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Biomedical subjects

G Casetta

Publications and source records attributed to G Casetta.

At least 37 records · Page 2Linked to original sources
PubMed1997

Tobacco smoke, recurrences, and p53/bcl-2 expression in bladder cancer.

Overexpression of p53 is considered to be predictive of mutations of the p53 gene. Exposure-specific mutations of the p53 gene have been described for cancers at different sites. An association between p53 mutation/overexpression and smoking has been described in early stage bladder cancer, but results were conflicting. We have conducted a study on 131 bladder cancer cases, considering p53 expression and smoking habits in an area where the use of air-cured tobacco, rich in carcinogenic arylamines, is common. The study suggests that the use of air-cured tobacco induces p53 overexpression (possibly via mutation) in early stage-low grade bladder cancer, more frequently than flue-cured tobacco (odds ratios = 3.4, 95% confidence intervals 0.9-13 in stage 1; odds ratios = 24, 95% confidence intervals 1.1-519 in stage 1, grade 1). However, all the excess associated with air-cured tobacco was concentrated in recurrences. When available, the biopsies of recurrent cases with early-stage disease were re-examined and all showed p53 expression at first diagnosis (with 10-50% of cells positive) (n = 5). It is hypothesized that exposure to tobacco-related chemicals increases the risk of recurrences via p53 overexpression/mutation. Expression of the bcl-2 gene was detected in only 2 out of 13 p53-positive smokers.

Adult↗
PubMed1997

[Perirenal immunoblastic lymphoma. Description of a case].

The primary perirenal localization of non-Hodgkin lymphomas is rare and normal methods of image diagnosis do not enable a reliable preoperative diagnosis. In the majority of cases renal function is not affected and this pathology is often presented as an occasional finding. The pathologies included in the differential diagnosis are renal neoplasias, abscess and inflammatory processes in a perirenal site. Echotomography shows the lesion as an hypoanechoic zone surrounding the kidney. Computed tomography show it as isodense with the renal parenchyma. Histological tests together with immunohistochemical tests identified a malignant large B cell immunoblastic-type lymphoma in the case described here, with plasmoblastic-plasmocytic differentiation and high malignancy according to the Working Formulation. The pathogenesis of this rare localisation is controversial. We maintain that lymphomatous proliferation may be triggered off by lymphatic follicles present in the perirenal space. The concomitant presence of other clinical signs, such as splenomegalia and adenopathies, may contribute to the diagnosis. On the contrary, monolateral involvement in the absence of other signs, as in this case, raises considerable problems of differential diagnosis. Perirenal lymphoma must therefore always be borne in mind in the diagnosis of renal or perirenal masses.

Humans↗
PubMed1997

p53 expression compared with other prognostic factors in OMS grade-I stage-Ta transitional cell carcinoma of the bladder.

OBJECTIVE: Recent studies have investigated the possibility that p53 protein and some macroscopic tumoral features, such as diameter and focality of the lesion, play a significant prognostic role in bladder cancer progression. A retrospective study was conducted on papillary grade-I stage-Ta transitional cell carcinoma (TCC) of the bladder. METHODS: p53 expression was evaluated using the immunohistochemical method. A group of 31 patients with papillary grade-I and stage-Ta TCC of the bladder with no recurrence or who recurred with no histological grading and staging variation in a 4-year mean follow-up period was compared with 28 grade-I and stage-Ta papillary TCC patients who underwent recurrences and a worsening in histological grading (grade II or grade III) or staging (T1) within the same period of time. The aim of this study was to investigate the hypothesis that altered patterns of expression of the protein products of the mutated p53 tumor-suppressor gene, when independently evaluated in comparison with other tumoral prognostic factors, are associated with tumor recurrence and progression in patients with Ta papillary grade-I TCC of the bladder. RESULTS: Our data show that when a p53 threshold of > 0% was considered, 53.6% of patients with tumor progression in the follow-up period were p53-positive compared with only 16.1% of the nonprogressing group (chi 2 = 6, p = 0.02). On the contrary, p53 failed to show any value in predicting progression when a 5% threshold was considered (chi 2 = 1.12, p = 0.92). The multifocality of the tumoral lesion and recurrent tumor was highly predictive of tumor progression for both variables (chi 2 = 5.16, p = 0.003, and chi 2 = 0.23, p = 0.006, respectively). Multivariate analysis revealed p53 nuclear overexpression (at a threshold of > 0%) to be a single valuable prognostic factor of progression (OR = 10.20, p = 0.009) and recurrence (OR = 54.19, p = 0.01). CONCLUSIONS: Our results lead to the conclusion that p53 immunohistochemical detection has no prognostic value in predicting tumoral relapse or progression of TaGI TCC of the bladder when a 5% positivity threshold is considered. On the contrary, when a p53 nuclear labelling of > 0% is considered as positive staining, this tumor marker becomes highly predictive of tumor recurrence and progression. These findings seem therefore to suggest the use of a slight p53 positivity (> 0%) as a valid tool in predicting the clinical behavior of TaGI bladder TCC. The prognostic impact of a multifocal lesion and a recurrent tumor as markers of progression is also confirmed by these results.

