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M Scarpelli

Publications and source records attributed to M Scarpelli.

At least 73 records · Page 4Linked to original sources
PubMed1989

Quantitative evaluation of recurrent meningiomas.

Clinical, histological and karyometric parameters, nuclear DNA content and the number of nucleolar organizer regions were investigated in 9 recurrent meningiomas and 10 meningiomas which had not recurred within a 10-year period. There were no significant differences between the two groups as to age, sex, site of the tumours and most of the histological parameters scored. Recurrent tumours showed a higher number of mitotic figures and the nucleolus was visible in most of the cells. Cell density, nuclear area, perimeter and nuclear DNA content had values with no statistically significant differences between the two groups. However, significant differences were found in the distribution of the nuclei in the different ploidy regions. Most of the nuclei in the non recurrent cases were in the diploid range, whereas in recurrent tumours there was a reduction in the number of diploid cells associated with an increase in 2c--4c and 4c components. Recurrent tumours also showed a higher number of nucleolar organizer regions positively stained using an argyrophil method. The mitotic count and the nucleolar organizer regions appeared to be the best predictors for recurrence.

Adult↗
PubMed1989

Malignant glial tumours: prognostic value of quantitative microscopy.

Nuclear and cell density features have been measured in 22 cases of glioblastoma divided into two groups according to their survival periods, i.e. less than 12 months or more than 12. The results have demonstrated that the logarithmic transformation of the following features show up statistically significant differences (p less than 0.05): mean of the logarithm of nuclear area, standard deviation of the logarithm of perimeter and standard deviation of the logarithm of the roundness factor. The standard deviation of the roundness factor has been shown to be another parameter with statistically significant differences between the two groups. Forward stepwise discriminant analysis was adopted in order to identify the quantitative features which contributed most significantly to discriminating between the two groups. The results suggested a combination of two features, i.e. the standard deviation of the logarithm of the roundness factor and the mean of the logarithm of the roundness factor. The comparison between actual and predicted categories showed 68.18% agreement: 7 out of 22 cases were allocated incorrectly by the computer. However, when a classification probability threshold was adopted, the 7 incorrectly allocated cases assumed an "intermediate" position between the two groups, in agreement with their survival.

Aged↗
PubMed1989

Histomorphometric and morphologic studies of the carotid body and aortic paragangliomas.

Morphometric and morphological parameters have been evaluated in tumours of carotid body paraganglia and of aorticopulmonary and aorticosympathetic paraganglia. Paragangliomas are characterized by a higher cell density and rounder nuclei (roundness factor) than non-neoplastic carotid body paraganglia. The nuclear area has similar mean values in tumours and normal paraganglia; however, the former group shows higher standard deviation values and coefficients of variation, reflecting the fact that paragangliomas have nuclei of variable size; the variation is more pronounced in aorticopulmonary and aortico-sympathetic paragangliomas. However, subgroups on the basis of morphological features (architectural patterns and degree of intensity of argyrophilia), site of origin, and clinical behaviour (metastases and recurrences) show no morphometric differences.

Aorta↗
PubMed1989

Discrimination between follicular adenoma and follicular carcinoma of the thyroid: preoperative validity of cytometry on aspiration smears.

The aim of our study was to evaluate the validity of the quantitative analysis of nuclear features on aspiration smears in the distinction between follicular adenoma and follicular carcinoma. Karyometric and DNA features, including the nucleolar count, were evaluated on the cytologic material of 28 cases; the values were in general slightly higher in the carcinomas than in the adenomas, with overlap between the two diagnostic groups. By plotting the two most discriminant and least correlated parameters against each other and by drawing two straight lines (one perpendicular to the axis representing the mean of the major nuclear diameter at the 9-microns point, the other perpendicular to the axis of the percentage of nucleolated cells at the 75% point), we obtained two regions: a rectangle delimited by the two axes and the two lines containing 86% of adenomas, and the remaining part of the plane containing 79% of carcinomas. The validity of this approach was tested in 32 new cases not included in the original bivariate classification: accuracy 87%; sensitivity 86%; specificity 88%; predictive value of adenoma 88%; predictive value of carcinoma 85%. In conclusion, a simple cytometric method, i.e., the combined evaluation of the mean of the major nuclear diameter with the percentage of nucleolated nuclei, allows a substantial distinction to be made between follicular adenoma and carcinoma.

Adenocarcinoma↗
PubMed1989

Reproducibility of DNA measurements in imprints of thyroid adenoma. Variation sources.

