To determine whether indexes obtained from a newly developed echocardiographic automated border detection (ABD) technology provide a reliable estimate of left ventricular (LV) diastolic filling, ABD variables of LV filling were compared with volumetric measurements determined by radionuclide angiography. Forty-two patients with a variety of heart diseases (age range, 11 to 76 years) underwent ABD echocardiographic studies on the same day as the radionuclide examination. Technically adequate ABD data could be obtained in 31 patients (74%). Nineteen healthy subjects served as normal controls. Area-time and volume-time waveforms for echocardiographic measurements were obtained from LV short-axis views at the level of the papillary muscles and four-chamber apical views. Both the diastolic indexes derived from the waveform of area change (short-axis view) and volume change (four-chamber apical view) correlated with radionuclide variables. Values measured from the ABD area-time waveform showed the following correlations: peak filling rate (r = 0.86; standard error of the estimate [SEE] = 0.62), time to peak filling rate (r = 0.85; SEE = 23.11), rapid filling phase fractional change (r = 0.79; SEE = 5.51), and atrial filling phase fractional change (r = 0.71; SEE = 5.82). Correlations of indexes derived from the ABD volume-time waveform were as follows: peak filling rate (r = 0.87; SEE = 0.50), time to peak filling rate (r = 0.90; SEE = 22.03), rapid filling fractional change (r = 0.83; SEE = 5.33), and atrial filling fractional change (r = 0.77; SEE = 4.68). ABD LV filling parameters in patients with heart disease and normal control subjects were significantly different. Thus ABD data from short-axis and apical views have a strong linear relation with radionuclide ventriculographic measurements and may be used as a method to assess LV diastolic filling.

Adolescent↗

PubMedDate not supplied

Gastric hepatoid adenocarcinoma with autophagy-related necrosis-like tumor cell death: report of a case.

A case of hepatoid adenocarcinoma of the stomach is presented. The characteristic features of the tumor are summarized on the basis of the authors' experience and the literature. Ultrastructural examination revealed patchy condensations of chromatin throughout the nucleus suggestive of necrosis-like programmed cell death (PCD). These nuclear alterations were associated with the occurrence of vacuoles and lipofuscins, conferring an autophagic phenotype to this PCD. Thus, the case reported here provides an example of autophagic-related necrosis-like PCD. Alternative PCDs are reviewed and their morphologic distinction is discussed.

Adenocarcinoma↗

PubMedDate not supplied

Degranulation patterns of eosinophils in advanced gastric carcinoma: an electron microscopic study.

Recruitment and activation of eosinophils have been studied intensely in asthma and other allergic diseases. Less is known about the infiltration and degranulation patterns of eosinophils in the tumor stroma. Seven cases of advanced gastric carcinomas were found to be massively infiltrated by eosinophils and studied by light and electron microscopy. Gastric carcinomas, despite having similar numbers of tissue eosinophils, exhibited markedly different degranulation patterns. In 2 cases, resting nondegranulating eosinophils were found. Piecemeal degranulation was the predominant mode of secretion from eosinophils localized within the tumor stroma in 4 cases. Eosinophil exocytosis and cytolysis were rarely observed. In 1 case, crystals morphologically similar to Charcot-Leyden crystals were observed at the extracellular level as well as in phagosomes of tissue macrophages, confirming active sequestrations of eosinophil Charcot-Leyden protein by macrophages in vivo. In the same case, eosinophils showed characteristic features of early and late apoptotic changes, such as condensed chromatin, focal dilatation of nuclear envelope, and preserved plasma membrane. Morphological association between apoptotic eosinophils and deposition of granules in the tumor stroma was found. Extracellular deposition of intact granules from apoptotic eosinophils was distinct from eosinophilic (necrotic) cytolysis, and has reported previously in experimental studies in vitro. To the knowledge of the authors, this case represents the first report of late apoptotic eosinophils that release their granules within the tumor stroma in a human gastric carcinoma.

Aged↗

PubMedDate not supplied

PVF velocity pattern in patients with heart failure: transesophageal echocardiographic assessment.