Aged↗
PubMed1997

DNA flow cytometry and 67Ki proliferating index as prognostic factors of early recurrence and progression in G1-G2/Ta-T1 and G3/Ta-T1 transitional cell carcinoma of the bladder.

Using flow cytometry, gross genomic alterations, defined as DNA ploidy, and the fraction of S-phase cells, can be calculated in bladder cancer cells. In aneuploid superficial bladder cancer the recurrence rate has been reported to be three times higher than in diploid forms. A correlation between the S-phase fraction and progression has been reported for G1-G2/Ta-T1 tumours, but not for G3/Ta-T1. The aim of our study is to evaluate whether the traditional cytometric parameters can be used as valid predictors of early recurrences and progression in G1-G2/Ta-T1 and G3/Ta-T1 bladder cancer patients and to compare the proliferation indexes as defined by S-phase fraction and 67Ki monoclonal antibody in the two groups of patients.

Aneuploidy↗
PubMed1997

[Renal multifocal carcinoma with adrenal gland metastasis in a patient previously treated with radical nephrectomy: what kind of therapy. Review of the literature].

A case of multiple adrenal metastases due to renal cells carcinoma, associated with a multifocal simultaneous renal cells carcinoma has been observed in a female patient previously submitted to radical contralateral nephrectomy for the same disease. In particular, stress is laid on computerized tomography scan diagnosis and surgical procedure.

Adrenal Gland Neoplasms↗
PubMed1996

[Renal agenesis and homolateral seminal vesicle cyst. Case report].

The authors present a case of renal agenesis and seminal vesicle cyst in a young man, diagnosed because of several micturion disorders partially cleared up with antibiotic therapy. We discuss about the diagnosis technique which includes Ultrasound Scanner, Computed Tomography, Magnetic Resonance and pelvic arteriography. Then we describe the surgical approach and finally we discuss about embryogenesis.

Adult↗
PubMed1995

[Appearance in 2 brothers of double primary neoplasms: right renal carcinoma and gastric adenocarcinoma].

We report a clinical case of a double primitive tumour (right kidney clear cell carcinoma and gastric carcinoma) in two brothers. There is no history of cancer in the parents. Both patients were previously affected by gastric ulcer. No report of association between the two neoplasms was found in literature. The age of the patients (61 and 70 years) and the singleness of the kidney tumour seem to exclude the case of a familial kidney cancer. The neoplastic transformation of the gastric ulcer is instead a quite frequent report with an incidence of about 1%. Alterations of oncogenes or tumour suppressor genes shared from both neoplasm are at present still unknown. Nevertheless molecular analysis of patients' neoplastic genome could point out typical chromosome translocations/deletions or gene mutations.

Adenocarcinoma↗
PubMed1995

[Measurement of skeletal alkaline phosphatase in prostatic carcinoma. Preliminary report].

Bone metastases frequently occur in prostate carcinoma. Total body radionuclide scan with diphosphonate methylene labelled with 99Tc is commonly used to diagnose such metastases. However this technique is aspecific and frequently unreliable. In recent years several biological markers dealing with bone metabolism were studied. Serum determination of skeletal alkaline phosphatase (ALP) and moreover of its bone isoenzyme (BAP) could be considered a reliable index of osteoblastic activity. In this preliminary report we analyzed a group of 43 patients affected by prostate carcinoma with or without bone metastases. The American Urological Association (AUA) staging system was adopted. Sixteen patients were D2, bone metastases had been suspected by means of radionuclide bone scan and confirmed by Computerized Tomography and/or aimed X-rays. Tandem R-Ostase by Hybritech was used to measure BAP, normal value is set to 20 micrograms/L. All D2 tumours had pathological BAP values (mean value 87.50 micrograms/l); 1/3 stage A, 5/13 stage B, 5/9 stage C and 0/2 stage D1 patients had pathological findings. One of this patients, stage C, revealed a bone metastase at a later bone scan.

Acid Phosphatase↗
PubMed1995

[Surgical treatment of benign prostatic hypertrophy and Kelami syndrome].

The authors analyze a group of 116 consecutive patients treated with transvesical prostatic adenomectomy or transurethral prostatic resection for benign prostatic hypertrophy (BPH) isolated five of them with a Kelami syndrome. These patients, aged between 53 and 70 years old, had a relevant ventral penile deflection with severe sexual impairment postoperatively. Among them only one asked for a corrective surgical procedure. Aetiology, preventive measures and therapeutic choices are discussed. Authors pointed out that this syndrome is actually underestimated considering the high number of transurethral or open surgery procedures for BPH.

Aged↗
PubMed1994

Carcinogen-DNA adducts in bladder biopsies and urothelial cells: a risk assessment exercise.

We have determined the levels of DNA adducts (using 32P-postlabelling) in the biopsies of 20 bladder cancer patients and in the exfoliated bladder cells of 36 healthy volunteers. The aims of the study were (a) to estimate the concentration of DNA adducts in cancer cases and controls according to the level of smoking; and (b) to investigate whether bladder cancer cases had higher levels of adducts in bladder cells than healthy controls had. A dose-response relationship between smoking levels and adduct levels was present among both cancer cases and controls. Cancer cases and the controls had similar adduct levels for the same level of smoking. According to a risk assessment exercise, adduct levels among heavy smokers were roughly comparable with those found in mice and dogs treated with bladder carcinogens, at doses which induce a 50% lifetime risk of bladder cancer.

