Biomedical subjects

S Bianchi

Publications and source records attributed to S Bianchi.

At least 253 records · Page 14Linked to original sources

PubMed1992

M1 and M3 muscarinic receptors: specific roles in sleep regulation.

P-fluoro-hexahydro-sila-difenidol hydrochloride (p-F-HHSiD) (15, 30 micrograms) and pirenzepine (7.5, 15, 30 micrograms), which are highly selective M3 and M1 muscarinic antagonists, respectively, were injected intracerebroventricularly into freely moving rats. p-F-HHSiD (30 micrograms) reduced wakefulness (W) (from 34.7 +/- 3.1 to 24.9 +/- 1.3 min) and increased slow wave sleep (SWS) (from 56.7 +/- 2.4 to 67.2 +/- 1.5 min); however, it did not modify desynchronized sleep (DS) latency and percentage in 6 h recordings. W and SWS were not affected by pirenzepine (7.5, 15, 30 micrograms) which decreased significantly DS amount but left unaffected DS latency. The results suggest that each muscarinic receptor subtype may induce different and specific changes in sleep phases and cortical desynchronization processes.

Animals↗

PubMed1992

Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension.

To determine the prevalence of increased urinary albumin excretion (UAE) in essential hypertension and to establish whether this abnormality is associated with deranged renal function, we have measured UAE in a group of 123 patients with essential hypertension and in 110 normal subjects. Mean arterial pressure (MAP) was 96 +/- 0.6 mm Hg in normal subjects and 121 +/- 0.3 mm Hg in patients with essential hypertension (p less than 0.01). Mean UAE was 8.6 +/- 0.5 in normal subjects and 32.9 +/- 3.3 mg/24 h in patients with essential hypertension (p less than 0.01). Forty percent of patients with essential hypertension manifested a UAE exceeding 30 mg/24 h and had an average UAE of 72.0 +/- 4.7 mg/24 h. MAP in patients with increased UAE was similar to that in subjects with normal UAE (121 +/- 0.5 vs. 121 +/- 0.4 mm Hg). Creatinine clearance was also not different between these two groups (91 +/- 1.8 vs. 94 +/- 1.5 ml/min). No correlation was found between UAE and MAP or creatinine clearance. Long-term prospective studies are needed to extablish whether an increase in UAE may predict future nephrosclerosis in essential hypertension.

Albuminuria↗

PubMed1992

Immunohistochemical evidence for the occurrence of endothelin in the vascular endothelium of normal and inflamed human dental pulp.

The occurrence and distribution of the regulatory peptide endothelin in normal and inflamed human dental pulp was studied by immunocytochemistry. Endothelial cells in both normal and inflamed pulp displayed endothelin-like immunoreactivity. Neither pulp cells nor dental nerves were immunoreactive. No significant change in the distribution of endothelin immunoreactivity could be detected in the samples of inflamed pulp tissue, the immunoreactive material being detectable only within the endothelium. However, the intensity of the immunostaining was less intense in the samples of inflamed pulp. It is reasonable to presume that endothelin, produced and released locally by endothelial cells, may participate via a paracrine mechanism in the regulation of blood pressure and flow in normal and pathological human dental tissues.

Adolescent↗

PubMed1992

[Role of endovesical echography in the assessment of bladder neoplasms].

The correct assessment of T (depth of infiltration of bladder wall by cancer) is relevant to plan therapy. In fact, besides staging the local lesion, this can predict pelvic and lumboaortic lymphnode involvement (N parameter) statistically. At the INRCA Hospital in Florence, from January 1987 to December 1989, transurethral US was performed on 66 patients affected with bladder carcinomas, in order to assess the value of this diagnostic method; in all patients pathologic staging on surgical specimens from TUR (63 cases) and cystectomy (3 cases) was performed. Follow-up lasted 24 months at least. When comparing US staging (according to Holm classification) to postoperative histopathologic findings, our results showed that US tends to overstage the lesions, while no understaged tumors were seen in our series. Diagnostic accuracy was 70%. It must be pointed out that TRUS demonstrated hidden submucosal tumors in two patients previously treated with intravesical chemotherapy. Retrospectively, we were able to detect causes of error in cancer staging in some cases--i.e., large carcinomas, calcifications on tumors, radiotherapy scars, bladder wall inflammation due to intravesical BCG therapy. Moreover, some lesions which appeared to have been overstaged with TRUS and which had been treated according to histopathologic findings from TUR exhibited recurrence or disease progression. This was probably due to incomplete TUR and to the presence of residual tumor in the bladder wall.

