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Biomedical subjects

F M Vecchio

Publications and source records attributed to F M Vecchio.

At least 37 records · Page 2Linked to original sources
PubMed1994

DNA ploidy pattern in human chronic liver diseases and hepatic nodular lesions. Flow cytometric analysis on echo-guided needle liver biopsy.

BACKGROUND: Significantly elevated fractions of diploid hepatocytes and reduction in the polyploid populations have been reported in human and experimentally induced hepatocellular carcinomas (HCC). This study was conducted to determine how these changes are related to conditions that often precede HCC, such as chronic hepatitis, cirrhosis, and premalignant focal nodules in cirrhotic livers. METHODS: Ultrasound-guided needle biopsy specimens of the liver were obtained from patients with chronic hepatitis, cirrhosis, or ultrasonographically diagnosed nodules within cirrhotic livers; biopsy specimens also were taken from patients without hepatic disease. DNA flow cytometry was performed on isolated nuclei to determine the percentages of diploid, tetraploid, and octaploid hepatocytes; the S-phase fraction for each diploid peak and the diploid/polyploid (tetraploid + octaploid) ratio also were calculated. Part of each specimen was reserved for evaluation of hepatocyte binuclearity. RESULTS: Chronically hepatitic (18 patients) and cirrhotic (18 patients) livers showed significantly increased diploid/polyploid ratios, with respect to normal livers, that were significantly correlated with decreases in hepatocyte binuclearity. This trend was even more marked in euploid nodules (4 premalignant and 5 malignant), in which the S-phase fractions were significantly higher than those of normal liver; aneuploidy was found in 6 of 11 malignant and 2 of 6 premalignant nodules.

Aged↗
PubMed1994

Concomitant preoperative radiochemotherapy in operable locally advanced rectal cancer.

PURPOSE: The aim of this study was to examine the effectiveness of a combination of preoperative radiotherapy and chemotherapy for operable locally advanced rectal cancer (Stages II and III). METHODS: Chemotherapy and radiotherapy are started jointly on day one of the therapy. 5-Fluorouracil is given in a dosage of 1000 mg/m2/day as a continuous 24-hour infusion for 4 days. Mitomycin C is given as a bolus intravenous at a dosage of 10 mg/m2 the first day. The radiation therapy is given to a total dosage of 37.8 Gy. Surgery is generally performed four to five weeks following completion of the radiation therapy. From March 1990 to April 1993, 34 patients with histologically documented adenocarcinoma of the rectum have been treated. Twenty-one lesions were located in the lower third of the rectum. Twenty-nine neoplasms were judged by initial clinical staging as Stage III. RESULTS: Patients compliance to the treatment have been 97 percent. Toxicity of treatment has been low (15 percent). Tumor sizes decreased 50 percent or more in about 80 percent of patients. Distance of the tumor from the anal canal increased in all but seven cases. Twenty-two anterior resections have been performed. The morbidity rate has been 24 percent. No postoperative mortality has been reported. Histologic examination of surgical specimens after integrated treatment showed in 10 cases a tumor confined to the rectal wall (T2), in 3 patients only a residual tumor limited to submucosa (T1), and in 5 (15 percent) patients no evidence of neoplastic cells (T0). CONCLUSIONS: We conclude that preoperative radiochemotherapy was generally well tolerated; in all cases we had a reduction of tumor sizes, surgery presented no technical difficulties, and there was the effect of stage reduction.

Adenocarcinoma↗
PubMed1994

Circadian variations of epithelial cell proliferation in human rectal crypts.

BACKGROUND/AIMS: Evidence (almost exclusively from animal studies) suggests that proliferation within the colorectal mucosa undergoes circadian variations. The epithelial cells that line the human colorectal crypt occupy definite positions along the longitudinal axis according to their proliferative potential and degree of differentiation. Thus, circadian rhythmicity was investigated in humans to locate the areas along the longitudinal crypt axis in which diurnal fluctuation might occur. METHODS: Rectal mucosal biopsy specimens were obtained every 4 hours for a 24-hour span from each of 23 subjects (8 healthy volunteers and 15 with histories of sporadic adenomatous polyps). [3H]thymidine histoautoradiography was used to determine ratios of S-phase to total cells (total labeling index) in the crypt. Glands were also divided into 5 equal compartments from base (compartment 1) to mouth (compartment 5), and labeling indices were calculated for each. RESULTS: Important temporal variations were confined to compartment 2 (F = 5.15, P = 0.0003) and total labeling indices (F = 3.57, P = 0.005). Despite individual variations, proliferation was generally higher at night and lower during afternoon. Upper-crypt proliferative rates (compartments 4 and 5) remained decidedly stable (F = 0.5, P = NS). Normal subjects and patients with polyps displayed similar circadian behaviors. CONCLUSIONS: Circadian fluctuation in proliferation is confined to the area of the crypt normally associated with replication. Upper-crypt indices, including those that were higher than normal (a colon-cancer risk marker) are stable over 24 hours. These findings should be useful in planning chemoprevention trials and chemotherapeutic regimens.

