Biomedical subjects
M Ionescu
Publications and source records attributed to M Ionescu.
No relationship between insulin antibodies and transient remission in type 1 diabetic patients.
It has been speculated that the insulin antibodies may contribute to the prevention of the onset of the transient remission in insulin-treated diabetic patients. To address this hypothesis, we analysed the titre of insulin antibodies (determined by RIA method, using polyethylenglycol separation technique and expressed as percentage of binding of insulin) in two groups of patients: group A: 46 type 1 diabetics, 25 males and 21 females aged 24 +/- 11.2 years, mean +/- SD, who did not manifest during the first period of the disease any clinical sign of remission; group B: 21 type I diabetics, 13 males and 8 females, aged 25.3 +/- 8.0 years, who manifested in the first year either a partial (18 cases) or a total (3 cases) transient remission. Thirty-eight of cases with disease onset before 1984 were treated with conventional insulins (27 of 46 cases in A group and 11 of 21 cases in B group); the remaining cases were treated with monocomponent (MC) insulins. The binding of the insulin was significantly higher in the patients treated with conventional insulins vs those treated with MC insulins, i.e., 18 +/- 7.1% vs 10.2 +/- 5.2% (p < 0.001). However, no difference was found in the binding of insulin in A group (14.5 +/- 1.3%) compared with B group (13.7 +/- 11.1%). Moreover, in 3 cases from B group the onset of the remission was coincident with the increase of insulin antibodies.
[Total proctocolectomy with an ileoanal anastomosis and reservoir].
The following report documents the initial experience (13 cases) and the one year functional and quality of life results after restorative proctocolectomy procedures in the Surgery Clinic of Fundeni Hospital. The histologic preoperative diagnosis was ulcerative colitis in 7 patients (53.84%) and familial polyposis in 6 patients (46.16%). 80% of patients experienced at least one postoperative complication after pouch construction or ileostomy closure. There was a single death in our patient group. This occurred in a patient with malignized polyposis, who died in the first 24 hours after operation from bilateral pulmonary emboli. The necropsy exam has shown also a metastatic nodule of the liver. The most frequent complication in our series was the small bowel obstruction and the pouch-anal anastomosis leak (30.76%). Patients' follow-up was achieved by means of a questionnaire which assessed pouch function at follow-up visit at 1 month, 3 month, 6 month and one year after the ileostomy closure. Quality of life was also assessed by that questionnaire and included injury into aspects of occupational, social and sexual function. The functional and quality of life results in this series was very similar to that reported by other authors who have performed restorative proctocolectomy for ulcerative colitis and familial polyposis.
Serum content of the C-propeptide of the cartilage molecule type II collagen in children.
OBJECTIVE: The C-propeptide of cartilage type II procollagen, together with the N-propeptide, are removed from newly synthesized procollagen during collagen fibril assembly in cartilage matrix. The presence and content of the C-propeptide reflect the synthesis of this molecule. Recently, we showed that serum levels of the C-propeptide are increased in adults with rheumatoid arthritis, pointing to increased synthesis of this molecule. In this study we examined its content in the sera of children to determine whether it changes during development. METHODS: Sera were obtained from 44 premature infants (cord blood), 75 children (0-18 years), 14 young adults (18-22 years) and 47 adults (35-60 years). The concentration of serum C-propeptide of type II procollagen was determined by a solution phase competitive inhibition radioimmunoassay which uses a polyclonal antiserum specific for the bovine and human C-propeptide. RESULTS: Compared with adults, concentrations of the C-propeptide of type II procollagen were significantly elevated in children of ages 0-14 years. Concentrations were constant until 10 years of age (premature infants: 14.5 +/- 1.4 ng/ml, mean +/- SE; 0-10 years: 13.6 +/- 1 ng/ml). In children of ages 10-14 years, during which the pubertal growth spurt is ordinarily observed, the mean concentration increased (10-14 years: 21.6 +/- 0.7 ng/ml) although not significantly due to the variation between individuals. Concentrations at all ages younger than 14 were significantly greater than those in older adolescents ages 14-18 (6.3 +/- 0.7 ng/ml), young adults (8.4 +/- 2.0 ng/ml) and adults (5.7 +/- 0.4 ng/ml). Serum concentrations did not show significant differences with respect to sex, but varied from child to child at any given age. CONCLUSIONS: The measurement of this circulating C-propeptide may be of use in studying the biochemical and physiological bases of changes in cartilage turnover in children, and abnormalities thereof.
Esophageal tumor with an unusual histological appearance: a case report.
