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Biomedical subjects

A Amorosi

Publications and source records attributed to A Amorosi.

At least 91 records · Page 5Linked to original sources
PubMed1988

Gastric cancer in a high-risk area in Italy. Histopathologic patterns according to Lauren's classification.

Two thousand five hundred forty cases (1628 males and 912 females) of primary gastric cancer (GC) histologically diagnosed in gastroscopic biopsy or resected specimens, occurring from 1973 to 1982 in a high risk area in Italy (Florence), were reviewed. According to Lauren's criteria, 1587 (62.5%) were classified as intestinal type, 624 (24.6%) as diffuse type and 329 (12.9%) as mixed unclassified. The intestinal type is more frequent in males and increases in both sexes with advancing age; conversely for the diffuse type. In the two 5-year periods (1973-1977 and 1978-1982) the intestinal type shows a reduction over time more evident in females than in males, in contrast to the increasing trend for the diffuse type. In males, the distribution of Lauren's histologic types is stable over time for resected specimens, whereas there is a significant reduction of intestinal type for biopsy specimens. In females, both for resected and biopsy specimens there is a reduction of the intestinal type and an increase of the diffuse type from the first to the second period. For a subgroup of 297 subjects two different specimens were available (gastroscopic biopsy and surgical); sensitivity and positive predictive value, for biopsy specimen as compared with the resected one, in the diagnosis for Lauren's histologic types were calculated. An excess of diagnoses in the mixed/unclassified category for biopsy material was evident (positive predictive value = 44.3%). However, for the two main histologic types, the biopsy appears a quite reliable indicator of the final diagnosis on surgical material (intestinal: ppv = 88.6%; Diffuse: ppv = 87.0%). The study supports the hypothesis that the reduction in GC mortality in the Province of Florence in recent years may be associated with a moderate reduction in the frequency of the intestinal type.

Adult↗
PubMed1988

Short-term effects of bile diversion on postgastrectomy gastric histology.

Twelve partially gastrectomized subjects who have consecutively undergone total biliary diversion for severe bilious vomiting were studied before and after operation in order to assess the effects of surgery on gastric histology and enterogastric reflux. Before and six months after operation, the following protocol was performed: (1) blood examinations including serum basal gastrin; (2) endoscopy with multiple gastric biopsies; and (3) quantitation of bile acids in the gastric aspirate. Of the preoperative symptoms, bilious vomiting and heartburn completely disappeared postoperatively in all the subjects. Fasting bile reflux was significantly reduced (bile reflux was annulled in six and considerably lowered in the remaining six subjects), and erythema of the gastric mucosa completely disappeared in all the subjects after diversion. Among histological findings, while a significant regression of foveolar hyperplasia was found both in the perianastomotic area and in the body of gastric remnant, none of the other aspects identifiable in postgastrectomy gastric mucosa (chronic gastritis changes included) were affected by diversion. These results show that biliary diversion is effective in correcting reflux, bilious vomiting, erythema, and foveolar hyperplasia of the gastric mucosa and confirm the suggested relationship between bile reflux and gastric foveolar hyperplasia.

Adult↗
PubMed1988

Incidental finding of renal cell carcinoma with histological regressive aspects in a pregnant woman.

A renal cell carcinoma was incidentally discovered with sonography in a 32-year-old pregnant woman. Magnetic resonance imaging was used to provide further information about tumor stage without causing adverse effects on the fetus. The patient underwent radical nephrectomy at the third month of pregnancy and subsequently delivered a normal full-term child. Pathology revealed regressive aspects which can be possibly ascribed to high progesterone levels during pregnancy.

Adult↗
PubMed1988

Billroth I versus Billroth II partial gastrectomy in the treatment of gastric ulcer.

