Papers by Alexandru Blidisel
PubMed, Jun 17, 2005
The paper presents two unusual pathological aspects of a hernia and an appendicitis. It is about ... more The paper presents two unusual pathological aspects of a hernia and an appendicitis. It is about a massive old inguinal hernia, with strangulation and an intra-saccular congestive acute appendicitis that occurred after a traumatic injury of the region. The presumptive diagnosis through a dynamic monitoring of the patient, clinical and biological analysis has made possible a favorable solution of the case.
Annals of Diagnostic Pathology, Oct 1, 2007
Objectives: The levels of high-sensivity C-reactive protein (hpCRP) show activity of an inflammat... more Objectives: The levels of high-sensivity C-reactive protein (hpCRP) show activity of an inflammatory process. This aimed to study the levels of highsensivity C-reactive protein in patients before coronary artery bypass grafting (CABG) and 3 months after the operation. Methods: From March to June 2006 we examined 168 patients (125 male, 43 female). The mean age was 56.53 ± 7.8 (range, 35-70). Duration of coronary artery disease was 57.93 ± 34.62 months. 86 (51.19%) patients had acute myocardial infarction and 158 (94.05 %) patients had arterial hypertension. Stable angina was detected among 142 (83.52%) patients (group I), unstable angina was identified among 26 (15.48%) patients (group II), angina "de novo" was in 2 (1.19%) cases. Group III included 40 patients without coronary atherosclerosis according to coronarography. All the patients were operated on and the programme of their treatment included a 3-month course of statin drugs. Results: The patients with unstable angina had the level of hsCRP 2.19 ± 0.19 mg/dL, the patients with stable angina had the level 1.11 ± 0.19. The patients with instable angina had a higher level of hsCRP (P b .01). The patients of group III had the low level of hsCRP 0.16 ± 0.1 mg/dL (P 1 b .01; P 2 b .001). In 3 months we detected the considerable reduction of the level hsCRP in group I and II. Thus, in group I the level hsCRP went down to 0.38 ± 0.21 mg/dL (P = .005), in group II to 0.21 ± 0.09 mg/dL (P = .001). We did not find the dependence of the levels hsCRP on the intensity of coronary atherosclerosis according to coronarography, age, and gender. Conclusions: The levels of high-sensivity C-reactive protein decreased after coronary bypass grafting in 3 months. We guess it was possible thanks to the use of statin drugs, which influence the activity of an inflammatory process.
Experimental and Therapeutic Medicine, Jun 3, 2021
Multiple myeloma (MM) is a neoplasm of the B lymphocytes characterized by the uncontrolled prolif... more Multiple myeloma (MM) is a neoplasm of the B lymphocytes characterized by the uncontrolled proliferation of a plasmocyte clone. Magnetic resonance imaging (MRI) remains the most sensitive and specific imaging method for the detection of bone marrow infiltration, before macroscopic bone changes are visible, with evidence that the detection rate and overall performance of MRI could be enhanced by applying diffusion-weighted imaging (DWI). The aim of our research was to evaluate whether measuring apparent diffusion coefficient (ADC) values in newly diagnosed patients with MM could be a prognostic factor for the course of the disease and to ascertain whether there is any correlation with other prognostic factors in MM. A retrospective study was performed on a group of 32 patients with newly diagnosed MM that underwent at least two whole-body (WB)-MRIs; one before and one after induction therapy. Patients with advanced stage of disease showed an increased ADC value: Stage 2 vs. stage 1 (1.162 vs. 0.289, P=0.033), respectively, stage 3 vs. stage 1 (0.867 vs. 0.289, P=0.041). In addition, ADC values were inversely correlated with survival time: r=-0.641, P<0.001. According to the multivariate linear regression model, we observed that for every point of ADC value (before treatment) the survival was decreased/reduced by 14.5 months. Moreover, bortezomib therapy predicted an increase in the survival length/duration by 7.9 months. Our regression equation proved to be a good fit for the model, explaining 57.8% of survival duration (adjusted R 2 =0.578). In conclusion, the negative prognostic factors associated with WB-MRI are represented by high ADC values before treatment (for every point of ADC the survival was decreased by 14.5 months) and focal/diffuse marrow involvement.
