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Biomedical subjects

M Barbareschi

Publications and source records attributed to M Barbareschi.

122 records · Page 7Linked to original sources

[Breast metastasis as the initial clinical symptom of renal adenocarcinoma].

Renal adenocarcinoma shows an unpredictable clinical course. At autopsy, metastases are present in as many as 95 percent of patients with renal adenocarcinoma. The percentage of metastases from renal adenocarcinoma is greater than would be expected from the frequency of this carcinoma among all carcinomas. The breast is an exceptional site of metastasis, that is not described in literature. In the present report the metastasis in the breast represented the early symptom of renal adenocarcinoma.

Adenocarcinoma↗

A sporadic case of congenital hypotrichosis simplex of the scalp: difficulties in diagnosis and classification.

Hereditary hypotrichosis simplex of the scalp is a genotrichosis characterized by a hair defect limited to the scalp in the absence of other ectodermal or systemic abnormalities. Only large pedigrees consistent with autosomal dominant transmission have been described to date. In this article the clinical and scanning electron microscopy findings of a nonfamilial case of congenital scalp hypotrichosis simplex are reported. In some patients the diagnosis of sporadic hypotrichosis simplex of the scalp should be considered after ruling out all other possible causes of congenital and hereditary hypotrichosis.

Child, Preschool↗

Terbinafine induces the PMNL priming effect and enhances in vitro PMNL fungicidal activity against Candida albicans blastospores.

Terbinafine, a new antifungal drug of the allylamine category, has been shown not to interfere with some polymorphonuclear leucocyte (PMNL) functions such as chemotaxis and chemiluminescence. The aim of the present study was to elucidate the effects of terbinafine on PMNL respiratory burst activation and killing of Candida albicans blastospores by PMNLs at the biochemical and ultrastructural level by means of scanning electron microscopy (SEM). Terbinafine is shown to enhance the respiratory burst and superoxide anion release in human PMNLs stimulated by phorbol esters or chemotactic peptides, and to have a priming effect on PMNL functions. Moreover, in our experiments we found that terbinafine does not interfere with PMNL killing of C. albicans blastospores but, in fact, at the concentration found in tissues after oral administration, slightly increases it. As PMNLs play a key role in the early stages of fungal infections we suggest that in vivo terbinafine induces priming of PMNLs, and that this effect is related to enhanced candidacidal activity independent of direct drug damage to fungal particles.

Antifungal Agents↗

A new case of trichothiodystrophy associated with autism, seizures, and mental retardation.

We report a patient with trichothiodystrophy associated with autism, mental retardation, and seizures. The diagnosis was based on the presence of brittle hair, with a marked decrease in sulfur-rich amino acid content, and characteristic features such as "tiger tail" under polarizing microscopy and trichoschisis under scanning electron microscopy. Macroscopic alterations were mostly observed in the frontal and occipital hair, with only microscopic abnormalities in the occipital hair. We consider this an unusual expression of this disease.

Adolescent↗

AgNOR counts in endometrial and endocervical carcinomas.

The histologic differentiation between endometrial and endocervical adenocarcinomas is a common diagnostic problem. In the present study, the distribution of nucleolar organizer regions (NOR) is evaluated in the two groups of neoplasm, but it is concluded that NOR counts do not offer any histological discriminant between endometrial and endocervical carcinomas.

Adenocarcinoma↗

AgNOR distribution in serous tumours of the ovary.

The present paper investigated the distribution of AgNOR in serous tumours of the ovary, with a particular attention to borderline lesion and carcinomas. AgNOR are classified as large AgNOR (LN) and small AgNOR (SN) and are counted separately in 100 nuclei for each tumor. Total number of AgNOR was also recorded (TN). The study shows that the mean values of LN, SN and TN increase from adenomas to borderline lesions and carcinomas, with highly significant differences (p less than 0.001). LN show the most impressive differences between borderline lesion and carcinomas, without overlap of values. The follow up of the patients is not long enough for any correlation between AgNOR counts and prognosis, but preliminary data suggest that high AgNOR counts in borderline tumors should be interpreted very cautiously, because they do not seem to have any correlation with a more aggressive behaviour.

Adenoma↗

AgNOR distribution in normal and dysplastic laryngeal mucosa and in laryngeal epidermoid carcinomas.

Samples of normal and dysplastic laryngeal mucosa and of laryngeal epidermoid carcinomas were submitted to the AgNOR silver staining technique. AgNORs were subdivided in large (LN) and small (SN) and counted separately along their sum (TN). Overlap of values is great between normal and mildly dysplastic mucosa and between moderate and severe dysplasia. Grouping together normal with mildly dysplastic mucosa, and moderate with severe dysplasia, their mean values show minimal overlap and the differences between them are highly significant. Plotting the mean values of these two groups and of carcinomas, the linear interpolations show a clearcut increase of values.