Short- and long-term results of B-I and B-II reconstructions were compared in order to assess which anastomosis is to be recommended after partial gastrectomy for gastric ulcer. All the patients (287) electively operated for gastric ulcer 10-20 years ago were considered for the study. Operative mortality did not significantly differ, while duration of post-operative time before discharge and post-operative morbidity were significantly lower after B-I. Long-term percentage probability of survival was higher after B-I than after B-II (87.0 and 63.7 after 19 years, respectively), while quality of life was similar in the two groups. In the 64 subjects (26 B-I and 38 B-II) who underwent the study protocol, fasting bile reflux appeared more abundant and bile acid concentration greater after B-II than after B-I. While bacteria and nitrite concentrations did not differ in the two groups, bile acid pattern differed in a greater deoxycholic acid percentage concentration in the B-II group. In spite of an increased deoxycholic acid concentration and therefore a probably more lithogenic bile, gallstones were shown in 23.11% and 39.41% of the B-I and the B-II subjects, respectively, without significant differences. In conclusion, when partial gastrectomy is indicated for gastric ulcer, B-I reconstruction seems preferable to B-II because of its lower post-operative mobility, less evident entero-gastric reflux and histological consequences, less evident bile acid pattern changes from normal, and an apparently longer life-expectancy after discharge.

Adult↗
PubMed1987

Gastric histology and fasting bile reflux after partial gastrectomy.

Forty-four randomized, partially gastrectomized subjects were studied to assess whether gastric histologic findings after partial gastrectomy were related to reflux. Gastric biopsy specimens (12) were taken at different distances from the anastomosis. Histologic findings were as follows: (a) hyperplastic changes of the foveolar epithelium and (b) loss of the chief and parietal gland cells with atrophy of gastric glands (chronic atrophic gastritis). Hyperplastic changes typical of the perianastomotic area gradually decreased with increasing distance from the anastomosis. Hyperplastic changes showed a greater prevalence in Billroth II than in Billroth I subjects (100% vs. 29.4%). No significant association was found between histologic findings and symptoms. Hourly bile acid quantity (fasting bile reflux) and concentration were determined in the gastric aspirates. Bile reflux was greater after Billroth II than after Billroth I (fasting bile reflux median values: 30.5 vs. 0.18 mumol/h, respectively). The same was true for bile acid concentration (mean bile acid concentration median values: 624.9 vs. 17.5 mumol/L, respectively). Moreover, Billroth I subjects with hyperplasia had a greater quantity and concentration of reflux than those without hyperplasia (fasting bile reflux and mean bile acid concentration median values: 2.6 vs. 0.8 mumol/h and 4.7 vs. 2.7 mumol/L, respectively). These findings show that bile reflux is correlated with hyperplastic changes of the foveolar epithelium, but prevalence and severity of atrophic gastritis were not related to reflux. Therefore, although we failed to show any relationship between chronic atrophic gastritis and reflux, foveolar hyperplasia was shown to be reflux related.

Bile Reflux↗
PubMed1987

Periurethral neurofibroma.

A periurethral neurofibroma presenting as a midline perineal mass was removed in a three-year-old boy. An immunohistochemical study of S-100 protein distribution within the tumor tissue was performed.

Child, Preschool↗
PubMed1984

Procarbazine hydrochlorate carcinogenesis in Osborne-Mendel rats.

3 mg/day procarbazine hydrochlorate, in a total dose of 300 mg, provoked tumours or raised their number in a variety of rat organs and tissues. 70.8% males and 92.5% females bore tumors against 16.6 and 33% of the controls. It is suggested that the lack of a specific target organ is due to the metabolic conversion of procarbazine to alkylating agents in the liver. The chemical structure, distribution of these agents within the organism and the different organ-specific enzyme activation and inhibition systems are probably responsible for the variable organotropism.

Animals↗
PubMed1983

Induction of lung tumors and lymphomas in BALB/c mice by metronidazole.

