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L Resta

Publications and source records attributed to L Resta.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Evaluation of resection margins as a prognostic factor in the surgical treatment of laryngeal carcinoma].

A series of 564 patients who underwent conservative or radical surgery for laryngeal carcinoma were studied in a postoperative follow-up. In particular the onset of local recurrences was studied in relation to the histopathological typing of the resection margin. Histology was performed both on the surgical sample and performing an additional biopsy on the surgical margin. The incidence of local recurrences--in relation to the positive or negative tumor infiltration at the resection margins of the surgical sample--was analogous throughout the entire case study (11.1% vs. 11.7%). Only as light increase in the incidence of recurrence was found in those patients with partial laryngectomy (12% vs. 8.9%) although this was not statistically significant. On the contrary, when the marginal biopsy tested positive for neoplasm, it was clearly and significantly related to a higher incidence of T recurrences. This held true for all cases as a whole (36.4% vs. 10.1%, p < 0.04) and, in particular for those treated with partial laryngectomy (46.2% vs. 3%, p < 0.02). On the basis of these observations it can be concluded that, where possible, additional biopsy should be performed to integrate the traditional evaluation of the margins of the surgical piece in order to gain greater prognostic reliability, particularly in cases of partial surgery. From the therapeutic point of view, the authors assert that scheduling supplementary radiation therapy and shorter intervals between follow-up examinations is timely if the resection margin tests positive.

Adult↗
PubMed1997

Molecular biopathology of metaplastic, dysplastic, and neoplastic laryngeal epithelium.

In a large series of more than 100 cases of laryngeal carcinomas, the presence of steroid hormone receptors was demonstrated in the cytosol and in the nuclear fraction. Their presence was confirmed by the identification of estrogen receptor isophorms and by the detection of hormone-related proteins such as ER-D5. EGFr, and cathepsin D. These molecules were also variably expressed in normal, hyperplastic, and dysplastic epithelium. These data suggest a possible role of hormone receptors during laryngeal carcinogenesis. Finally, the presence of an Angiotensin II receptor was studied in neoplastic and preneoplastic laryngeal epithelium.

Carcinoma, Squamous Cell↗
PubMed1997

Epidemiological and clinical relief on hyperplastic lesions of the larynx.

Chronic hyperplastic laryngopathies are considered precancerous lesions because of their possible transformation in time into malignant epithelial neoplasia. We studied 130 patients affected by "hyperplastic laryngeal lesions" according to their semeiological characteristics. The lesions affected the vocal cords in 127 cases and in only 3 cases the ventricular bands. All patients underwent microlaryngoscopy while under general anesthesia and were treated by limited excision (37%) or total stripping (63%). The histomorphological classification by Kleinsasser (7) was used. The following clinical checks showed that 30 out of 48 patients (62.5%) treated by partial stripping recovered; in 11 the lesion relapsed (23%) and in 7 cases (14.5%) a carcinoma appeared. Of those cases treated by total stripping 65 patients (79%) recovered, 12 (15%) relapsed and 5 (6%) showed carcinoma. In conclusion we noticed the appearance of a malignant lesion after surgery in 12 out of 130 cases (9.2%). The cancerization was about 3 times more frequent in patients with histological results of degree II than in those with degree I (17% vs. 6%). Our study confirms that the laryngeal hyperplastic lesion represents a possible passage to cancer in a limited number of cases (< 10%), but with a triple probability for degree II dysplasia in respect to degree I. The patients affected by dyskeratosis, regardless of type of lesion, need a regular follow-up and immediate radical surgery because of the frequent incidence of relapse.

Alcohol Drinking↗
PubMed1997

Expression of ER-D5 and EGFr in laryngeal carcinoma and pre-malignant epithelium.

The expression of estrogen receptors was biochemically assessed in a series of 46 cases of consecutive laryngeal carcinomas. ER-D5 and EGFr were also immunohistochemically detected in 44 and 46 cases respectively. There was no correlation between the expression of these molecules and the typical anatomo-clinical prognostic parameters of laryngeal tumors. The concomitant expression of estrogen receptors, ER-D5 and EGFr was also investigated in normal, hyperplastic and dysplastic epithelium. An increasing expression of ER-D5 and EGFr from normal to hyperplastic and dysplastic epithelium was noted. These data suggest a possible role of hormone receptors in the laryngeal carcinogenesis.

Biomarkers, Tumor↗
PubMed1996

AT1 angiotensin II receptor subtype in the human larynx and squamous laryngeal carcinoma.

