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Biomedical subjects

M Acalovschi

Publications and source records attributed to M Acalovschi.

30 records · Page 2Linked to original sources
PubMedDate not supplied

The impact of advances in radiologic biliary imaging on the diagnosis of obstructive jaundice. Comparative analysis of two groups of patients hospitalized at a 5-year interval.

The study evaluates the impact of advances in biliary imaging techniques on the accuracy and rapidity of diagnosis in patients with obstructive jaundice. Two series of patients hospitalized at an interval of 5 years in the same clinic were prospectively analyzed. In both series, the results of ultrasonography (US) and percutaneous transhepatic cholangiography (PTC) were compared with the intraoperative findings. The performances of US in the assessment of ductal dilatation and choledocholithiasis significantly improved during this period. The fine-needle biopsies taken from the solid masses in liver or pancreatic parenchyma under US guidance in the second series of patients contributed to the greater proportion of correct preoperative diagnoses in this group. The number of PTC investigations increased in the second group (p less than 0.001) given the clinicians' confidence in the safety and easy performance of this method. Using both methods, the etiology of biliary obstruction was correctly diagnosed preoperatively in 85.2 per cent of the second series of patients, significantly more frequently than in the first series of patients (62.7 per cent) (p less than 0.05). The mean period in hospital necessary for the diagnosis decreased during the period analyzed from 15.4 +/- 10.8 days to 10.2 +/- 7.8 days (p less than 0.05), a fact with direct impact on the course of disease, and also on the hospital costs.

Biliary Tract↗
PubMedDate not supplied

A necroptic study of the prevalence of cholelithiasis in liver cirrhosis.

The prevalence of cholelithiasis in liver cirrhosis was analyzed on 1320 consecutive necropsies which included 245 subjects with gallstones and 133 with liver cirrhosis. Gallstones were found in 24.8% of the cirrhotics, a prevalence significantly higher than in noncirrhotic subjects (17.8%) (p less than 0.05), and were more frequent in cirrhosis for all age-groups. The mean age of death was lower in cirrhotic than in noncirrhotic subjects (p less than 0.05). It was also lower, but without statistical significance, in cirrhotics without gallstones than in cirrhotics having gallstones. The ratio between lithiasic women and men was 0.8/1 in liver cirrhosis, as compared to 1.6/1 in noncirrhotic subjects. The proportion of pigment stones was significantly increased in liver cirrhosis (47.5%) (p less than 0.02). Chronic hemolysis secondary to hypersplenism, a know lithogenic factor in liver cirrhosis, might account for the predominance of pigment stones in this disease. Other lithogenic factors could be hyperestrogenism, changes in the proportion of biliary lipids etc. Complications of gallstones occurred less frequently in cirrhotic than in noncirrhotic patients, but complications of cholecystectomy represented the cause of death in 27.2% of cirrhotics as compared to 14.0% of noncirrhotic patients (p less than 0.02). These observations argue for a conservative, non-surgical attitude towards silent or uncomplicated gallstones in cirrhotic patient.

Adolescent↗
PubMedDate not supplied

Gallstones--mineralogical and chemical investigations.

A comparative study of the mineralogical-structural characteristics and chemical composition of gallstones was performed on stone samples removed intraoperatively from the gallbladders of 12 patients. The study included all the types of gallstones. Their chemical components determined were: bilirubin, cholesterol, phospholipids, calcium, proteins. The stones were examined physically (size, number, shape, color) and the radial or concentric disposition of the layers was estimated on cross-sections. Thin sections (2 X 10(-2)mm) were obtained and examined by polarizing microscope in order to observe the inner structural characteristics. The crystallographic analysis of all the types of stones studied is reported. In all the samples, a perfect concordance was found between the mineralogical structure and the chemical composition of the gallstones. The results obtained are valuable premises for further research in the formation of stones, since a mineralogical study offers the possibility to estimate variations of crystal aggregation, according to the local changes of the gallbladder (inflammation, bacterial growth, pH, etc.).

Bilirubin↗
PubMedDate not supplied

Pathogenetic interrelations between cholesterolosis and cholesterol gallstone disease.

In order to define the relationship between cholesterolosis (COL) and cholesterol gallstone disease (CGD), risk factors were comparatively investigated in a great number of patients. Sex, age and metabolic risk factors were the same for both diseases, but gallbladder anomalies and neuroendocrine disturbances were more often associated with COL. The lipid composition of the gallbladder bile was determined in patients with COL. The bile acid decrease and the increase of cholesterol molar concentration (moles %) were found, similar to those known in CGD. The similarity of risk factors and of bile lithogenicity, as well as the frequent association of COL and CGD suggest a pathogenic relationship of both diseases. Local morphological changes in conditions of high biliary cholesterol levels may be responsible for the intraparietal precipitation of cholesterol in COL. Thus, COL seem to be a peculiar variant of CGD and its classification into the heterogeneous group of cholecystoses is at present questionable.

Adult↗
PubMedDate not supplied

Time trends in the incidence of hepatocellular carcinoma in liver cirrhosis. A retrospective necropsy study in a large Romanian town (1973-1992).

The present study retrospectively analyses all the necropsies (5, 112) performed in the two departments of pathology of a large Romanian town (Cluj-Napoca) during a ten-year interval (1983-1992) in order to estimate the prevalence of hepatocellular carcinoma (HCC). To evaluate the time trends of the association of HCC with liver cirrhosis, all cirrhotic subjects necropsied during two consecutive ten years intervals in one of the departments of pathology (Third Medical Clinic) were analysed. The prevalence of HCC was 8/100,000, with a derived incidence of 1.6/100,000 population/year. HCC was more frequent in males, and it occurred more frequently in cirrhotics (13.8%) than in noncirrhotics (0.6%) (p < 0.0001). The trends in the incidence of HCC in liver cirrhosis were evaluated for the 258 cirrhotic subjects necropsied during two ten year periods (1973-1982 and 1983-1992) in the Third Medical Clinic. HCC was found in cirrhotics older than 40 years, in proportions between 14 and 25% for the different age groups. There was an increasing tendency of HCC incidence in cirrhotic subjects over the last 20 years, significant for the 70-79 years age group. These data indicate a low incidence of HCC in our geographic area and suggest an increasing trend of the HCC association to liver cirrhosis over the last 20 years, more obvious in the advanced ages.

Adult↗