Biomedical subjects
Publications and source records attributed to A Blidaru.
The paper is a retrospective study about complex treatment (surgery, chemotherapy and radiotherapy) in a group of 25 patients with retinoblastoma. The best results were in patients with early diagnosis, who came soon after surgery for chemotherapy and radiotherapy. Non presentation for chemotherapy and radiotherapy was the main cause of therapeutical fail.
The false acute abdomen is a real Clinic picture. In pur experience it represents the 0.63% of acute surgical abdomen. Sometimes diagnosis could escage because patient's erethism. To obviate this event surgeons must reach a detailed history, perform a complete pshysical examination and repeat clinical evaluation many times above all when then the clinical picture is dubious. Laboratory and instrumental tests could be useful to reach accurate diagnosis. However, in our opinion, when clinical and physical examination are unclear, sometimes in spite of disappointment of other physicians, do explorative laparotomy is better is than non-treatment of an acute surgical abdomen. False acute abdomen.
The evolution of conceptions regarding the treatment of "operable" mammary cancer has balanced during the past 25 years between amputation of the mamma and non-mutilating treatments. The main achievements concerning the evolution of this site of cancer, as well as the selection criteria for a limited operation, such as they result from the literature and from the studies performed by the authors, are pointed out. These criteria, although numerous, should be very rigorously observed. The cooperation surgeon-radiotherapist-anatomo-pathologist is absolutely compulsory. Authors report 16 cases of women with mammary cancer, in 9 of whom the criteria were carried out. The results obtained are for the time being favourable but as the group is very small, definitive conclusions cannot be drawn.
The goal of our study was to analyse the prognostic values for some matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in breast cancer. We evaluated the activity and the expression levels of MMP-9, MMP-2, TIMP-1 and TIMP-2 in malignant versus benign fresh breast tumor extracts. For this purpose, gelatinzymography, immunoblotting and ELISA were used to analyse the activity and expression of MMPs and TIMPs. We found that MMP-9 expression level and activity are increased in malignant tumors. In addition, MMP-9/TIMP-1 and MMP-2/TIMP-2 ratio values obtained by us were significantly different in malignant tumors compared to benign tumors. We suggest that the abnormal MMP-9/TIMP-1 balance plays a role in the configuration of breast invasive carcinoma of no special type and also in tumor growth, while altered MMP-2/TIMP-2 ratio value could be associated with lymph node invasion and used as a prognostic marker in correlation with Nottingham Prognostic Index. Finally, we showed that in malignant tumors high expression of estrogen receptors is associated with enhanced activity of MMP-2 and increased bcl- 2 levels, while high expression of progesterone receptors is correlated with low TIMP-1 protein levels.
Immune control is achieved by the balance between tumour reduction mechanisms and the "immunological creeping" phenomenon. The purpose of this study was to look into the alterations of the immune effector component in the case of mammary tumours. The study included 42 cases of women with a clinical diagnosis of mammary tumour, initially referred for surgery, with a mean age of 45.07 (18-65 years of age). Neither radiotherapy nor chemotherapy had been given to the patients before surgery. Histopathological examination performed intraoperatively as well as later, under paraffin, revealed 12 cases of malign tumours. The control group consisted of 18 women (blood donors), apparently healthy, with a mean age of 41 (30-49 years of age). In both groups, the immune status was assessed by means of: lymphocyte counts, T-lymphocyte counts (TL), rosetting, lymphocyte blastic transformation test (BLT) under the action of polyclonal mitogens, immunoglobulin dosing and Interleukin-2 (IL-2) determination in lymphocyte cultures stimulated with mitogens. The conclusion of our results has been that even in the less advanced stages of mammary cancer, there occur alterations of the immune response represented by: A decrease in the total number of lymphocytes, especially through a decrease of the TL number; A decrease of the lymphocyte blastic transformation index on stimulation with PHA; A decrease of IL-2 concentration in cultures stimulated with mitogens through the impairment of the TL CD4+ (TL Helper) function. The decrease of IL-2 production capacity influences the transmission of the immune message to the cytotoxic TL and thus impairs the cytotoxic effector component whose role is to remove tumoral cells. Evidence of IL-2 involvement in the immunodeficiency of mammary cancer patients could prove useful for diagnosis purposes and could plead in favour of the therapeutic potential of this interleukin.
Mammographic screening and improvement of mammography resolution have resulted in the increasingly frequent identification of small-size mammary lesions that have no clinical expression. If in Western countries, approximately one quarter of breast cancers are discovered when clinically occult, in Romania such cases are rare and, most of the times, discovered merely by chance. Infraclinical mammary lesions identified by mammography pose problems concerning the appropriate response. The paper assesses the various diagnosis and therapy choices as well as the localization techniques to be employed in order to establish the best approach. We describe twelve cases of infraclinical mammary lesions identified by mammography. In two of this cases fine needle aspiration biopsy with cytological examination was used, and in one case we performed core biopsy and histological examination. In those cases, lesion localization has been performed using stereotactic X-ray devices. In nine cases, we performed excisional biopsy with histologic assessment. In four of those cases, the lesions proved to be malignant. Preoperative localization was performed with hookwires placed in the proximity of the lesion under mammographic control. In five of those cases, lesion coordinates have been determined by stereotaxy. Using this technique, we removed, in all cases, the clinical lesions identified by mammography. We believe surgical excision to be the best approach in such lesions. Total removal of the lesion enables a thorough histopathological examination resulting in more accurate diagnosis. Curative surgery is also possible within the same surgical procedure. Unless preoperative localization is performed the surgeon is in the position to excise an image that has no clinical expression. Under this circumstances surgical removal is performed blind, as the lesion is hard to be found even intraoperatory. Preoperative localization provides guidance to the surgeon, ensures removal of the lesion that has been identified by mammography and helps avoids unnecessary mammary resection.
Explore the source record for details and available documents.
The sentinel ganglion concept originates in the assumption according to which the primary tumor drains into a specific lymph node area and then runs through the lymphatic nodes in an orderly, sequential mode. When neoplastic dissemination along the lymphatic pathway occurs, there is an initial invasion of a specific lymph node (rarely more than one) located on the drainage route. That first lymph node has been identified as the sentinel node, which mirrors the regional lymph node status. In order to establish the indication for lymphadenectomy and avoid the situations in which such a surgical procedure would be of no use (N-), the only correct method consists in the identification and biopsy of the sentinel node which can be performed using vital staining (blue dye), radioactive tracers or both. The technique of sentinel lymph node identification and biopsy by means of radioactive tracing includes: -pre-surgical lymphoscintigraphy, -identification of the sentinel lymph node and its excisional biopsy, -intra-operative histopathological examination, paraffin embedded sections and immunohistochemical stains of the sentinel lymph node. The paper presents the refinement of the technique and the validation of the method for identification and biopsy of the sentinel lymph node in breast cancer with the intra-operative use of NEOPROBE 2000 gamma probe at the "Prof. Dr. Alexandru Trestioreanu" Oncological Institute in Bucharest. It is a prospective study which enrolled 93 patients with breast cancer between September 2003-December 2005, who underwent sentinel node biopsy. Complete axillary dissection (back-up lymphadenectomy) was performed in all cases. By comparing the pathological results of the frozen section of the sentinel node, with the paraffin embedded and immunohistochemical ones of the remaining axillary nodes, we present the following results: sensibility 97,15% (34/35), specificity 100% (93/93), positive predictive value 100% (34/34), negative predictive value 98,3% (58/59).
Explore the source record for details and available documents.