Keratin 5 (K5) is present in the basal layer of a stratified squamous keratinized and non-keratinized epithelium. K5 and K14 have been demonstrated in the mucosa and tumors of the oral cavity, oropharynx, hypopharynx and larynx, and in the mitotic active basal cells of a stratified squamous epithelium. The aim of the present study was to assess K5 expression in squamocellular carcinoma with various localizations in the head and neck. A total of 13 biopsy fragments were included from patients diagnosed with squamocellular carcinoma of the larynx area (n=2), pharynx (n=2), hard palate (n=1), tongue (n=2), submandibular (n=1), lip (n=1), gingival sulcus (n=1), nasal pyramid (n=1), maxilla (n=1) and zygomatic (n=1). The immunohistochemical staining for K5 was evaluated according to the following score criteria: 0 (0% positive cells); 1 (<10% positive cells); 2 (10–30% positive cells); and 3 (>30% positive cells). K5 expression was observed in all squamocellular carcinomas included in the present study with scores between 1 and 3. For well- and moderately-differentiated histopathological types, a maximum score of 3 was recorded for all of the cases, not including the laryngeal area, which presented a score of 2. The following scores were identified in the regions of the poorly differentiated carcinomas: Jaw, 3; gingival sulcus, 2; and tongue and submandibular area, 1. These observations may aid with an improved stratification of head and neck squamocellular carcinoma, thus improving the diagnosis and treatment strategies for this type of cancer.

Liver transplantation is now a standard procedure for the treatment of end stage liver diseases. Since 1968 until 2012, a number of 113,627 liver transplantations were performed in Europe, in 28 countries and 153 institutions. Despite these impressive fi gures the waiting list is growing every year. Transplant surgeons were preoccupied to fi nd new ways to increase the donor pool. Among them: reduced size liver transplantation, split liver technique and more recently living donor liver transplantation. At fi rst in the early `90, living donor liver transplantation was used for pediatric patients because the left lateral hepatic segments were harvested. This graft is too small for the metabolic demands of an adult patient. So the next step was the harvesting of the right liver lobe from the donor and transplantation to adult patients. Living donor liver transplantation has gained fast a wide acceptance but there are a few issues to discuss. The main concern is about the donor safety which is a healthy person undergoing major surgery with potential risks. Also the surgical technique evolved due to a better understanding of the anatomy and physiology of the liver and the right liver graft. We discuss here the anatomical and surgical basis for living donor liver transplantation with the right liver lobe.

This article describes a hybrid surgical technique for high-risk patients with thoraco-abdominal aortic dissections and aneurysms. The technical aspects of the first stage of surgical treatment - visceral and brachiocephalic debranching are described in detail. 17 surgical interventions for chronic dissection and aneurysm in the thoracic and thoracoabdominal aortas were performed at the Vishnevsky National Medical Research Center of Surgery of Ministry of Health of the Russian Federation in the period from 2014 to 2019. In two cases, we observed postoperative pancreatitis after surgical treatment of the abdominal aorta branches, which we managed using conservative therapy. After open surgery, all patients were discharged in a satisfactory condition. The selected technique made it possible to prepare patients for the following stage of treatment - endografting of the aorta - without developing serious complications.

This article presents a clinical observation of a patient with a giant atherosclerotic abdominal aortic aneurysm and comorbid uncorrected coronary artery disease. Taking into account the threat of aneurysm rupture, we have chosena surgical intervention using methods that reduce the risk of cardiovascular events in the perioperative period: the distal-first technique allowed us to reduce the aortic clamping time, and the use of temporary axillofemoral bypass grafting reduced peripheral resistance and stress on myocardium.

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The correct endodontic treatment involves the exact determination of the working length. This is accomplished by combining several techniques: the tactile technique, X-ray with the needle or the endodontic probe in the root canal and comparing with the average tooth length.The determination of average tooth length depends on the geographic area. The current table used in practice contains the values gathered on a population group that is different than ours; the table has been made on Caucasian subjects.In conclusion, our study aims to determine the proper average values of our geographic zone, the table obtained by completing the equation of the endodontic therapy that will admit the proximity of the Romanian reality.

Endodontic retreatment with direct crown access is the main choice in cases of endodontic treatment failure, even if the practitioner`s effort and duration is significantly greater compared with other procedures. The retreatment with crown access repeats root canal treatment through direct access at the level of tooth crown. The objective is to clean up the canal from irritant agents, such as microorganisms, surviving from the previous therapy or passed through afterwards. Thus, a treatment restart is in accordance with the logics of root canal therapy and is preferred at any time if possible. The aim of this study was to observe, over a 4-year span, the efficiency of endodontic retreatment with direct coronary approach. From 2012 to 2016, 148 patients, with ages ranging from 18 to 65 years, were retreated endodontically. All patients were included in a regular monitoring plan of 3 months and 1-year post treatment. X-rays were performed during these observations, assessed with Orstavik criteria (1991), each radiography having assigned a periapical index (PeriApical Index – PAI). In conclusion, this study confirms that first choice of retreatment in case of endodontic treatment failure is restarting of the retreatment with direct crown access (91% success rate), failure of which leads to a surgical approach using endodontic microsurgery techniques.