Papers accepted for publication
1. Histopathological parameters and immunoexpression of CD45RO (CLA) and CD68 in chronic rhinosinusitis with nasal polyps
Irina Enache, Alex Emilian Stepan, Florin Anghelina, Ionica Daniel Vilcea, Mioara Desdemona Stepan, Carmen Aurelia Mogoanta, Andrei Osman
Nasal polyps develop as a result of inflammation of the nasal and sinus mucosa. Allergies and nasal infections cause inflammation, and these are the main reasons why these symptoms appear in the first place. This study highlights the involvement of macrophages, as well as T- and B-lymphocytes, in the pathophysiology of nasal polyps. For the evaluation of lymphocyte activity, we analyzed the immunoexpression of cluster of differentiation 45RO [CD45RO; common leukocyte antigen (CLA)] and for macrophages we analyzed the immunoexpression of cluster of differentiation 68 (CD68). Our research, conducted on 110 sinonasal polyps harvested from chronic rhinosinusitis patients with nasal polyps, focused on analyzing both the epithelial and stromal compartments in relation to pre-established composite scores. Additionally, specific histopathological parameters were included in the study. We concluded that the inflammatory cells were more prevalent in the stromal compartment compared to the epithelial compartment. The statistical evaluation of CD45RO (CLA) and CD68 scores in the stromal compartment were also associated with high histological composite scores.
Corresponding author: Carmen Aurelia Mogoanta, Associate Professor, MD, PhD; e-mail: carmen_mogo@yahoo.com
Abstract - Download PDF PDF
2. Unveiling the cause of sudden cardiac death: a macroscopic and microscopic analysis at the Institute of Forensic Medicine, Cluj-Napoca (Romania)
Daniela Cristina Pavel, Costel Vasile Siserman, Mihaela Laura Vica, Bogdan-Alexandru Gheban, Ioana-Andreea Gheban-Rosca, Alexandra Maria Sonfalean, Denisa Stefania Jurje, Denisa Lucian, Silvia Stefana Balici, Horea-Vladi Matei
Sudden cardiac death (SCD) remains a critical public health problem, prompting efforts to understand its underlying causes and identify patients at risk. Despite declining cardiovascular mortality in developed nations, SCD still claims millions of lives annually, disproportionately affecting men and older individuals with a higher prevalence of ischemic heart disease. This study aimed to investigate the potential association between macroscopic and microscopic diagnoses in SCD cases based on a cohort of 3438 medico-legal autopsy reports collected at the Institute of Forensic Medicine, Cluj-Napoca, Romania, between 2014-2018. By analyzing representative heart tissue samples collected during autopsies, particularly from areas exhibiting visible abnormalities, we aimed to establish a link between macroscopic observations and microscopic confirmation. A detailed histopathological analysis on archived tissue samples focused on both ventricles, on areas with potential macroscopic indicators like myocardial ischemia, coronary atherosclerosis, and interstitial fibrosis. Standard techniques were employed to prepare tissue sections for microscopic examination, allowing for the evaluation of various parameters such as the presence and extent of atherosclerosis, necrosis, fibrosis, lipomatosis, edema, and blood stasis. This study investigated the correlation between macroscopic observations of potential SCD risk factors, such as ischemia, atherosclerosis, and fibrosis, and their microscopic confirmation through detailed tissue analysis. Our analysis revealed that circulatory-metabolic lesions of the heart, lung and brain are central and strongly correlated both macroscopically and microscopically with a SCD event, while non-circulatory pathology needs to pass the threshold for macroscopic diagnostics before being able to significantly influence the chances for developing a SCD event. Establishing such associations could improve the accuracy of high-risk SCD factors identification, potentially leading to more effective preventive strategies.
