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Horea Gozar, Alexandru Chira, Örs Nagy and Zoltán Derzsi

Abstract

Finite element modeling is a field of medicine with great potential future in experimental studies and in daily clinical practice as well. Computational modeling is currently used in several medical applications including orthopedics, cardiovascular surgery, and dentistry. In orthopedics, this method allows a proper understanding of joint behavior, as well as of more complex articular biomechanics that are encountered in several conditions such as ankle fractures or congenital clubfoot. Currently, there is little data on the development of a 3D finite element-defined model for congenital clubfoot. This paper aims to summarize the current status of knowledge and applications of finite element modeling of the foot and ankle.

Open access

Ionela Pașcanu, Claudia Banescu, Simona Huțu, Horea Gozar and Radu Neagoe

Open access

Radu-Alexandru Prișcă, Andrada Loghin, Horea-Gheorghe Gozar, Cosmin Moldovan, Tekla Mosó, Zoltán Derzsi and Angela Borda

Abstract

Objective: The mechanism by which the ureter propels urine towards the bladder has a myogenic origin, through peristaltic contractions. This pyeloureteral autorhythmicity is generated by specialized, electrically active cells, the interstitial cells of Cajal, located in the proximal regions of the upper urinary tract. The aim of this study was to describe the exact location and the distribution of interstitial Cajal cells in the human upper urinary tract and to analyze their normal number and morphology. This is a preliminary study, which will allow the study of these cells in different urinary tract pathologies.

Material and Method: Urinary tract fragments were sampled at different levels, from 13 autopsy cases. Cases with clinical evidence of renal disease, and with histological changes in the kidney or in the urinary tract tissue samples, visible in hematoxylin-eosin staining, were excluded. The interstitial Cajal cells were highlighted with anti-CD117 antibody, immunohistochemically.

Results: Cajal cells were indirectly highlighted by the presence of a finely granulated cytoplasm indicating immunoreactivity. These cells were spindle-shaped or stellate, with cytoplasmic extensions at one or both poles of the cell and large oval nucleus. We found that interstitial Cajal cells were located at all upper urinary tract levels, with a higher predominance in the calyces and pyelon. Interstitial Cajal cells were observed mostly between the two layers of the muscularis, but also between the muscle bundles. Most often, these cells were parallel to the muscle fibers.

Conclusion: Our study describes the method of detection of interstitial Cajal cells in normal human urinary tract. These results can be used to analyze the number, morphology and the location of these cells in different congenital pathologies, such as vesicoureteral reflux, pyeloureteral junction obstruction or primary obstructive megaureter.

Open access

Ioana Raluca Chirteș, Cristina Oana Mărginean, Horea Gozar, Anca Meda Georgescu and Lorena Elena Meliț

Abstract

Pulmonary abscess or lung abscess is a lung infection which destroys the lung parenchyma leading to cavitations and central necrosis in localised areas formed by thick-walled purulent material. It can be primary or secondary. Lung abscesses can occur at any age, but it seems that paediatric pulmonary abscess morbidity is lower than in adults. We present the case of a one year and 5-month-old male child admitted to our clinic for fever, loss of appetite and an overall altered general status. Laboratory tests revealed elevated inflammatory biomarkers, leukocytosis with neutrophilia, anaemia, thrombocytosis, low serum iron concentration and increased lactate dehydrogenase level. Despite wide-spectrum antibiotic therapy, the patient’s progress remained poor after seven days of treatment and a CT scan established the diagnosis of a large lung abscess. Despite changing the antibiotic therapy, surgical intervention was eventually needed. There was a slow but steady improvment and eventually, the patient was discharged after approximately five weeks.