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Biomedical subjects

G Massi

Publications and source records attributed to G Massi.

At least 55 records · Page 3Linked to original sources
PubMed1996

Pathogenesis and pathology of liver disease associated with alpha 1-antitrypsin deficiency.

alpha 1-Antitrypsin (alpha 1-AT) accumulates in the rough endoplasmic reticulum through a mechanism of polymerization. Polymerization is favored by the incorrect tertiary structure of the alpha 1-AT caused by a point mutation at position 342 of the protein. Accumulation of alpha 1-AT in the liver cells (and in hepatocytes and colangiocytes) is not sufficient per se to explain the liver disease that is manifested in a minority of PiZ subjects and thus, a trigger factor must be hypothesized. A virus (hepatitis C virus or some other kind of virus not identified as yet) is among the most probable trigger factors. In Z subjects (among the general population), relevant liver disease is probably a more rare event than thought in the past and most of these subjects escape major liver disease. Usually, liver disease is not a significant problem in patients with COPD.

Adult↗
PubMed1994

Clinically silent inflammatory gut lesions in undifferentiated spondyloarthropathies.

Gastrointestinal inflammation or infection can be associated with various forms of arthritis, such as, acute reactive arthritis triggered by enteritis due to gram-negative bacteria or ankylosing spondylitis and peripheral arthritis in relation to Crohn's disease and ulcerative colitis. Using colonoscopy, we have found a high prevalence of clinically silent inflammatory lesions in 38 patients (24 males and 14 females) affected by undifferentiated spondyloarthropathies (SpA). Microscopic inflammatory lesions were present in all the patients. Three patterns of nonspecific chronic inflammatory alterations were observed. No difference was noted between patients taking or not taking nonsteroidal anti-inflammatory drugs. Direct immunofluorescence demonstrated the presence of IgG, IgA, IgM, C3, C4 and fibrinogen in 75% of the specimens examined. The finding of chronic inflammatory gut lesions hypothesizes that a local activation of the immune system depending on the persistence of intestinal microbial antigens or toxins, due to impaired elimination or increased exposition, may have a part in the pathogenesis of SpA.

Adult↗
PubMed1994

Prognostic value of flow cytometric deoxyribonucleic acid index in endometrial carcinoma: comparison with other clinical-pathologic parameters.

OBJECTIVE: The aims of the current study were to verify the impact of flow cytometric deoxyribonucleic acid index on clinical outcome in endometrial carcinoma and to assess whether its value is independent from the other clinical-pathologic features. STUDY DESIGN: In a prospective series 74 cases of endometrial carcinoma with surgery performed at our institution were studied. Flow cytometry was performed on fresh tumor samples. The median follow-up period was 31 months (range 8 to 52). Disease-free survival and actuarial survival were the end points of the study. RESULTS: Among the 74 patients (53 with diploid and 21 with aneuploid tumors) there were 14 recurrences and 10 deaths caused by the disease. The recurrence rate was 7.5% for the diploid and 47.6% for the aneuploid tumors (p < 0.001). Mortality was 3.8% for diploid and 38% for aneuploid cases (p < 0.001). Disease-free survival was 89.1% in the former group and 36.3% in the latter. Actuarial survival (Kaplan-Meier method) was 94.7% and 49.5%, respectively. Deoxyribonucleic acid index, stage (International Federation of Gynecology and Obstetrics), and grade of differentiation were significantly correlated with survival, whereas age, depth of myometrial invasion, and histologic type were not. In a multivariate analysis (Cox proportional hazards) deoxyribonucleic acid index was the strongest independent predictor of clinical outcome, followed by International Federation of Gynecology and Obstetrics stage, whereas grade of differentiation yielded no independent prognostic information. CONCLUSIONS: The flow cytometric deoxyribonucleic acid index is an important independent prognosticator, and its determination should be included in the standard management of endometrial cancer.

Actuarial Analysis↗
PubMed1994

Improving pictures in dermatopathology.

We have found that a remarkable improvement in the resolution of the details and in the richness of halftones can be obtained using 4" x 5" black-and-white professional films specifically prepared for scientific and documentary photography. Through modification of the developing time and developer dilution, a close control of the contrast and gray tones is also possible. Using this large-format film, a contact print can be made and top-quality pictures obtained even for a subject as difficult as skin pathology.

Humans↗
PubMed1994

Palpebral syringomas and Down's syndrome.

