[Sarcomatous degeneration of a schwannoma of the lumbar plexus: combined radiologic and anatomopathologic diagnosis. Report of a case].
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Female↗
Biomedical subjects
G Rossi
Publications and source records attributed to G Rossi.
[Surgical treatment of post-mastectomy lymphedema of the upper limb].
The authors analyze their experience of surgical treatment of post-mastectomy lympho-edemas of the upper arm. They have performed 14 operations, each upon patients with praecox or later oedema, following Cariati's classification, and with median age of 56.5 years. Seven patients were present at the follow-up in 6 has been performed microsurgical lympho-venous anastomosis, in 1 a fasciotomy of the forearm and in 1 patient some silastic tubes were positioned in her subcutaneous tissue. An improvement of the subjective symptoms has been recorded in 57.14% of the patients, while the objective ones have improved in 50% of the patients. The authors think that the microsurgical treatment of the lymphedema post-mastectomy of the upper arm is the first choice nowadays.
Adult↗
[Computerized tomography of osteochondral diseases of the talus dome].
The definition "osteochondritis dissecans" of the talus improperly includes a variety of diseases involving the chondral surface of the talus dome and the relative subchondral bone. To investigate the CT diagnostic potentials in the study of these conditions, 35 patients complaining of a "painful ankle" were examined with plain radiography and axial and direct paracoronal CT over a 2-year period. Twelve patients were then examined with double contrast CT arthrography with air and iodated contrast agents. CT diagnostic accuracy was assessed evaluating the following parameters: the presence and extent of the subchondral bone fragment, the presence of residual bone fragment attachment at the lesion base or its intraarticular dislocation, the presence of subchondral bone cysts, of chondral surface lesions and, finally, of capsular and ligamentous damage. All the patients with CT findings of osteochondral conditions of the talus dome were submitted to arthroscopic examination/treatment and/or surgical arthrotomy. Baseline CT exams accurately depicted all the lesions, except for early (grade I) lesions. Moreover, the administration of intraarticular contrast agent (CT arthrography) increased the diagnostic accuracy in articular cartilage studies. Therefore, the authors believe baseline CT on the orthogonal planes to represent an effective tool for the staging of osteochondral talar lesions and for accurate treatment planning.
Adolescent↗
[Incidence of lymphoproliferative diseases in Northern Italy].
INTRODUCTION: In the last 6 years we have observed an increasing number of cases of lymphoma, extranodal cases being the majority over nodal ones. This fact induced us to investigate the incidence of NHL and HD in the population served by the Lecco Hospital, Department of Pathology, as well as the temporal trend from 1990 to 1995. MATERIALS AND METHODS AND DATA: All hospitals and dispensaries located in the surrounding areas of Lecco including the district of Menaggio and Morbegno are dependent on the Department of Pathology of Lecco Hospital. In fact, the surgical pathology of this area with its 272144 inhabitants converges in our department. We investigated the incidence of nodal and extranodal lymphomas in this population in the period between january 1990 and december 1995 while isolating the number of new cases reported in our files. The incidence per age, population over three-years period has been epressed as the number of cases per million population per year (cases per pmp/y). RESULTS: 285 patients aged 20 to 90 years old (mean 62.5) were selected (51% males, 49% females): they presented 141 nodal lymphomas (36 HD and 105 NHL) and 144 extranodal lymphomas of which 57 primary gastric lesions (22 males and 35 females, mean-age 63.5 in the male group (range 38-85) and 59.0 in the female group (range 31-91)). In nodal as in extranodal lymphomas the diffuse large B-cell lymphomas were the most frequent entity diagnosed, furthermore we noted an increase of incidence in all age groups in the last six years for NHL, mostly NHL HG, in contrast to decrease for HD. About gastric lymphomas, 2/3 were diffuse large B-cell lymphoma with or without low grade component, while the remaining were low grade B-cell lymphoma and only three cases were gastric peripheral T-cell lymphoma. Gastric lymphomas show a higher incidence than in other countries. CONCLUSION: These results show an increase of the incidence of non-Hodgkin lymphomas, mainly of high grade, during six years and in all age groups. On the contrary we observe a tendency in reduction for Hodgkin Disease. Primary gastric lymphomas show a greater increase and their incidence has been estimated in 17.5 cases per 100,000 per 5 years.
Adult↗
Atom-specific surface magnetometry.
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Journal Article↗
Urokinase-type plasminogen activator/type-2 plasminogen-activator inhibitor complexes are not internalized upon binding to the urokinase-type-plasminogen-activator receptor in THP-1 cells. Interaction of urokinase-type plasminogen activator/type-2 plasminogen-activator inhibitor complexes with the cell surface.