Aged↗
PubMed1994

[Leiomyosarcoma of the spermatic cord. Case report and revision of the literature].

A 76 year old man presented with an asymptomatic, very big left scrotal mass that was found to be a leiomyosarcoma of the spermatic cord. It was treated by radical orchiectomy with ligation of the spermatic cord at the internal inguinal ring. Convalescence was uneventful. 6 months postoperatively there was no evidence of local recurrence of the neoplasm or distant metastasis.

Aged↗
PubMed1993

Urinary levels of tumour associated antigens (CA 19-9, TPA and CEA) in patients with neoplastic and non-neoplastic urothelial abnormalities.

The urinary excretion of carbohydrate antigen 19-9 (CA 19-9), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) was evaluated in 264 patients with bladder cancer. Cut-off levels were established using a pool of healthy blood donors. The combined determination of CA 19-9 and TPA had a sensitivity of 74% in pTa and 83% in pT1 tumours, and 62% in grade 1, well differentiated tumours. Absence of disease at follow-up was related to a significant decrease in CA 19-9 and TPA in 129 patients with superficial (pTa or pT1) bladder carcinoma, followed up for at least 3 years. Recurrences, defined as new tumours at the same site or elsewhere in the bladder, were associated with an increase in the mean values but this was not statistically significant. A poor prognosis was indicated in patients with infiltrating tumours and the following pre-operative levels: TPA > 1500 u/l or CA 19-9 > 300 u/ml or CEA > 50 ng/ml.

Aged↗
PubMed1992

Immunohistochemical detection of estrogen and progesterone receptors in the normal urinary bladder and in pseudomembranous trigonitis.

According to recent studies showing the presence of estrogens receptors (ERs) in the human female lower urinary tract, we performed ER and progesterone receptor (PR) assays in fresh frozen and paraffin embedded biopsies taken from the urinary bladder. Fourteen females undergoing endoscopy during staging for gynecological cancer (endometrium, cervix, ovary) and 15 women complaining of recurrent abacterial cystitis (pseudomembranous trigonitis) were enrolled in the study as Group 1 and Group 2, respectively. After informed consent, they were submitted to cystoscopy, during which two biopsies were taken: one on the trigonum and the other on the bladder lateral wall. ERs were identified in both groups only in the trigonum (7/14 patients in Group 1 and 8/15 in Group 2), whereas the bladder lateral wall always stained negative. PRs were found at both sites in both groups (11/14 cases on the trigonum and 7/14 on the bladder lateral wall in Group 1; 11/15 and 2/15 respectively in Group 2). Morphological localization of PRs showed intense omogeneous staining in the nuclei of the stromal fibroblasts too. A clear correspondence between the presence of steroid receptors at the squamous metaplasia of the trigonum was observed. These data are discussed speculating about a possible endocrine pathogenesis of pseudomembranous trigonitis.

Adult↗
PubMed1990

Detection of estrogen receptors in the trigonum and urinary bladder with an immunohistochemical technique.

In order to detect estrogen receptors (ER) in the female bladder, 5 premenopausal and 10 postmenopausal women affected by gynecological diseases were submitted to cystoscopy, during which both the trigonum and the bladder lateral wall were biopsied. A new, simple, cost-effective immunohistochemical technique was employed to stain the estrogen specific binding sites. ER were found in the trigonum of 3 premenopausal and 4 postmenopausal subjects, while the bladder lateral wall was always ER-negative. A comparison with previously used ER detection methods and a discussion of further hypothetical applications of the immunohistochemical technique in the study of the lower female urogenital tract are reported.

Adult↗
PubMed1989

Wheat bran in the selective therapy of absorptive hypercalciuria: a study performed on 18 lithiasic patients.

The binding properties of raw vegetable fiber towards bivalent cations suggested the prescription of brain as a dietary supplement to limit intestinal calcium absorption in hypercalciuric patients. A group of 18 patients with a specific diagnosis of absorptive hypercalciuria received a dietary supplement of 14 gm. wheat bran at the 2 principal meals for 90 days. A complete assessment of mineral metabolism was performed after 45 and 90 days. Mean basal calciuria was 357 mg. per 24 hours and a significant decrease was noted after 45 days (245 mg. per 24 hours) and 90 days (240 mg. per 24 hours), with a p value of less than 0.01. Urinary oxalate did not vary significantly (0.34 to 0.38 to 0.31 mMol. per 24 hours) and neither did phosphate levels (1,020 to 900 to 893 mg. per 24 hours). A slight and pathologically insignificant decrease was noted in serum iron and urinary magnesium; this fact could be considered a side effect owing to the nonselective binding properties of fiber. Therefore, the positive results achieved confirm the effective action of wheat bran in the treatment of correctly diagnosed absorptive hypercalciuria.

Absorption↗