DNA measurement represents a type of quantitative analysis which allows us to gain prognostic information on malignant tumors and to study the natural history of the epithelial neoplasia. However, there are sources of variation in evaluating the DNA content. These include variation due to field selection, variation between observers (interobserver variation), and variation between laboratories (interlaboratory variation). The influence of various variation sources was studied in 4 experiments. When DNA measurements were made from the same microscopic fields, the results did not differ remarkably. However, observer training proved to be important. Intra- and interobserver variation was lower among experienced morphometrists than among inexpert observers. Different laboratories and image analyzers may give different results when the same case is measured. To overcome at least part of the potential variation sources, undergraduates and postgraduates at the Departments of Pathology of Ancona and Kuopio Universities are specially trained in the use and application of morphometry. Special sampling rules should be applied and observers encouraged to follow the rules as uniformly as possible.

Adenoma↗
PubMed1988

Comparison of computerized analysis of nuclear DNA changes in uterine cervix dysplasia and in urothelial non-invasive papillary carcinoma.

The nuclear DNA content was measured in preneoplastic lesions of the uterine cervix and in papillary carcinomas of the bladder. Three groups of features were calculated from the raw data: basic DNA, DNA deviation and DNA distribution. The basic DNA features, concerning both the cervix and the bladder, showed a progressive increase in the mean DNA content, a decrease in the percentage of diploid nuclei and steadily increasing values of polyploid and aneuploid nuclei. Among the DNA deviation features, the malignancy grade value was zero in the normal cervical epithelium and in the normal urothelium. An increase in this value was evident in moderate dysplasia and in urothelial papillary carcinoma of grade 2, the highest value being in CIS and in grade 3. Concerning the DNA distribution features, the values of the 15th and 95th percentiles and their difference were progressively higher both in the cervix and in the bladder, expressing a continuous shift and spread of the DNA content measurements in the different diagnostic categories, with respect to normal epithelium and urothelium. The statistical analysis showed that the strongest correlation is between 2c D.I. and % of polyploid nuclei in the cervix and between M.I. and % of aneuploid nuclei greater than 4c in the bladder. In the cervix the most discriminating feature is the Malignancy Grade, whereas in the bladder it is the percentage of diploid nuclei. The comparison between the results of the three groups of features showed that: 1) Mild dysplasia of the cervix and urothelial papillary carcinoma of grade 1 showed similar changes in DNA features. Both were basically characterized by increased proliferative activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Papillary↗
PubMed1988

Reproducibility of mitotic counts and identification of mitotic figures in malignant glial tumors.

Quantitative pathology is a rapidly growing field of pathology. This field is developing methods allowing greater objectivity and better reproducibility in diagnostic decisions. The introduction of quantitative pathology as a teaching subject in medical education will help this field to become more widely and more correctly applied. Courses on quantitative pathology are organized yearly by the Department of Pathology at the University of Ancona. The 1986 course emphasized training of students in understanding basic problems such as variation caused by tissue processing, instrumentation, data handling and interpretation, and variation between observers. In this paper we describe experiments performed during the course on identification and quantitation of mitoses in malignant glial tumors. The participants, i.e. students of the postgraduate Pathology School, could identify mitoses with a 'substantial' reproducibility. However, when the observers were allowed freely to choose the fields to count, the reproducibility was 'slight'. The study suggests that sampling rules should be applied which secure reproducible application of morphometric method also on condition of free selection of fields. Because the application of such rules needs expertise in histopathology, it seems that morphometric method can best be applied by histopathologists themselves.

Glioma↗
PubMed1987

Prognostic value of computerized DNA analysis in noninvasive papillary carcinomas of the urinary bladder.

DNA parameters and a DNA status index were calculated in cases of noninvasive urothelial papillary carcinomas and apparently normal urothelium. DNA feature analysis included the measurement of basic parameters as well as those related to DNA deviation. Normal urothelium had a diploid content with a few values between 2c and 4c. The papillary lesions in the three grades showed a progressive decrease in diploid nuclei and steadily increasing percentages of tetraploid ones. One case of grade 1 papillary carcinoma and some of grade 2 showed a small proportion of aneuploid cells; the proportion quintupled in grade 3. The values of parameters related to DNA deviation increased progressively in the three grades, numerically expressing the shift from diploidy. The DNA status index is a multiparameter classification in which a single number, ranging from 0.5 to 3.7, expresses the degree of DNA deviation from a non-proliferating diploid population. The cases of normal urothelium and of grade 1 had the lowest values, from 0.5 to 1.9, whereas grade 3 cases had the highest, from 2.2 to 3.7. The index values of grade 2 cases were partly intermediate and partly in the range of the neighboring grades. The DNA status index has a prognostic significance. In fact, associated lesions and recurrences were only observed in cases with index values over 2.0.

