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C Giardina

Publications and source records attributed to C Giardina.

67 records · Page 4Linked to original sources
PubMed1984

[Simulation of the metastatic spread of mammary carcinoma by evaluation of the shortest routes in a computerized model of the lymphatic system represented in a three-dimensional map].

A simulation model of mammary lymphatics has been realized by a computerized system to draw a tridimensional map of all lymphnode stations (axillary, supraclavear and internal mammary lymphnodes) draining from the breast. The purpose was to identify the minimal routes between tumor and lymphnodes and among different nodal points that represent lymphnodes of the lymphatic net situated at various distance from tumor. A simulation of node metastatization has been performed giving to every route of the model a different weight represented by the distance between the nodes.

Breast Neoplasms↗
PubMed1980

[Histological findings on the relation between elastosis and breast neoplasms and dysplasia].

Connective tissue changes with particular reference to elastosis in malignant and dysplastic breasts are studied. Hyperelastosis was closely associated with carcinoma particular with scirrhous type also in the perineoplastic area; on the contrary the percentage of the phenomena in benign displastic disease is significantly low. Elastosis was located around carcinomatous tissue, mammary neoplastic ducts and also around veins and as scattered foci in the stroma. The site of production of elastic fibers is discussed. Elastosis accompanying carcinoma is considered more than a simple association but its prognostic significance has not an absolute value.

Breast Diseases↗
PubMedDate not supplied

Interobserver reproducibility in diagnosis of breast lesions. A panel in Puglia (Italy). GSBioCaM.

BACKGROUND: Given the incidence of breast cancer, histologic agreement is necessary to select the proper treatment. METHODS & STUDY DESIGN: Twelve pathologists working in Puglia (Italy) independently evaluated a set of 88 slides of breast lesions. The set included 31 cases which presented difficulties at the moment of first diagnosis (problem cases) and 57 cases without problems (routine cases). Each pathologist was requested to classify lesions according to four categories: A, benign; B, atypical proliferation; C, in situ carcinoma; D, invasive carcinoma. For each case, the definite diagnosis was considered that provided by most of the pathologists (prevalent diagnosis). For the evaluation of degree of agreement, kappa statistics were utilized. RESULTS: Among routine cases, agreement was observed in 68.4% of cases (38/57) and in 29% of problem cases (9/31). The pair-wise comparison between all participating pathologists showed a good overall agreement, (kappa mean, 0.66; range, 0.57-0.76). The agreement of each pathologist with the prevalent diagnosis was high for invasive (mean kappa, 0.88) and benign lesions (mean kappa, 0.83) followed by in situ carcinoma (mean kappa, 0.64). The lowest value observed was for atypical lesions (mean kappa, 0.25). CONCLUSIONS: The results showed a good overall degree of diagnostic concordance among participating pathologists, all working in the Italian region of Puglia. The findings emerging from the study are comparable to those of other studies performed with selected pathologists specifically specialized in breast pathology. Moreover, the study confirmed the diagnostic difficulties for borderline lesions and the necessity of further investigation for sclerosing lesions with discordant diagnoses.

Breast Neoplasms↗
PubMedDate not supplied

Sentinel lymph node biopsy for sparing axillary dissection in selected patients with breast cancer.

Axillary lymph nodal status in breast cancer remains one of the more important prognostic factors. In early breast cancer axillary lymph node metastasis are found only in 10-18%. It can be deduced that in all these patients a complete axillary dissection is an overtreatment. The concept of sentinel lymph node (SN) was applied to breast cancer. Of course if SN examination gives negative findings, the patient will avoid axillary lymphadenectomy. 134 patients with localized breast cancer were evaluated for enrollment into the study. In 40 (29.8%) patients lymphoscintigraphy was performed together with an injection of vital dye to identify the SN, in 94 (70.1%) only vital dye was utilized. The mapping procedure was successful in 129 cases (96.2%). In our study there was concordance between SNs and axillary nodes in 120 out off 124 cases (96.7%). The false-negative rate was 4.8% (4/83). The overall sensitivity of the SN biopsy was 91.1% (41/45), with a negative predictive value of 95.1% (79/83). Five patients had SN negative and they decided do not undergo axillary lymphadenectomy. This study demonstrates that accurate SN identification was obtained combining lymphoscintigraphy and blue dye. Moreover, each method requires a suitable learning curve. After an accurate training, complete axillary lymphadenectomy can be avoided in selected patients.

Adult↗
PubMedDate not supplied

Combined adrenal adenoma and myelolipoma in a patient with Conn syndrome. Case report.

Adrenal myelolipoma is an uncommon benign tumor usually discovered by chance in patients with hypertension, obesity, arteriosclerosis or cancer. The association with adrenocortical endocrine dysfunctions is rare. We report herein an unusual case, the second in the literature to the best of our knowledge, of combined adrenal adenoma and myelolipoma in a patient with Conn syndrome.