In order to assess the role of the pulmonary venous flow (PVF) velocity pattern in the evaluation of patients with congestive heart failure (CHF), we studied 41 CHF patients by means of transthoracic echocardiography (TTE) and multiplane transesophageal echocardiography (TEE). The etiology of CHF was idiopathic or ischemic dilated cardiomyopathy in 19 patients and hypertensive heart disease in 22. Sixteen subjects without cardiovascular disease were selected as normal controls. PVF peak systolic and peak early diastolic (D) velocities were recorded by TEE and TTE and the systolic fraction (SF) was measured (i.e., the systolic velocity-time integral-VTI-expressed as a fraction of the sum of systolic and early diastolic (VTI). TEE tracings were obtained in all patients and had more laminar-appearing spectral signals, thus were used for analysis. By TEE the mitral flow velocity patterns were also evaluated: peak early diastolic velocity (E), peak velocity at atrial contraction, E velocity normalized for VTI (E/VTI), deceleration time (DT), and left ventricular isovolumic relaxation time (LVIRT). The left ventricular ejection fraction (LVEF) was calculated by two-dimensional echocardiographic images using the modified Simpson method. The SF was lower in CHF patients as compared with normal controls (p < 0.0001). The E/VTI ratio was higher, and DT and LVIRT were shorter (p < 0.0001) in CHF patients. A significant correlation was observed between SF and LVEF in CHF patients (r = 0.76, p < 0.001). Two different PVF velocity patterns (type A:SF << 50%, D > 50 cm/s; type B:SF approximately 50%, D > 50 cm/s) were recognized in patients with a low LVEF (type A) and a nearly normal or normal LVEF (type B). Patients with LVEF < 40% showed mean SF values significantly lower than patients with LVEF > 40% (33.26 +/- 10.84 vs. 51.00 +/- 4.00%, p < 0.0001). Mean DT and LVIRT values were not significantly different in patients with LVEF < 40% and > 40%. Thus in CHF patients TEE PVF velocity patterns help in distinguishing patients with systolic dysfunction (low LVEF and SF) from patients with predominant diastolic impairment (normal or nearly normal LVEF, high D velocities).

Adult↗

PubMedDate not supplied

Integrin beta2-chain (CD18) over-expression on CD4+ T cells and monocytes after ischemia/reperfusion in patients undergoing primary percutaneous revascularization.

beta2-integrin subunit (CD18) plays an essential role in leukocyte recruitment and adhesion in sites of endothelial injury. We analyzed the surface expression of CD18 on T lymphocytes and monocytes in a series of patients presenting acute coronary syndrome (ACS) who underwent primary percutaneous intervention (PCI) for coronary artery revascularization. We found that basal CD18 expression on peripheral blood-derived CD4+ (but not CD8+) T lymphocytes was significantly increased in ACS patients as compared with age-matched healthy volunteers. During primary PCI, a significant increase in CD18 molecule density was detected immediately after balloon deflation (reperfusion) on both CD4+ T cells and monocytes obtained from the right atrium (RT) as compared with basal values. These data suggest that upregulation of CD18 molecules plays an important role in local recruitment of CD4+ T cells and monocytes to the site of endothelial damage after ischemia/reperfusion, therefore being responsible, at least in part, for the inflammatory-mediated complications associated with primary PCI.

Aged↗

PubMedDate not supplied

Immunohistochemical demonstration of metallothionein in eyes with choroidal melanomas.

