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Biomedical subjects

M De Santis

Publications and source records attributed to M De Santis.

At least 163 records · Page 9Linked to original sources

Morphologic and immunohistochemical observations on the mammary and extramammary Paget's disease: implications for the histogenesis.

Using a panel of three anti-CK MoAbs, belonging to Gown's Classes II, III and IV, the Paget's cells shown a variable reactivity to such antibodies indicating a more frequent immunocytochemical similarity to the cells of the epidermal basal-ductal system than to the cells of the glandular secreting section of the epidermal derivatives. According these findings the P.C. not necessarily is the result of a cellular migration from ductal section toward the epidermis, but may arise from a epidermal basal-stem cell, from a ductal or more rarely from glandular secreting cell. This assumption is enforced also by the expression of the CEA from morphologically bonafide basal epidermal cells in proximity of the pagetic lesion.

Antibodies, Monoclonal↗

[Magnetic resonance in the staging of renal carcinoma. The results compared with computed tomography in 42 cases].

In order to investigate the value of MRI in the staging of renal cell carcinoma and to compare the results of MRI and CT, the authors evaluated by means of MRI and CT 42 patients affected with renal cell carcinoma. All patients underwent surgery, and pathology of the surgical specimens was performed. A comparison was made between the surgical and pathologic data and MRI and CT results. Moreover, a comparative evaluation of MRI and CT findings was also made. From the comparison between pathologic data and CT and MRI results MRI was seen to have correctly staged 36 of 42 cases (85%), versus CT 33 of 42 cases (78%). Moreover, MRI proved to be superior to CT in evaluating venous involvement (stages III A and III C) and extra-fascial tumor spread (stage IVA). On the contrary, no significant differences were found between MRI and CT in the evaluation of perirenal involvement (stages I-II) and lymph node metastases (stage III B). MRI misdiagnosed 6 of 42 cases: 2 false negatives in evaluating extracapsular tumor spread, 1 false positive of mesenteric infiltration, 1 false positive of renal vein thrombosis, 1 false positive and 1 false negative in evaluating lymph node metastases. CT misdiagnoses (9 of 42 cases) were the same as those of MRI in 5 cases, while in the MRI false positive of renal vein thrombosis CT was correct. The extant 4 incorrect CT findings were: 2 false positive of renal vein thrombosis, 1 false negative of infiltration of diaphragm and psoas muscle, 1 false positive infiltration of the right liver lobe. As yet, therefore, MRI cannot be routinely employed to stage all renal cancer patients. On the contrary, MRI should be considered as a second-choice diagnostic tool to employ in selected cases when CT alone cannot solve all the problems relative to staging.

Adult↗

[Early diagnosis of hepatocarcinoma: criteria for the performance of screening in patients with liver cirrhosis].

In Italy the incidence of hepatocellular-carcinoma (HCC) in patients with liver cirrhosis is estimated approximately 5% per year. The new imaging technologies make it possible to perform screening programs for the early detection of HCC in these patients; early diagnosis of HCC is recommended as the best strategy in order to enable surgical approach, which seems to be the only effective therapy: screening programs must consider the cost-benefit ratio in the choice of patients and standards of investigation. In the Japanese authors' opinion all patients with liver cirrhosis must be screened every three months with an ultrasonographic liver examination (US) and a measurement of serum alpha-1-fetoprotein level (AFP) and every nine months with a computed tomography (CT) of the liver: at a 5% annual incidence of HCC the cost of a single diagnosis is estimated about 8000 +. In our opinion the cirrhotic patients in Child's C class (approximately 20%) can be excluded from the screening programs, since the survival expectation of these patients is always poor, whether HCC is present or not. Furthermore, considering the acknowledged reliability of the US in the detection of space occupying lesions of the liver, periodical CT examination seems to be unproductive. AFP has a low sensibility as a marker of HCC; nevertheless a progressive increase of its levels can be considered an index of possible blastomatous transformation of cirrhotic liver. In comparison with the Japanese screening programs, the proposed changes might obtain a 55% reduction of the cost of a single diagnosis of HCC, without significant diagnostic loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗

[The mortality among the makers of vinyl chloride in Italy].

A mortality study was performed on 5,946 vinyl chloride (VC)-polyvinyl chloride (PVC) workers of the nine Italian plants. The aims of the study were to investigate the cause-specific mortality of workers exposed to VC in production and polymerization stages and to ascertain whether exposure is associated with a higher risk of cancers other than liver angiosarcoma. An incident cohort was enumerated in five plants, a mixed cohort in two and a cross sectional one in the remaining two facilities. Cause-specific Standardized Mortality Ratios (SMR) were calculated for the six incidence cohorts with a sufficiently long follow-up period. Both Italian and regional rates were used for the comparison. A pooled analysis of six cohorts was performed. For deceased persons, information from death certificates was used in the mortality analysis. Additional clinical and pathological data were sought for all decreased individuals (Best Evidence = BE). The results of the study confirm the carcinogenic action of vinyl chloride on the liver but not on the other suggested target organs (i.e., lung, lymphopoietic tissues, brain). A deficit for all causes of death and cardiovascular disease was evident in most cohorts and in the pooled cohort. Analysis of BE data showed a broad spectrum of carcinogenic action of VCM on the liver as demonstrated by the occurrence of both angiosarcomas and other histotypes of tumours.

