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The invasive conjunctival squamous cell carcinoma (SCC) of the eyeball is a malignant tumor that invades only the conjunctiva and rarely the eyeball and the tissue of the orbit. We presented the clinical case of a 91-year-old patient, hospitalized at the 2nd Ophthalmology Clinic of the "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital of Iasi, Romania, due to a solid tumor mass of approximately 1×2 cm, which was noticed under the bulbar conjunctiva of the right eye in the nasal sector. The magnetic resonance imaging (MRI) examination showed an adherent tumor of the right eye sclera, presenting invasion into the tissue of the orbit. The right eyeball was enucleated en bloc with the adherent tumor and the partial exenteration of the nearby orbital tissue was carried out as well. The pathological examination revealed that the immunohistochemical (IHC) reactions turned positive for the anti-cytokeratin AE1/AE3 antibody and showed a relatively high Ki67 labeling index, but it did not show immunoreactivity for human melanoma black-45 (HMB-45) marker and S100 protein. The histopathological (HP) diagnosis was poorly differentiated SCC of the right ocular conjunctiva with infiltration of cornea, sclera and orbital connective and adipose tissues (pT4N0M0). The invasive conjunctival SCC requires an early diagnosis for elderly patients in order to prevent the ocular and orbital invasion and the appearance of metastases. This tumor rarely occurs during the ninth life decade, the literature reporting only three cases. HP examination of the lesion is the gold standard for diagnosis, especially when IHC stainings are added.

Morbid obesity is a metabolic disease characterized by an excessive accumulation of adipose tissue (=40%). This disorder is commonly associated with cardiovascular disease, arteriosclerosis, type 2 diabetes, hypothyroidism and some types of cancer. The most common metabolic signals associated with the disease are leptin, ghrelin, with antagonic effects. Our study aimed at highlighting leptin and ghrelin expression levels, as well as establishing correlations between them and clinical-biological parameters in obese patients. The biological material was taken intraoperatively from the visceral adipose tissue. Expression of genes of interest was performed after total RNA extraction and reverse transcription-polymerase chain reaction (RT-PCR) and amplification with TaqMan specific primers. The results of the study showed significant differences in the expression of leptin mRNA between obese patients and the control group as well as the gender of the subjects. Ghrelin levels correlated positively with obesity, but not with gender. There were no significant correlations between the expression of the genes of interest and the parameters studied (age, body mass index - BMI, cholesterol, triglycerides, glycemia, diabetes, hypothyroidism and hypertension). The results of the study suggest that the evaluation of leptin levels can be used clinically in assessing the metabolic status of the patient with malignant obesity.

In our observational study, we performed the clinical and functional examination, analyzed imagistic and histological findings and evaluated the correlation between previous aspects in patients with primary knee osteoarthritis (PKOA) and Baker's cyst (BC). The correlations were made to better understanding of BC in patients with PKOA and optimal choosing for treatment. Seventy patients with painful PKOA (ACR criteria) and BC were assessed. We evaluated knee pain using a 100 mm VAS and functional status using the pain, stiffness and functional subscales of WOMAC index. All patients were imagistic examined (ultrasonography and MRI). Thirty-eight patients with PKOA and simple BC respond to conservative treatments. Thirty-two patients with PKOA and complex BC need surgical removal (arthroscopic decompression ± open excision in larger cysts). For these patients, it is performed histological assessment. Any medical team that manages a PKOA patient with BC may develop the treatment plan based upon not only the size of BC, symptoms and other associated conditions but also on the WOMAC scoring and complex anatomic and histological data about BC.

