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R Bussani

Publications and source records attributed to R Bussani.

At least 73 records · Page 4Linked to original sources
PubMed1995

Neoplastic and borderline lesions of the prostate: autopsy study and epidemiological data.

Early detection and management of prostatic cancer (PC) is an important public health problem in all industrialized countries, where the relative rate of the elderly population is rapidly increasing. We examined the epidemiology of PC in the province of Trieste, Italy and studied the relationship between prostatic intraepithelial neoplasia (PIN) and PC. The average annual incidence of PC was 99.3 per 100,000 (1,739 new prostatic cancer cases were histologically diagnosed at autopsy or in surgical specimens between 1980 and 1993). In patients over 85 years of age, the incidence rate was 1,209 per 100,000 compared with 64 per 100,000 in the 55-64 age group. Trends in PC incidence rates showed a significant increase among men under 64 years of age and those between 65-74 years. Survival analysis showed that 94% of the patients with well differentiated PC were alive at 5 years, compared with 80% and 40% of those with moderately differentiated and poorly differentiated cancer, respectively. We studied 130 whole autopsy prostates, 70 radical prostatectomies with carcinoma, 63 transurethral resections or adenomectomies without cancer from patients who later developed PC and 94 transurethral resections or adenomectomies from patients who did not develop PC. The 102 prostatic cases with cancer had a high rate of PIN, and the relative frequency of PIN 3 was high (almost 70%, versus almost 0% in benign prostates). In addition, the frequency of PIN was higher in benign prostates of patients who later developed PC (almost 50% of the cases) than in benign autopsy and surgical prostates. PIN was spatially associated with cancer in 75% of the cases. This study confirms the strong relationship between PIN and PC.

Adult↗
PubMed1995

Early fetal endocardial fibroelastosis and critical aortic stenosis: a case report.

Endocardial fibroelastosis is characterized by an abnormal thickening of the endocardium of one or both ventricles; the disorder may occur with or without other cardiac anomalies. A diagnosis of endocardial fibroelastosis in utero using fetal echocardiography may be made on the basis of increased echodensity of the endocardium and poor contractility of the ventricle. We describe a case of very early diagnosis of fibroelastosis and aortic valve stenosis observed in utero at 14 weeks' gestation by transvaginal echocardiography.

Adult↗
PubMed1995

Renal angiomyolipoma with extrarenal involvement--in vascular, lymph-node and perirenal tissue. Reports of four cases.

Extrarenal involvement was found in four cases of renal angiomyolipoma. In one case the wall of the inferior right bronchial artery was infiltrated, lymph nodes were involved in two cases and the perirenal fat in one case. Extrarenal extension does not seem to alter the prognosis of renal angiomyolipoma. Expectant treatment of this rare condition therefore appears to be warranted.

Adult↗
PubMed1994

High relative risk of a second pulmonary cancer in patients affected by laryngeal cancer: differences by specific site of occurrence and lung cancer histotype.

The frequency of a second primary lung tumor in patients affected by laryngeal cancer has been evaluated on the basis of 128,532 biopsies and 27,753 autopsies carried out from January 1, 1979 through December 31, 1988. Among these cases, 432 laryngeal cancers and 44 synchronous or metachronous pulmonary cancers have been detected (7 during life, 37 at autopsy). The highest risk of developing a lung tumor has been evidenced in patients affected by supraglottic cancer during the first 2 years of follow-up (relative risk [RR]: 32.56 for supraglottic patients versus 5.55 for glottic patients). This is particularly true of patients affected by multicentric supraglottic tumors (RR: 62.5). A significant hyperfrequency of undifferentiated lung cancers also has been noted in supraglottic patients (RR: 45.45 for supraglottic versus 14.28 for glottic patients). The information provided by autopsy allows for a more realistic and detailed outlining of the issue of tumor multiplicity, stressing the importance of strict preventive and follow-up protocols.

Actuarial Analysis↗
PubMed1994

Fibromuscular dysplasia. A case report with multivessel vascular involvement.

A case of multivessel fibromuscular dysplasia involving the cervico-cephalic arteries, the right renal artery and the iliac arteries is reported. It was associated with reversible bilateral internal carotid arteries and vertebral arteries dissection, left thalamic infarct, right hemorrhagic cerebellar infarct, renovascular hypertension and intermittent claudication of the right lower limb. This report indicates that fibromuscular dysplasia is a systemic angiopathy. Renovascular hypertension may foster the appearance of complication such as dissection of the arteries affected by fibromuscular dysplasia. In the case investigated the dissection of cervico-cephalic arteries was followed by spontaneous healing and a favourable neurological outcome whereas at the iliac arteries a rapid deterioration was observed.