Cause of Death↗

[131I]metaiodobenzylguanidine treatment of malignant pheochromocytoma: experience of the Rome group.

Five cases of malignant pheochromocytoma (3 men and 2 women, aged 26-43 years) were treated with [131I]metaiodobenzylguanidine (131I-MIBG). One patient had a voluminous adrenal tumor and multiple distant metastases; two patients had a recurrent tumor; two others a post-surgical residual tumor. The therapeutic procedure essentially consisted of single doses (2.6-7.4 GBq) of 131I-MIBG administered by slow i.v. infusion, given in several therapeutic courses at 1-5 month intervals. The treatment resulted in a complete response in one case with residual tumor and in a partial response in the case with disseminated disease. Two cases showed stabilization of the disease, whereas therapy was ineffective in the fifth case. Nevertheless, pain relief was observed in this patient. The treatment had a very low toxicity and was well tolerated by all patients.

3-Iodobenzylguanidine↗

The role of [131I]metaiodobenzylguanidine in the treatment of medullary thyroid carcinoma: results in five cases.

Therapeutic doses of [131I]metaiodobenzylguanidine (131I-MIBG) were administered to 5 patients, 3 men and 2 women aged from 33 to 66 years, with proven medullary thyroid carcinoma (one "intermediate" papillary/medullary tumor). The treatment procedure consisted of single doses (3.7-8.5 GBq) of 131I-MIBG given by slow i.v. infusion at 2-8 month intervals. In two advanced-stage patients the treatment played an important palliative role, ranging from an objective response (substantial, but not complete, regression of the tumor) to pain relief which was significant for these patients. In three other cases with residual/recurrent tumor, 131I-MIBG complemented conventional treatment in the attempt to effect a cure which actually was achieved in one case. The only side-effect observed was a transient, mild hematologic toxicity in some cases.

3-Iodobenzylguanidine↗

The role of immunocytochemical assays in the diagnosis of stereotactic biopsies from intracranial tumors.

A selected panel of monoclonal antibodies (MoAbs) directed to distinct tumor associated antigens (TAA) has been tested to define the capability of these reagents to differentiate among metastatic carcinoma, lymphoma and primary brain tumor on cytologic specimens obtained with stereotactic techniques. Results obtained on 50 patients bearing either single or multiple brain lesions demonstrated that immunocytochemical (ICC) methods can distinguish between primary brain tumor and brain metastasis suggesting, in 90% of patients with cryptic primary neoplasia, the site of origin of the tumor.

Antibodies, Monoclonal↗

Urothelial cell changes due to busulfan and cyclophosphamide treatment in bone marrow transplantation.

Since the administration of cyclophosphamide and busulfan can cause hemorrhagic cystitis and changes in urothelial cells, an investigation was carried out to see whether patients undergoing bone marrow transplantation (BMT) who were treated with these drugs showed such urothelial changes and whether exfoliative urinary cytology can contribute to the early diagnosis and monitoring of such changes. Morphologic and morphometric analyses were performed on cytocentrifuged, Papanicolaou-stained preparations of 700 samples from 107 patients. Various degrees of urothelial cell changes were found in 30.8% of the cases. These changes consisted mainly of a considerable increase in the size of the nucleus and of a cytoplasm that was often bizarrely shaped. Even the structures of the nucleus and the cytoplasm changed. The results of this study showed that exfoliative urinary cytology permits an early diagnosis and monitoring of urothelial cell changes related to the administration of busulfan and cyclophosphamide in connection with BMT.

Adolescent↗

Drug abuse in pregnancy: fetal growth and malformations.

The influence of drug addiction in pregnancy on the fetus is in terms of malformation, ponderal and functional development and post-natal psychoneuromotor development. The Authors evaluate the incidence of this complications in 101 drug addicted pregnant patients and the results are shown below.

Abnormalities, Drug-Induced↗

[Role of computerized tomography in the definition of the area to be irradiated in bone metastases].

In the Department of Radiology of the Catholic University S. Cuore in Rome, a review was made of 342 CT examinations with a view towards optimizing the therapeutic planning in patients affected by bone metastases. All patients were submitted to radiological positioning and then to CT evaluation in order to assess the volume to be treated. In 224 cases it was not necessary to perform wide CT examination (3-5 standard tomograms being enough, 2 of which at the superior and inferior margins of the planned field). In the second group of 118 patients it was necessary to perform CT (serial axial scans)--increasing by 1-1.5 cm--up to the superior and inferior margins of the lesion. The existence of 2 types of lesions was confirmed: those involving mainly bony structures and those infiltrating the soft tissues. CT evaluation allowed the definition of the target volume to the real extension of the lesion in 14% of the whole of cases, while in the group of 118 cases studied more thoroughly, the percentage went up to 41%. CT allowed a better assessment of secondary bone lesions, especially in kidney and lung neoplasms. The metastatic site that required a more frequent modification of the irradiation field was the chest. To conclude, the authors emphasize the importance of CT in assessing the target volume, especially in those cases in which conventional radiology does not allow a reliable evaluation of the lesion, possibly compromising the local monitoring of the disease.

Bone Neoplasms↗