Biomedical subjects

D Marconi

Publications and source records attributed to D Marconi.

26 records · Page 2Linked to original sources

PubMed1995

Menstruation is associated with disordered expression of desmoplakin I/II and cadherin/catenins and conversion of F- to G-actin in endometrial epithelium.

Endometrium is unique since it is the only tissue that undergoes regular cyclic bleedings. Menstrual shedding is associated with the breakdown of endometrium, including the fragmentation of endometrial glands. To gain insight into the underlying basis of fragmentation of the endometrial epithelium during the menstrual phase, we examined the expression of proteins implicated in epithelial cell-cell binding in human endometria throughout the entire menstrual cycle. Western blotting failed to reveal differences in the relative amount of E-cadherin, alpha- or beta-catenin or actin in the menstrual endometria compared with those in the proliferative or secretory phases. However, specific changes in the expression pattern of these proteins as well as desmoplakin I/II were detected by immunohistochemical staining in epithelial cells of menstrual endometria. Desmoplakin I/II, E-cadherin, alpha- and beta-catenins and beta-actin were localized to intercellular borders as well as the luminal and basal regions of glandular epithelium during the proliferative and secretory phases. Immunoreactivity of E-cadherin and alpha-catenin was confined to epithelial cells, whereas beta-catenin and beta-actin were present in epithelial cells, as well as in stroma and endothelial cells. Binding of F-actin to fluorescein isothiocyanate-labelled phalloidin localized this form of actin to the intercellular borders, and the basal and luminal cytoplasm of epithelial cells in proliferative and secretory endometria. Menstrual shedding was associated with disorganization of the site-specific distribution of desmoplakin I/II, E-cadherin and alpha- and beta-catenins.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗

PubMed1995

The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy.

OBJECTIVE: To show that intrauterine anesthesia is a reliable method for reducing pain associated with endocavitary procedures. DESIGN: A prospective, randomized, double-blind study. SETTING: The Department of Obstetrics and Gynecology, Tor Vergata University of Rome, Rome, Italy. PATIENTS: Forty-five patients undergoing diagnostic hysteroscopy (n = 27) or hysteroscopy and endometrial biopsy (n = 18). INTERVENTIONS: Five milliliters of 2% mepivacaine or saline solution were injected transcervically into the uterine cavity before performing the procedures. MAIN OUTCOME MEASURES: Evaluation of pain reduction on a visual analogue scale. RESULTS: Pain expectation and pain reported were reduced during and after the procedures. CONCLUSION: Topical anesthesia effectively reduces pain during hysteroscopy and endometrial biopsy.

Anesthesia, Local↗

PubMed1995

Hysteroscopically detected asymptomatic müllerian anomalies. Prevalence and reproductive implications.

OBJECTIVE: To assess the prevalence of uterine anomalies and relative reproductive function in 322 women with abnormal uterine bleeding (AUB) evaluated by diagnostic hysteroscopy. STUDY DESIGN: Uterine contours were classified as septate/bicornuate, arcuate or normal on the basis of hysteroscopy. A complete medical history was obtained from all the subjects; it included a questionnaire on menstrual characteristics, reproductive history and pregnancy outcome. Cumulative birth rates, frequency of spontaneous abortion, preterm delivery, malpresentation and mode of delivery in patients with normal and abnormal uteri were compared using life table analysis, the log-rank test and chi 2 analysis. RESULTS: Arcuate, septate/bicornuate and unicornuate uteri were observed in 6.5%, 3.7% and 0.3% of women, respectively. Although 24-month pregnancy rates and monthly fecundability rates were similar in women with and without müllerian anomalies, the 36-month cumulative live birth rate was significantly lower in women with a septate/bicornuate uterus. Overall, women with uterine malformations showed a significantly higher miscarriage rate (P < .05) and a significantly lower term delivery rate (P < .05) than women with a normal-shaped uterus. CONCLUSION: Diagnostic hysteroscopy in women with AUB detected a 10% prevalence of uterine anomalies, which were associated with a significantly higher incidence of spontaneous abortion and lower cumulative live birth rates.