The presence of the angiotensin type 1 receptor (AT1 Ang II-R) was investigated in normal and diseased human larynx using a specific monoclonal antibody (6313/G2). When tissue AT1 content was studied by SDS electrophoresis with immunoblotting, the receptor was detected in 10/10 laryngeal tumours, and in 7/10 samples of normal tissue from the same patients. Two immunostaining bands, approximately 75 kDa, were present in all cases. Immunocytochemistry performed on sections of 45 formalin-fixed, paraffin-embedded laryngeal tissue samples showed that the receptor was expressed in normal respiratory epithelium only in a perinuclear pattern, above the nucleus toward the cell apex. In addition, the antigen was invariably present in skeletal muscle cells and in the columnar duct epithelium of minor salivary glands. The secretory cells were negative, but the antibody stained the adjacent myoepithelial cell layer. As expected, smooth muscle cells of the vessel walls also expressed Ang II-R. In metaplastic epithelium deriving from respiratory epithelium, the receptors were distributed diffusely throughout the cytoplasm of basal and parabasal cells. In dysplastic epithelium, cells of all layers were strongly positive. Finally, squamous cell tumours showed varying numbers of immunoreactive cells, which stained in a diffuse cytoplasmic and membranous pattern. Computer-assisted image analysis of the stained sections showed that the positivity for Ang II-R dramatically increased in dysplastic and well-differentiated cancer cells (3- and 5.5-fold higher than in normal epithelium, respectively), but there was less in poorly and very poorly differentiated cancer. Receptor abundance was not correlated with tumour size nor lymph node involvement. These results suggest a possible role of Ang II in the growth or function of normal and neoplastic larynx tissue, which is especially significant in early neoplastic change.

Aged↗
PubMed1996

Human larynx expresses isoforms of the oestrogen receptor.

Commercially available enzyme immunoassays (EIAs) were used for oestrogen (ER) and progesterone (PR) receptor determination in the cytosol fraction of 118 human larynx cancer specimens and in the corresponding histologically proven non-malignant tissues. Fifty-one ER positive cancerous samples had corresponding non-cancerous tissues also expressing the receptor. A high resolution isoelectric focusing (IEF) technique followed by immunoblotting with the H222 anti-ER monoclonal antibody was used to evaluate the presence of ER isoforms in the 51 ER positive human larynx cancer specimens and in their corresponding non-malignant tissues. In both tissues, four ER isoforms were detected, with isoelectric points (pI) similar to those obtained in breast and endometrium carcinomas (6.1, 6.3, 6.6 and 6.8). A significant difference in the expression of ER isoforms between cancerous and non-cancerous tissue was found; precisely, the 94.1% of the ER positive non-malignant specimens co-expressed the four isoforms while they were detected in only the 35.5% of the malignant specimens (P < 0.0001 by Fisher's exact test). In larynx cancer, the concentration values of ER and PR did not correlate, nevertheless tumours co-expressing the four ER isoforms had PR levels significantly higher than those which did not (P = 0.02 by Mann-Whitney Wilcoxon sum rank test). To investigate the possibility that the isoforms of the monomeric 4S form of the ER (those with pI 6.3, 6.6, and 6.8) could dimerise, a cold agarose gel electrophoresis technique was used on IEF-separated ER isoforms. In summary, the evidence shows that all the isoforms are able to form homodimers and that the isoforms at pI 6.3 and 6.8 are able to dimerise with that at pI 6.6 but, under the same experimental conditions, they do not form the 6.3/6.8 heterodimer. It was concluded that: (1) the four isoforms of the ER are co-expressed by the non-malignant human larynx and the cancer loses the capacity to express some of them; (2) the complete complement of ER isoforms (all four) is needed for PR expression; (3) the monomeric 4S isoform with pI 6.6 has the capacity to form homo- and heterodimers, while the remaining two are only able to homodimerise.

Breast Neoplasms↗
PubMed1996

Primary carcinoma of the fallopian tube: report on two cases.

Two cases of carcinoma of the Fallopian tube were treated by total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy followed by chemotherapy consisting of several courses of a cisplatin, epirubicin and cyclophosphamide combination. One patient received three additional courses of combined cisplatin-taxol. At 60 months from onset of therapy one patient (Stage IIa-Grade 1 tumor) is alive and well, while the other (Stage III-Grade 3 tumor) died of disease 26 months from initial treatment. Second-look laparotomy proved useful in assessing response to chemotherapy. CA-125 blood levels helped monitoring tumor activity. Anamnestic data relevant to tuberculous salpingitis on one case, and bilateral salpingoplasty for tubal occlusion, in the other case, may stand for some remarks.

