80%), moderate dysplasia – 14(16.5%), severe dysplasia – 3(3.5%). In cases with low/moderate dysplasia – polypectomy: sufficient as a therapeutic act. In cases with high dysplasia – oncological approach: in 1 case – rectosigmoidian resection with ileostomy and in 2 cases colonic resection with primary anastomosis. After polypectomy, patients have been followed every 6 months – without recurrency. Conclusions. Because a large number of cancers arise from malignancy adenomatous polyps, their diagnosis in the premalignant phase followed by polypectomy considerably decrease the chance of the occurrence of colorectal neoplasia in the future

Современные аспекты атерогенеза

The basic postulate of atherosclerosis etiology and pathogenesis has changed during the last decade. This study, carried out on the human aorta and coronary heart vessels collected on 64 autopsies performed shortly after demise. Those with with cardiovascular insufficiency and an atherosclerosic background from 31 to 69 years of age were taken into the study group. Apoptotic cells were identified using terminal deoxynucleotidyl transferase (TUNEL). The TUNEL-labeled nuclei were found mainly in the region of the plaque that shows a dense infiltration by macrophages. The death of foam cells at the edge of the lipid core shows both necrosis and apoptosis. The remnants of apoptotic nuclei are also present in the lipid core. Apoptosis plays a key role in regulation of cell accumulation during atherosclerosis. It suggests involvement of ICE in SMC death in fibrous regions of complex atheroma and in macrophage death in the lipid-rich core of the lesions.На протяжении последнего десятилетия основные постулаты этиологии и патогенеза атеросклероза претерпели значительные изменения. Наши исследования были проведены на аорте, коронарных артериях сердца и сонных артериях на этапе раннего патологоанатомического вскрытия у умерших в результате церебро- и кардиососудистых патологий на фоне атеросклероза. Апоптотические клетки были идентифицированы TUNEL-методом. Tакже был подтвержден апоптоз макрофагов, клеток гладкой мускулатуры и эндотелиальных клеток. TUNEL-положительные ядра преимущественно были обнаружены в области бляшки богатой макрофагами. Смерть пенистых клеток может быть вызвана как некрозом так и апоптозом. Остатки этого процесса присутствуют в некротическом ядре бляшки. Апоптотический процесс играет решающую роль в регулировании клеточных отложений, вызывает смерть клеточных элементов в области фиброзной капсулы, провоцируя дестабилизацию и разрыв бляшки

Impactul factorilor eco-agrotehnici la formarea calităţii strugurilor pentru producţia de vinuri roze

This article containsstate-of-the-art data in technology of rosè wines productionand their colourindices. In addition, a complex of factors is presented,all required for tipical colour formation during the primary stages of winemaking and extraction of antocyans obtained from red grapes is presented. Newtechnologies were proposed for obtaining rosè wineswitha low and high content of phenolic components. Some hypotheses are formulated regarding the technologicalrequirements for rosè winesand a number of important challenges in modern winemakingare registere

An alarm signal for the medical world addressed from the pathological anatomy service in the Republic of Moldova

Department of Morphopathology, Nicolae Testemitsanu State University of Medicine and Pharmacy Chisinau, the Republic of Moldova, Department of Microscopic Morphology/Histology, Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaBackground: Maintaining the quality and safety of pathology services is crucial for the efficient delivery of health care. However, pathology is, perhaps, the least understood of the medical specialties. In particular, the scope of pathology and the integral role it plays in all areas of medicine are not well recognized even by some of those working in health care environments. Strategic partnerships have as the main goal the enlargement of collaborative research and partnership on national and international level, mainly, but not exclusively in European Research Area. There is a perceived need for improved management practices, use of new technologies, and increased use of some categories of the personnel. Issues with the employment program were mentioned, including tracking, matching people to jobs, training, and finding more opportunities. There was a call for greater visibility in the community (both medical and scientific). The problems facing pathology teaching and pathology teachers mirror those of most other medical disciplines, namely a lack of time and money, and competing pressures from many other sources. Conclusion: There is the danger of producing doctors who cannot explain disease to their patients, who abuse laboratories and who have no interest in pursuing pathology as a career, leading to a slow and possibly irreversible decline in pathology as a medical profession

Fitobezoarul gastric asociat cu ulcere gastrice hemoragice

Bezoarele gastrice sunt formaţiuni rar întâlnite în practică. Ele se pot forma în stomacul sănătos ca rezultat al alipirii diverselor substanţe indigerabile şi incapacităţii lor de a trece de pilor. În mod clasic bezoarele apar drept complicaţii ale operaţiilor pe stomac care creează un mediu slab acid, scad motilitatea gastrică şi dereglează funcţia pilorică normală. Prezentăm un caz de fi tobezoar gastric la un pacient de 20 ani, complicat cu ulcere gastrice hemoragice, rezolvat prin rezecţie gastrică tip Billroth I