An unusual esophageal tumor in a 58-year-old man complaining of dysphagia and weight loss is herein described. Esophageal radioscopy and endoscopy visualized a huge polypoid tumor which was occluding the esophagus. After esophageal resection, the histological examination revealed miscellaneous benign cells (squamous, columnar fat cells, cartilaginous cells, and glandular structures) and two different malignant areas (spindler sarcomatous cells and squamous cells). There was no malignant invasion in the stalk, in the adjacent esophageal wall, or in the periesophageal tissue, and there were no malignant adenopathies. The postoperative course was favorable for one year, until the patient developed pain in the right superior back. A sarcomatous relapse was diagnosed by fine-needle biopsy under CT guidance, and the patient subsequently received radiation therapy.
Plasmid profile analysis and restriction enzyme analysis in characterizing Shigella flexneri isolates from an outbreak.
Shigella flexneri strains which are multiply resistant to antimicrobial agents were isolated from 11 children from an orphanage in Cluj-Napoca during an epidemiological investigation initiated by the Department of Epidemiology. Plasmid profile analysis and restriction endonuclease analysis were used in conjunction with biotyping, serotyping and antimicrobial susceptibility testing for identifying epidemiological related isolates. All strains were serotype 2a and with one exception all of them showed the same resistotype. Plasmid profile analysis differentiated S. flexneri isolate into four patterns, with two common plasmids of 3.5 and 1.9 kb. This study indicates that this outbreak was caused by at least two different strains of S. flexneri which were not differentiated by the classical technique-biotyping, serotyping and antimicrobial susceptibility pattern.
Interactions between Borrelia burgdorferi and eukaryote cells: comparative ultrastructural aspects.
In the present study, mammalian VERO cells, human polymorphonuclear leukocytes (PMN) and mouse peritoneal macrophages (MPM) were coincubated with B31 Borrelia burgdorferi strain (Bb) and examined by transmission electron microscopy. The results indicate that the spirochete adheres to the mammalian cells mainly by the apical pole and less frequently by the lateral wall. In VERO cells and MPM cell penetration is accomplished especially by cytoplasmic membrane destruction, the spirochete appearing free in the cytoplasm, but also by phagocytosis. In this latter case the pathogen is seen in phagosome. In PMN the internalization takes place exclusively by phagocytosis, the spirochete undergoing destruction in phagosomes. Sometimes an alteration of the phagosomal membrane is observable, probably produced by the pathogen as a mechanism to avoid fusion with the lysosome. Other aspects indicate the contribution of the parasitized cell cytoskeleton to the spreading of Borrelia to adjacent cells. MPM does not represent a very efficient barrier against Bb, as can be seen from the cellular behaviour of the spirochetes in this study, PMN seems to a more efficient barrier, by its unique capacity to destroy the microorganism after phagocytosis.
[Lyme disease--its diagnostic and treatment principles].
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Plasmid profile analysis and antibiotic resistance of Salmonella strains from clinical isolates in Cluj-Napoca.
Resistance patterns, plasmid profiles and the genetic resistance determinants were investigated in 38 isolates of Salmonella enterica serotype Typhimurium and 19 isolates of Salmonella enterica serovar Enteritidis derived from children hospitalized in two clinics in Cluj-Napoca, during the period of 1995-1997. Incidence of plasmid and antibiotic resistance was very high in Salmonella typhimurium isolates. All strains were resistant to almost all antibiotics tested but susceptible to the third generation cephalosporines and fluoroquinolones. We identified three resistance patterns and six plasmid profiles. Each plasmid profile was characterized by the presence of two large plasmids of 150-180 Kbp. Approximately 60% of strains harbored three or four small plasmids of 1.3 to 9.5 Kbp. The plasmids of 8.5 Kbp encoded resistance to beta-lactam antibiotics and were non-conjugative. The other small plasmids were cryptic and also non-conjugative. Salmonella enteritidis isolates were susceptible to many antibiotics, except Tetracycline and Trimethoprim-Sulfamethoxazole. We identified three different resistance patterns but nine plasmid profiles. All plasmid profiles were characterized by the presence of a large plasmid (> 100 Kbp). The number and the diversity of small plasmids were higher than in S. typhimurium strains. There was no parallelism between resistance and plasmid profile: for the same resistance pattern a number of two or three plasmid profiles were found. Our conclusions are that Salmonella typhimurium strains were multiresistant to antibiotics and that many genetically different strains of Salmonella typhimurium and Salmonella enteritidis were responsible for gastroenteritis in children from Cluj County. The increasing antibiotic resistance highlights the need for more refined methods in genetic and epidemiological characterization of bacteria involved in gastrointestinal infections.