Adult↗
PubMed1994

Cowden's disease with extensive gastrointestinal polyposis.

Cowden's disease, or multiple hamartoma syndrome, is a rare condition classified recently as a hereditary preneoplastic syndrome. Multiple orocutaneous hamartomas are associated with involvement of other organ systems, including fibrocystic breast disease and breast carcinoma, goiter, thyroid cancer, gastrointestinal polyps, and endometrial carcinoma. We describe a patient with Cowden's disease who underwent extensive gastroenterological work-up and review other cases in the literature.

Adenomyoma↗
PubMed1994

Nodular regenerative hyperplasia of the liver: ultrasonographic appearance and echo-guided bioptic diagnosis.

Nodular regenerative hyperplasia of the liver is characterized by multiple and usually small nodules of hyperplastic hepatocytes surrounded by compressed atrophic liver cells. Given the small size of nodules and the preserved framework, the imaging techniques often show a normal liver and blind percutaneous biopsy is misinterpreted. The Authors report two cases of nodular regenerative hyperplasia diagnosed by ultrasound and percutaneous echoguided biopsy.

Biopsy, Needle↗
PubMed1992

Accurate specimen preparation and examination is mandatory to detect lymph nodes and avoid understaging in colorectal cancer.

Lymph node involvement in colorectal cancer, one of the most important prognostic factors, can be sometimes underestimated. In this study the authors report the results of two different techniques of specimen preparation and examination. In 240 patients (Group I), histologic examination was performed using a conventional procedure. In Group II (60 cases) the resected bowel and its mesentery were separately stretched, pinned on to a cork board, and fixed. The mesentery was divided according to node location (intermediate and principal) and evaluated by sight and palpation to identify lymph nodes. The bowel segment was divided from 5 cm proximally to 5 cm distally to the tumor every 10 mm in serial 3 mm slices. Three and 10 mm slices were then carefully examined by sight and palpation. Isolated lymph nodes embedded in groups (10-12 per paraffin block) were stained and investigated for neoplastic involvement. The specimen examination procedure used in Group II resulted in identification of a higher number of lymph nodes (mean = 41.1) and nodal metastases (mean = 10) compared to the standard technique used in Group I (mean = 11.3 and 2.4, respectively--P < .05). The percentage of N+ cases also was increased in Group II (48.3%) when compared to that in Group I (30.4%; P < .05). The new technique is simple, inexpensive, and efficacious for the detection of lymphatic metastases in colorectal cancer.

Colorectal Neoplasms↗
PubMed1992

[The experience of diagnostic and therapeutic integration in rectal cancer. Preliminary notes].

In our University, many different radiosurgical options are available to treat rectal carcinoma. Selecting the patients to submit to treatment requires accurate clinical and radiological staging. A team of radiologists, radiotherapists, surgeons, endoscopists and pathologists has been created to stage the patients and to follow the final results. The team have decided the diagnostic and therapeutic protocols. The patients with rectal cancer undergo radiotherapy after staging and are subsequently restaged. If indicated, surgery is performed and histology is compared with restaging, to assess the accuracy of the diagnostic procedures. All diagnostic and therapeutic decisions are made collectively by the team, during scheduled meetings. All data are stored in a computer program. This paper deals with the working method we used, its advantages and the outcome of the first 23 studied patients. Restaging was compared with histology: transrectal US (performed in 8 patients) showed 100% accuracy in evaluating local tumor spread (T). CT had 91% accuracy in defining T and 60% accuracy in N, with a tendency to overstaging. In 78% of patients > 50% reduction of tumor size was observed and the distance from the anal canal increased in 95.5%. This study will provide the overall accuracy of the clinico-radiologic staging, the survival rates and the indication of prognostic signs.

Aged↗
PubMed1991

Epithelioid hemangioendothelioma of the liver: report of two cases.