Treatment pecularities of the spleen injuries in politraumas

Clinica Chirurgie N1 “N. Anestiadi”, Laboratorul ”Chirurgie Hepato-Pancreato-Biliară, USMF „N. Testemițanu”, Chișinău, Republica Moldova, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Actualitatea temei. Dilema tratamentului chirurgical în leziunile splinei în condiții de politraumă constă în necesitatea efectuării unei hemostaze sigure care deseori se asigură numai prin splenectomie, iar pentru profilaxia complicațiilor postoperatorii situația dictează efectuarea unei operații organomenajante.Scopul lucrării: Implementarea operațiilor organomenajante pe splină în condiții de politraumă. Material şi metode: Au fost supuşi studiului 155 pacienți politraumatizați cu leziuni ale splinei. Tactica medico-chirurgicală de tratament a fost următoarea: splenectomie 122 (78,71%), tratament non-operator 2 (1,29%), aplicarea TachoCombului – 5 (3,23%) suturare+TachoComb+omentopexie 3 (1,93%), suturare + TachoComb – 7 (4,52%), omentopexie – 5 (3,22%), splenorafie 11 (7,1%). Atitudinea organomenajantă a fost efectuată la pacienții hemodinamic stabili sau stabilizați cu leziune anatomica ce corespunde gradului I–III (American Assosiation for the Surgery of Trauma) în lipsa patologiei splinei şi a coagulopatiei. Repartizaerea pacienților care au beneficiat de tratament organomenajant conform gradelor leziunii splinei : grad I–6, II– 15, III–12. Rezultate: În condiții de politraumă prezervarea splinei s-a obținut în 21,29 %. Complicații hemoragice postoperatorii n-am avut. Mortalitatea în lotul de studiu a constituit 35 (22,58%). Cauzele deceselor au fost: traumatismul asociat sever (14), şocul hipovolemic ireversibil (5), sindromul CID (2), insuficiența poliorganică (11), complicații septice postoperatorii (3). Concluzii: Posibilitatea efectuării operațiilor organomenajante pe splină în condiții de politraumă se estimează la ~ 20 % şi se aplică în leziunile ce corespund gradelor I–III (American Assosiation for the Surgery of Trauma).Introduction: The dilemma of the surgical treatment with the spleen injuries in politraumas necessities a proper homeostasis which is made by a splenectomy and for the prophylaxis of the postoperative complications a save-organ operation should be made. Aim: Save-organ operations usage in politraumas. Material and methods: 155 patients with politraumas were studied. The following medico-surgical strategy was used: splenectomy – 122 (78,71%), non-operative treatment – 2 (1,29%), TachoComb application – 5 (3,23%), spleenoraphy +TachoComb+omentopexy – 3 (1,93%), spleenoraphy+TachoComb – 7 (4,52%), omentopexy – 5 (3,22%), splenoraphy – 11 (7,1%). Save–organ method was applied on the hemodynamic steady patients or established by anatomical lesion of the 3rd grade (American Association for the Surgery of Trauma) in conditions of the spleen pathology and coagolapathy lack. The classification of the patients which were treated according to the save-organ method according to the grades of the spleen lesions: I–6, II–15, III–12.Results: In conditions of politraumas the preserving of the spleen was possible 21,29 %. Postoperative hemorrhagic complications were absent. Mortality – 35 cases (22,58%). The death reasons: associate severe trauma (14), irreversible hypovelmic shock (5), CID (2), multiorgan failure (11), postoperative septic complications (3).Conclusions: The possibility of the save-organ operations on the spleen in politraumas constitutes ~20%, and must be applied on the injuries of I–III grades (American Assosiation for the Surgery of Trauma)

Heteronuclear {TbxEu1-x} furoate 1D polymers presenting luminiscent properties and SMM behavior

We report the synthesis, crystal structure and photo-magnetic properties of novel Tb/Eu polymeric complexes of general formula {TbxEu1−x(α-fur)3(H2O)3}n, supported by 2-furancarboxilic acid: the homonuclear Tb(III) complex {Tb} (1), four heterodinuclear complexes, {Tb0.8Eu0.2} (2), {Tb0.7Eu0.3} (3), {Tb0.3Eu0.7} (4), and {Tb0.1Eu0.9} (5), and the homonuclear Eu(III)-only complex {Eu} (6). X-ray diffraction experiments show that the α-furoate ligands, acting in bridging mode, consolidate the 1D polymeric chains along the c-axis. Luminescence studies show the sensitization capability of the furoic acid ligand. Color tuning from green to red can be successfully achieved through the heterodinuclear strategy. We have measured Eu emission by direct excitation at the resonant 7F0 → 5L6 (395 nm), and indirectly, by excitation of the non-resonant wavelength (280 nm) which provokes ligand → Tb → Eu energy transfer. Besides, ac susceptibility measurements under varying frequencies and temperatures reveal that mixed {TbxEu1−x} complexes exhibit field-induced slow relaxation dynamics, with extremely slow relaxation times, owing to direct processes affected by the bottleneck effect. Thus, the {TbxEu1−x} complexes represent interesting low-dimensional multifunctional materials combining both luminescent and SMM magnetic properties