Adenocarcinoma↗
PubMed1995

[Invasion of cricoid cartilage by T2-T3 laryngeal cancer].

This paper reports a study of microscopic infiltration of the cartilage of the cricoid carried out in 335 patients with T2-T3 carcinomas of the larynx who had undergone total laryngectomy. The results of the investigation revealed microscopic infiltration of the cricoid cartilage in 12% (14/335) of the cases examined. The incidence, however, was much higher in those cases of extension to the hypoglottis (28% vs 5%, p < 0.0001) or in cases of an even greater extension of the tumor (13% vs 7%). In the 161 patients with neoplasias situated in the glottis, there was cricoid invasion in 30 cases regardless of the tumor class. However, with regard to cases with extension to the hypoglottis, a higher incidence of cricoid infiltration (20% vs 8%, p < 0.002) for all T classes was observed. As for as those cases with neoplasias in the supraglottis are concerned, there were no patients classified T2 (0/50) with cricoid infiltration against 8% in T3 subjects (10/124). In these subjects extension to the hypoglottis led to microscopic invasion of the cricoid cartilage in a greater number of patients (31% vs 3%, p < 0.0001). These observations confirm that microscopic infiltration of the cartilagenous skeleton of the larynx, especially of the cricoid, is relatively frequent. Factor of even higher risk are occurrence in the glottis and, in all the situations examined, extension to the hypoglottis. In addition, except in cases of vestibular T2, there is a 5 to 8% possibility of microscopic infiltration of cricoid cartilage even in the absence of clinical signs of hypoglottic invasion.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma↗
PubMed1994

Immunohistochemical and immunoradiometric evaluations of total cathepsin D in human larynx.

By using a commercially available immunoradiometric technique (Cath-D-IRMA, Cis BioInt.) the distribution of total cathepsin D (cath-D) in 30 malignant and in the corresponding histologically-proven non-malignant fragments obtained from lymph node negative patients suffering from larynx cancer was investigated. In both tissues the oestrogen and progesterone receptors were also assayed. In 17 out of the 30 samples, the cath-D was also assayed by immunohistochemistry using the M1G8, a mouse monoclonal antibody raised against cath-D (Cis BioInt.). Our data indicate that cath-D is present in prismatic cells of the normal laryngeal epithelium and in the cancerous cells. In cancerous larynx, the outer cell layer of large tumour nests showed the highest degree of immunoreactivity, while fibroblasts and inflammatory cells always showed a very faint staining. Cathepsin D levels were significantly higher (P < 0.0001) in the cancerous fragments (with a mean of 33 +/- 3.4 pmol/mg protein) than in the corresponding non-cancerous specimen (with a mean of 20.8 +/- 2 pmol/mg protein). A significant positive association (P < 0.001) between cath-D and progesterone receptor (PR) concentration values in the cancerous larynx was observed; accordingly, tumours expressing PR had significantly (P = 0.0005) higher cath-D levels than the tumours which did not contain the receptor. In contrast, such a relationship was absent in the non-malignant specimens. As regard the oestrogen receptor, no significant relationship between this and cath-D was observed. We conclude that cath-D measured by IRMA in tissue cytosols is mainly derived from cancerous cells, the contribution from fibroblasts and inflammatory cells being negligible. Cathepsin D overexpression and association with the PR in the malignant part of the larynx could indicate a possible role of the receptor in the biology of this disease.

Aged↗
PubMed1994

Lipomatous tumors of the uterus. Clinico-pathological features of 10 cases with immunocytochemical study of histogenesis.

The clinico-pathological and immunocytochemical findings of 10 uterine fatty tumors (1 pure lipoma and 9 lipoleiomyomas) are referred. This kind of tumor is more frequent in older postmenopausal women, treated for a preoperative diagnosis of uterine leiomyoma. Macroscopically the tumor may show different consistence and colour as a consequence of the amount of lipomatous component. The microscopical detection of areas of perivascular immature mesenchymal cells with differentiation into adipocytes supports the hypothesis of "neometaplasia" of the lipomatous component derived from immature perivascular cells. On the contrary, the evidence of multivacuolation in smooth muscular cells and the presence of muscle markers in typical mature adipocytes in lipoleiomyomas, as revealed by immunocytochemistry, suggests the hypothesis of direct transformation of smooth muscle cells into adipocytes.