The urokinase-type plasminogen activator (uPA) and its inhibitor PAI-2 form a covalent complex that, upon binding to the uPA receptor (uPA-R), is cleaved into two fragments of molecular masses 70 kDa and 22 kDa. The 70-kDa fragment results from the interaction of the B chain of uPA and PAI-2 whereas the 22-kDa fragment is the A chain of the enzyme [13]. We prove that, at 37 degrees C, the 70-kDa fragment is released into the medium, whereas the 22-kDa fragment remains bound to the cell surface. uPA complexed with its other specific inhibitor, PAI-1, is cleaved into fragments of identical sizes, but the 70-kDa component is internalized via the alpha 2-macroglobulin receptor. At 4 degrees C, both uPA/PAI-2 complex degradation products remain bound to the uPA-R. We propose that the 70-kDa molecule, which lacks the uPA binding region for uPA-R, is bound to uPA-R via a new binding site, unmasked only when uPA-R is occupied by uPA/PAI-2 complexes.
Cell Line↗
Diagnosis and treatment of primary aldosteronism.
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Adenoma↗
Evidence for breaking of the active site dimetal cluster in Cu,Co superoxide dismutase upon copper reduction: a polarized absorption spectra study.
The polarized absorption spectra of the cobalt chromophore in orthorhombic crystals of bovine Cu,Co superoxide dismutase (SOD), bearing the copper ion in both the oxidized and the reduced states, are reported together with the calculated isotropic spectrum. All the absorption bands are polarized and a spectral shift, from 598 nm to 588 nm, is observed in only one of them upon copper reduction. This shift, previously described in solution studies, is unequivocally assigned to the detachment of the copper side from the imidazolate bridging copper and cobalt ions in the oxidized catalytic center. At variance with a recent X-ray diffraction investigation on Cu(I),Zn SOD, this result indicates that reduction of copper in Cu,Co SOD is associated to the breaking of the dimetal cluster also in the crystalline state.
Animals↗
Chromosomal localization of mitochondrial transcription factor A (TCF6), single-stranded DNA-binding protein (SSBP), and endonuclease G (ENDOG), three human housekeeping genes involved in mitochondrial biogenesis.
By using a PCR-based screening of a somatic cell hybrid panel and FISH, we have assigned the loci of mitochondrial single-stranded DNA-binding protein (SSBP), mitochondrial transcription factor A (TCF6), and mitochondrial endonuclease G (ENDOG) genes to human chromosomes 7q34, 10q21, and 9q34.1, respectively. The products of these three genes are involved in fundamental aspects of mitochondrial biogenesis, such as replication and transcription of the mitochondrial genome. The chromosomal localization of these genes is important to testing whether the corresponding proteins may play a role in the etiopathogenesis of human disorders associated with qualitative or quantitative abnormalities of mitochondrial DNA.
Chromosome Mapping↗
White matter hyperintensities in Parkinson's disease. Clinical correlations.
OBJECTIVES: To verify recent preliminary data indicating that white matter hyperintensities on magnetic resonance imaging are more abundant in patients with Parkinson's disease (PD) than in healthy subjects and to examine possible correlation between these abnormalities and clinical features of PD. DESIGN: Magnetic resonance imaging data on patients with PD and normal subjects were compared as to frequency, extent, and topographic location of white matter hyperintensities; moreover, in the PD group, we studied the possible correlation of white matter hyperintensities with clinical features such as severity, disease duration, and therapy. SETTING: The outpatient clinic of the Institute of Clinical Neurology and the Neuroradiology Unit of the University of Pisa (Italy). PATIENTS: We studied 102 nondemented patients with idiopathic PD and 68 sex- and age-matched healthy controls, all screened for absence of cerebrovascular risk factors. OUTCOME MEASURES: White matter hyperintensities were classified as periventricular hyperintensities and deep hyperintensities. Frequency, extent, and topographic location of both periventricular and deep hyperintensities were evaluated. The clinical parameters examined were disease duration, treatment type, and disease severity (using Hoehn and Yahr staging and the Unified Parkinson's Disease Rating Scale), as well as disease progression index (ratio between Hoehn and Yahr stage and disease duration). RESULTS: The frequency and the extent of periventricular hyperintensities were significantly higher in patients with PD than in healthy subjects. Moreover, within the PD group, the patients who had periventricular hyperintensities had significantly shorter disease duration and greater disease severity, ie, a higher disease progression index, than those who did not. CONCLUSION: These data suggest that periventricular hyperintensities may represent a marker for a clinical subtype of PD characterized by a more rapid neurodegenerative process.