PubMed, Jan 9, 2013
Introduction: Hepatic resection had an impressive growth over time, both by broadening the range ... more Introduction: Hepatic resection had an impressive growth over time, both by broadening the range of its indications and the occurrence of changes and technical tricks in order to reduce postoperative mortality and morbidity. Material and methods: This study is a retrospective study presenting an analysis of 133 patients hospitalized in the Department of Hepatic Surgery in City Hospital Timisoara, between January 2000 and November 2011, in which a surgical intervention was performed, either for a primary hepatic tumor (benign or malignant) or a secondary liver tumor. All cases were analyzed in terms of etiopathogenesis, preoperative and intraoperative investigations, indication and type of hepatectomy performed, the surgical technique used and postoperative evolution. Results: The study group comprises 133 patients. From the whole group, 100 patients (75.19%) were diagnosed with primitive liver tumors, in 70 patients (70% of primary tumors) HCC occurring on a cirrhotic liver. Liver disease was secondary in 33 patients (24.81%), colorectal tumors being most commonly involved (19 patients). Of all liver resections, 21 (15.79%) were major hepatectomies. The remaining were minor hepatectomies, including a trisegmentectomy (V, VI, VII), 51 bisegmentectomies and 60 liver resections limited to one segment. Vascular clamping was used in 89 cases (66.92%), pedicular clamping in 65 patients (73.03%) and selective extraglissonian clamping in 24 patients (26.97%) respectively. Of the 33 patients with liver metastases, 12 (36.36%) received synchronous resections. The most common complication in our study group was postoperative liver failure, found in 45 patients (33.83%), being irreversible in one case (2.22%), followed by the death of the patient. In 34 patients (75.55%), hepatic failure was seen in cirrhotic patients and the other cases were patients with major hepatec-tomies. Hepatic failure occurred in 35 patients (77.78%) with vascular clamping, four of them after selective clamping. 31 of the patients (68.89%) with postoperative liver failure were transfused, 25 patients (55.55%) receiving more than 2 units of blood. Of all patients, 3 (2.25%) died postoperatively. Conclusions: Respecting the principles of liver surgery, hepatic resection can be performed, even in cirrhotic patients, with acceptable morbidity and minimal mortality. The most common complication after hepatic resection, in our study group, was postoperative liver failure, which was mostly reversible.
Current Issues in Molecular Biology, Feb 6, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
In Vivo, 2021
Background/Aim: Colon cancer liver metastases with desmoplastic growth pattern (dGP) have a highl... more Background/Aim: Colon cancer liver metastases with desmoplastic growth pattern (dGP) have a highly heterogeneous therapy response. The aim of the study was to evaluate the dGP liver metastasis molecular profile from a chemo-naive patient by mimicking metastatic process on an experimental chick embryo chorioallantoic membrane (CAM) model. Materials and Methods: Three successive CAM passages of dGP human colorectal liver metastases were immunophenotyped for keratin (K) 8, and 20, CLIC1, VEGF, EGFR, CD34, podoplanin, Ki67, E-cadherin and vimentin. Results: Metastatic cells gradually lost K20 while K8, E-cadherin and vimentin heterogeneously increased during passages. VEGF, CLIC 1, EGFR expression increased in metastatic cells especially at the tumor graft periphery. Scattered proliferating and non-proliferating podoplanin-positive tumor cells, lymphatic and blood vessels were heterogeneously detected in tumor xenografts depending on passage stage. Conclusion: By mimicking repetitive metastatic processes we proved that metastatic cells change their phenotype. This may explain why not all metastases have a similar response to therapy.