Actins↗
PubMed1994

Expression of AgNORs in serous ovarian tumors.

The nosological nature of the borderline ovarian tumor has been investigated by several methodological approaches. The aim of our research was to verify how the study of the nucleolar organizer regions (AgNOR) may offer its contribution on this subject. We studied 18 cases of ovarian serous tumours, respectively 6 benign, 6 borderline and 6 malignant. A separate calculation for clusters (> 1 mu) and total NORs was performed on fifty neoplastic cells chosen at random from every tumour. The findings recorded were the following: 1) the quantity and shape of clusters, dots and total NORs were significantly increasing from benign to borderline to malignant tumours; 2) the number of the dots and total NORs was higher in the case of borderline tumour stage III than in other cases limited to the ovary; 3) the clusters of the poorly differentiated carcinomas were much less numerous than the clusters of those well differentiated; instead the dots and the total NORs were more numerous. These data suggest a correlation between the number of the NORs and the biological activity of the tumours. The borderline serous tumours of the ovary showed a median position between benign and malignant tumours.

Adult↗
PubMed1993

Expression of cathepsin D in malignant and in the corresponding non-malignant node-negative laryngeal samples: correlation with receptors for androgen, glucocorticoid, oestrogen and progesterone.

A standard immunoradiometric technique was used to investigate the distribution of the intracellular aspartic proteinase cathepsin D in 33 malignant and in the corresponding histologically-proven non-malignant fragments obtained from lymph node negative patients suffering from larynx cancer. In both tissues the androgen, glucocorticoid, oestrogen and progesterone receptors were also assayed. Our data indicate that cathepsin D was present in both tissues, with level significantly higher (P < 0.0001) in the cancerous fragments (with a mean of 33 +/- 3.4 pmol/mg protein) than in the corresponding non-cancerous specimen (with a mean of 20.8 +/- 2 pmol/mg protein). A significant positive association (P < 0.001) between cathepsin D and PR concentration values in the cancerous larynx was observed; accordingly, tumours expressing PR had significantly (P = 0.0005) higher cathepsin D levels than the tumours which did not contain the receptor. In contrast, such a relationship was absent in the non-malignant specimens. As regards the other steroid receptors, no significant relationship between them and cathepsin D was observed. We conclude that cathepsin D may have a role also in laryngeal carcinoma and that its association with the PR could indicate a possible role of the receptor in the biology of this disease.

Aged↗
PubMed1993

Effects of progesterone administered by nasal spray on the human postmenopausal endometrium.

The aim of the study was to assess the effectiveness of progesterone (P) administered by nasal spray (NS) in inducing secretory changes within estrogen and non-estrogen primed postmenopausal endometrium. Ten healthy post-menopausal women before vaginal hysterectomy for prolapse were randomly treated by either oral estrogens for 3-4 weeks combined for the last 5-7 days with nasally administered P at the daily dose of 34 mg, or by only P for 6 days. Endometrial samples were taken before P administration and 8 h after the last dose. In the group not treated with estrogens, P did not induce significant secretory changes in any case except one which showed a proliferative endometrial pattern at the first evaluation. In the group treated with estrogens, in all the cases after P administration clear secretory changes (abundant vacuoles, endoluminal secretion) occurred. It is possible to conclude that P administered by NS exerts an end-organ effect within the endometrium of postmenopausal women pretreated with estrogens.

Administration, Intranasal↗
PubMed1993

Effects of the repetitive administration of progesterone by nasal spray in postmenopausal women.

OBJECTIVE: To study the effects of 10 days of nasal spray P treatment on P serum levels and the endometrium. DESIGN: Prospective. SETTING: University Medical School. PATIENTS: Eight postmenopausal women received oral conjugated estrogens at a daily dose of 0.625 mg for 4 weeks immediately before vaginal surgery for prolapse. For the first 9 of the last 10 days the patients also received a nasal spray dosage of 11.2 mg P three times a day; on the 10th day they received only one dose. MAIN OUTCOME MEASURES: Blood samples were taken at 8:00 A.M. on treatment days 1, 3, 5, 7, 10, and 11 to follow P serum concentration levels. Endometrial samples for histologic examination were collected before P administration and immediately after surgery to evaluate the end-organ effect. RESULTS: Mean P serum levels increased sixfold after 9 days of nasal spray P administration [from 0.612 +/- 0.280 ng/mL (1.958 +/- 0.896 nmol/L) to 3.925 +/- 1.553 ng/mL (12.560 +/- 4.970 nmol/L)] and declined thereafter, returning to the before treatment levels 24 hours after the last administration. In all subjects, the first histologic evaluation showed proliferative endometrium; the second showed clear secretive changes. CONCLUSIONS: Repetitive nasal spray P administration for 10 days in postmenopausal women led to increasing P serum levels and, when the estrogen stimulation was adequate, to secretory changes in the endometrium (end-organ effect).