Humans↗

PubMed1992

The vanishing tricuspid annuloplasty. A new concept.

A tricuspid De Vega annuloplasty with absorbable 2-0 polydioxanone sutures was performed on 16 sheep supported by cardiopulmonary bypass. The anulus diameter was reduced by 2 to 6 mm. Four sheep died perioperatively. The 12 survivors were electively killed at 2-week intervals during a period of 6 months. Infective endocarditis was not observed. At the time of death no gradient was found on simultaneous pressure measurements of the right atrium and ventricle. Epicardial echocardiography did not reveal tricuspid stenosis or regurgitation. Macroscopically there was no thrombus and the tricuspid leaflets were of a normal appearance. A thin white cord was observed at the anulus in all animals killed after 12 weeks. The annular size remained as surgically induced until the fourth month, but it reverted to its preoperative size after 5 months. Histologically there was granulation tissue initially only around the foreign material, but then progressively it appeared also between the foreign filaments, with the development of multinucleated foreign body giant cells. At approximately 5 months most of the foreign material had been disrupted or absorbed, leaving a tenuous ring of granulation tissue, which allowed expansion of the tricuspid ring to its original circumference. By 6 months most of the foreign material had disappeared and was replaced by loose collagenous tissue. The concept of a "vanishing annuloplasty" is advanced, with particular application in children and in patients with functional tricuspid insufficiency.

Animals↗

PubMed1992

Nuclear grading and prognosis in node negative breast cancer.

The authors evaluated retrospectively 287 node negative breast cancer patients treated solely with surgery and followed-up for at least five years. Cases were retrospectively classified according to nuclear grade. The prognostic value of T category and nuclear grade were compared at univariate and multivariate analysis. Five-year overall or relapse-free survival was dependent on T (T1 = 0.96 or 0.86, T2 = 0.88 or 0.76, T3 - 4 = 0.58 or 0.38, T2 - 4 = 0.86 or 0.72) and on nuclear grade (G1 = 0.94 or 0.82, G2 = 0.88 or 0.74, G3 = 0.80 or 0.72, G2 - 3 = 0.88 or 0.74). Nuclear grade was associated to T category, as low grading tumors were more frequent among T1 as compared to T2 - 4 cases (chi-square = .09, df = 2, p less than 0.05), but both nuclear grade (G2 - 3 vs. G1: relative risk = 1.89, p = 0.022) and T category (T2 - 4 vs. T1: relative risk = 2.23, p = 0.013) were independently and significantly associated to overall survival. Although their limited discriminating power does not justify their clinical use in selecting high risk node negative patients to adjuvant therapy, they should be used as prognostic factors as they are as efficient as other new indicators and by far cheaper and simpler to assess.

Adult↗

PubMed1992

Histological pattern of benign breast disease as a risk factor for invasive breast cancer.

Morphological criteria for histologic diagnosis of both typical and atypical breast epithelial hyperplasias have recently been thoroughly reviewed. Typical epithelial hyperplasia ranges from mild to florid and is characterized by a lack of cytologic atypia. Atypical hyperplasia (AH) is a borderline epithelial lesion between typical hyperplasia and carcinoma in situ. AH represents the most important histopathologic predictor of future breast cancer (BC) according to a case-control study we have recently carried out in a cohort of women previously treated for histologically confirmed benign breast disease (BBD). The use of histologically defined categories in order to predict BC risk depends on the utilization of strict and uniform diagnostic criteria that are currently far from being defined and widely accepted as shown in studies of inter-observer variability among pathologists. Further studies are needed to evaluate inter-observer reproducibility and to assess BC risk among women with different BBD types.