Aged↗
Cell-to-cell contact modulates the expression of the beta 1 family of integrins in primary cultures of thyroid cells.
The expression of the beta 1 family of integrins was studied in normal thyroid tissue cultures and monolayer cell cultures. The expression of the various subunits was measured by flow cytofluorometry with specific monoclonal antibodies and by Northern analysis. In monolayer cell cultures but not in tissue cultures, the expression of the alpha 3 subunit on the cell membrane progressively increased soon after plating, reaching a 30-fold higher intensity. The alpha 2 subunit, not detectable in native follicular cells, was expressed de novo and reached a remarkable high level. Up-regulation of alpha 2 and alpha 3 in monolayer cell cultures was serum-independent and preceded the expression of proliferating cell nuclear antigen, [3H]thymidine incorporation, and cell replication. Northern analysis demonstrated an increased level of beta 1 integrin mRNA. The increase of alpha 2 and alpha 3 was readily reversible since the expression of these molecules returned to a lower level when cultures reached a high cell density. Down-regulation did not occur until cell cultures were confluent. When cells from high cell density and low integrin expression were harvested and sparsely seeded in culture, up-regulation of integrins was observed again, while rapid reaggregation of isolated cells inhibited this phenomenon. Altogether these data suggest that cell-to-cell contact may regulate the expression of beta 1 integrins in thyroid primary cultures.
Antigens, CD↗
Tumor necrosis factor receptors of the monocyte derived Langerhans cell phenotype "MoLC".
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Antibodies, Blocking↗
Orthotopic liver transplantation in a patient with severe hemophilia A: a life-saving treatment for the first Italian case.
Clinical cure of hemophilia A by orthotopic liver transplantation has been reported in 11 cases. We describe the first successful Italian case. A 27-year-old man had cirrhosis caused by previous infections with the hepatitis B, C and D viruses following life-long treatment with factor VIII concentrates made from large plasma pools. He was, however, seronegative for the human immunodeficiency virus. In the year before transplantation, life-threatening gastrointestinal bleeding due to severe esophageal varices required a large transfusion regimen (on average, 13 bags of red cell concentrates and 35,000 U of factor VIII/week). To perform orthotopic liver transplantation 8,000 U of factor VIII were given during surgery together with 10 bags of red cells and 11 of fresh-frozen plasma. Intraoperative bleeding was not different from that of non-hemophilic patients undergoing orthotopic liver transplantation. No additional factor VIII was used after transplantation and factor VIII levels in plasma were always above 50 U/dl, reaching the highest value of 184 U/dl on day 4 post transplantation. He was discharged from hospital 10 weeks after transplantation with factor VIII levels of 68 U/dl. All virological markers are currently negative, except anti-hepatitis C virus antibodies. In this patient orthotopic liver transplantation was a life-saving treatment for end-stage cirrhosis and a cure for hemophilia A.
Adult↗
Prognostic value of histological grading in ductal adenocarcinoma of the pancreas. Klöppel vs TNM grading.
A new histological grading system with prognostic correlation for pancreatic cancer was proposed by Klöppel et al. in 1985. Histological sections from 60 ductal adenocarcinomas operated on between January 1980 and December 1990 were retrospectively reviewed in order to compare Klöppel's grading with standard TNM's grading and assess their prognostic value. Klöppel grading was determined through the following histologic and cytologic factors: number duct-like structures, mucus production, neoplastic epithelium, arrangement and pleomorphism of nuclei, and mitotic activity. A score from 0 (well differentiated) to 2 (poorly differentiated) was given to each factor. The mean value obtained dividing the sum of the different values by the number of parameters was used to construct a malignancy scale and therefore allocate each patient to his Klöppel grading. The concordance index K between the two grading systems was relevant (K = 0.85 p < 0.001). There was no relation either between gradings (Klöppel or TNM) and preoperative duration of symptoms or between gradings and UICC stages. TNM's G2 grades of malignancy, N status, and tumor stage were significantly related to survival time (p < 0.05). Klöppel's grading does not show any advantage over the classical and simpler TNM's grading, even though it can be considered more objective and therefore more easily reproducible. This characteristic further should be enhanced by the introduction of a malignancy scale such as the "mean value."
Aged↗
Results of surgical management of tuberculosis: experience in 206 patients undergoing operation.
