Association between liver histology, carotid ultrasonography and retinal vascular changes in patients with nonalcoholic fatty liver disease (NAFLD)

Vol. 53 No. 3 Suppl., 2012
This supplement was not sponsored by Outside Organizations.


Cristina L. Baloseanu, C. T. Streba, C. C. Vere, Violeta Comanescu, I. Rogoveanu

Introduction: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing all over the world. NAFLD has been demonstrated to be associated with carotid artery atherosclerosis, evaluated using the intima-media thickness (IMT). In this article, we focused on the association between NAFLD, carotid parameters such as: intima-media thickness (IMT), pulsatility index (PI) and resistivity index (RI) as markers of subclinical atherosclerosis and the presence of retinal vascular disorders. Patients and Methods: We compared carotid IMT, pulsatility and resistivity index evaluated by ultrasonography, in 10 patients with histological-proven NAFLD and retinal vascular changes (retinophotographies). Results: The degree of hepatic steatosis, necroinflammation and fibrosis in NAFLD patients was strongly associated with the value of carotid IMT and also with PI and RI. Moreover, there seems to be a connection between the degree of NAFDL and the retinal vascular changes in patients with carotid atherosclerosis. Conclusions: These results suggest that the severity of liver histopathological lesions among NAFLD patients is strongly associated with carotid parameters: IMT, IP, IR and also with retinal vascular changes. Further controlled studies are needed to confirm the results.

Corresponding author: Costin Teodor Streba, MD, PhD; e-mail:

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C. C. Nistor-Ciurba

The management of pure ductal carcinoma in situ (DCIS) involves local excision, with or without consecutive radiotherapy, or simple mastectomy. Assessment of the recurrence risk is the essential step in decision-making. The hypothesis of this study was that besides the apparition of true recurrences after prior complete excision there may be also cases with residual disease present distant from the initial excised lesion (more than 2 mm). The last ones could be better considered as being cases of evolving disease. To evaluate the presence of residual disease in the re-excision specimens derived either from mastectomies or wide local re-excisions, a cohort of 102 cases of DCISs, operated in "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania, between 2000 and 2007, were studied. The presence of residual tumor in re-excision specimens was correlated with high grade of DCIS and with age of the patient (less than 60 years). The analysis of mastectomy specimens revealed that 35.4% of all mastectomies had no residual disease (unnecessary mastectomies). Moreover, 59.8% of them had no residual disease or only close residual disease, virtually curable by simple re-excision. This study suggests that up to 59.8% of mastectomies could be avoided. Important is to select those cases in which avoiding mastectomy may be done assuming an acceptable recurrence risk. The study shows that those cases are from over 60-year-old group and those having histological grade G1. Larger prospective studies are needed to confirm the results of this study.

Corresponding author: Codrut Cosmin Nistor-Ciurba, MD; e-mail:

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