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Biomedical subjects

F Nardi

Publications and source records attributed to F Nardi.

At least 109 records · Page 6Linked to original sources

Spiral CT of the abdomen after distention of small bowel loops with transparent enema in patients with Crohn's disease.

BACKGROUND: [corrected] To evaluate the capability of a computed tomographic (CT) technique that combines distention of the small bowel loops with a transparent enema with contrast-enhanced spiral CT of the abdomen in patients with Crohn's disease. METHODS: We evaluated the abdomen with spiral CT after distention of the small bowel loops with a transparent enema of methylcellulose in 40 patients consecutively referred for radiologic evaluation of Crohn's disease of the small bowel. Fluid was infused through a nasojejunal catheter with a peristaltic pump. Ultrasonography was used to prevent bowel overdistention and detect arrival of methylcellulose to the cecum. Contrast-enhanced spiral CT of the abdomen was then performed, and the degree of contrast enhancement and the thickness of the walls of the involved loops were evaluated. A series of 10 patients with retrograde distention of the last ileal loop from large bowel water enema was used as a control. The results of the CT were compared with those of conventional radiographic small bowel studies. RESULTS: The normal small bowel wall was 1.9-2.5 mm thick (mean = 2. 1 mm); density values of the normal enhanced wall varied between 25 and 60 HU (mean = 32 HU) and presented a homogeneous structure. Bowel segments involved by the disease were 4-12.5 mm thick (mean = 9.2 mm), had density values of 75-150 HU (mean = 105 HU), and showed a multilayered appearance. Compared with conventional radiography, CT detected longer lesions or additional segments involved by the disease process in 14 cases, 11 additional fistulas, two abscesses, and mesenteric changes in 21 cases. CONCLUSIONS: The small bowel CT enema technique provides good results in the study of patients with Crohn's disease and can be used to evaluate patients with advanced lesions.

Adult↗

The diagnostic usefulness of electron microscopy investigation of orbital embryonal rhabdomyosarcomas.

The ultrastructural study of three malignant orbital tumors, only one of which was correctly diagnosed as embryonal rhabdomyosarcoma upon histologic examination, is reported. In all 3 cases electron microscopic investigation revealed the presence of rhabdomyoblasts. These are easily recognizable in one case in which the diagnosis was made on the basis of the optical microscopic study. The other two cases needed further tests to evince rhabdomyoblasts. The importance of an ultrastructural study for a histogenetic characterization of this kind of tumor is emphasized. As far as embryonal rhabdomyosarcomas are concerned the electron microscopic study is possible, and it gives useful results even when material fixed with routine histologic methods (formalin, Bouin's solution) are used.

Child↗

Malignant mesothelioma in Rome, Italy 1980-1995. A retrospective study of 79 patients.

AIM AND BACKGROUND: To evaluate the characteristics of a case-series of 79 malignant mesothelioma patients collected from the main teaching hospital of Rome, Italy, and other local clinics of Latium Region and to assess the role of asbestos exposure, since previous studies on the occurrence of the disease in this area were lacking. METHODS: The study included cytohistologically diagnosed malignant mesothelioma (71 pleural, 7 peritoneal, and 1 testicular tunica vaginalis) detected or referred for consultation during the period 1980-1995. Information regarding occupational and/or nonoccupational exposures was derived from clinical records and interviews, when available. RESULTS: Patients were resident in Rome and other towns of Latium; a few were from other parts of central and southern Italy. Exposure to asbestos was assessed for 45.5% of patients, another 45.5% had unknown exposure, and for the remaining 9% such information was lacking. Occupational exposure occurred in 53% of men for whom information was available and nonoccupational exposure occurred in 20% of women. The study identified two clusters of cases from an asbestos-cement plant and a facility where asbestos was ubiquitous. Furthermore, most exposed subjects reported occupations in the construction industry, which is particularly active in the Latium Region; others were railroad workers, naval mechanics and navy personnel, bakers, explosive workers and car mechanics. A few patients reported indoor exposure to asbestos at home and/or in the workplace. CONCLUSIONS: The study confirmed that mesothelioma risk is present in several job titles of the construction industry, and it is no longer confined to workers employed in the manufacture or application of asbestos products. The occurrence of malignant mesothelioma in patients with unexpected occupational and nonoccupational exposures indicates the need for further investigation on previously underestimated exposures.