Between January 1978 and December 1990, 206 operations for pulmonary tuberculosis were performed at our institution, a former sanatorium located in northern Italy. Patients with tuberculoma and pleural tuberculous disease were excluded from this series. Cavitary sequelae, bronchiectases, and hemoptysis were the most common indications for resection. Scar cancer and mycetoma were associated diseases in more than 60% of the patients. Healing was achieved in 90% of the patients. Operative mortality was 3%. Overall morbidity was 29.1%. Patient stratification showed that sputum-positive patients had a higher morbidity (30%) and a lower healing rate (86.2%). Before operation, an accurate assessment of both the performance status and the functional reserve of the surgical candidates is emphasized. Despite a high complication rate, aggressive surgical treatment of drug-resistant tuberculosis or its stabilized sequelae is warranted to achieve anatomobiological eradication of the disease, thus avoiding long-term troublesome complications.
Adolescent↗
Low-dose ovine corticotropin-releasing hormone stimulation test in diabetes mellitus with or without neuropathy.
The function of the hypothalamic-pituitary-adrenal (HPA) axis was evaluated in insulin-dependent diabetics without (group I, n = 10) or with (group II, n = 10) established symptomatic neuropathy and in age- and weight-matched normal controls (n = 11). Since the corticotropin (ACTH)/cortisol response to the minimal-effective dose of corticotropin-releasing hormone ([CRH] 0.03 microgram/kg body weight) represents a useful tool for HPA axis examination, all subjects were tested with the low-dose ovine CRH stimulation test. Experiments started at 8:30 AM, when CRH was injected after two basal blood samples were withdrawn, and lasted 2 hours. Basal serum levels of ACTH were similar in the three groups. Administration of CRH induced a small but significant increase in ACTH levels in all subjects; however, the CRH-induced ACTH increase was significantly higher in normal controls than in diabetic groups I and II. Furthermore, a significantly lower ACTH response was observed in group II than in group I. In contrast, basal and CRH-induced cortisol levels were significantly higher in diabetics than in normal controls. Comparisons between diabetic groups showed that both basal and stimulated cortisol secretion was significantly higher in group II than in group I. When peak ACTH responses to CRH and basal cortisol levels were combined, a significant negative correlation was found (r = .545, P < .02). These data show that even uncomplicated diabetes mellitus is associated with adrenal hyperfunction. Such an alteration is more pronounced in the presence of neuropathy.
Adrenocorticotropic Hormone↗
Impact of autologous blood transfusion on blood support in general thoracic surgery: analysis of 969 patients over a 5-year period.
Autologous blood transfusion (ABT) is increasingly used in order to avoid transfusion-related risks. The effectiveness of this simple and feasible procedure depends on several factors, such as the timing of surgery, the patient's overall condition and, last but not least, the pre-disposition of the medical team towards the routine use of ABT. We report our experience in blood support with ABT for general thoracic surgical patients, indicating an overall partially satisfactory outcome due to a limited use of the procedure. In 1992, 61 patients (38%) received autologous blood only, as compared to 9 patients (6%) who had received ABT in 1989. The average pre-deposit per patient ratio in 1992 was 1.2 units, which provided insufficient autologous blood support. In the same period, only 23 patients were subjected to acute normovolemic hemodilution (ANH). However, we noted a reduction of homologous transfusions from 2.9 +/- < 2.1 in 1989 to 2.0 +/- < 1.5 in 1992 (P < 0.01). In addition, we observed that a single pre-deposit was not enough to enhance erythropoiesis and to improve post-operative red blood cell rescue when performed in patients with Hb > 11 g%. Based on our data, we emphasize a more extensive move to ANH, along with pre-deposit, in order to avoid unnecessary homologous blood transfusions.
Blood Transfusion↗
Past contraceptive method use and risk of ectopic pregnancy.
The relationship between past contraceptive method use and risk of ectopic pregnancy has been analyzed in a case-control study conducted in Milan, Italy. Cases were 158 women with diagnosis of ectopic pregnancy confirmed by laparoscopy or laparotomy, admitted to a network of university and general hospitals of Milan. The first control group (obstetric controls) included 243 women who gave birth at term (more than 37 weeks' gestation) to healthy infants at the same hospitals where the cases had been identified. The second control group (non-obstetric controls) was a random sample of 158 women admitted to the same network of hospitals where cases had been identified for diseases other than malignant, hormonal, or gynecological in origin. A total of 37 (23%) cases, 21 (9%) obstetric and 24 (15%) non-obstetric controls reported ever IUD use. The corresponding relative risk, RR, of ectopic pregnancy was 3.5 (95% CI 1.3-4.6) when non-obstetric subjects were considered as control group. The risk of ectopic pregnancy increased with duration of IUD use: in comparison with obstetric and non-obstetric controls, the RR were 2.3 and 2.0 for users for less than 2 years and 4.3 and 2.6 for longer users. There was no clear relation between time since last IUD use and risk of ectopic pregnancy, and no evidence of a decline of risk with increasing time since stopping use.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