Adult↗
PubMed1994

Carotid atherosclerosis: echographic patterns versus histological findings.

The study was carried out on 25 whole carotid arteries explanted from a corpse and perfused at constant pressure to reproduce the conditions of an in vivo examination as much as possible. Out of 5 samples with intimal thickening detected by echo, fibrosis of the tunica media was observed by the pathologist in 4 and microcalcification in 1. In 4 vessels with soft plaques at echo scanning, a wide necrotic area (2 cases), slack connective tissue (1 case) and cystic lesions (1 case) were observed. Hard lesions with (5 cases) or without (2 cases) a cone of shadow at echo evaluation corresponded to fibrous (2 cases) or fibrocalcific (3 cases) plaques. The histological study of the two echo-diagnosed thrombi showed an intermediate echographic pattern and the main feature of the non-occluding thrombus was the absence of a lumen-lesion interface. Mixed plaques were diagnosed at echo in 9 arteries and the correspondent histological aspect was a typical atheromatous lesion in all cases. Thus, the comparison of the ultrasound image with the histological findings proved the reliability of echography in the detection of atheromatous lesions with an excellent agreement between the results at the 2 examinations. Since the type of carotid lesions has an impact upon clinical events these results might support the use of vascular ultrasound images in clinical applications.

Arteriosclerosis↗
PubMed1994

[Extrarenal angiomyolipoma: vascular, lymphonodal, and perirenal localization. Report of 4 cases].

Angiomyolipomas are rare renal tumors considered benign even though evidences of occurrence of the disease in lymphnodes and vascular structures as well as in a variety of distant sites, such as the liver, the uterus, the nasal cavity and others, have occasionally been reported. We describe one case of late lesion of angiomyolipoma within the wall of the inferior bronchial artery, two cases of lymphnodes involvement and one case of angiomyolipoma extending into the perirenal fat.

Adult↗
PubMed1993

Right ventricular dysplasia: a clinical and pathological study of two families with left ventricular involvement.

BACKGROUND: Right ventricular dysplasia is a heart muscle disease of unknown cause that is often familial and is anatomically characterised by adipose or fibroadipose infiltration of the right ventricular myocardium. It is generally regarded as a selective disorder of the right ventricle. AIM: To investigate the prevalence and characteristics of left ventricular involvement in two families in which at least one member had right ventricular dysplasia confirmed at necropsy. METHODS AND RESULTS: Eight patients were found to be affected by right ventricular dysplasia. In three of them this was confirmed at necropsy. Echocardiography or angiography or both showed left ventricular involvement in seven. This ranged from localised wall motion abnormalities to moderate or severe left ventricular dysfunction. The disease was progressive in four cases. At necropsy the left ventricular myocardium showed predominant fibrosis and degenerative changes of the myocardial cells. There were areas of myocardial thinning with fatty infiltration at the apex in two patients. CONCLUSIONS: Familial right ventricular dysplasia can be a progressive disorder that affects the left ventricle. Advanced disease may be clinically confused with dilated cardiomyopathy.

Adult↗
PubMed1992

Magnetic resonance imaging in right ventricular dysplasia.

Fifteen patients with right ventricular dysplasia were investigated by T1-weighted spin- and gradient-echo pulse sequences, using a protocol that enabled both a subjective analysis of myocardial signal intensity and a quantitative/qualitative analysis of right and left ventricular function. In 8 patients, 3 investigators independently recognized abnormally hyperintense areas in the anatomic sites usually affected by the disease. In 7 of these patients, these areas showed an overlap with a-dyskinetic areas imaged by both magnetic resonance imaging (MRI) and echocardiography. In 1 patient who underwent a cardiac transplant, MRI of the explanted heart showed an excellent correlation between the distribution of the lesions and the in vivo/in vitro features. The data were compared with those from an equivalent sample of patients affected by dilated cardiomyopathy. In the latter patients, no focal hyperintensities were attributed to any anatomic sites in the right ventricule, and no focal a-dyskinetic foci were observed. Furthermore, the 2 groups of patients were significantly different in regard to dimensional and functional quantitative parameters. The results suggest that MRI is useful in integrating echocardiographic data and can be helpful in diagnosing this disease in late stages.

Adipose Tissue↗
PubMed1992

Left ventricular involvement in right ventricular dysplasia.