Case-Control Studies↗

PubMed1994

Hysteroscopic Evaluation in Patients with Thickened Endometrium at Vaginal Ultrasound Examination

The purpose of this study was to evaluate the hysteroscopic appearance of the endometrium in cases with abnormal thickening (>8mm) evaluated by vaginal ultrasound. We considered postmenopausal patients who were asymptomatic and those with abnormal uterine bleeding (AUB). Hysteroscopy with endometrial biopsy revealed cancer, hyperplasia, polyps, and myoma in patients with AUB. In the asymptomatic group with increased endometrial thickening, hysteroscopy revealed hyperplasia, polyps and myoma. Our results show that vaginal ultrasound is a reliable method for evaluation of the endometrium in postmenopausal women. Hysteroscopic examination is required to assess the endometrial pathology, and to determine which patients will require biopsy or surgical intervention.

Journal Article↗

PubMed1994

Hysteroscopic Findings of Placental Site Nodule (PSN). A Case Report

The hysteroscopic findings of placental site nodule, an unusual and cytologically alarming lesion, is reported. A 29-year-old woman, para 2, presented with a 3 month history of intermenstrual bleeding. The last spontaneous delivery occurred 12 months previously. Pelvic examination was negative. Ultrasound examination revealed increased thickness and irregularity of the endometrium (16-18 mm). Diagnostic hysteroscopy performed the same day revealed the endometrial surface to be irregular due to a focal nodular lesion with increased regular vascularization in the fundal area. The nodule was about 2 cm in diameter, had an irregular surface and a variegated appearance, and was white-red in color with hemorrhagic and necrotic areas. A targeted biopsy of the lesion was performed. Histologic examination revealed a "placental site nodule." A subsequent D&C confirmed the diagnosis. Fifteen days after surgery, hPL and hCG serum levels were evaluated and were negative. This is the first hysteroscopic report of a placental site nodule. We conclude that hysteroscopic evaluation of abnormal uterine bleeding is very important, because it allows the examination of the uterine cavity and lesions, making possible a guided biopsy. Hysteroscopy is also useful during the follow-up of this type of pathology.

Journal Article↗

PubMed1994

The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy.

STUDY OBJECTIVE: To determine whether the pain and discomfort of routine hysteroscopy with endometrial biopsy to diagnose infertility and endometrial pathology can be minimized by topical application of mepivacaine. DESIGN: Prospective, randomized, double-blind study. SETTING: The Department of Obstetrics and Gynecology at a teaching hospital in Rome, Italy. PATIENTS: Eighteen women undergoing diagnostic hysteroscopy. INTERVENTIONS: Hysteroscopy and endometrial biopsy were performed after transcervical injection of 5 ml 2% mepivacaine or 5 ml saline solution into the uterine cavity. MEASUREMENTS AND MAIN RESULTS: Difficulty introducing the hysteroscope was rated by the operator on a scale of 1 to 3. An observer scored visible signs of each woman's distress using a three-point scale. The patients reported their pain 15, 30, 60, 120 minutes after the procedure on a visual analog scale. Mepivacaine was more effective than placebo according to all measurements. CONCLUSIONS: Topical mepivacaine reduced the pain experienced during and after hysteroscopy and endometrial biopsy.

Adult↗

PubMed1992

[Hysteroscopic evaluation of endometrial ultrasonic anomalies in asymptomatic postmenopausal patients. Preliminary results].

A group of 248 asymptomatic postmenopausal patients was evaluated using transvaginal echography. Thirty-five patients with endometrial echopatterns which were larger than 8 mm and/or irregular then underwent hysteroscopy and endometrial biopsy. Results show that 31.4% of cases in which there was a thickening of the endometrial echopattern correspond to the presence of polyp, myoma, synechia with atrophic endometrium. In conclusion, the Authors affirm the inappropriateness of the term "endometrial echopattern" in menopause, since this term should be reserved to describe the typical appearance of the endometrium during the reproductive phase. They stress that ultrasonography can reveal anomalies of the internal echostructure of the womb but that further tests (e.g. hysteroscopy, biopsy) are required to diagnose their nature.

Adult↗

PubMed1992

[Crohn disease in pregnancy. Considerations on and discussion of a clinical case].

Crohn's disease with acute abdomen in pregnancy is described. The Authors evaluate Crohn's disease together with the diagnostic, prognostic and therapeutic problems and relationships between this disease and pregnancy. They conclude as underlining the rarity of Crohn's disease beginning in pregnancy and so the importance of symptoms related to this disease in fertile age woman to make diagnosis and therapy before pregnancy.

Abdomen, Acute↗