Biomedical subjects
Publications and source records attributed to S Bianchi.
The authors present a case of os hamuli proprium, a congenital anomaly of the hook of the hamate. A unilateral presentation of this anomaly is rare--this is the first to be reported in the literature. The lesion could easily be mistaken for a fracture of the hook of the hamate. Radiologists and orthopaedists should be aware of the possibility of such a misdiagnosis.
A case of two histologically different contemporary multiple primary cancers of the breast and the oral cavity is reported. The clinical and histopathological description of the lesions is completed by a discussion on the most recent reported data.
A consecutive series of 185 instances of histologically confirmed nonpalpable infiltrating carcinoma of the breast is presented. Histologic nodal involvement was found in 12 per cent and was dependent on the size of the tumor. Conservative surgical treatment was the predominant method used during the study period. The ten year over-all survival was studied and compared with that of 4,217 instances of palpable carcinoma of the breast observed during the same period. The ten year survival rates were, by far, better for nonpalpable (94 per cent) than for palpable carcinomas (65 per cent). A better prognosis for nonpalpable carcinomas was confirmed also by multivariate analysis (Cox) with adjustment for potential confounders, such as age, stage or nodal involvement. The possible confounding effect of over diagnosis and length or lead time bias is discussed. Although this difference in survival might be partially explained by the aforementioned confounders, the chance of increasing life expectancy and conservative surgical treatment encourages preclinical detection of carcinoma of the breast.
We used a Hertel exophthalmometer to measure the degree of ocular protrusion in 852 subjects who had no history of orbital trauma or disease, endocrine disease, severe myopia, buphthalmos, or craniofacial deformities. The subjects ranged in age from 3 to 10 years. No statistically significant difference was observed between boys and girls or between right and left eyes in each age group. The mean normal protrusion values ranged from 9.11 mm in the 3-year-old group to 11.67 mm in the 10-year-old group. The mean outer orbital margin distance ranged from 78.7 mm in the 3-year-old group to 89.1 mm in the 10-year-old group. The data obtained were tabulated to plot percentile distribution curves of normal exophthalmometric values and outer orbital margin distance in children. No subject had more than 2 mm of asymmetry between the eyes.
The authors examine the problems of planning and conducting a multicentric case-control study on diet and gastric cancer in Italy. The solutions chosen for the study design, cases and controls identification, dietary interview, production of a common protocol for the field work are discussed. Results on the evaluation of the quality and comparability of collected data are presented. Further, compliance of cases and controls to the interview and to the blood and urine sampling with reasons of non-response are shown. Finally, the phases of the study and the methods for improving and controlling homogeneity among Centers are summarized.
A case-control study was conducted in high- and low-risk areas of Italy to evaluate reasons for the striking geographic variation in gastric cancer (GC) mortality within the country. Personal interviews with 1,016 histologically confirmed GC cases and 1,159 population controls of similar age and sex revealed that the patients were more often of lower social class and resident in rural areas and more frequently reported a familial history of gastric (but not other) cancer. After adjusting for these effects, case-control differences were found for several dietary variables, assessed by asking about the usual frequency of consumption of 146 food items and beverages. A significant trend of increasing GC risk was found with increasing consumption of traditional soups, meat, salted/dried fish and a combination of cold cuts and seasoned cheeses. The habit of adding salt and the preference for salty foods were associated with elevated GC risk, while more frequently storing foods in the refrigerator, the availability of a freezer and use of frozen foods lowered risk. Reduced GC risk were associated with increasing intake of raw vegetables, fresh fruit and citrus fruits. Lowered risk was also related to consumption of spices, olive oil and garlic. Neither cigarette smoking nor alcoholic beverage drinking were significantly related to GC risk. The case-control differences tended to be consistent across geographic areas, despite marked regional variations in intake levels of certain foods. The high-risk areas tended to show higher consumption of food associated with elevated risk (traditional soups, cold cuts) and lower consumption of foods associated with reduced risks (raw vegetables, citrus fruits, garlic). Our findings indicate that dietary factors contribute to the regional variation of stomach cancer occurrence in Italy, and offer clues for further etiologic and prevention research.