Epithelioid hemangioendothelioma is a very rare tumour of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. Confirmation of its endothelial origin is achieved by positive staining for Factor VIII-related antigen or by the demonstration of Weibel-Palade bodies by electron microscopy. We report two cases of primary epithelioid hemangioendothelioma of the liver that occurred in our center in the last ten years. The first patient is a 21 year old woman who presented with a right upper quadrant pain and an echographic finding of multiple hepatic lesions suggestive of metastases. The second patient is a 32 year old woman operated on for a cerebral glioma, in whom an abdominal CT scan, performed in view of radiotherapy, revealed multiple hepatic lesions, originally interpreted as being metastatic. In both cases, diagnosis was made based on the histologic examination of biopsies have been adopted in each case: the first patient has undergone successful liver transplantation. In the second patient an attentive surveillance appeared to be the best option, due to the presence of a previous cerebral glioma.

Adult↗
PubMed1990

Effect of different fractions of alkaline reflux on the gastric stump and the esophagus: an experimental research on pigs.

An experimental study was conducted to evaluate the effect of different fractions (bile and pancreaticoduodenal secretions) on the gastric stump and esophageal mucosa. Twenty pigs underwent partial gastrectomy (two-third distal) and cardiomyotomy in order to induce free gastroesophageal reflux. Then, reconstruction of the alimentary tract was performed to assess the effects of different types of alkaline reflux. A combined (biliary and pancreaticoduodenal) reflux, an isolated biliary reflux, and an isolated pancreaticoduodenal reflux were induced, respectively, in three different groups of five pigs each. In a control group a Roux-en-Y gastrojejunostomy was performed. Nine months later, the animals were sacrificed, the esophagus and the gastric stump were removed for histologic examination. The results show that the most severe histopathological lesions are determined by combined alkaline reflux; on the other hand, separated fractions can induce only mild changes on the gastric stump and esophageal mucosa.

Alkalies↗
PubMed1989

Type II estrogen receptors in the papillary cystic tumor of the pancreas.

Two cases of papillary cystic tumor (PCT) of the pancreas were investigated for the presence of estrogen receptors (ERs) and progesterone receptors (PgRs). Both PCT and normal pancreas are able to specifically bind 3H-estradiol. This binding almost exclusively results from the presence of high levels of type II ER, whereas type I ERs were absent or present at very low levels. Both normal and neoplastic pancreas studied immunohistochemically for the presence of nuclear ER had negative results. This could be explained assuming that anti-ER antibodies are specific for type I binding sites. In conclusion, the presence of specific estrogen as well as progesterone binding may explain the sex and age predilection of PCT and suggest a possible hormone sensitivity for this tumor.

Adolescent↗
PubMed1988

Clinico-pathological correlations in the diagnosis of acute myocardial infarction in the elderly.

A series of 200 consecutive patients with autopsy-proven acute myocardial infarction (AMI) was retrospectively studied in order to assess the degree of clinico-pathological agreement and to detect the reasons for disagreement. A correct clinical diagnosis of AMI was made in 86 cases (Group A = 43%) and was missed in 114 cases (Group B = 57%). Atypical presentation and concealed history were more common in group B. The AMI qualified to be the main disease in 83 patients of group A and in 81 of group B and was considered a contributory cause of death in three of group A and in 33 of group B (P less than 0.01). The mean number of diseases coexisting with the main disease for each patient was significantly lower in group A than in group B (P less than 0.01). The mean age was 65.2 +/- 12 years for group A patients and 69.1 +/- 12 years for group B patients (P less than 0.02). With the patients grouped according to age (group I: less than 60 years = 46 cases; group II: greater than or equal to 60 years = 154 cases), the diagnostic accuracy was 61% in group I and 38% in group II (P less than 0.01). Groups I and II did not differ in clinical presentation, ECG and enzyme diagnostic accuracy, while the number of diseases coexisting with the AMI was significantly higher in group II (P less than 0.001). Ageing, the atypical presentation and the coexistence of several diseases seem to account for most of the unrecognized AMI.

Age Factors↗
PubMed1988

Fibrolamellar carcinoma of the liver: a distinct entity within the hepatocellular tumors. A review.

Fibrolamellar carcinoma (FLC) of the liver is a clinicopathologic type of hepatocellular carcinoma (HCC) with a favorable prognosis with long-term survival. At variance with the usual HCC, FLC occurs predominantly in young people, both male and female, usually without preexisting liver disease. The distinctive pathologic features of FLC are presented and reviewed. Both gross and microscopic findings suggest that FLC is the malignant counterpart of focal nodular hyperplasia that may arise from preexisting focal nodular hyperplasia. The storage of copper and fibrinogen inside tumor cells is a peculiarity of FLC, and it appears to be in a close relationship with the oncocytic appearance of FLC cells having a deeply eosinophilic, finely granular, mitochondrion-rich cytoplasm. All other immunohistological and ultrastructural findings strongly support the high degree of differentiation of FLC.

