Detection of epidermoid squamous-cell carcinoma by laser induced autofluorescence – preliminary results

Epidermoid squamous-cell carcinoma is by far the most common malignant tumor of larynx (95-96%), representing 1.6-2% of cancers in men and 0.2-0.4% of malignancies in females, with a world growing incidence and a slight dominance in urban areas. By exposing cells and tissues to UV light, the excitation of naturally occurring chromophores occurs in part by non-radiative deactivations, in part via fluorescence emission. Using laser induced autofluorescence (LIAF) in natural tissues not impregnated with photosensitizers as a noninvasive autofluorescence technique for both diagnosis and intraoperative assessments of laryngeal cancer we can improve the tumor malign identification in vivo. A total of three laryngeal biopsies (i.e. three pairs of tissues, each pair containing a healthy and a tumor tissue sample extracted from the same patient) were considered in this study. The samples were collected from patients previously diagnosed with stage T3 laryngeal carcinoma. Immediately after the surgery fragments of normal tissue and neoplastic tissue were collected, fragments of which later, after freezing, were sectioned in 25-30 μm thickness slices and stretched to quartz slides. All samples were subjected to controlled laser irradiation using a pulsed diode laser (λ=375nm, pulse width=87ps, frequency 31MHz) and the autofluorescence and its lifetime were collected using two optical fibers (inner diameter 400µm and 1500µm, respectively) positioned in a 45o geometry. The signals were recorded using a spectrograph and a photo-sensor module, the output of which was fed to a digital oscilloscope. We assessed the impact of laser induced autofluorescence and autofluorescence lifetime measurements in order to identify the differences between healthy and tumoral laryngeal tissue and outlining them, in terms of differences between the laser autoinduced fluorescence averaged intensity. The results determined the usefulness of laser induced spectroscopy in the diagnosis of laryngeal squamous cell carcinoma, discriminating between the malignant and normal tissue by analyzing the differences in spectral autofluorescence intensity and autofluorescence lifetime. Acknowledgements: This work has been financed by the National Authority for Research and Innovation in the frame of Nucleus programme - contract 4N/2016 and the project number PN-II-IDPCE-2011-3-0922. The authors thank Prof. M. L. Pascu for permanent support in performing this research

ACUTE RECURRENT PANCREATITIS MAY HAVE A INDICATION FOR SURGICAL TREATMENT?

Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Retrospective study that include the patients admitted to hospital with diagnosis of acute pancreatitis, with at least one episode of acute pancreatitis in medical history, in General Surgery Clinic of the Bucharest Emergency Clinical Hospital during January 2016 – December 2018. From the total of 77 patients admitted to hospital with diagnosis of acute pancreatitis, with at least one episode of acute pancreatitis in medical history, from a ethiological point of view of the acute episode, dietary excces was found in 57% of cases, 30% being chronic consumers ethanol, 14% of patients were obese, 22% had diabetes (half of them with poor blood glucose control), 8% had severe complications during hospitalization, 5% requiring surgery. The mortality rate among patients with acute recurrent pancreatitis was 2.6%. In the study group, recurrent episodes of pancreatitis were more frequent in males (74%), especially associated with obesity and alcohol consumption. The success rate of conservative treatment was 95%, even in the presence of episodes of acute pancreatitis and comorbidities. Acute recurrent pancreatitis is a disease that affects decades of age 50-60 years. It mainly targets male patients in the context of obesity and alcohol consumption. Patients who had diabetes mellitus with poor control had a poor development. The main treatment remains conservative, with a positive response for 95%, of the patients included in the study