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The Authors show the results of clinical tests of the Caridex system performed on adults between the ages of 15 and 60 years under the treatments of the Hospital's Odontological Division of the Pavia University. On this ground, after considering the advantages and disadvantages that the chemo-mechanical removal offers to the patient, the Authors show the real indications asserting that this system, even if is not able to supplant the traditional methodologies, it can be helpful if mixed with them and, in limited cases, it can completely replace the drill.
The Authors observed at the SEM the surface of the dentine treated with the Caridex system, comparing it with the one of cavities prepared with traditional systems. The use of chemo-mechanical system consents to obtain a more indented and cleaned surface, even if more or less covered by mineralized deposits that can be removed with the use of a detergent for cavities. It results a surface particularly proper to the use of adhesives fillings materials.
The authors compared four different methods for tooths filling employing cements and gutta-percha by means of stereo and scanning electron microscopy. For this they prepared and filled 32 monoradicular teeth divided in 4 groups of 8 elements and afterwards they made sections at 2, 5, 8 mm from the apex. The thermomechanic condensation techniques showed very good effects. Good performances come using the vertical and lateral condensation techniques when the single cone method produced variable results.
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A total of 62 infertile women with a laparoscopic diagnosis of endometriosis were allocated randomly to two treatment groups, one of which (32 patients) received oral danazol 600 micrograms/day and the other (30 patients) received intranasal buserelin 1200 micrograms/day for 6 months. Suppression of serum levels of estradiol was greater with the gonadotropin-releasing hormone agonist treatment. Pain symptoms improved markedly during treatment in both groups. At the end of treatment a repeat laparoscopy was performed only in the patients who agreed to it (12 in the buserelin group and 13 in the danazol group), and it did not reveal significant differences in the effects of the two treatments on the endometriotic implants. All of the patients were followed up for at least 12 months, during which pregnancy was attempted. At 18 months the cumulative pregnancy rate was 48% in the patients treated with buserelin and 43% in those treated with danazol. Pain recurrence was observed in about half of the patients in each group 1 year after treatment suspension. The side effects were more frequent and more severe in the danazol-treated patients, whereas those given buserelin generally reported only symptoms of hypoestrogenism. The results of this study suggests that buserelin is at least as effective as danazol in the treatment of endometriosis when the outcome is considered in terms of restored fertility, and its side effects are less severe.
The presence of CA 125 was investigated in endometriotic tissue and endometrial mucosa using two different immunohistochemical methods, indirect immunofluorescence and the avidin-biotin immunoperoxidase technique. Neither of the methods revealed the antigen in the 12 endometriotic fragments studied. The endometrial mucosa both of patients with endometriosis and of the control subjects was positive with indirect immunoperoxidase staining in all cases, whereas with indirect immunofluorescence it was positive in 75 and 67%, respectively. Thus the mechanism(s) responsible for distribution of the antigen in different tissues and its reported high serum levels in advanced endometriosis is still unclear.
Thirty-nine infertile patients with laparoscopic diagnosis of endometriosis were allocated randomly to treatment with gestrinone 2.5 mg twice weekly (20 patients) or danazol 600 mg/day (19 patients) for 6 months. If amenorrhea was not obtained after 1 month of treatment, the gestrinone dose was increased to 2.5 mg three times a week (7 patients) and the danazol dose to 800 mg/day (2 patients). One month after the end of the treatment, a repeat laparoscopy was performed only in the women who agreed (7 of the gestrinone treated group, 9 of the danazol group). All of the patients were followed for at least 12 months after the end of the treatment, during which time they attempted to conceive. There was a marked improvement of pain symptoms during the treatment in the patients of both groups. The repeat laparoscopy did not reveal significant differences between the two groups in the reduction of the disease extent. Eighteen months after treatment suspension, the cumulative pregnancy rate was 33% in the patients treated with gestrinone and 40% in those treated with danazol. Pain symptoms recurred during the follow-up in 57% of the gestrinone and 53% of the danazol group. The side effects were more frequent and severe with the danazol treatment, whereas those caused by gestrinone were mostly weight gain and acne. The results of this study suggest that gestrinone is as effective as danazol in the treatment of infertility associated with endometriosis and is better tolerated.