BACKGROUND: Palpebral syringomas have been reported to be more frequent in patients with Down's syndrome than in the normal population. OBJECTIVE: The aim of the present study was to evaluate, in a population of institutionalized patients with Down's syndrome, the prevalence of syringomas and their possible cytogenetic relationships. METHODS: Sixty-one institutionalized patients with Down's syndrome were examined in order to assess the presence of palpebral syringomas. Sixty mentally retarded non-Down's syndrome individuals were used to control group. RESULTS: Fourteen patients, 13 females and 1 male, were found to be affected. The prevalence of syringomas in both sexes was 23%; 42% of all females, and 55% when only adult females were considered, had syringomas. Thirteen of the 14 affected patients had a karyotype of Down's syndrome with free trisomy 21, 1 had a mosaicism 47,XX, +21/46,XX. Histologic examination confirmed the diagnosis in all 4 biopsied cases. A clear-cell pattern was observed only in 1 patient while, sporadically, few tubules showed a central syringial-type cuticula. CONCLUSION: The higher prevalence found in females, as compared to males, can be partially explained by their older age (mean 23.8 vs. 13.9 years). Palpebral syringomas are a common cutaneous pathology in adult females with Down's syndrome.

Adolescent↗
PubMed1993

Schauta-Amreich vaginal hysterectomy and Wertheim-Meigs abdominal hysterectomy in the treatment of cervical cancer: a retrospective analysis.

OBJECTIVE: The aim of the current study was to determine the effectiveness of Schauta's vaginal hysterectomy in the treatment of stage IB or IIA cervical carcinoma. STUDY DESIGN: In a retrospective analysis the results of Schauta's operation have been compared with those of Meigs' operation in 793 consecutive cases of stage IB or IIA cervical carcinoma. In 201 of them adjuvant radiotherapy was given. A total of 356 patients with stage IB and 76 with stage IIA underwent Schauta's operation, whereas 288 and 64 patients with stage IB and IIA, respectively, were operated on with Meigs' procedure. For statistical analysis the Mantel-Haenszel test was used. RESULTS: In stage IB the 5-year survival (Kaplan and Meier method) was 81% in the Schauta group and 75% in the Meigs group (p < 0.05). The results for stage IIA were 68% and 64%, respectively (difference not significant). In a separate analysis for stage IB and treatment by surgery alone, 5-year survival rates for the 283 in the Schauta group and the 175 in the Meigs group were 83% and 78%, respectively (difference not significant). CONCLUSION: Schauta's vaginal hysterectomy showed a high rate of cure for stage IB or IIA cervical cancer. Therefore we conclude that it can be used as an alternative to the Meigs operation in the presence of obesity or elevated surgical risk.

Adult↗
PubMed1992

[Rare neoplasms of the pancreas: the papillary-cystic tumor. A report of 2 cases].

The authors report two cases of papillary-cystic tumor of the pancreas in two young women. Making a review of literature, they emphasize the rarity of this neoplasm and analyze the possible histopathologic origin, the difficult diagnosis before surgery, surgical therapy and the good prognosis of this pancreatic "curable" tumor.

Adult↗
PubMed1992

Liver involvement in infants with PiSZ phenotype of alpha 1-antitrypsin deficiency.

Between July 1985 and June 1989, 19,432 newborns were screened during the first days of life to determine their Pi (protease inhibitor) phenotype. Fourteen infants were identified to be carriers of the PiSZ phenotype. Their clinical and biochemical follow-up data were recorded at 2, 5, and 12 months of age; only one case underwent a liver biopsy due to repeated abnormal liver enzymes. Three of 14 PiSZ infants showed some hepatic dysfunction at 2 and 5 months of age, but at 12 months all patients had normal liver function tests. None of them had clinical, biochemical, or morphological signs of neonatal cholestasis. The clinical and biochemical data related to the liver involvement are similar to those of the PiMZ phenotype, though the serum levels of alpha 1-antitrypsin in PiSZ carriers match those of the PiZZ group.

Alanine Transaminase↗
PubMed1992

Staging of cervical cancer: reliability of transrectal US.

One hundred twenty-four patients with invasive carcinoma of the cervix were examined with transrectal ultrasound (TRUS) before treatment. Since surgery preceded any other kind of therapy, sonographic findings could be compared with the surgical pathologic stage. The accuracy of staging with TRUS was 83%, compared with an accuracy of 78% for clinical staging performed according to the criteria of the International Federation of Gynecology and Obstetrics (FIGO). For extent of parametrial involvement, the sensitivity of TRUS evaluation was 78%, with a specificity of 89% and a diagnostic accuracy of 87%. The same reliability parameters for clinical evaluation were 52%, 92%, and 84%, respectively. From these data and from analysis of the cases--in which a discrepancy between clinical and TRUS staging was observed--it can be concluded that TRUS could be usefully applied to routine pretreatment evaluation of patients with cervical carcinoma.

Adult↗
PubMed1992

Sex steroid modulation of neurohypophysial hormone receptors in human nonpregnant myometrium.