Right ventricular dysplasia, a heart muscle disease of unknown cause, anatomically characterized by variable replacement of myocardial muscle with adipose or fibroadipose tissue, is usually considered a selective disorder of the right ventricle. However, concomitant left ventricular involvement has been noted in a few cases. The aim of this study was to evaluate the prevalence and characteristics of left ventricular involvement in right ventricular dysplasia, as well as possible progression of the disease. Thirty-nine patients with right ventricular dysplasia were studied by M-mode and two-dimensional echocardiography; 28 of them also underwent cardiac catheterization, and in 25 endomyocardial biopsy was performed. On first examination the left ventricle was normal in 25 patients, whereas in the remaining 14 right ventricular abnormalities were associated with left ventricular involvement, characterized by asynergic areas (12 patients) or diffuse mild hypokinesis (two patients). During follow-up (27 patients, 84.1 +/- 66.1 months) 10 patients showed worsening of right ventricular function; in nine the appearance or worsening of left ventricular abnormalities was observed. Five patients died (four in congestive heart failure and one suddenly). Results of postmortem examination (available in two patients) showed atrophy of myocells and a massive fatty and fibrous infiltration of the right ventricular wall, associated with degenerative changes and fibrosis of the left ventricle. In conclusion, right ventricular dysplasia may be associated with left ventricular involvement and the disorder appears to be progressive in some instances.

Adult↗
PubMed1992

Electrocardiography of myocarditis revisited: clinical and prognostic significance of electrocardiographic changes.

To clarify the clinical and prognostic value of the ECG, an ECG review was undertaken in 45 consecutive patients with a histologic diagnosis of active myocarditis (29 men and boys and 16 women and girls; age, 36.8 +/- 15 years; idiopathic myocarditis, 39 cases). In patients (21) with symptoms of recent onset (less than or equal to 1 month) AV block and repolarization abnormalities were the prevailing ECG features at the time of admission, and a pseudoinfarction pattern (Q waves plus ST-segment elevation) frequently heralded a rapidly fatal course ("fulminant myocarditis"). Left atrial enlargement and atrial fibrillation, left ventricular hypertrophy and LBBB, which prevailed in patients who had symptoms for longer periods, corresponded to the most severe degree of left ventricular dysfunction during the initial hemodynamic and echocardiographic evaluation. The overall mortality rate after 58 +/- 24 months from the time of diagnosis was 29%. Abnormal QRS complexes and LBBB were markers of poor survival, independently of initial indexes of left and right ventricular function, both of which indicate an increased propensity for sudden cardiac death.

Adult↗
PubMed1992

Supraglottic versus glottic laryngeal cancer: epidemiological and pathological aspects.

Between 1979 and 1988, 432 cases of previously untreated laryngeal cancers were histologically diagnosed at the Institute of Pathological Anatomy of the University of Trieste. Of these cases, 192 were supraglottic and 182 glottic cancers. The overall crude incidence was 31.06 0/0000 in males and 2.29 0/0000 in females, with a male/female ratio of 10.2:1 for supraglottic cancers vs. 20.4:1 for glottic cancers. Our incidence values for laryngeal cancer, and supraglottic lesions in particular, are similar to those recorded in France, Spain and other areas of Italy, i.e. in nations where wine production and consumption is very high. The 3-year adjusted survival rate was 45.7% for supraglottic and 83% for glottic cancer patients. Subjects with supraglottic cancer often had a poor prognosis because of the high frequency of cervical lymph node involvement, recurrences and visceral metastases; cancers of the aryepiglottic folds presented the worst clinical evolution.

Adult↗
PubMed1992

Left ventricular involvement in right ventricular cardiomyopathy.

Right ventricular cardiomyopathy is generally considered a disease with isolated right ventricular involvement, although there are some case reports of concomitant abnormalities of the left ventricle. In order to evaluate the prevalence, characteristics and natural history of left ventricular involvement in this disease, 39 patients with right ventricular cardiomyopathy were studied by 2-dimensional echocardiography. At first evaluation 25 patients (group 1) showed right ventricular abnormalities and a normal left ventricle. In the remaining 14 patients (group 2) the right ventricular abnormalities were associated with left ventricular involvement (asynergic areas and/or mild diffuse hypokinesia). During the follow-up, left ventricular involvement appeared in 6 patients of group 1 and worsened in 4 patients of group 2. Five patients died. Pathological examination (available in 4 cases) showed, at the level of the right ventricle, marked atrophy of myocytes and fibro-fatty replacement, and predominant fibrosis at left ventricular level. Left ventricular involvement is thus frequent in right ventricular cardiomyopathy. At least in some cases the disease appears to be progressive.

Cardiomyopathies↗
PubMed1991

Quantitative texture analysis in echocardiography: application to the diagnosis of myocarditis.

