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Cluj-Napoca, Romania

Fratila O.C.,3rd Medical Clinic | Craciun C.,Babes - Bolyai University
Journal of Gastrointestinal and Liver Diseases | Year: 2010

Background: Infliximab is a monoclonal anti-TNF-alpha antibody that has been shown to be effective in Crohn's disease therapy. However, data are scarce about the mechanism of action and its efficacy in ulcerative colitis (UC). Aim: To assess intracellular changes of the colonic mucosa in patients with UC before and after infliximab treatment. Methods: 7 patients (18-65 years, 4 men) with active, refractory, moderate to severe UC (Lichtiger's Clinical Activity Index >6, Endoscopic Index >4) underwent colonoscopy before and 4 weeks after the initial infusion of infliximab 5mg/kg of body weight. Endoscopically obtained biopsy specimens were processed specifically, stained with uranyl-acetate and lead citrate and examined with a JEOL-1010 transmission electron microscope. Results: Before treatment we noticed severe alterations of the epithelium: microvilli depletion, shattering of the epithelial junctions, cytoplasmic vacuolization, dilatation of the endoplasmic reticulum, pycnotic nuclei, altered structure of mitochondria and Golgi complexes. Rarefaction of the goblet cells, and abnormal mucus formation and secretion were also observed. The corresponding chorion showed structural alteration of component cells, obstructed capillaries, erythrocyte extravasation, and many plasmocytes and neutrophils. After infliximab, improvement in morphology and function of the epithelial organelles, rich mucus secretion and recovery of the chorionic components were noticed. Conclusions: Our study revealed important intracellular alterations of the UC mucosa that were restored after infliximab therapy. These features may contribute to a better understanding of UC pathogenesis and mechanism of action of the anti-TNF-alpha therapies.

Gheorghe L.,Fundeni Clinical Institute of Digestive Diseases and Liver Transplantation | Pascu O.,3rd Medical Clinic | Ceausu E.,Victor Babes Hospital for Infectious Diseases | Csiki I.E.,Institute of Public Health | And 4 more authors.
Journal of Gastrointestinal and Liver Diseases | Year: 2010

Background: An overall prevalence rate of HCV infection in Romanian adult population was recently estimated to be 3.23%. The proportion of treated patients with chronic hepatitis C in our country has never been assessed. Aims: 1) to analyze the quality and quantity of antiviral therapy delivery; 2) to determine the proportion of patients being annually and ever treated with antiviral therapy in Romania and 3) to identify barriers against treatment of HCV infected-population in Romania. Results: The number of annually treated patients remained relatively stable between 2002 and 2007 (1,813 patients treated with pegylated interferon and ribavirin in 2002 and 2,446 in 2007). There was a doubled increase in reimbursed treatment in 2008 and 2009 (4,503 and respectively 4,701 treated patients) due to a special campaign organized to increase awareness and prevention of HCV transmission. The median time to therapy approval varies from county to county; overall it is 10.23 months. A total number of 25,318 patients with chronic C hepatitis were treated between 2002-2009, corresponding to a cumulative proportion of 4.1% of the prevalent cases of HCV infection treated in Romania until 1st January 2010. The main limiting factor of access to antiviral therapy for hepatitis C in Romania remains the lack of funds. Conclusions: This is the first analysis of the nationwide practice for treatment of hepatitis C in Romania. Increased public health efforts are required to improve access to antiviral therapy for hepatitis C in Romania.

The pathology of the digestive tract, extremely popular, with equal sex distribution, can have a clinical history of chronic illness or emergency. Diagnosis is based on endoscopy (identifies the lesion, permits histological sample under visual control, and minimally invasive treatment for polypoid benign tumors). Ultrasonography, being non-invasive and very accessible, is often used as the initial imaging procedure to detect or exclude digestive pathology with similar symptoms. Understanding digestive ultrasound is conditioned by the image quality which can be achieved by removing air and food debris. Even so, the characteristics of the inflammatory diseases and the detection of tumors, particularly those with endoluminal development, can be difficult. In recent years transabdominal ultrasound examination of the digestive tract was supplemented with more precise methods of investigation of the lumen and circulation of the intestinal wall. These methods are represented by the administration of oral or ano-rectal homogenous substances (hydrosonography) and the by intravenous administration of agents containing stabilized microbubbles (CEUS). With these methods useful information are being obtained, high in sensitivity and specificity of lesions characterization. Judicious selection of the cases and of the examination technique remains the key to a successful diagnosis in all situations.

Vicas C.,Technical University of Cluj Napoca | Lupsor M.,3rd Medical Clinic | Badea R.,3rd Medical Clinic | Nedevschi S.,Technical University of Cluj Napoca
2010 IEEE International Conference on Automation, Quality and Testing, Robotics, AQTR 2010 - Proceedings | Year: 2010

In this paper we present a novel method of detecting anatomical structures from liver ultrasound images. Local texture anisotropy is evaluated using a specially designed bank of Gabor filters. We show that the proposed method is well suited for processing liver ultrasound images and it is robust with respect to its parameters. A practical application of this method is then presented. Image features are computed on detected structures. These features are then used in conjunction with a classifier (Support Vector Machines) to discriminate between left and right lobe liver images. This classifier is used to label ultrasound images. The labeling algorithm obtained a very low error rate (<1%). It can successfully replace the human expert in image labeling.

Routine exploration of the digestive tract is performed under "fasting" condition, without further training. The investigation is limited due to hidroaeric and alimentary content and deep location of some digestive parts (gastric fornix, colon flexures). Oral administration contrast agents cause a distension of the digestive lumen which allows a satisfactory viewing of the "hidden" regions and endoluminal detection of small formations. A combination of conventional and contrast ultrasound brings additional information which increase the overall performance of the ultrasound method.

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