Breast Diseases↗

PubMed1992

Endometriosis and nonobstructive müllerian anomalies.

We reviewed the case records of all women (N = 748) who underwent laparoscopy for infertility in our department from 1985-1990. The patients were divided into two groups, cases and controls, according to the presence of nonobstructive müllerian anomalies (N = 198) or absence of such anomalies (N = 545); women with obstructive müllerian anomalies (N = 5) were excluded. The patients were analyzed for the presence of endometriosis, malformation class, and productive history. The frequency of endometriosis was 30.8% in the women with nonobstructive müllerian anomalies, versus 38.5% in the controls (P = .209). Among the subjects with unicornuate uterus, the prevalence of endometriosis (55%) was significantly greater compared with the patients with other nonobstructive müllerian anomalies (28%) (P less than .05), but not compared with the controls (38.5%). Overall, no differences were observed in the frequency of endometriosis between infertile women with and without nonobstructive müllerian anomalies. Our results seem to exclude a common pathogenetic factor underlying endometriosis and nonobstructive müllerian anomalies.

Adult↗

PubMed1992

Pain symptoms associated with endometriosis.

We evaluated the prevalence and severity of dysmenorrhea, pelvic pain, and deep dyspareunia and their relation to disease stage and site in 124 infertile women with endometriosis and 67 infertile women with normal findings. Seventy-eight endometriosis patients had stages I-II disease and 46 had stages III-IV. The frequency of dysmenorrhea was similar in patients and controls; pelvic pain was more frequent only in patients with stages III-IV, whereas deep dyspareunia was more prevalent regardless of disease stage. Dysmenorrhea was significantly more severe in stages III-IV patients than in either stages I-II patients or controls. Pelvic pain was more severe in stages III-IV, but we observed a statistically significant difference only in comparison with stages I-II. An association of two or more pain symptoms was more frequent in women with endometriosis than in those with normal pelves (relative risk = 3.1, 95% confidence interval 1.52-6.46). Ovarian endometriomas were the only lesions significantly associated with severe dysmenorrhea and pelvic pain. We conclude that endometriosis in infertile women causes pelvic pain, the severity of which is related to the extent of the disease.

Adult↗

PubMed1992

Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis.

OBJECTIVE: To evaluate the diagnostic capability of transvaginal ultrasonography in detecting diffuse adenomyosis. DESIGN: We compared the preoperative transvaginal ultrasound (US) findings and the pathological findings of the surgical specimen in a series of women who underwent hysterectomy for menorrhagia. PATIENTS: Forty-three women (mean [+/- SD] age of 46 +/- 5) with recurrent menorrhagia and enlarged uterus, without evidence of uterine leiomyomas at abdominal US and of endometrial disease at vabra curettage. SETTING: Tertiary care center, university medical school. MAIN OUTCOME MEASURES: Sensitivity, specificity, predictive positive and negative values of transvaginal US in the diagnosis of diffuse adenomyosis. RESULTS: The sonographer diagnosed adenomyosis in 22 patients, whereas the pathologist found adenomyosis in 20 women, confirming the US findings in 16 cases and making an ex novo diagnosis in 4. The sensitivity of transvaginal US was 80%, the specificity 74%, the predictive value of a normal test 81%, and that of an abnormal test 73%. CONCLUSIONS: Transvaginal US seems to represent a real advance in the preoperative diagnosis of diffuse adenomyosis.

Adult↗

PubMed1991

Follicular Hurthle cell tumors of the thyroid gland.