Corresponding author: Mihaela Laura Vica, Associate Professor, MD, PhD; e-mail: mvica@umfcluj.ro
Abstract - Download PDF PDF
3. Biological and cytological-morphological assessment of tuberculous pleural effusions
Iancu Emil Plesea, Elena Leocadia Plesea, Razvan Mihail Plesea, Mircea-Sebastian Serbanescu, Marian Olaru, Dragos Nicolosu, Gheorghe Gindrovel Dumitra, Valentin Titus Grigorean, Claudia Lucia Toma
Aim: Tuberculosis (TB) came back in the top of causes for infectious disease-related deaths and its pleural involvement is still in the top two extrapulmonary sites. The authors continued their studies on TB pleural effusions (Pl-Effs) with the assessment of biological and cytological variable of pleural fluid (PF), introducing in the investigation algorithm and testing a new tool, the computer-assisted evaluation of cell populations on PF smears. Patients, Materials and Methods: A series of 85 patients with TB pleurisy (PLTB) were selected from a larger group of 322 patients with different types of Pl-Effs. The algorithm of investigation included. clinical variables, biological assays of PF, gross aspects including imagistic variables and PF cytology on May-Grunwald-Giemsa (MGG)-stained smears. All the data obtained were entered into and processed using Microsoft Excel module of the 2019 Microsoft Office Professional software along with the 2014 XLSTAT add-in program for MS Excel. The PF cellularity was assessed qualitatively by a cytologist and quantitatively with in-house software. Continuous variables were compared using Pearson s correlation test, while categorical variables were compared using chi-squared test. Results: Our analysis showed that patients were usually males, aged between 25 and 44 years with Pl-Eff discovered at clinical imagistic examination, almost always one-sided and free in the pleural cavity. Its extension was either moderate or reduced. The PF had a serous citrine appearance in most of the cases, and biological characteristics pleaded for an exudate [high levels of proteins and lactate dehydrogenase (LDH)], with elevated adenosine deaminase (ADA) values and rich in lymphocytes (Ly). The attempt to identify the pathogen in PF was not of much help. Apart from Ly, neutrophils [polymorphonuclear neutrophils (PMNs)] were a rare presence and their amount had only a trend of direct correlation with Ly. The same situation was encountered in the case of mesothelial cells (MCs). The comparison between the qualitative and the quantitative, computer-assisted evaluations of cytological smears showed that the results of the two methods overlapped in less than one third of the cases, although the sensitivity and specificity values as well as the two calculated predictive values of the qualitative method were encouraging. Conclusions: The assessment of biological variables and cell populations of the PF are basic tools in the diagnosis of pleural TB. The assessment of PF cell population could be improved by the use of computer-assisted quantitative analysis of the PF smears, which is simple to design, easy to introduce and handle and reliable.
Corresponding author: Elena Leocadia Plesea, MD, PhD; e-mail: elena.plesea@umfcv.ro
Abstract - Download PDF PDF
1. Histopathological parameters and immunoexpression of CD45RO (CLA) and CD68 in chronic rhinosinusitis with nasal polyps
Irina Enache, Alex Emilian Stepan, Florin Anghelina, Ionica Daniel Vilcea, Mioara Desdemona Stepan, Carmen Aurelia Mogoanta, Andrei Osman
Nasal polyps develop as a result of inflammation of the nasal and sinus mucosa. Allergies and nasal infections cause inflammation, and these are the main reasons why these symptoms appear in the first place. This study highlights the involvement of macrophages, as well as T- and B-lymphocytes, in the pathophysiology of nasal polyps. For the evaluation of lymphocyte activity, we analyzed the immunoexpression of cluster of differentiation 45RO [CD45RO; common leukocyte antigen (CLA)] and for macrophages we analyzed the immunoexpression of cluster of differentiation 68 (CD68). Our research, conducted on 110 sinonasal polyps harvested from chronic rhinosinusitis patients with nasal polyps, focused on analyzing both the epithelial and stromal compartments in relation to pre-established composite scores. Additionally, specific histopathological parameters were included in the study. We concluded that the inflammatory cells were more prevalent in the stromal compartment compared to the epithelial compartment. The statistical evaluation of CD45RO (CLA) and CD68 scores in the stromal compartment were also associated with high histological composite scores.