Revista Româna de Medicina Veterinara, 2019
![Research paper thumbnail of [Endoscopy-assisted harvesting and free latissimus dorsi muscle flap transfer in reconstructive microsurgery]](https://a.academia-assets.com/images/blank-paper.jpg)
PubMed, May 8, 2008
Because of their generous dimensions, constant anatomy, great plasticity and well defined vascula... more Because of their generous dimensions, constant anatomy, great plasticity and well defined vascularization, muscles remain the preferred choice when approaching reconstruction of complex tissue defects resulting after trauma or oncological resections. The latissimus dorsi, represents a widely used flap when performing reconstructive microsurgery using free tissue transfer, but with important postoperative complications like seroma, donor-site hematoma and large scars. Along with the development of video assisted harvesting of muscular free flaps, the minimal invasive approach brings an important decrease of the donor site morbidity, followed by a faster healing. This article presents the case of a patient diagnosed with chronic osteomyelitis fistula, on the site of an older posttraumatic fracture at the level of the tibial diaphysis, where a large debridement of soft tissues and the involved bone was performed, followed by microsurgical reconstruction of the left over defect, using a free latissimus dorsi muscular flap harvested by endoscopic-assisted technique.
Microsurgery, 2007
Recent technical development has led to remarkable performances in video-guided surgical procedur... more Recent technical development has led to remarkable performances in video-guided surgical procedures. A video-endoscopic system (VES) is evaluated as an alternative magnifying solution for microsurgical procedures and compared to table-top microscopes in terms of technical and surgical aspects. Six surgical residents without microsurgical experience, alternating both systems, performed each 12 aortic endto-end anastomoses on Sprague-Dawley rats using the triangulation technique. All anastomoses underwent quality review, total and single suture time, suture spacing, vessel bite, vessel overlapping and wall penetration were evaluated and graded. Overall anastomosis quality score was 52.28 (out of a maximum of 140) using the microscope and 42.7 using the VES. Despite significant differences in total anastomosis time, the learning curves are similar for the two systems and no major differences were noted in terms of overall anastomosis quality. Video-assisted microsurgery can become a useful instrument for microsurgery training. V
PubMed, Nov 21, 2007
The aim of this study was to develop an experimental model of pancreas transplantation in rats as... more The aim of this study was to develop an experimental model of pancreas transplantation in rats as a standardized tool for research in transplant immunobiology. Brown Norway (donors) and Lewis (receptors) rats, males, with an average weight of 220 grams, were used. The diabetes was induced in recipients using streptozocin. The pancreas was harvested with a duodenal stump, a segment of aorta containing the celiac and superior mesenteric artery and the portal vein and transplanted as follows: Group A (n=8) - systemic venous drainage; Group B (n=8) - portal venous drainage. The exocrine drainage of the pancreatic graft was established by para-topic reintegration of the graft duodenal stump in the recipient. Postoperative follow-up consisted of daily measurement of glycemia and macroscopic evaluation of the proximal duodenal stump mounted as a cutaneous stoma. Overall postoperative survival at 8 days was 87,5% for Group A and 75% for Group B. Glycemia levels started to regain normal values in both groups, at 2 days postoperatively. Rejection started at 9 and 10 days postoperatively for Group A and B respectively, being expressed by the gradual re-appraisal of hyperglycemia that followed necrosis of the proximal duodenal stump. The experimental model described is functional and has the advantage of being used either with portal or systemic drainage of the pancreatic graft. The results obtained show no significant difference between the time-points of normal postoperative glycemia when either systemic or portal venous drainage were used.
PubMed, Feb 8, 2014
Neisseria meningitidis is a normal commensal of human mucous membranes that is no longer consider... more Neisseria meningitidis is a normal commensal of human mucous membranes that is no longer considered to be restricted to the nasopharynx. Due to the practice of oral sex, the mucous membranes of the cervix, urethra or anus have become a potential infection site for this bacterium. Inserting an intrauterine device (IUD), can alter the protective barrier of the endocervical mucosa, allowing for bacterial infection and systemic spread. We present a case report of a 40-year-old woman who presented with abdominal pain, spotting and fever after inserting an IUD and developed a fulminant septic shock. Blood cultures and cultures from ascites showed the presence of Neisseria meningitidis group Y. From our knowledge, there are a few cases presented in the literature of toxic shock syndrome after IUD insertion, caused by Staphylococcus aureus or Streptococcus group A, but this is the first case of meningococcal sepsis after IUD insertion described. So, even though IUDs rarely cause significant infection, physicians should consider this device as a possible source in reproductive-age women with the clinical features of sepsis.