Carcinoma, Papillary↗
PubMed1986

Multivariate classifications of transitional cell tumors of the bladder: nuclear abnormality index and pattern recognition analysis.

The authors report their experiences in applying two types of computer-aided multivariate classification systems in transitional cell tumors of the bladder. The systems are based on nuclear changes in urothelial papillary lesions. 19 out of 54 parameters, selected on the basis of the overlapping area between contiguous grades and the monotonic function, were combined mathematically to obtain the nuclear abnormality index. This index expresses the progressive nuclear abnormalities as a single number on a continuous scale from 0.5 to 2.6. The standard deviation (SD) of the 10 largest nuclear area values in the lower half of epithelial thickness (L), the mean perimeter (L), the SD of the roundness factor in the upper half of epithelial thickness (U), the SD of the logarithm of area (L) and the percentage of round nuclei (U) represent the smallest, the most discriminant and the least correlated set of features for the pattern recognition analysis. The latter shows an agreement of 92% between computer and histologic classifications-estimated by applying Bayes theorem. A good correlation exists between nuclear abnormality index and computer grading by pattern recognition analysis.

Carcinoma, Transitional Cell↗
PubMed1986

Quantitative evaluation of the progressive nuclear abnormalities in urothelial papillary lesions.

The natural history of noninvasive urothelial papillary carcinomas is characterized by structural and nuclear abnormalities of the epithelial lining in the three grades. Morphometry is applied to measure nuclear-related quantitative parameters from the lower (L) and upper (U) halves of urothelial thickness, i.e. perimeter, area and roundness factor. Their mean and SD as well as the derived parameters have values steadily higher from normal-looking urothelium to G3, whereas the relative frequency distribution shows over-lapping among the grades. The multivariate analysis is then applied. First of all the smallest number of least correlated and most discriminant features is selected: SD of nuclear area log (L), percentage of round nuclei (L), mean of the 10 largest values of nuclear area (L) and mean nuclear perimeter (L). The results of the pattern recognition analysis based on these features show the following percentages of agreement between histopathological and computer classifications: 94% in the training set and 80% in the test set. The calculation of the classification probability and the adoption of a threshold approach of 0.25 less than P less than 0.75 are helpful in identifying the 'in-between' cases, i.e., those in the 'intermediate' position between G1 and G2 and between G2 and G3. Morphometry and multivariate analysis allow us to quantify the nuclear abnormalities of urothelial papillary carcinomas and show a progressive and continuous spectrum of modifications.

Cell Nucleus↗
PubMed1985

Subarachnoid haemorrhage due to widely metastatising malignant ependymoma.

A case of a widely metastasing malignant ependymoma in a 35-year-old man is reported. The first and most impressive clinical feature was a massive subarachnoid bleed with rapidly developing spinal cord compression due to widespread metastases over the cord and the cauda equina. The cerebral ependymoma was finally shown on a CT scan. Subarachnoid haemorrhage caused by malignant spinal deposits seems to be exceedingly rare. Finally, some problems of classification concerning the malignant forms of ependymoma are discussed.

Adult↗
PubMed1985

Noninvasive papillary transitional-cell tumors. Karyometric and DNA-content analysis.

An investigation was undertaken to quantify and correlate the nuclear and DNA-content modifications in the different grades of noninvasive urothelial papillary carcinoma. Nuclear area and a roundness factor were studied by histomorphometry in 35 cases, and the DNA content was analyzed in 27 cases. The values of the nuclear area and the roundness factor increased from normal-looking urothelium to grade 3 tumors. The DNA-content analysis indicated a progressive change of ploidy and the presence of an aneuploid (greater than 4c) population in some of the grade 2 and grade 3 lesions. A high coefficient of correlation between the nuclear abnormalities and the DNA content was found.

Aneuploidy↗
PubMed1984

Histomorphometry and pattern recognition analysis of urothelial papillary lesions.

The authors report the results of the grading of urothelial papillary carcinoma using histomorphometry and pattern recognition analysis. Features concerning nuclear area, the nuclear roundness factor and inclination angle were measured in 38 cases of urothelial papillary carcinomas. The relative frequency distribution showed overlapping among the grades with a reduction in the practical significance of histomorphometry. To overcome this problem, the pattern recognition analysis was applied. It was found that mean nuclear area, mean roundness factor and percentages of round and horizontal nuclei represent the optimal discriminating set of the subsequent steps in the malignant urothelial transformation.

Carcinoma, Papillary↗
PubMed1982

Mass lesions of the frontal lobes in acute head injuries. A comparison with temporal lesions.