Adult↗

[The extempore intraoperative cytology of peritoneal lavage fluid. A study of the reliability of the method].

Data are presented about a 100 cases prospective study, designed to evaluate sensibility/specificity of intra-operative cytology on peritoneal washing in case of cancer of digestive tract. Data analysis showed a very low sensibility of the test (according with most of literature observations) that does not allow to consider it fully reliable. Authors, thus, suggest a critical use of the test and state doubts about his real value in the intra-operative correct managing of therapeutic options.

Abdominal Neoplasms↗

[Malignant mesothelioma in the industrial area of Colleferro].

The study describes the occurrence of pleural and peritoneal malignant mesothelioma in the Colleferro industrial area (Province of Rome, 9 municipalities, population 63,000, period 1993-98) which is the site of a large chemical plant (BPD) producing organic chemicals, acid mixtures, insecticides, explosives and dynamite, and was involved in manufacturing/maintenance of railroad rolling stock. Asbestos was extensively used in these plants in the past. Mesothelioma cases were actively searched from data in files of pathology archives, hospital admission and discharge (records), and death certificates recorded at local health authority register. 23 potential cases were identified for whom clinical charts and pathological slides were reviewed. A multidisciplinary evaluation of all collected information confirmed 18 cases of cyto-histologically proven malignant mesothelioma (pleural/peritoneal ratio of 2.75:1) among residents and/or workers at BPD. The remaining 5 cases were defined as not mesothelioma; however, two were cases of lung cancer (both occupationally exposed to asbestos). All subjects with malignant mesothelioma had been occupationally exposed to asbestos (14 males and 3 females), except one (1 female with domestic exposure). No mesothelioma case was attributable to environmental exposure. Of the 17 cases with occupational asbestos exposure, 15 occurred in BPD workers employed in manufacturing/maintenance of railroad rolling stock (3 cases), general maintenance services (5 cases), or in the armaments sector (7 cases) and 2 in residents but not BPD workers (1 baker, 1 pipefitter). The incidence rate in residents of the 9 municipalities was 5.5 in males and 1.3 in females (standardized on the Italian population x100,000, census 1981). For Colleferro municipality only, the incidence was 10.1 in males and 4.1 in females, which are the highest rates reported so far in Italy. Besides confirming the risk of mesothelioma risk in railroad rolling stock manufacturing and asbestos-insulated pipe maintenance workers, this study identifies a cluster of malignant mesothelioma in explosives production workers.

Aged↗

Chondroblastoma of the rib presenting as an intrathoracic mass. Report of a case with fine needle aspiration biopsy, immunocytochemistry and electron microscopy.

We describe an unusual case of chondroblastoma of the rib, initially presenting as a mediastinal mass eroding a vertebra, in which the preoperative diagnosis was made by fine needle aspiration (FNA) cytology and confirmed by histology and electron microscopy of the surgical specimen. Cytologic study of the smears revealed osteoclastlike giant cells and dishesive, mononucleate tumor cells; sections of the paraffin-embedded, aspirated material showed the chondroid matrix and typical chicken wire calcific deposits. Supporting diagnostic evidence was provided by immunohistochemical demonstration of S-100 protein. Unusual features were the presence of intranuclear pseudoinclusions and cytoplasmic granular deposits, which proved to contain iron on histochemical staining, ultrastructural morphology and x-ray analysis. This case emphasizes the value of FNA cytology in providing a correct diagnosis of chondroblastoma as well as the utility of embedding the aspirated material for histologic, immunohistochemical and ultrastructural studies.

Adult↗

[Fine needle aspiration biopsy (FNAG) guided with tomodensitometry of pulmonary and mediastinal masses. Personal experience].

