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I E Pleşea

Publications and source records attributed to I E Pleşea.

7 recordsLinked to original sources

Morphological experimental study of bone stress at the interface acetabular bone/prosthetic cup in the bipolar hip prosthesis.

By calculating the tension and distortion of the elements composing the bipolar prosthesis under extreme conditions encountered in real life using a special post-processing program, we established the variation curves of the contact pressure at the hip bone-cup, armor-cup and cup-femoral head interface. By comparing the data obtained from all the examined cases, important conclusions were drawn regarding the influence of tension and pressure distribution on the structural integrity and biomechanics of the prosthesis, as well as the acetabular wear and tear, in order to assess its reliability. The experimentally determined tension and distortion status at the acetabular bone-metal armour interface, lead to the wear and tear phenomenon, which can be explained by three mechanisms and theories incompletely reflecting the overall process. The histopathologic study of the acetabular bone tissue using FEM (finite elements method) on surgically removed specimens will probably lead to the identification of a series of factors that could reduce the rate of the wear and tear process.

Acetabulum↗

The value of intraoperative diagnosis in breast lesions.

UNLABELLED: Frozen section examination is aimed at making a preoperative diagnosis, determining the benign or malignant nature of a breast lesion, but also the most suitable surgical procedure. The sensitivity and specificity of this method and the causes of discrepancies were analyzed in a retrospective study of 2 177 breast lesions. METHOD: 1,150 frozen sections from 2,177 breast lesions were performed in the interval 1999-2005. The sections made at the open door cryostat and measuring 5 microm were stained with rapid Hematoxylin-Eosin. The following terms were used for describing the intraoperative diagnosis: negative, positive, and await paraffin section. After the frozen section diagnosis was made, the frozen tissue was thawed to room temperature and fixed in formalin overnight for further paraffin processing. The remaining unfrozen tissue was processed into a paraffin section. RESULTS: The number of cases and the number of frozen sections increased from 1999 (341 cases, 87 frozen sections) to 2005 (441 cases, 220 frozen sections). Mean sensitivity (a/a+c) was 94%, and mean specificity (d/b+d) was 99%. The false positive cases accounted for 0.08%, while the false negative ones for 2.26%. In 7% of the cases the diagnosis could not be made on frozen section. CONCLUSIONS: Despite the raging popularity of aspiration cytology, frozen section still stands out as the method of choice for rapid diagnosis. Frozen section is not indicated to be performed on mammographically detected lesions, small lesions, papillary lesions, proliferating fibrocystic disease, or tubular carcinoma.

Breast Diseases↗

Osteoarticular tuberculosis--a ten years case review.

Extrapulmonary sites of tuberculosis must not be neglected as they are not so rarely fortuitous discovering. The morphological diagnosis of tuberculosis is generally easy to do. However, there are the atypical lesions rising diagnostic difficulties. The authors reviewed the histopathological diagnostic in 19 cases of osteoarticular tuberculosis lesions selected from 390 cases of surgical extrapulmonary granulomatous lesions, using for difficult cases, with atypical lesions, new diagnostic tools as immunohistochemistry and DNA amplification technique by the polymerase chain reaction.

Adolescent↗

Morphoclinical study of intracerebral haemorrhage with intraventricular extension.

AIMS: The study is an integrated assessment of clinical, image and morphological parameters in severe intracerebral haemorrhages (ICH) complicated with intraventricular extension (IVE). MATERIAL AND METHODS: The studied group had 93 cases of patients with ICH and IVE who were hospitalized in the Emergency County Hospital of Craiova and died during hospitalization. The parameters evaluated were clinical (relation with the seasons, age, sex, arterial blood pressure, the motor deficit, degree of coma, Glasgow score at admission and medical care) and morphological (the sites of the intraparenchymal haematoma and IVE, the size of the intraparenchymal haematoma, the presence of the mass effect, perilesional oedema and subarachnoid effusion). The latter were assessed on CT films and during autopsy. RESULTS: The presence of IVE as a complication of ICH showed a predilection for cold seasons, especially autumn. From the 93 studied cases 51 were men and 42, women. 52.6% of the patients were in the fifth and sixth life decade. Almost 80% of the patients had IIIrd stage arterial hypertension at admission, over 80% motor deficits and almost 60% Glasgow scores lower than 6. The ventricular effusion involved at least one of the lateral ventricles. The hematomas had huge dimensions as compared to hosting encephalic structures, in lobar sites involving more than one lobe. Other risk factors as mass effect and perilesional oedema were constantly present. CONCLUSIONS: The association of IVE with other independent risk factors such as hypertension, low Glasgow scores volume of intraventricular bleeding, dimensions of haemorrhagic foci, presence of mass effect and perilesional oedema results in the death of patient despite any sustained therapeutic intervention.