Altered myocardial texture associated with inflammatory infiltration or fibrosis of the myocardium has already been described using qualitative and subjective analysis of two-dimensional echocardiograms. The aim of this work is to test whether quantitative analysis of regional image texture in two-dimensional echocardiograms would be an accurate method to identify myocarditis and myocardial fibrosis. A set of 20 two-dimensional studies with endomyocardial biopsy evaluation was examined in 13 patients. Biopsy-proven myocarditis was present in 8 studies; myocarditis and fibrosis in 4; fibrosis in 3; healing/healed myocarditis in 5. A control group of 8 normal subjects was also studied by echocardiography. After quantitative texture analysis of the first order, entropy appeared to consistently differentiate myocarditis from controls. Among second-order parameters, patients affected by myocarditis or fibrosis showed a decreased entropy and higher angular second moment versus controls. We conclude that myocarditis and fibrosis induce similar image texture alterations in ultrasonic images, with increased spatial heterogeneity of the gray level distribution, which can be differentiated from normal structures with digital image analysis techniques.

Adult↗
PubMed1991

Clinical aspects and haemodynamics in the follow-up of dilated cardiomyopathy and myocarditis.

Many studies on the natural history of dilated cardiomyopathy show high probability of death or of cardiac transplantation in a large percentage of patients. These studies have several methodological limitations. Our prospective study, carried out from 1971, and which evaluated 120 patients, showed improved survival in more recent years. Survival 3 years after diagnosis changed from 30% (1971-6/1981) to 88.4% (7/1986-1/1989). Thirty patients were investigated by haemodynamic exercise test to assess their haemodynamic behaviour during exercise, to evaluate the effects of pharmacological treatment and to define parameters of prognostic value. Different haemodynamic behaviours were observed. Haemodynamic investigation during exercise is useful to assess the effect of treatment and may have prognostic value. Myocarditis presents a spectrum of clinical symptoms and echocardiographic abnormalities. In patients with congestive heart failure left ventricular dysfunction is common. Patients with atrioventricular block or chest pain usually have good left ventricular function. During follow-up, improvement is possible but persistent left ventricular dysfunction is associated with a high mortality rate. When left ventricular function is good at presentation and does not deteriorate during follow-up the prognosis is good.

Cardiomyopathy, Dilated↗
PubMed1991

Changes in underlying causes of death during 85 years of autopsy practice in Trieste.

In 1901, 20% of autopsied subjects in Trieste were under the age of 30 and 28.8% were over 70. By 1985, only 0.2% were under 30 years of age and 74.5% over 70. An analysis of autopsy reports for 1901 reveals that the primary causes of death at that time were tuberculosis (22.4%), acute pulmonary infections (13.7%) and malignant neoplasms (10.6%). Other pathological conditions found at autopsy were infectious lesions (10.4%), chronic obstructive pulmonary disease (10.2%), arteriosclerosis (only 6.4%), syphilis (4.7%), nutritional deficiency (4.7%), cirrhosis of the liver (4.6%) and acute infections (1.1%). Overall, infectious diseases accounted for 55% of deaths in 1901. In 1985, the cause of death was infection in only 3.7% of cases. During the period analysed, the percentage of deaths from cancer tripled and mean length of survival increased by more than 20 years. In 1901, the neoplasms found most frequently were gastric cancer in males (17.9%) and cancers of the uterus and ovary in females (both 13%). Lung cancer accounted for 7.7% of all deaths from malignant neoplasms in males, and breast cancer for 10.8% of such deaths among females. By 1985, lung cancer accounted for 32.4% of deaths from malignant neoplasms among males and breast cancer for 18% among females. Between 1901 and 1985, there were highly significant increases in the numbers of deaths due to arteriosclerosis and to malignant neoplasms in people of each sex.

Adult↗
PubMed1990

Clinical and pathologic study of familial dilated cardiomyopathy.

To evaluate the occurrence of familial cases of dilated cardiomyopathy (DC), 165 consecutive patients were studied. Diagnosis of myocardial disease was based on clinical, hemodynamic, bioptic, postmortem or a combination of these criteria. Twelve patients (7% of cases) showed evidence of myocardial disease in greater than or equal to 1 relative; 27 patients with myocardial disease were detected in the 12 families, but a suspected history of myocardial involvement was present in a further 16 cases. In 6 families proband and relatives were affected by DC (total 14 cases); in 1 of these families the disease began with an atrioventricular block. In 4 families the relatives showed the presence of myocarditis at the endomyocardial biopsy. In 2 families the relatives presented a right ventricular cardiomyopathy. The mode of inheritance was autosomal dominant in 7 families, recessive in 4; X-linked pattern may be hypothesized in 1. Nine patients died under the age of 45 years: 2 of sudden death, 6 of chronic heart failure and 1 of cerebral embolism. Familial transmission is not rare. Different modes of genetic transmission (autosomal dominant, recessive and X-linked) and different forms of myocardial disease suggest that familial DC may be a multifactorial disease.

Adolescent↗