PURPOSE: The since immunohistochemically detectable metallothionein (MT) overexpression has been described in a variety of human tumours, including skin melanomas, in relation to different stages of tumour development and progression. MATERIALS AND METHODS: We used a monoclonal antibody to investigate the distribution of MT in 18 formalin-fixed, paraffin-embedded, surgically enucleated eyes with choroidal melanomas, from 18 patients (8 male, 10 female; age range 30-83 years, mean 58.7). Clinico-pathological details and follow-up data (2-124 months, mean 36.1) were also available. MT immunoreactivity was recorded and the percentage of stained cells was graded for semiquantitative purposes. Correlations between immunohistochemical data and morphological characteristics of melanomas were investigated using non-parametric methods; survival analysis was done by the Kaplan-Meier method and the survival curves were compared by the Mantel-Cox log-rank test. RESULTS: MT immunoexpression was found in 15/18 cases (83.3%) with staining scores from 1 to 3; MT staining varied in intensity and was mainly localized in the cytoplasm, although a combined nuclear/cytoplasmic reactive pattern was seen in neoplastic elements. No differences in MT immunostaining were seen in relation to age or sex, tumour size, histotype and amount of pigment; univariate analysis of survival data showed no prognostic significance regarding MT expression. CONCLUSIONS: The immunohistochemical evidence of MT in neoplastic elements could be related to the production of this scavenging protein in the tumour for cell defense mechanisms against hydroxyl free radicals, and to act as a Zn donor, since Zn is required for the synthesis of DNA and DNA-repair enzymes.

Adult↗

PubMedDate not supplied

Mast cell interaction with tumor cells in small early gastric cancer: ultrastructural observations.

The authors studied the mast cells by light and electron microscopy in four small intramucosal early gastric cancers (EGC). Mast cells were found in the tumor stroma and among neoplastic cells of adenocarcinoma glands. Stromal and adenocarcinoma-infiltrating mast cells were ultrastructurally identified as T mast cells, and exhibited anaphylactic or piecemeal degranulation. Tumor cells in intimate contact with mast cells showed no cytopathic changes. These data do not support a mast cell-mediated cancer lysis, such as that reported in some systems in vitro. The interepithelial localization of T mast cell in adenocarcinoma glands is similar to that observed in some disease states, including interstitial cystitis, fibrotic lung disorders, and mucosal allergic reaction. The findings suggest that T mast cells may be involved in the pathophysiology of the host reaction to small intramucosal EGC.

Adenocarcinoma↗

PubMedDate not supplied

[Biologically borderline neoplasms: epithelial hemangioendothelioma. A case report].

The case of a patient affected by an epithelial hemangioendothelioma of the arm is described. A definitive diagnosis was possible only by histologic examination. The difficulty to reliably predict the biological behaviour of these tumors is emphasized and therefore the necessity of a follow-up of the patient for many years is stressed, even in the case of a histologically benign tumor.

Adult↗

PubMedDate not supplied

[Myogenic stromal tumors of the stomach: personal experience].

Myogenic gastric tumours are a rare pathology and present difficulties in terms of nosographic classification, which in most cases can be overcome thanks to improvements in imaging and immunohistochemical techniques. Over the period 1995-1999 we observed 5 patients with aspecific dyspeptic symptoms and occasional epigastric pain, suffering from non-epithelial gastric tumours, associated, in one case, with a carcinoma of the stomach. Histological examination of endoscopic biopsies was inconclusive for a definite histopathological diagnosis, while intraoperative biopsies showed the myogenic origin and the absence of morphostructural abnormalities. In the light of these data, we performed three wedge resections, one distal gastric resection and, in the patient with advanced gastric cancer, a D3 total gastrectomy. Histological examination, immunohistochemistry and cytofluorometry enabled us to diagnose stromal tumours with a low risk of malignancy in all cases. At follow-up after 9-54 months all patients are still alive and free of disease. Though the preoperative diagnosis of stromal tumours is possible with endosonography and CT, only histology, immunohistochemistry and cytofluorometry enable us to define the condition nosographically and establish a prognosis with sufficient accuracy to allow correct surgical treatment. A prolonged follow-up is always necessary to identify eventual relapses and/or metastases, which are particularly frequent in the borderline group or in cases with a high risk of malignancy.

Adult↗

PubMedDate not supplied

[Acute bleeding in gastrointestinal stromal tumor: case report].

A.A. refer a case report on a patient observed in emergency condition for acute bleeding from digiunal bowel by a GIST. Starting from clinical case, describe a brief profile of clinical, histogenetic, diagnostic and prognostic characteristics of the GIST also delineated by recent reports from literature; agree with other A.A. about treatment procedure represented always by resection of affected intestinal tract and never by enucleation for inconstant and unforeseeable biologic comportment by this tumours.

Acute Disease↗