Histopathological features in esophageal atresia with lower esotracheal fistula

State University of Medicine and Pharmacy „Nicolae Testemitanu”, Institute Center of Mother and ChildIntroduction. Despite the success obtained in reconstructive operations of esophageal atresia, a major frequency of complications documented in the postoperative period has been still persisting, including dysphagia, gastroesophageal reflux, esophageal peristaltic disorders etc. Aim to analize the spectrum of morphopathological changes revealed in cases of esophageal atresia with lower esophageal-tracheal fistula and to establish the role in the development and evolution of postoperative complications. Methods: Histopathological study was conducted on 21 patients. It included autopsy materials performed on unoperated specimens from 8 newborns with esophageal atresia and lower esophageal-tracheal fistula, and in 13 cases from operated newborns. Serial sections both of the proximal segment (sealed/blunt) of the esophagus and of the distal segment to the fistula were made. Results: On the level of the atretic segment of the esophagus (sealed/blunt), the esophageal wall was characterized by a well differentiated structure, the proper muscular coat of the submucosa being frequently hypertrophied. The submucosa exhibited a dense fibrillar connective tissue with predominance of collagen fibers, with their emphasis towards the atretic end. Reduction of autonomic and myenteric nervous network was found in different ratio in the muscular coats (circular and longitudinal layer). The muscular coat located focally or regionally was often substituted by plates of collagenized and mesenchymal connective tissue. The distal fistulated segment of the esophagus was characterized by advanced dysplastic changes, absence of muscular coats or its reduction, with presence of chaotic hypotrophic or hypertrophic fibers or bundles, arranged in a mass of connective tissue. Compared with the proximal segment, including the region of the fistulous orifice, in some cases presence of glandular structures of pseudoadenomatous and cystic appearance was observed. There could be observed ganglioneuronal structures with vascular and granular dystrophy on the level of fibro-muscular dysplastic processes in areas which showed presence of nervous myenteric network. Conclusion: The results of this study allowed to confm obvious structural pathological changes that may significantly influence regenerative-reparative processes and postoperative esophageal motility after reconstructive operations

The estimation of the peculiarities and the activity degree of the consisting inflammatory processes in the benign prostatic hyperplasia

Secţia Urologie, IMSP Spitalul Clinic Municipal “ Sf. Treime”, Catedra Morfopatologie, USMF „N. Testemiţanu”, Secţia Ştiinţifică Morfopatologie, IMSP Institutul de Cercetări Ştiinţifice în Domeniul Ocrotirii Sănătăţii Mamei şi Copilului, Catedra Urologie şi Nefrologie Chirurgicală, USMF „N. Testemiţanu”, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. The conducted study has the aim to estimate the histopathological peculiarities of the inflammatory processes, evaluated in prostatic nodular hyperplasia, the character and the activity of these processes in the area of nodular hyperplasia structures, and the border limit in the adenectomy. The results of the morphopathological study allowed detailed diagnosis of the prostatic hyperplasia. Severe modifications of inflammatory origin and considerable implications of the structural-architectonical components indicate concomitant persisting or coexisting of chronic or acute prostatitis. The establishment of the lesion character, activity degree of the inflammatory process, saving border limit in the surgical management regarding the residual cavity of cleavage and postoperative prognosis was the second aim of the study. It facilitates the choice of the best therapeutic and surgical approach. The character of the inflammatory processes coexisting with prostatic benign hyperplasia was evaluated. A clinical-morphological concept of inflammatory associations in prostate benign hyperplasia was formulated