A clinicopathologic study of 153 cases of thyroid follicular Hurthle cell tumor (HCT) is presented. Follow-up, available in all cases, ranged from 5 to 26 years (median, 9 years). These neoplasms were divided into three categories on the basis of presence and degree of capsular and vascular invasion, pattern of growth (follicular, trabecular, or solid), nuclear atypia, and necrosis. The categories were benign (90 cases), indeterminate (35 cases), and malignant (28 cases). All the tumors classified histologically as benign or indeterminate behaved in a clinically benign fashion. Of the 28 tumors classified histologically as malignant, 20 had a clinically malignant behavior. At survival analysis, no clinical or pathologic feature among the carcinomas was found to correlate with a fatal outcome. It is concluded that histologic criteria alone can distinguish benign from malignant HCT and that clinical or pathologic feature cannot predict behavior among the malignant tumors.

Adenoma↗

PubMed1991

Endometrial patterns during danazol and cyproterone acetate treatment for endometriosis: structural and ultrastructural study.

We studied the endometrial structure and ultrastructure in serial biopsies from 16 patients with endometriosis treated with danazol (n = 9) or the combination cyproterone acetate plus ethinyl estradiol (n = 7) for 6 months. Biopsies were performed before and at 3 and 6 months of treatment. The material obtained was studied by light (LM), scanning (SEM) and transmission electron microscopy (TEM). A morphometric analysis was performed evaluating three morphometric and three stereologic indices. The results indicate that danazol had a progestational effect on endometrial glands and stroma, associated with a marked hypotrophy of the mucosa. The cyproterone acetate/ethinyl estradiol combination induced progressive atrophy of the endometrium with an increase in the stromal component and a reduction of glandular tissue.

Adult↗

PubMed1991

A case-control study of gastric cancer and diet in Italy. III. Risk patterns by histologic type.

In a case-control study of gastric cancer (GC) in high-risk and low-risk areas of Italy, 923 GCs were systematically categorized by one pathologist according to the Lauren classification distinguishing 2 main histologic types, intestinal (55%) and diffuse (23%). Intestinal types outnumbered diffuse types by a 3 to 1 margin in high-risk regions in the north-central part of the country, while both types occurred at nearly equal rates in low-risk areas. Intestinal types also occurred relatively more frequently at older ages and among males. Relative risks of each type of GC were evaluated in relation to dietary and other data obtained from interviews with the cancer patients and controls. The risk patterns for intestinal and diffuse types were remarkably similar. Increased risks of both types were associated with high intake of meat, salted/dried fish, seasoned cheeses and traditional soups, while decreased risks of both types were found among heavy consumers of fresh vegetables and fruits. Correspondingly similar patterns were seen with indices of nutrients, with risks of both intestinal and diffuse GC rising with animal protein intake and declining with consumption of vitamins C and E. Both types were inversely related to socio-economic status, and neither was associated with cigarette smoking. A familial history of GC was reported more frequently by patients with each type than by controls, although the highest risk was for unclassified GC, a group of poorly differentiated and medullary carcinomas accounting for 15% of all GCs in this study. The findings suggest that, despite differences in geographic and demographic patterns, the intestinal and diffuse types of GC have etiologic factors in common.

Adult↗

PubMed1991

Re-examination of the anatomic indications for hysteroscopic metroplasty.

Until now the indication for hysteroscopic metroplasty has been based on laparoscopic findings and thus depended on the operator's experience. Using ultrasound and magnetic resonance images of double uteri it should be possible to find more objective indications for this operation. When three points are identified on longitudinal scans of the uterine fundus, the two tubal ostia and the mid-point of the fundal perimetrium, hysteroscopic metroplasty is indicated only in uteri in which the third point is at least 5 mm above a straight line drawn between the tubal ostia. This classification criterion includes more cases than laparoscopic criteria in this study; we performed hysteroscopic metroplasty in 23 double uteri and had we followed the laparoscopic criteria the operation would have been performed only in 19.

Diagnosis, Differential↗

PubMed1991

Benign breast disease and breast cancer: a case-control study in a cohort in Italy.