We report 15 cases of a distinctive variant of thyroid papillary carcinoma designated as "diffuse sclerosing papillary carcinoma" (DSPC). This lesion is characterized by the following morphologic findings: (a) diffuse involvement of one or both lobes, (b) numerous micropapillary formations located within cleftlike spaces consistent with lymph vessels, (c) extensive squamous metaplasia, (d) large number of psammoma bodies, (e) marked lymphocytic infiltration, (f) prominent fibrosis. Of all these features, we believe the widespread intrathyroid lymphatic permeation to be the most important, in the sense of conditioning the other morphologic findings and the behavior of the tumor. When compared with conventional papillary carcinoma, the DSPC variant exhibits the following characteristics: (a) similar predilection for women, (b) younger age at the time of presentation, (c) greater incidence of cervical lymph node involvement, (d) greater incidence of lung metastases, (e) smaller probability of disease-free survival on follow-up. The practical importance of the recognition of this variant of papillary carcinoma lies in its ability to clinically simulate thyroiditis and the more aggressive therapeutic approach that might be needed to eradicate it.
Twenty-three patients with laparoscopically diagnosed endometriosis and pelvic pain were allocated randomly to treatment with cyproterone acetate 27 mg plus ethinyl estradiol 0.035 mg/day (11 patients) or danazol 600 mg/day (12 patients). All women received treatment for 6 months, except for one in the cyproterone group who suspended treatment for nonmedical reasons and was excluded from analysis of the results. The clinical condition and pain symptoms were monitored in all patients for 1 year after treatment suspension. The intensity of pelvic pain at diagnosis, during treatment, and at follow-up was evaluated by a multidimensional verbal score and an analogue scale. At the end of treatment, a repeat laparoscopy was performed in those patients who agreed (four in the cyproterone group, five in the danazol group); the results showed a partial regression of endometriotic lesions in both groups, with no significant differences between them. Dysmenorrhea disappeared in all patients during treatment. At 6 months after suspension, dysmenorrhea recurred in 66% of the cyproterone group and 58% of the danazol group, and at 1 year in 89 and 92%, respectively. Intermenstrual pelvic pain improved markedly during treatment in both groups; 6 months after treatment withdrawal it was present in four cyproterone subjects and four danazol group patients, whereas after 1 year, only one woman in the danazol group did not have this symptom. Deep dyspareunia was less affected by treatment, and 6 months later had recurred in all the women.(ABSTRACT TRUNCATED AT 250 WORDS)
The effect of administration of an LHRH-analogue (LHRH-a) was evaluated in 11 patients with benign prostatic hyperplasia (BPH) in whom there were contraindications for surgery. These patients, who already had impaired potency due to age or serious illness, were given 1500 micrograms LHRH-a in the first week and 1200 micrograms from the eighth day onwards. They all improved significantly (P less than 0.001) with regard to their urological symptoms on day 60 of treatment. Our results demonstrate the influence of androgen in maintaining established BPH, the effectiveness of LHRH-a therapy in selected patients with BPH and the usefulness of a salivary testosterone assay for the follow-up of treatments expected to lower the bioavailability of androgen to target tissues.
The effects of relaxin on the hypertrophy of the parametrial fat cells in ovariectomized virgin mice have been studied histologically and morphometrically. This hormone has been previously demonstrated by us to induce hypertrophy also in the adipose cells of the mouse mammary gland. This effect produced by relaxin on mammary adipocytes was greater than that due to estrogen alone and independent of pretreatment with estrogen. When insulin was given after estrogen in place of relaxin the effect was nearly the same as that following relaxin alone. On the contrary, in parametrial adipocytes under the same hormonal conditions, we found an increase in the mean diameter of 28% following estrogen alone, 57% following relaxin alone, 80% when relaxin was given after pretreatment with estrogen, and 60% when insulin was given after pretreatment with estrogen at the same dose as relaxin. These results clearly reveal that relaxin is a very active hormone in promoting lipid deposition in the parametrial adipose cells, and that such an effect attains a maximum following a pretreatment with estrogen. Moreover, these findings indicate that the parametrial fat cells can be included in the list of the targets of relaxin.