Corresponding author: Carmen Aurelia Mogoanta, Associate Professor, MD, PhD; e-mail: carmen_mogo@yahoo.com
Abstract - Download PDF PDF2. Unveiling the cause of sudden cardiac death: a macroscopic and microscopic analysis at the Institute of Forensic Medicine, Cluj-Napoca (Romania)
Daniela Cristina Pavel, Costel Vasile Siserman, Mihaela Laura Vica, Bogdan-Alexandru Gheban, Ioana-Andreea Gheban-Rosca, Alexandra Maria Sonfalean, Denisa Stefania Jurje, Denisa Lucian, Silvia Stefana Balici, Horea-Vladi Matei
Sudden cardiac death (SCD) remains a critical public health problem, prompting efforts to understand its underlying causes and identify patients at risk. Despite declining cardiovascular mortality in developed nations, SCD still claims millions of lives annually, disproportionately affecting men and older individuals with a higher prevalence of ischemic heart disease. This study aimed to investigate the potential association between macroscopic and microscopic diagnoses in SCD cases based on a cohort of 3438 medico-legal autopsy reports collected at the Institute of Forensic Medicine, Cluj-Napoca, Romania, between 2014-2018. By analyzing representative heart tissue samples collected during autopsies, particularly from areas exhibiting visible abnormalities, we aimed to establish a link between macroscopic observations and microscopic confirmation. A detailed histopathological analysis on archived tissue samples focused on both ventricles, on areas with potential macroscopic indicators like myocardial ischemia, coronary atherosclerosis, and interstitial fibrosis. Standard techniques were employed to prepare tissue sections for microscopic examination, allowing for the evaluation of various parameters such as the presence and extent of atherosclerosis, necrosis, fibrosis, lipomatosis, edema, and blood stasis. This study investigated the correlation between macroscopic observations of potential SCD risk factors, such as ischemia, atherosclerosis, and fibrosis, and their microscopic confirmation through detailed tissue analysis. Our analysis revealed that circulatory-metabolic lesions of the heart, lung and brain are central and strongly correlated both macroscopically and microscopically with a SCD event, while non-circulatory pathology needs to pass the threshold for macroscopic diagnostics before being able to significantly influence the chances for developing a SCD event. Establishing such associations could improve the accuracy of high-risk SCD factors identification, potentially leading to more effective preventive strategies.
Corresponding author: Mihaela Laura Vica, Associate Professor, MD, PhD; e-mail: mvica@umfcluj.ro
Abstract - Download PDF PDF3. Biological and cytological-morphological assessment of tuberculous pleural effusions
Iancu Emil Plesea, Elena Leocadia Plesea, Razvan Mihail Plesea, Mircea-Sebastian Serbanescu, Marian Olaru, Dragos Nicolosu, Gheorghe Gindrovel Dumitra, Valentin Titus Grigorean, Claudia Lucia Toma
Aim: Tuberculosis (TB) came back in the top of causes for infectious disease-related deaths and its pleural involvement is still in the top two extrapulmonary sites. The authors continued their studies on TB pleural effusions (Pl-Effs) with the assessment of biological and cytological variable of pleural fluid (PF), introducing in the investigation algorithm and testing a new tool, the computer-assisted evaluation of cell populations on PF smears. Patients, Materials and Methods: A series of 85 patients with TB pleurisy (PLTB) were selected from a larger group of 322 patients with different types of Pl-Effs. The algorithm of investigation included. clinical variables, biological assays of PF, gross aspects including imagistic variables and PF cytology on May-Grunwald-Giemsa (MGG)-stained smears. All the data obtained were entered into and processed using Microsoft Excel module of the 2019 Microsoft Office Professional software along with the 2014 XLSTAT add-in program for MS Excel. The PF cellularity was assessed qualitatively by a cytologist and quantitatively with in-house software. Continuous variables were compared using Pearson s correlation test, while categorical variables were compared using chi-squared test. Results: Our analysis showed that patients were usually males, aged between 25 and 44 years with Pl-Eff discovered at clinical imagistic examination, almost always one-sided and free in the pleural cavity. Its extension was either moderate or reduced. The PF had a serous citrine appearance in most of the cases, and biological characteristics pleaded for an exudate [high levels of proteins and lactate dehydrogenase (LDH)], with elevated adenosine deaminase (ADA) values and rich in lymphocytes (Ly). The attempt to identify the pathogen in PF was not of much help. Apart from Ly, neutrophils [polymorphonuclear neutrophils (PMNs)] were a rare presence and their amount had only a trend of direct correlation with Ly. The same situation was encountered in the case of mesothelial cells (MCs). The comparison between the qualitative and the quantitative, computer-assisted evaluations of cytological smears showed that the results of the two methods overlapped in less than one third of the cases, although the sensitivity and specificity values as well as the two calculated predictive values of the qualitative method were encouraging. Conclusions: The assessment of biological variables and cell populations of the PF are basic tools in the diagnosis of pleural TB. The assessment of PF cell population could be improved by the use of computer-assisted quantitative analysis of the PF smears, which is simple to design, easy to introduce and handle and reliable.
Corresponding author: Elena Leocadia Plesea, MD, PhD; e-mail: elena.plesea@umfcv.ro
Abstract - Download PDF PDF