Carcinoma, Squamous Cell↗

Malignant cellular blue nevus with true nodal metastases.

A case of malignant blue nevus initially misdiagnosed as cellular blue nevus with atypia is reported: the correct diagnosis was established after the onset of true nodal metastases. Diagnostic criteria in this difficult field of dermatopathology are examined and their limits discussed in view of the not rare pitfalls reported in literature.

Adult↗

Invasive node-negative breast carcinoma: multivariate analysis of the prognostic value of peritumoral vessel invasion compared with that of conventional clinico-pathologic features.

The prognostic value of the determination of peritumoral vessel invasion (PVI) in node-negative breast cancer (NNBC) patients is still controversial. This is mainly related to the subjective criteria of evaluation of this histologic finding using morphological methods only. In this study, to assess PVI by stricter criteria, we used both conventional morphological and immunocytochemical techniques, using antibodies specific to endothelial cells (i.e. factor VIII-related antigen and the CD-31 antibody). In a series of 233 evaluable NNBC, with a median follow-up of 5 years, we found that 11% of the tumors (25 out of 233) were PVI-positive. A weak association was observed only between PVI and tumor size (p = 0.076). In univariate analysis PVI significantly predicted relapse-free survival (p = 0.0009), but not overall survival (p = 0.1208). The odds of relapse and death for patients with PVI-positive carcinomas were 4.36 and 2.24 times higher than for those with PVI-negative tumors. As far as relapse-free survival is concerned, tumor size (p = 0.0012), histologic grading (p = 0.022), estrogen receptor (p = 0.016) and progesterone receptor expression (p = 0.017) also had a significant prognostic value. Only tumor size significantly predicted overall survival (p = 0.0038) in this series. For 5-year relapse-free survival both PVI (p = 0.014) and tumor size (p = 0.017) were significant and independent prognostic variables by multivariate analysis. Our results demonstrate that PVI and tumor size are important histological features to identify high-risk NNBC patients. Further studies are needed to compare the prognostic significance of PVI and tumor size with that of novel biological prognostic indicators of emerging importance in this neoplasia.

Adult↗

Tumor angiogenesis predicts clinical outcome of node-positive breast cancer patients treated with adjuvant hormone therapy or chemotherapy.

PURPOSE: Experimental studies suggest that angiogenesis is necessary for breast cancer progression and metastasis and that it may play a role in responsiveness to some chemotherapeutic agents and to tamoxifen. To investigate whether angiogenesis predicts the clinical outcome of patients with node-positive breast cancer, we determined intratumoral microvessel density in a series of patients treated with either adjuvant hormone therapy (n=84) or chemotherapy (n= 107). PATIENTS AND METHODS: We monitored 191 patients for a median of 62 months. Intratumoral microvessel density was measured using light microscopy, and microvessels were immunostained using the anti-CD31 antibody. Microvessels were carefully counted (per 200x field) in the most vascularized area of each tumor. The results of intratumoral microvessel density were analyzed by both univariate and multivariate statistical analysis and were correlated with clinical outcome. RESULTS: In univariate analysis, intratumoral microvessel density was significantly associated with relapse-free survival and overall survival, both in patients who received adjuvant hormone therapy and those who received chemotherapy. In the group treated with adjuvant hormone therapy, estrogen receptor status was also predictive for both relapse-free and overall survival. The number of involved nodes was predictive for overall survival. In patients treated with adjuvant chemotherapy, the number of involved nodes, tumor size, and progesterone receptor status were significantly predictive for relapse-free and overall survival. Multivariate analysis showed that intratumoral microvessel density was the strongest independent predictor of outcome in both treatment groups. CONCLUSIONS: Intratumoral microvessel density is an independent predictive indicator in node-positive breast cancer patients treated with either adjuvant chemotherapy or adjuvant hormone therapy. Assessment of tumor angiogenesis may therefore be useful in selection of those patients who are more likely to benefit from conventional adjuvant therapies (i.e., those with minimally vascularized tumors) from those with highly vascularized and more aggressive tumors, for whom novel forms of systemic therapy are advocated.

Adult↗

Pulmonary tuberculosis revealed by lupus vulgaris in an immunocompetent patient.

A seventy-four-year-old patient had lupus vulgaris associated with the nodular, confluent ulcerated type of pulmonary tuberculosis. The diagnosis had been missed on several occasions. The presence of cutaneous tuberculosis in developed countries is emphasized again. It is also stressed that chronic dermatosis of unknown nature in an immunocompetent patient may have a tubercular origin. Complete resolution of the disease was achieved after almost two years of anti-tubercular therapy.

Aged↗