CT-guided fine-needle aspiration biopsy (FNAB) was performed on the patients with pulmonary or mediastinal masses to obtain material for cytologic/histologic diagnosis. Diagnostic accuracy and safety of the technique were evaluated in 75 patients affected with thoracic lesions still undiagnosed after thorough radiological and endoscopic investigations. The cytologic and/or microhistologic samples allowed a correct diagnosis to be made in 61 cases (81%), with no false positives and 7 false negatives (9%). The samples were inadequate for diagnostic purposes in 7 cases (9%). Specificity, sensitivity, and diagnostic accuracy were 68%, 76%, and 81%, respectively. No major complication was recorded and a case of asymptomatic pneumothorax resolved spontaneously within 48 hours. CT-guided FNAB of space-occupying lesions in the lung and mediastinum is therefore a rapid and valuable diagnostic tool and is quite safe when performed by skilled operators.

Adolescent↗

Distribution of silver-stained interphase nucleolar organizer regions as a parameter to distinguish neoplastic from nonneoplastic reactive cells in human effusions.

The distribution of interphasic nucleolar organizer regions (NORs) was studied in cytologic preparations of human serous effusions in order to differentiate malignant cells from nonmalignant reactive cells. The study was carried out on 80 cases of metastatic adenocarcinoma, 10 cases of mesothelioma, 10 reactive pleural effusions and 5 peritoneal washings. Visualization of NORs at the light microscopic level was obtained using a silver-staining technique for acidic proteins selectively associated with NORs. The morphologic data were also statistically evaluated by means of an automated image analyzer. The quantity of silver-stained NORs was higher in cancer cells (both mesothelioma and adenocarcinoma) than in reactive mesothelial cells. Moreover, NORs were more irregularly distributed within the nucleoli and were more variably sized in cancer cells than in reactive mesothelial cells.

Ascitic Fluid↗

Use of the cytocentrifuge for electron microscopy investigations.

A simple method of cytocentrifugally processing cell suspensions for conventional and histochemical investigations at the ultrastructural level is described. Fixed sediments from cell-poor suspensions are resuspended in an albumin-buffered solution. A few drops of the albumin cell solution are cytocentrifuged, leaving a cell disc on a plastic support. A brief dipping in a paraformaldehyde-glutaraldehyde mixture transforms the cell disc into a compact thin fragment attached to the plastic support. Cytocentrifugation of cell-rich suspensions, on the other hand, produces a thicker cell disc, which can be easily detached from the plastic slide. In both cases, the postfixation, dehydration and infiltration are directly carried out on the cell disc. The present method is particularly useful for the ultrastructural study of cell-poor suspensions and can also be performed on cell suspensions previously stained with several histochemical procedures.

Centrifugation↗

Platelet-derived growth factor receptor immunoreactivity in mesothelioma and nonneoplastic mesothelial cells in serous effusions.

Expression of the platelet-derived growth factor receptor (PDGFR) was detected by immunocytochemistry in normal and malignant mesothelial cells from 14 benign effusions and 22 mesotheliomas. Two well-characterized antireceptor monoclonal antibodies to the PDGFR alpha-subunit (PR292) and beta-subunit (PR7212) were used. PDGFR alpha-subunit outlined cell membranes intensely in nonneoplastic mesothelial cells, whereas it was focal in mesothelioma and limited to a few cases only. PDGFR beta-subunit was weakly expressed in the cytoplasm of normal mesothelium; in contrast, malignant mesothelial cells showed strong cytoplasmic staining. Our results show that normal mesothelium may be responsive to PDGF by the predominant expression of PDGFR-alpha and less by PDGFR-beta and indicate the presence of growth-stimulation loops in mesothelioma through PDGF/PDGFR-beta interaction. Also, scattered staining for the PDGFR alpha-subunit suggests that a PDGF-A chain/PDGFR-alpha interaction may also be active in mesothelioma cells growing in suspension.

Adult↗