Age Factors↗
PubMed1987

The importance of gastric emptying in reflux esophagitis: an experimental research on pigs.

A study was conducted on pigs to evaluate the importance of gastric emptying rate in reflux esophagitis development. Gastric emptying was previously measured in 25 pigs. Then, the following operative procedures were carried out: Heller's cardiomyotomy, common bile duct ligature, cholecysto-gastric anastomosis, and extramucosal duodenal myotomy on 10 animals (group A); the same procedures except extramucosal duodenal myotomy on another 10 animals (group B); common bile duct ligature and cholecysto-gastric anastomosis on the last 5 animals (group C). Six months later, gastric emptying was measured again; whereas in group A a significant shortening of gastric emptying was found, the other 2 groups remained unchanged. Then, all the animals were sacrificed and the lower third of the esophagus was removed for histologic examination. In all the pigs undergoing cardiomyotomy (groups A and B) appearance of esophagitis was found. No signs of esophagitis were found in group C. The conclusions reached are cardiomyotomy is in all cases responsible for reflux esophagitis development; extramucosal duodenal myotomy is capable of shortening gastric emptying, but this does not affect reflux esophagitis development.

Animals↗
PubMed1987

Polyps of the colon in juvenile and young patients: histological type and C.E.A. content in relation to follow-up.

31 colonic polyps in 21 patients between 2 and 30 years of age removed by endoscopy were studied. The site, size, cytohistological characteristic and tissue CEA content of these polyps were evaluated. 58% of the polyps were located in the rectum and sigmoid, the remaining 42% were in the descending colon. At histological examination 13 polyps proved to be neoplastic, 3 of which had severe dysplasia. In 3 cases of juvenile hyperplastic hamartomatous polyps and in 5 cases of inflammatory polyps the tissue C.E.A. was low; in 13 neoplastic polyps it was in direct correlation with the degree of dysplasia. Moreover in 10 patients with neoplastic polyps, 5 presented further adenomas at follow-up, and in 3 of them the C.E.A. tissue content of the first polyps obtained was medium to high. The occurrence in young patients of polyps of the colon with C.E.A. content medium to high must be followed by endoscopic examination at close intervals.

Adolescent↗
PubMed1986

Autopsy rate in younger and older hospitalized patients.

A retrospective study of the autopsy rate of the clinico-pathological correlations was made in a group of inpatients. The trend of autopsy rate was observed in all inpatients died in a university hospital during a nine year period (from 1975 to 1983). The agreement between the clinical and pathological death diagnosis was retrospectively controlled in 294 consecutive patients died and submitted to autopsy in the same hospital during a 6 month period (from January to June 1983). The results show that: In the oldest (greater than 60 yrs) patients, the autopsy rate trend was significantly reduced from 1975 to 1983, whereas the hospital admissions and the mortality rate increased. In the youngest subjects (less than 60 yrs), the autopsy rate trend, the hospital admissions and the mortality rate did not significantly change from 1975 to 1983. In all the years considered, the autopsy rate was significantly reduced in the oldest class (p less than 0.001). The agreement between the clinical and pathological diagnosis was observed in 83% of cases in the less than 60 years class and in 63% of cases in the greater than 60 yrs class (p less than 0.001). The association of main disease with other diseases was significantly more frequent in the greater than 60 yrs class with respect to the less than 60 yrs class (p less than 0.01). It has been concluded that the autopsy, especially in the elderly, is absolutely necessary for a better quality control of the clinical diagnosis and of the medical care.

Age Factors↗
PubMed1986

Effect of tamoxifen on steroid hormone receptors and creatine kinase activity in human endometrial carcinoma.

Estrogen receptor (ER), progesterone receptor (PR) and creatine kinase (CK) were measured in cancerous tissue from 29 post-menopausal patients with endometrial carcinoma under basal conditions and after a short course of tamoxifen treatment. ER and PR were detected in nearly all tumors. CK was detected in all of the tumors examined. After tamoxifen, PR and CK increased simultaneously in 26% of cases, while they were either enhanced, decreased or unmodified in the remainder. No correlation could be found between increase of PR and tumor differentiation. CK, however, was enhanced only in the more differentiated cancers. These results indicate that only a percentage of endometrial cancers are responsive to tamoxifen. It is hypothesized that patients bearing these tumors are those likely to benefit from endocrine therapy.

Cell Transformation, Neoplastic↗