Neurohypophysial hormone receptors were studied in myometrial specimens obtained from nonpregnant women using binding and in vitro contractility studies. The mathematical modeling of self- and cross-competition curves among [3H]oxytocin (OT), [3H]arginine vasopressin, the V1 vasopressin (VP) antagonist [3H]d(CH2)5TyrMeAVP, the corresponding unlabeled peptides, and the OT agonist [Thr4, Gly7] OT strongly indicates the presence of multiple classes of OT and arginine vasopressin receptors. The latter show the same pharmacological characteristics as the neurohypophysial hormone receptors described by our group for the human pregnant myometrium; in addition, they regulate the contractility of uterine strips. Blocking experiments were performed to evaluate the relative OT and V1 VP receptor distribution in 30 uterine specimens obtained from normal cycling and postmenopausal women. The glucuronoconjugate metabolites of 17 beta-estradiol and progesterone were also measured in 16 patients in early morning urine samples taken the same day as surgery. Our results show that V1 VP receptors are not only present but also biologically active in all the uterine specimens studied with virtually equal density in normal cycling and postmenopausal women. However, their concentrations do not correlate with either estrogen or progesterone urinary levels. The lowest OT receptor density was found at mid-cycle and in menopause, independently of any correlation with the urinary estrogens. Conversely, OT receptors rise sharply in the late luteal phase and during menstruation. In addition they show a positive relationship with glucuronoconjugate metabolites of progesterone levels. These results indicate that progesterone does not inhibit the expression of uterine OT receptors in the human uterus. Furthermore, they imply that neurohypophysial hormones are involved in the control of uterine activity during the menstrual cycle.

Adult↗
PubMed1990

Eosinophilic fasciitis associated with inflammatory neutrophilic vasculitis.

The authors report a case of eosinophilic fasciitis with an histopathological pattern of inflammatory neutrophilic vasculitis associated with the typical inflammatory infiltrate. The presence of this type of vasculitis which may be observed in the initial forms of scleroderma supports the hypothesis of a considerable overlap between these two entities.

Eosinophilia↗
PubMed1990

Human myometrium during pregnancy contains and responds to V1 vasopressin receptors as well as oxytocin receptors.

We have recently demonstrated the presence of two classes of neurohypophysial hormone receptors in the vagina, myometrium, and oviduct of rabbit: an oxytocin (OT) site and a V1 arginine vasopressin (AVP) site. We now report binding and in vitro contractility studies on human myometrial specimens obtained at cesarean section from women at the end of pregnancy. The program Ligand was used to analyze self- and cross-displacement curves for labeled OT, AVP or its V1 antagonist d(CH2)5TyrMeAVP, the corresponding unlabeled peptides, and selective analogs. Our results clearly indicate the presence of heterogeneity of binding sites in human uterus. Blocking experiments were performed to evaluate the density of OT and V1 AVP receptors in individual uterine specimens. The contractile response of the same samples to OT, AVP, and analogs was also evaluated. Our results indicate that V1 AVP receptors are present in all of the uterine specimens investigated, with virtually equal density from 32 weeks to term. AVP and the V1-selective agonist [Phe2,Ile3,Orn8]VP stimulate contractility of uterine strips, an effect blocked by nanomolar concentration of the V1 antagonist d(CH2)5TyrMeAVP. Uterine OT receptors increase during late pregnancy, peaking in early labor. A significant correlation between the density of OT receptors and the frequency of uterine contractions (external tocography) was found in pregnant women before surgery. OT stimulated in vitro contractility of uterine strips only when the density of receptors was more than 150 fmol/mg protein. In conclusion, we identified biologically active V1 AVP receptors in human uterus at the end of gestation and confirmed the primary relevance of OT receptors in human parturition.

Adult↗
PubMed1990

[Histological simulators of Kaposi's sarcoma in the initial phase].

Early Kaposi's sarcoma might be simulated by many different conditions, especially when the vascular component is prominent. the criteria suggested to differentiate early Kaposi's simulators are discussed. We found that these criteria are high in sensibility but low in specificity, therefore, we suggest using these criteria only when they are found in clusters.

Diagnosis, Differential↗
PubMed1989

[Prognostic factors in acute mesenteric ischemia. Experience of 64 cases].

A retrospective study of 64 cases of acute mesenteric ischaemia is reported. The patients have been treated, during the past 12 years, at the Department of Surgery "Flaiani", Ospedale San Camillo de Lellis-Rome. In terms of favourable prognosis, the following factors have shown to be statistically significant: enteric resection carried out, thrombosis of superior mesenteric vein, preoperative normal BUN and WBC count. The diagnostic value of CPK-BB is emphasized as well as the prognostic significance of a prompt surgical treatment.

Acute Disease↗