Metronidazole, which is widely used in the treatment of "Trichomonas vaginalis", "Entamoeba histolytica" and "Giardia lamblia" infections, was administered to BALB/c mice by stomach tube in an aqueous solution at a dose rate of 2 mg/day for 100 days (total 200 mg) to test its carcinogenicity. The treatment induced a significant increase in lung tumors in male mice (p less than 0.001) and provoked the appearance of lymphomas in females (p less than 0.001). Although there is insufficient evidence to pass judgement on the potential carcinogenicity of metronidazole in man, the results of this and other investigations reported in the literature have demonstrated that metronidazole develops carcinogenic activity in rats and mice.

Animals↗
PubMedDate not supplied

Helicobacter pylori cag pathogenicity island is associated with enhanced interleukin-8 expression in human gastric mucosa.

BACKGROUND: In vitro studies showed that Helicobacter pylori strains carrying the cag pathogenicity island are able to induce epithelial secretion of Interleukin-8. AIMS: To evaluate the assessment of cag pathogenicity island and the expression of Interleukin-8 in the gastric mucosa of Helicobacter pylori-infected patients and correlate these data with the activity of gastritis and Helicobacter pylori density. METHODS: cag status was determined by polymerase chain reaction directly on gastric biopsies from 13 Helicobacter pylori+ patients with non-ulcer dyspepsia and 13 Helicobacter pylori+ with duodenal ulcer. Interleukin-8 gene transcription and protein expression were analysed by in situ hybridization and immunofluorescence, respectively. Gastritis activity and Helicobacter pylori density were also investigated. RESULTS: cag was present in 20/26 of Helicobacter pylori+ patients: in 7/13 non-ulcer dyspepsia (53.8%] and in 13/13 duodenal ulcer patients (100%), (p<0.05). Interleukin-8 mRNA and protein expression in epithelial and inflammatory cells was higher in cag+ than in cag- patients (p<0.005). Gastritis activity significantly correlated with cag (p<0.05) and Interleukin-8 expression (p<0.005]. Helicobacter pylori density was enhanced in cag+ [p<0.005] and correlated with Interleukin-8 expression (p<0.0051. CONCLUSIONS: The present study demonstrates that in Helicobacter pylori-infected human gastric mucosa, cag+ infection is associated with enhanced Interleukin-8 expression, higher levels of active gastritis and bacterial density, and presence of duodenal ulcer.

Antigens, Bacterial↗
PubMedDate not supplied

The availability of histologic grading among 5,923 Italian cancer patients and its relationship with survival: a population-based study.

AIM: The specific goal of the study was to evaluate the availability of the histologic grading of cancer and its effect on survival in an Italian population-based cancer series. METHODS: Data were drawn from the Tuscany Cancer Registry, active in central Italy since 1985. Among the cases incident during the period 1985 to 1989, bladder, prostate, colon, corpus uteri, rectum and stomach cancers, for which the proportion of graded cases exceeded 50%, were analyzed. Overall, 5,923 cancer cases were included. Ten-year relative survival rates by grade were computed. RESULTS: Overall, data on histologic grading was available only for 38% of cases. The sites most frequently graded were urinary bladder (80%), prostate (73%), colon (71%), corpus uteri (69%), rectum (65%) and stomach (56%). For all the cancer sites analyzed, the 10-year relative survival rates increased as the histologic grading improved. The grade distribution resulted related also to the disease extension, more limited the extension higher the proportion of well differentiated cases. CONCLUSIONS: Due to the evidenced importance of histologic grading as a valuable prognostic factor, it should be requested by clinicians and reported by pathologists more frequently than has been done in the area.

Adult↗
PubMedDate not supplied

Prostate cancer: population-based survival rates in central Italy.