Adenoma↗
PubMedDate not supplied

[Subareolar injection for sentinel lymph node biopsy in multiple breast cancer].

In this study we performed subdermal injection of 99mTc-labeled albumin combined with subareolar (SA) injection of blue dye to axillary lymphatic mapping and sentinel lymph node biopsy (SNLB) in patients with multifocal and multicentric breast cancer (MC) to evaluate the feasibility and accuracy of this technique. We compared the results with a group of patients with unifocal breast cancer. From January 1999 to March 2006 axillary lymph node mapping and SLNB was performed on 250 patients followed by a complete axillary lymph node dissection. Retrospective analysis showed that 32 (12.8%) of these patients have MC on final histopathologic examination and 218 (87.2%) have unifocal cancer. In statistical analysis tumor size shows a significant difference (p=.01) with largest lesions in MC. In MC often histological type is invasive lobular with or without in situ cancer (p= .001). Metastatic lymph node involvement was significantly higher in the MC group compared to unifocal cancer group (p=.001). False negative (FN) rate was 5.8% in MC and 9.6% in unifocal cancers. The overall accuracy of lymphatic mapping was 96.8% in MC and 97.6% in unifocal cancers. Sensitivity was 94.4% in MC and 91.2% in unifocal cancers. In this study we provide further evidence that lymphatic mapping may be reliable even in patients with MC. SA injection technique demonstrates a high sentinel lymph node identification rate and low FN rate; therefore this technique should been recommended to SLNB in patients with MC of the breast.

Adult↗
PubMedDate not supplied

[A case of recent atrial flutter treated with intravenous propafenone].

A recently observed case triggers an examination of Propafenone (P.) treatment of atrial flutter (AF). A review of the literature reveals that the question has not so far been sufficiently investigated. In fact only one paper reporting the inadequacy of P. in the treatment of certain forms of AF and atrial fibrillation caused by vagal hypertonia has apparently been published. The case presented here is of a 59 year old man with left bronchial pneumonia in a static phase and an ECG indicating AF. Treatment with P. in slow-release bolus form (2 mg/kg) converted the AF into sinus rhythm in the space of a few minutes. In the absence of any demonstrable cardiac pathology the condition in thought to have been caused by the patient's precarious metabolic status (hypoxaemia, sepsis).

Atrial Flutter↗
PubMedDate not supplied

Nuclear morphology and histological grading of oral squamous cell carcinoma (OSCC). A morphometric study.

Histological grading of oral squamous cell carcinoma (OSCC) is usually evaluated in a semiquantitative way and this causes a low grade of reproducibility of this prognostic evaluation. The aim in this preliminary phase is to investigate the relation between nuclear shape (studied by an analytical procedure) and histological grading to evaluate the weight of nuclear shape and dimension in grading formulation. Nine cases of OSCC were studied (3 cases of G1, G2 and G3 respectively) with 20 nuclei for each case. All the tumors were localized on the lip. Histologic grading according to the Bryne system was performed. Each nucleus was submitted to a morphometrical study by the SAM (Shape Analytical Morphometry) system which, apart from dimensions allows us to evaluate nuclear contour irregularities and nuclear shape asymmetry. Nuclei of squamous cell carcinoma show a progressive increase in dimensions (area, perimeter and diameter) from G1 to G3. Nuclei of G3 carcinoma are characterized by the most irregular shape. Size differences (mean value) are significant to differentiate G1 nuclei from G2 and G3 nuclei while shape parameters are useful in distinguishing G3 nuclei from G1 and G2. Multivariate discriminant analysis showed that by using only nuclear parameters it is possible to correctly classify about 80% of nuclei. This study, using quantitative methods, confirmed nuclear pleomorphism to be the most important feature in grading evaluation.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Nuclear shape and axillary metastases in breast cancer. Analytic morphometry of aspiration smears.

The aim of this work was to seek quantitative parameters other than dimensions to describe nuclear shape and, by this means, to determine the sum of contour irregularities and large asymmetries and seek a connection with the biologic behavior of the tumor. Nuclei of the cells obtained from 57 aspiration smears of breast cancers were studied. Dimensional parameters (area, perimeter, maximum diameter and roundness factor) and analytic parameters were computed by the Shape Analytical Morphometry software system to evaluate both contour irregularities and asymmetry of nuclear shape. All the tumors were subdivided according to their diameters into two groups: T1 tumors, the maximum diameter of which was < 2 cm (18 cases), and T2 tumors, the maximum diameter of which was > 2 cm and < 5 cm (39 cases). Among T1 tumors, both dimensional and analytic parameters were highly significant (P < .001) in distinguishing tumors with (N+) and tumors without (N-) axillary metastases, while among larger tumors (T2) only the analytic parameters showed degrees of significance, albeit variable. It could be inferred that in smaller tumors, aggressiveness is related to an increase in nuclear dimensions and shape distortions more so than in larger tumors.

Biopsy, Needle↗