PubMed, Dec 15, 2010
Gastroduodenal artery (GDA) aneurysm is a rare entity, comprising only 1.5% of all 3000 cases of ... more Gastroduodenal artery (GDA) aneurysm is a rare entity, comprising only 1.5% of all 3000 cases of visceral artery aneurysms that have been reported in literature. We report a case of a 55-year-old Caucasian man, diagnosed with right inguinal hernia. He was admitted to our department for surgical treatment. His medical history was remarkable for hypertension, and angina. He was operated the next day. A external oblique right inguinal hernia was diagnosed intraoperative. The Halsted technique was used for primary inguinal hernia. Immediate postoperative evolution was favorable, systolic blood pressure of 120 mmHg, pulse of 68 beats/minute. 16 h postoperative there was a sudden alteration of the general condition with signs of hemodynamic shock, with a systolic blood pressure of 60 mmHg, tachycardia of 110 beats/min. Physical examination revealed a pale, cold, and clammy patient. His hemoglobin had dropped from 14 g/dL on admission to 6 g/dL. A bedside ultrasound identified pelvic free fluid. An exploratory laparotomy revealed hemoperitoneum, and over 2 500 ml of blood and clot, a large hematoma was identified that was occupying the transvers colon mesentery and retroperitoneum. A clot was removed, revealing ruptured gastroduodenal artery aneurysm with active hemorrhage. The opening was isolated and closed. The contents were returned to the abdomen, which was irrigated and closed. Postoperative laboratory evaluation revealed hyperamylasemia (1543 IU/L, Normal Value (NV) = 15-95 IU/L). He remained normotensive throughout his 8-day hospitalization and was discharged home in good condition. In conclusion, gastroduodenal artery aneurysm rupture is a rare and patients can present with nonspecific symptoms. Rapid diagnosis, localization, and surgical or endovascular intervention are necessary to avoid devastating consequences.
European review for medical and pharmacological sciences, 2021
OBJECTIVE The use of current surgical techniques in the management of skin cancers that are not a... more OBJECTIVE The use of current surgical techniques in the management of skin cancers that are not amenable to other treatment options has become the cornerstone of dermatological surgical intervention. Among the many benign lesions and malignant lesions, such as squamous cell carcinomas, melanomas, and Merkel cell carcinomas, the tumors that are commonly excised surgically are the basal cell carcinomas (BCC). Although the majority of BCC lesions spread locally and are rarely metastatic, these lesions may recur, especially, if the excised tissue consists of positive surgical margins. As BCC lesions are more common on the head, face, and neck regions, inadvertent positive margin excisions to help avoid major disfigurement of the regions may contribute to their recurrence. Trichoepithelioma (TE) is a benign tumor that bears a close resemblance to BCC, and therefore, clinicians encounter difficulty in differentiating between TE and BCC lesions. Clinicians have to rely on histopathology an...
Chirurgia (Bucharest, Romania : 1990)
This study describes an experimental model of accessory renal allotransplantation in the big labo... more This study describes an experimental model of accessory renal allotransplantation in the big laboratory animal (pig). A total of 24 common-breed pigs were used. All allografts were transplanted in an accessory manner and revascularized at the level of the infrarenal abdominal aorta and inferior vena cava. The urinary drainage was performed either through a nexternal uretheroneostomy at the ipsilateral lumbar region (Group A--n=8) or by internal uretheroneocystostomy (Group B--n=8). All transplants were monitored for 8 days postoperatively using translumbar ultrasound-guided biopsies at 1, 4, 7 days. A total of 16 transplants were performed. 1 ectopic donor kidney was found and transplanted in the same fashion. Mean operative time was 125 minutes, immediate postoperative survival was 100% and at 72 hours, 87.5%. The onset of acute rejection was at day 4, by massive lymphocyte infiltration and was directly correlated with the abrupt decrease of the allograft diuresis in Group A, at da...