AIMS: To evaluate survival in prostate cancer patients in the Province of Florence where the Tuscany Cancer Registry is active. METHODS: The survival of 777 patients with prostate cancer diagnosed in the period 1985-87 was evaluated. The observed and relative survival rates 1, 3 and 5 years after diagnosis were computed. Also the prognostic effect of age, disease extension, tumor grade, histological verification, place of residence and year of diagnosis were evaluated using univariate and multivariate analysis. RESULTS: The observed survival was 73.4% 1 year, 42.5% 3 years and 29.2% 5 years after diagnosis. The relative survival was respectively 78.7%, 53.0% and 43.0%. Significant independent risks were evident when the disease was extended out of the prostate, for patients older than 80 years, for high grade tumors and for patients without histological verification. CONCLUSION: The 5-year relative survival rate in the province of Florence is similar to those from other European Registries and the Latina Registry, but much lower than the one reported by the SEER program in the US. Data on histological verification percentage, availability of information on disease extension, and tumor grade are discussed as indicators of the quality of the diagnostic approach in comparison with other registries.

Aged↗
PubMedDate not supplied

Agreement estimate among three Italian cancer registries in the coding of multiple primary cancers.

AIMS: The aim of the study was to compare agreement on the coding of multiple primary cancers (MPs) between three italian cancer registries, the Ragusa Cancer Registry (RCR), the Cancer Registry of Romagna (RTRo), and the Tuscany Tumor Registry (RTT), that adhere to different rules for accepting MPs and to study whether coding according to common International rules (IARC-IACR) increased comparability. METHODS: One hundred cases were randomly extracted from the archives of each registry from those recorded as having more than one cancer. For each of the 300 patients, the number of independent cancers was attributed independently by one coder from each registry. The coders coded the series twice: once following the local registry rules and once according to the IARC-IACR rules. The agreement was estimated by couples of coders by means of Cohen's kappa statistics. RESULTS: The agreement on MP status between coders using local rules and definitions was good between the RTT and RCR (kappa = 0.77) and very good between the RTRo and RCR (kappa = 0.81) and the RTT and RTRo (kappa = 0.96). Exclusion of 23 expected discordant cases increased the agreement. The agreement reached with the use of the IARC-IACR rules was very good (RTRo vs RCR, 0.95; RTT vs RTR, 0.94; RTT vs RTRo, 0.95). CONCLUSIONS: The comparison among the RTT, RTRo and RCR confirmed that the number of tumors considered MPs may be modified depending on the rules adopted. There were minor differences between the RTT and the RTRo since their rules were very similar. Most differences in agreement were with the RCR since its classification was conceptually different from the other two. The result on agreement with IARC-IACR rules is encouraging from the point of view of conducting a cooperative study among different registries on the incidence of MPs.

Humans↗
PubMedDate not supplied

Villous and serrated adenomatous growth bordering carcinomas in inflammatory bowel disease.

The histologic phenotype of the dysplastic lesion juxtaposing colorectal carcinomas was assessed in 100 consecutive colectomy specimens: in 50 patients with inflammatory bowel disease (IBD) and in 50 controls (non-IBD patients). Adenomatous growths (AG) were regarded both Dysplasia Associated Lesion or Mass (DALM) and sporadic adenomas. AGs juxtaposing carcinomas were found in 76% (n = 38) of the IBD cases: 52.3% (20 out of 38) were villous, 28.9% (11 out of 38) serrated, 5.3% (2 out of 38) tubular and the remaining 13.2% (5 out of 38) were mixed AGs. Juxtaposing AGs (sporadic adenomas) were also found in 58% (n = 29) of the control cases: 51.7% (15 out of 29) were villous, 6.9% (2 out of 29) tubular, 3.4% (1 out of 9) serrated and the remaining 37.9% (11 out of 29) were mixed. The majority or 81.2% (31 out of 38) of the dysplastic lesions juxtaposing IBD carcinomas were villous or serrated AGs, but only 55.1% (16 out of 29) in control cases. Serrated AGs in particular accounted for nearly 29% of the non-invasive dysplastic lesions abutting IBD carcinomas but only for 3% in control specimens. It would appear that villous and serrated AGs are the most common non-invasive neoplastic lesions from which IBD carcinomas originate.