Adult↗

Study of cerebral vascular structures in hypertensive intracerebral haemorrhage.

AIMS: The study was performed in order to assess the alterations of extra-parenchymal and intraparenchymal vascular structures in 82 hypertensive patients suspected of primary intraparenchymal hematoma, which died and were autopsied in order to confirm the diagnosis. MATERIAL AND METHODS: The studied material consisted of nervous tissue situated near and distant from the haemorrhagic lesion. The specimens of nervous tissue were processed by the classical histological technique and stained with the usual stainings and with immunohistochemical stains for basement membranes and endothelial cells. RESULTS: Extra-parenchymal arteries showed classic lesions of atherosclerosis. Atheromatous lesions were of all types, even the extension towards the media being encountered a complication with thrombosis. At the level of the intraparenchymal blood vessels, the spectrum of the lesions due to arterial hypertension included all steps of vascular wall degeneration, from hypertrophy of smooth muscle layer to complete hyalinization of arterial wall, but with a focal irregular distribution, not related with the proximity of haemorrhagic focus. High arterial blood pressure also influenced the capillary walls which showed focal or circumferential thickening due to the densification of the type IV collagen material from the basement membrane structure. The CD34 immunostaining showed that endothelial cells kept their structural integrity. CONCLUSIONS: The sequence of degenerative lesions of the cerebral vascular wall culminates with the hyalinization of excessive fibrillar material form arteriolar wall or from basement membranes. Hyalin material is weakening the wall resistance to the stress determined by the high values of blood pressure in hypertension, and, correlated with a minimal resistance of the surrounding cerebral parenchyma, can explain why the cerebral parenchyma is the only tissue in which blood pressure variations can determinate vascular rupture and cerebral haemorrhage. The more adequate term for describing the vascular wall changes seems to be sclerosis (arteriolar and even capillary) with hyalinosis.

Arterioles↗

Assessment of Gleason system use on different types of prostatic tissue samples.

One of the well-known and accepted methods of prostatic adenocarcinoma grading is Gleason system. The authors made a retrospective analysis of 221 prostatic adenocarcinomas divided into three groups (transvesical prostatectomies, transurethral resections and needle biopsies) following the type of surgical procedure used for drawing the tissue. Gleason scores and comparison between odd and even Gleason scores were assessed in the entire group and in each subgroup. High scores prevailed, meaning a tendency towards a low grade of differentiation. Even scores also prevailed meaning, on one hand, that, often, the examined specimen reveals only one pattern and, on the other hand, that surgical procedures as transurethral resections and unique needle biopsies cannot offer a sufficient material for examination, the multicentricity of prostatic carcinoma being well known.

Adenocarcinoma↗

Comparative study between prostatic carcinoma G1-G3 and Gleason grading systems.

The need of an accurate and prognostically valuable method for grading the prostatic carcinoma resulted in, in the last decades, a large number of systems, none of them succeeding in being unanimously accepted by the pathologists family. The authors selected and reassessed using Gleason system a group of 221 cases with prostatic adenocarcinoma previously diagnosed using a combined G1-G3 system. The results were converted from Gleason system to G1-G3 system and then compared with the initial diagnostics. The group was divided, following the type of surgical procedure used for drawing the tissue, into three groups: transvesical prostatectomies (TVP), transurethral resections (TUR) and needle biopsies (B). The concordance between the two systems was good, even the number of TUR and B specimens was significant (85% of the studied group) showing that any of them can be successfully used in current practice, depending only on pathologist's experience.

Adenocarcinoma↗