Contusions and lacerations of the frontal lobes are very frequent; 43.4% in the whole series of traumatic brain mass lesions. Clinical ICP, CT scan data and neuropathological findings in patients with such lesions are analysed and correlated. Moreover, the clinical features and the outcome of frontal masses undergoing surgery are also compared with similar lesions located in the temporal lobes. Frontal lesions cannot be differentiated on purely clinical grounds and the factors governing the outcome in both lactations are the same. On the whole, surgical indications nowadays seem to be rather rare; only lesions behaving truly as expanding lesions with obvious intracranial hypertension benefiting from surgery. Brain contusion-laceration syndromes in general can no longer be considered separate entities. Neither should they be included in the miscellaneous group of "traumatic intracranial mass lesions", since the pathophysiological significance of purely extracerebral effusions is entirely different. Traumatic contusions and lacerations and/or intracerebral haematomas, whether frontal or located elsewhere, should instead, be considered in the context of head injuries of a different degree of gravity, as having collateral features which, on occasion, may call for surgical management.

Adolescent↗
PubMed1980

Intracranial hypertension in severe head injuries.

Long-term ICP monitoring was carried out in a series of 124 patients with severe head injuries admitted to the Intensive Care Unit. Forty-nine percent of patients were admitted within six hours of injury. Most of them were referred by Community Hospitals. Only patients with diffuse brain lesions or patients operated on for mass lesions and remaining in a coma state after operation are taken into account. Altogether, 46 patients survived, but 15 of them remained severely disabled or in a vegetative state, and 78 died. Twenty-four percent of the whole series succumbed to fulminationg intracranial hypertension. The average survival in this group was 5.1 days. Twenty-nine percent died after exhibiting different levels of intracranial hypertension ranging from 20 to 50 mm Hg. In this group the role of extracerebral complications as a cause of death should not be underestimated. Death caused by cerebral lesions with ICP not exceeding 15 mm Hg was exceedingly rare in the first 72 hours. Normal or fairly raised ICP does not rule out the risk of devastating intracranial hypertension: reliable and harmless P/V tests are needed. All patients who survived after showing sustained intracranial hypertension exceeding 50 mm Hg were under 20 years of age. In the present series the results of treatment of intracranial hypertension were, on the whole, rather disappointing.

Adolescent↗
PubMed1980

Intrinsic third ventricle craniopharyngiomas with normal pressure hydrocephalus.

Two observations of intrinsic third ventricle craniopharyngiomas, both involving males in the fifth decade, are reported. Histologically, the tumours, one entirely solid and the other one chiefly cystic, were composed of squamous epithelium with microcysts and no calcifications. In the literature primary third ventricle craniopharyngiomas are considered to be exceedingly rare. However, if a more precise preoperative diagnosis, using computerised axial tomography, were made as a matter of routine, to verify third ventricular masses, it might demonstrate that these tumours are more common than previously believed. In both cases striking clinical pictures of normal pressure hydrocephalus were observed. The relations between intracranial pressure, CSF circulation and ventricular size are discussed. On mechanical grounds, it is very difficult to explain the poastoperative reduction in ventricular size, since there was no significant change in intracranial pressure.

Autopsy↗
PubMed1980

Traumatic cerebral mass lesions: correlations between clinical, intracranial pressure, and computed tomographic data.

After surveying the different phases of their previous experience with the diagnosis and management of traumatic cerebral mass lesions, the authors analyze the correlation between clinical, computed tomographic (CT), and intracranial pressure (ICP) data in 29 patients with traumatic intracerebral hematomas and/or brain lacerations. Clinically, the patients are classified in three groups: (a) deeply comatose patients (Glascow coma scale (GCS), 4 to 5); (b) patients with intermediate disturbances of consciousness (GCS, 6 to 10); and (c) patients with minor impairment of consciousness (GCS, more than 10). Sixteen patients were operated upon. Operation was ineffective in the patients who were already deeply comatose in the first hours after injury, even though elevated ICP was definitely reduced after operation in some of them. Conversely, patients with well-limited lesions, moderate disorders of consciousness, and persisting intracranial hypertension despite medical therapy seemed to be good candidates for delayed operation by limited procedures. In patients with intermediate disturbances of consciousness and no tendency to improvement or deterioration, ICP monitoring correlated with CT scan appearance may be of practical use for making the decision to operate. However, most cases diagnosed on CT scan have a benign course; the patients recover uneventfully with conservative management. In such patients careful clinical observation is usually sufficient. (Neurosurgery, 7: 337-346, 1980).

Adolescent↗