The largest artery in the human body, intimately connected to the heart, aorta is usually regarded as the major source of oxygenated blood for the circulatory system. The three concentric layers, which surround the aortic lumen-the tunics intima, media and adventitia, transform the aorta in a large elastic duct, which is irregular calibrated according to its segments. The special aortic distensibility is facilitated by its elastic circumferential lamellar complex. Any disturbance of its structural components is able to interfere with its normal and vital activity. Our study intends to reveal that the development of elastic lamellae should be regarded not only as an indispensable step for the aortic wall configuration, but also like a process in a firm connection with the rest of aortic wall components. The transition from intrauterine life to a new stage of life, childhood, has to determine an adequate adaptation of almost all the components of aortic wall, in order to sustain a consistent pulsatile blood flow. Stereological quantitative analysis of thoracic aortic fragments prelevated from newborns and children was performed in order to estimate the dynamic of vascular wall increase. We first estimated the general configuration of the thoracic aortic wall, quantifying the principal constituents; the connective tissue profile, investigated through its main elements, collagen and elastic fibers, supports the idea that each type of fiber has a distinct evolution in different groups of ages and has to be correlated with their involvement in maintaining of the aortic wall mechanical properties. Elastic fibers percentage volume was increased in both examined groups, with a small difference reported in children aorta, while collagen fibers exhibit a slow increase in children aorta. Our morphometric quantitative assessment suggests that further studies have to draw of in a precisely manner the outline of the secretory well defined function of vascular smooth muscle cells; the elucidation of the manner in which the secretory pathway for each type of fiber becomes fully adapted to every stage of aortic development will allow a new perspective in aortic pathology.

The diffuse neurofibroma is an uncommon subtype of neurofibroma that has received little attention in the imaging literature. Most common in ages 10-30, in males and females, with a slight predilection for the trunk, then head and neck, then limbs. May become very large, but very rarely undergo malignant transformation. Treatment of diffuse neurofibromas (not associated with NF1) is often surgical resection. Complete resection is often difficult because of the extensive and infiltrative nature of many of these lesions. To our knowledge, the diffuse neurofibroma has been reported extremely rarely within the shoulder girdle. In this report, we presented an adult patient, without NF1 diagnosed, who developed invalidate status of left upper limb due to a giant diffuse neurofibroma involving the left brachial plexus, with a high growth diffuse pattern and plexiform architecture imagistic, grossly and without results at both surgical interventions. The diagnosed was by MRI and sonographic imaging and histopathologic examination. His immediately survival perspective was not affected but the functionality of the left upper limb was severe reduced.

Angiogenesis represents one of the most important factors of the tumor proliferation. Renal carcinoma with clear cells is highly vascularized. Knowing numerous quantification systems of tumor angiogenesis, we used a simple one, the evaluation of the relative vascular density. We studied 61 cases with partial or total nephrectomy performed in the Urology Department of Timisoara County Hospital. We correlated the intensity of angiogenesis with a tumor proliferation factor PCNA (proliferating cell nuclear antigen) and with the monoclonal antibody PC10. Correlation of the two immunohistochemical methods with the degree of the tumor differentiation suggested an inverse ratio between vascular density and tumor proliferation degree.

Osteoporosis is a common affection characterized by a reduction of bone mass that affects mostly women after menopause. It currently leads to fractures, especially of the spine and hip thus enhancing the costs of medical care. There are many factors that contribute to its development, leading to various strategy lines to deal with it.The present study aims at showing how a multidisciplinary, multifactorial approach can be effective in treating and preventing new osteoporotic fractures.The study included 17 patients that had replacement arthroplasty for femoral neck fractures. Bone tissue fragments were obtained from all of them and analyzed by pathology specialists. A dual-energy X-ray absorptiometry exam was also performed on each patient. In the end, the data was collected and processed by rehabilitation experts in order to establish proper therapy.The hip fracture incidence was two times more frequent in women than in men, higher in the 71-80-year-old group. By analyzing the bone fragments atrophy could be seen, especially in the femoral neck as well as lamellae and osteon reduction and bone architecture alterations.Surgical or pharmacological treatments alone are not sufficient for handling osteoporosis. Strategies such as preventing falls, a proper diet, treating associated conditions and a well-established exercise program need to be considered. Specialists from several areas such as pathology, orthopedics, endocrinology, internal medicine and rehabilitation should work together to design the best approach to deal with osteoporosis.