Administration, Intranasal↗
PubMed1993

Articular cartilage echography as a criterion of the evolution of osteoarthritis of the knee.

We propose a modification of the Aisen's technique by which precise reproducible measurements of articular cartilage thickness of the knee is possible. A group of 23 patients with severe osteoarthritis was studied by ultra-sound (US) before knee prosthesis surgery. Evaluation with US was performed by a real-time scanner with a 7.5 MHz linear probe with upper-patellar transverse scans tangent to the upper patellar pole at 90 degrees knee flexion. The cartilage thickness was measured within the weight-bearing area. After surgery, on the corresponding gross pathological specimen, US re-evaluation and histological measurements were made. Results of pre- and post-operative ultrasonography (US) data were compared with histological data and a good correlation between these measurements was found (p(t) > 10%). Preoperative measurements ranged from 2.4 to 0.3 mm. In order to obtain normal reference values of the articular cartilage within the weight-bearing area of the femoral trochlea for comparison, a group of 10 control subjects was also studied with US as above. The US data were then compared with computed tomography (arthro-CT) evaluations. No significant differences in mean values were found between the two imaging techniques (2.2 mm versus 2.3 mm for the lateral condyle and 2.3 versus 2.3 for the medial condyle, respectively). We conclude that ultra-sound measurement of articular cartilage thickness of femoral condyles is a sensitive and reproducible technique which permits early diagnosis and management of knee arthropathy and also quantification of cartilage damage.

Adolescent↗
PubMed1993

Abnormal cervical PAP smear leading to the diagnosis of gastrointestinal cancer without cervico-vaginal metastases.

We report the case of an unsuspected G.I. cancer in a patient with no clinical signs other than ascites and positive PAP-smear on admission. Histologically, neither endometrium nor cervix were involved. To date, only 2 cases of primary gastrointestinal (gastric) cancers with no metastases to the cervix, suspected by PAP-smear, have been reported in medical literature. A few more have been reported with cervical metastases. The suspicion of intraabdominal adenocarcinoma was based on the evidence of signet ring cells found in the smear with negative cervical biopsies and negative fractional curettage. A postmortem examination confirmed the absence of genital involvement. Our aim is to remind the clinician that an abnormal PAP-smear, due to non gynecological malignancies, can, on rare occasions, be observed. In order to obtain a positive cervico-vaginal PAP-smear by a non gynecologic intraabdominal exfoliating cancer, both previous literature and our case suggest peritoneal effusion to be of major importance.

Adult↗
PubMed1993

Morphologic precursors of ovarian epithelial tumors.

OBJECTIVE: To correlate various types of hyperplastic lesions of the ovarian surface epithelium with primary disease of the female genital tract. METHODS: Using whole-organ multiple sections of the ovary, we studied 200 hysterectomy and bilateral salpingo-oophorectomy specimens distributed into four groups: cases without hyperplastic or neoplastic disease in the tube, uterus, or vagina; those with contralateral epithelial ovarian tumors; those with endometrial adenocarcinomas; and those with polycystic ovary disease. RESULTS: We found a high frequency of hyperplastic and metaplastic changes in the surface epithelium or in the inclusion cysts in ovaries with contralateral epithelial ovarian tumors (92%), endometrial adenocarcinomas (76%), and polycystic ovary disease (68%) compared to ovaries without hyperplastic or neoplastic disease (22%). These changes were frequently associated with intracystic papillae and psammoma bodies similar to those observed in epithelial tumors. The inclusion cysts were unrelated morphologically to signs of preceding ovulation, but were related to deep crypts of the ovarian epithelium and to stromal hyperplasia. CONCLUSIONS: The hyperplastic and metaplastic changes of the surface epithelium and related inclusion cysts can be considered morphologic precursors of common epithelial tumors. Similar changes are found as a response to a hormonal ovarian or extraovarian stimulus, which may play an important role in ovarian carcinogenesis.

Adenocarcinoma↗