Revista de Chimie, 2020
Anti-thyroid antibodies (atbs) (anti-TPO, anti-TG, anti-TRH receptor) are autoatbs that recognize... more Anti-thyroid antibodies (atbs) (anti-TPO, anti-TG, anti-TRH receptor) are autoatbs that recognize specific antigens that belong to thyroid structures. Several mechanisms were proposed to explain the breaking of immunotolerance to thyroid antigens. Our previous studies showed that IgG-anti-F(ab�)2 atbs exert immunosuppresives effect in vitro and inverse correlate with autoatbs in certain autoimmune diseases. Relying on sera from pregnant women with and without anti-thyroid atbs, respectively with or without spontaneous pregnancy loss we intended to analyze the IgG-anti-F(ab)2 atbs titers in sera of these categories of patients. The lot of patients consists of 126 pregnant women out of which 47 had a normal course of pregnancy and 79 experienced spontaneous abortion. Anti-TPO, anti-TG, and IgG-anti-F(ab�)2 atbs titers were measured in sera of these women. Although a difference was found between IgG-anti-F(ab�)2 atbs titer in pregnant women with positive versus negative anti-thyroid at...
1 Hepatic Surgery Department, Surgery Clinic, 2 Thoracic Surgery Clinic, Timisoara Clinical Emerg... more 1 Hepatic Surgery Department, Surgery Clinic, 2 Thoracic Surgery Clinic, Timisoara Clinical Emergency City Hospital, Victor Babes University of Medicine and Pharmacy, Timisoara.
Cancers
Hepatocellular carcinoma (HCC), the most frequent form of primary liver carcinoma, is a heterogen... more Hepatocellular carcinoma (HCC), the most frequent form of primary liver carcinoma, is a heterogenous and complex tumor type with increased incidence, poor prognosis, and high mortality. The actual therapeutic arsenal is narrow and poorly effective, rendering this disease a global health concern. Although considerable progress has been made in terms of understanding the pathogenesis, molecular mechanisms, genetics, and therapeutical approaches, several facets of human HCC remain undiscovered. A valuable and prompt approach to acquire further knowledge about the unrevealed aspects of HCC and novel therapeutic candidates is represented by the application of experimental models. Experimental models (in vivo and in vitro 2D and 3D models) are considered reliable tools to gather data for clinical usability. This review offers an overview of the currently available preclinical models frequently applied for the study of hepatocellular carcinoma in terms of initiation, development, and progr...
Revista de Chimie
Autoimmune thyroiditis is the most frequent autoimmune disease. We analyzed the association betwe... more Autoimmune thyroiditis is the most frequent autoimmune disease. We analyzed the association between the presence and value of titer of anti-thyroid antibodies (atbs) and spontaneous abortion (SA). Moreover, we analyzed the association between TSH values and the presence of anti-thyroids atbs. We tested anti-TPO and anti-TG atbs in 257 women: 85 probands, 87 pregnant women with normal pregnancy outcome, and 85 with SA. We tested TSH in 87 pregnant women with normal pregnancy outcome. No significant difference was found between the prevalence of cases with positive anti-TPO and anti-TG atbs in women with normal pregnancy outcome vs. SA patients. In women with positive atbs titer, anti-TPO and anti-TG values were higher in SA group compared with normal pregnancy outcome group. A significant threshold was reached only for anti-TG atbs. TSH values were higher in pregnant women with positive anti-TPO and anti-TG values compared with those with a negative atbs titer. In pregnant women with...
Materiale Plastice
The number of surgical procedures for abdominal wall defects is increasing, often requiring the i... more The number of surgical procedures for abdominal wall defects is increasing, often requiring the insertion of plastic material meshes. Surveillance of patients with inserted plastic meshes requires an accurate determination of the position of the mesh. However, this is a difficult task, depending on the kind of mesh, magnetic resonance imaging (MRI) protocol or consistence of the surrounding tissue (fat, muscle, aponeurosis). The aim of our research was to develop an experimental model to test the ability of MRI to identify the exact position of surgical plastic meshes: polypropylene or polyester. To simulate the placement of a mesh in human body we developed a model built up from two pieces of tissue with dimensions of 40 cm x 20 cm, harvested from a pig with a weight of 120 kg. The meshes were situated for MRI evaluation between the two pieces: abdominal pig muscle respectively suprajacent abdominal pig wall subcutaneous fat, approximately 2 cm high. Five surgical meshes were scann...
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Papers by Alexandru Blidisel