Adenoma↗
PubMedDate not supplied

Gastric carcinomas of intestinal type concur with distant changes in the gastric mucosa. A multicenter study in the Atlantic basin.

Population studies in the Pacific Basin showed that gastric carcinomas of intestinal type often concur with distant mucosal changes (DMCs). In the present work, the presence of DMCs was investigated in populations dwelling in the Atlantic Basin. A total of 1737 gastrectomy specimens were reviewed: 627 in New York, 435 in Reykjavik, 198 in Buenos Aires, 186 in Florence, 174 in London and the remaining 117 in Stockholm. A total of 17,282 sections were carefully scrutinized. The following DMCs were investigated: intramucosal glandular cysts, gastric cells with ciliated metaplasia, with large or small mucus negative vacuoles, and extensive intestinal metaplasia (IM). The highest frequencies of DMCs were found in Florence for specimens with intestinal type carcinoma: 41.3% had intramucosal cysts, 22.4% had cells with ciliated metaplasia, 12.9% cells with large vacuoles, and 50.9% had high IM. The highest frequency of gastric cells with small vacuoles was recorded in New York (9.1%), also in specimens with intestinal type carcinoma. Significantly lower DMCs percentages were found in specimens with carcinomas of diffuse type, and miscellaneous gastric diseases. The occurrence of DMCs was not influenced to a significant degree by the number of sections available per gastrectomy. Since environmental factors trigger the evolution of intestinal type carcinomas and as DMCs also occurred in specimens without carcinoma-although at a significantly lower rate--it is conceivable that DMCs are also evoked by environmental factors (before a gastric carcinoma ensues). DMCs were found in specimens having intestinal carcinomas either in the cardia, the corpus or the antrum. Thus, DMCs seem to provide the adequate "soil" for the development of gastric carcinomas of intestinal type, independently of the future localization of that tumor in the stomach.

Adenocarcinoma↗
PubMedDate not supplied

Expression of nm23 gene in gastric cancer is associated with a poor 5-year survival.

The nm23 gene is thought to play a role as an inhibitor of metastatic progression in several human cancers and its down-regulation has been associated with increased metastasis and reduced survival in some studies, though not in others. To better investigate the role of nm23 in gastric cancer (GC), the expression and prognostic impact of this gene was examined in 107 radically operated GC patients in a high risk area. The expression of nm23 was determined immunohistochemically by using the rabbit antibody anti-human nm23 protein. The expression of nm23 was detected in 40.2% (n = 43) of 107 gastric tumours and correlated with a poorer clinical outcome. In a survival analysis at 5 years, patients with nm23-positive tumours had significantly worse prognosis than patients (n = 64) with nm23-negative tumours (p < 0.05). The prognostic significance of nm23 expression was confirmed by multivariate analysis including terms for tumour stage and lymph node involvement. Our results suggest that the expression of the nm23 gene in gastric carcinoma is significantly related to tumour progression and poor prognosis at 5 years.

Adult↗
PubMedDate not supplied

Calf pseudohypertrophy in a patient with double neurogenic pathology.

A pseudohypertrophy of the calf can be rarely associated with neurogenic pathologies as S-1 radiculopathy, poliomyelitis, spinal muscular atrophy, traumatic lesions of peripheral nerves, intraspinal neurinoma. The causes of this particular phenomenon are unknown. The authors present the case of a 52-year-old man with an enlargement of the left calf suffering from a mild form of spinal paralytic poliomyelitis in the early childhood and episodes of severe left sciatica in the last four years. Electromyography demonstrated a pattern of denervation in both legs and an H-reflex absent when the left tibial nerve was stimulated. An open muscle biopsy of the left calf was performed. Light microscopic and ultrastructural examination of the muscle confirmed the presence of a pattern of "neurogenic type" pseudohypertrophy. Our results could be interesting for the understanding of the mechanism of neurogenic pseudohypertrophy. This case suggests that timing of stimulus or "dose" of denervation may be important factors in such a phenomenon.

Electromyography↗