Heteronuclear {TbxEu1-x} furoate 1D polymers presenting luminescent properties and SMM behavior

We report the synthesis, crystal structure and photo-magnetic properties of novel Tb/Eu polymeric complexes of general formula {TbxEu1-x(a-fur)3(H2O)3}n, supported by 2-furancarboxilic acid: the homonuclear Tb(iii) complex {Tb} (1), four heterodinuclear complexes, {Tb0.8Eu0.2} (2), {Tb0.7Eu0.3} (3), {Tb0.3Eu0.7} (4), and {Tb0.1Eu0.9} (5), and the homonuclear Eu(iii)-only complex {Eu} (6). X-ray diffraction experiments show that the a-furoate ligands, acting in bridging mode, consolidate the 1D polymeric chains along the c-axis. Luminescence studies show the sensitization capability of the furoic acid ligand. Color tuning from green to red can be successfully achieved through the heterodinuclear strategy. We have measured Eu emission by direct excitation at the resonant 7F0 ¿ 5L6 (395 nm), and indirectly, by excitation of the non-resonant wavelength (280 nm) which provokes ligand ¿ Tb ¿ Eu energy transfer. Besides, ac susceptibility measurements under varying frequencies and temperatures reveal that mixed {TbxEu1-x} complexes exhibit field-induced slow relaxation dynamics, with extremely slow relaxation times, owing to direct processes affected by the bottleneck effect. Thus, the {TbxEu1-x} complexes represent interesting low-dimensional multifunctional materials combining both luminescent and SMM magnetic properties

Cardiovascular syphilis. Syphilitic aortitis. Clinical cases

Secția Chirurgie Malformații Cardiace Congenitale, IMSP Spitalul Clinic Republican ”Timofei Moșneaga”, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Sifilisul cardiovascular este o formă tardiva a sifilisului visceral, care se manifestă prin mezaortită. În majoritatea cazurilor se complică cu anevrism a aortei , insuficiența valvei aortice și stenozarea ostium arterelor coronare. Material și metode: Prezentăm 3 cazuri de anevrism aortic sifilitic operați în Spitalul Clinic Republican,”Timofei Moșneaga”. Diagnosticul a fost confirmat preoperator prin investigații imagistice (Radiografie, CT vaselor magistrale) și investigații de laboratorserologice, iar postoperator confirmate prin histologia fragmentelor de aorta anevrismatică înlăturate. La toți 3 pacienți s-a intervenit chirurgical – Înlocuirea segmentului aortal anevrismatic, la 2 pacienți a fost nevoie de arrest circulator în condiții de hipotermie. Rezultate: Perioada postoperatorie la 2 pacienți (operați în condiții de arest circulator) complicată cu encefalopatie cu ameliorare treptată. Pacienții detubați în primele 30 de ore după intervenție. Externați la a 14-a zi postoperator. Plăgile cicatrizate per prima. Concluzii: Intervenția chirurgicală este metoda de elecție in tratamentul anevrismelor aortale sifilitice. Depistarea și tratamentul chirurgical al anevrismelor aortale sifilitice reduce numărul complicațiilor severe prin ruptura de anevrism.Introduction: Cardiovascular syphilis is a late form of visceral syphilis, which is manifested by mezaortitis. In most cases, it is complicated by aortic aneurysms, aortic valve insufficiency and coronary artery stenosis. Material and methods: We present 3 cases of aortic aneurysm caused by syphilis hospitalized in the cardiac surgery department. The diagnosis was confirmed preoperatively by imagistic investigation (X-Ray, CT), and serological investigations. Postoperatively confirmed by the histology of the removed aneurysmatic aortic fragment. All patients were surgically intervened by prostheses of the affected aortic segment, in 2 patients there was a need for circulatory arrest under conditions of hypothermia . Results: Post-operative period in 2 patients (operated under circulatory arrest) was complicated with encephalopathy that gradually ceded. Patients were extubated within the first 30 hours after syrgery. Discharged after 14 postoperative days. Primary scarring healing. Conclusions: Surgery is the method of choice in the treatment of aortic aneurysms caused by syphilis. The detection and surgical treatment of aortic aneurysm caused by syphilis reduces the number of severe complications represented by rupture of aneurysm