Sixty-two cases of invasive breast cancer were identified in a large cohort of women previously treated for biopsy-proven benign breast disease (BBD) at the Breast Unit of CSPO, in Florence, along with a group of 315 controls, strictly matched by age and year of diagnosis. A pathologist reviewed and reclassified all the original BBD slides according to recently proposed criteria (no evidence of epithelial proliferation, epithelial proliferation without or with atypia). Information about potential confounding factors was collected during personal interviews. In comparison to the women with "non-proliferative" BBD, women classified as having "proliferative disease without atypia" showed a weak and non-significant increase in risk (OR 1.3; 95% CI: 0.5-3.5). In contrast, women with "atypical hyperplasia" were at very high risk of developing breast cancer (OR 13.0; 95% CI: 4.1-41.7). When planning mammography screening or other large-scale early-diagnosis programmes for breast cancer in the general female population, follow-up of high-risk subgroups of BBD patients should be considered.

Adult↗

PubMed1991

The risk of breast cancer subsequent to histologic diagnosis of benign intraductal papilloma follow-up study of 339 cases.

The risk of developing breast cancer was investigated in 339 patients in whom histologically confirmed intraductal papilloma had been surgically removed. Follow-up ranged from 2 to 14 years, (average, 6.62 years). Ten breast cancers were observed, whereas 3 were expected on the basis of age-specific incidence rates drawn from local cancer registries (relative risk = 3.33, 95% confidence interval = 1.60-6.13). No significant difference in the relative risk was observed as far as papilloma type (single or multiple) was concerned. All breast cancers observed occurred in the same breast as the papilloma. Women in whom a benign intraductal papilloma has been excised should be carefully followed since they at are higher risk for ipsilateral breast cancer.

Adult↗

PubMed1991

Intranasal buserelin versus surgery in the treatment of uterine leiomyomata: long-term follow-up.

Forty-two women with symptomatic uterine myomas, candidates for myomectomy or hysterectomy, were randomized to 6 months' treatment with buserelin 1200 micrograms/day intranasally (n = 22) or immediate surgery (n = 20). After buserelin treatment or operation the patients were followed for at least 12 months. Buserelin was well tolerated, the uterine volume fell from 465 +/- 168 to 273 +/- 88 cm3, and hemoglobin values normalized in all anemic patients. Rapid myoma regrowth was observed in all patients in the buserelin group after treatment withdrawal. Pregnancy occurred during follow-up in one of five buserelin-treated myomectomy candidates. Menorrhagia recurred in eight of 15 buserelin-treated hysterectomy candidates, and a hysterectomy was required but no transfusion was needed. Two women entered natural menopause and were considered cured. In the surgery group all operations were uneventful: three women conceived after myomectomy, whereas four of the patients that underwent hysterectomy required transfusions. Thus buserelin treatment appears to be indicated for infertile patients when surgery is contra-indicated or could cause adhesions, and for hysterectomy candidates in perimenopausal age and/or with secondary anemia.

Administration, Intranasal↗

PubMed1991

Effects of ipriflavone and its metabolites on a clonal osteoblastic cell line.

Protective effects of ipriflavone, an isoflavone derivative, in osteoporosis are believed to be caused by the inhibitory action on bone resorption. A direct effect of ipriflavone on bone formation is as yet unknown. Ipriflavone and four of its metabolites (I, II, III, and V) were examined for their effects on parathyroid hormone response, collagen synthesis, alkaline phosphatase activity, and cell proliferation in a clonal cell population of rat osteoblastic cells. Pretreatment of osteoblasts with high concentrations of ipriflavone for 48 h significantly inhibited the cAMP response to parathyroid hormone, producing a shift in the dose-response curve; at lower concentrations metabolites II and III potentiated the cAMP accumulation induced by low doses of parathyroid hormone. The 48 h treatment with metabolite V at the 1 nM dose significantly stimulated collagen synthesis in osteoblastic cells. Ipriflavone and metabolite I showed a biphasic stimulatory action on the alkaline phosphatase activity of osteoblasts, with a maximal effect at the 0.1 and 1 nM doses, respectively. A similar biphasic response was observed with ipriflavone and metabolite I on osteoblastic cell growth, with a maximal effect at the 0.1 nM concentration. These results suggest a direct role of ipriflavone in modulating the synthetic and growth properties of osteoblast-like cells.

Alkaline Phosphatase↗