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S Bianchi

Publications and source records attributed to S Bianchi.

At least 127 records · Page 7Linked to original sources
PubMed1998

A new laparoscopic procedure for the correction of vaginal vault prolapse.

PURPOSE: We verified the feasibility and results of a new laparoscopic technique for repairing vaginal vault prolapse. MATERIALS AND METHODS: Laparoscopic repair of vaginal vault prolapse was done in 12 women 46 to 82 years old. Stage 1 consisted of culdoplasty similar to that of Moschowitz. Stage 2 included a transverse incision of the peritoneum covering the vaginal vault to expose the vaginal fascia. Two sutures were then fixed to the vaginal corners, passed through the subperitoneal connective tissue and attached to the fascia of the abdominal muscles with multiple stitches. RESULTS: No intraoperative or postoperative complications occurred and anatomical repair was complete in all women. Followup ranged from 9 to 28 months. Sexual function was recovered in all cases. CONCLUSIONS: If these results are confirmed in larger series with a longer followup, our laparoscopic approach would be considered a valid alternative to current surgical techniques.

Aged↗
PubMed1998

[Transitional cell carcinoma of the bladder in the first four decades of life].

BACKGROUND: The transitional cell carcinoma of the bladder is uncommon below the age of 40 years (1%). There is no univocity on the prognosis of such neoplasm. According to some authors such tumours are non invasive low-grade tumours with low recurrence and therefore an improved prognosis. But according to other authors bladder tumours do not have a different progression compared to tumours arising in older patients. METHODS: The authors present their experience on 28 patients, of whom 8 were under 30 years and 29 between 30 and 40 years of age. All patients had transitional carcinoma of the bladder with different grade and stage of tumour. All patients underwent an endoscopic or surgical treatment. RESULTS AND CONCLUSIONS: The follow-up of these patients show that tumours have a low grade of recurrence (5-10%) and an improved prognosis particularly in patients under 30 years.

Adolescent↗
PubMed1998

[Percutaneous biopsy in the definition of breast lesions: fine needle vs. 14-gauge].

INTRODUCTION: Any breast lesion/abnormality detected at mammography must be characterized as (non)-neoplastic before surgery. Fine needle aspiration cytology (FNAC) permits a precise diagnosis in over 70% of cases but exhibits many inadequate, false negatives or questionable findings. This makes surgical biopsy mandatory in many cases. An alternative is offered by fine needle biopsy (FNB: 16-18 G needles) or by large core biopsy (LCB: 14 G needles), which procedures can reduce the number of questionable diagnoses with no major discomfort or side-effects for the patient. MATERIAL AND METHODS: January, 1996, to October, 1997, we performed 422 microhistologic biopsies on breast lesions at the Unità Integrata di Senologia, Azienda Ospedaliera Careggi, Florence, Italy. 383 of these lesions were nonpalpable. FNB was performed in 221 cases and LCB in 201. Most biopsies (65%) were carried out under US guidance and some others (25%) under stereotactic guidance. RESULTS: Microhistologic biopsy allowed accurate lesion characterization in most cases, even though LCB obviously performed much better. Samples were inadequate in 5.88% of cases with FNB and only in 2.98% of cases with LCB. The false negative rate was 1.92% for FNB and 0.99% for LCB. Surgical biopsy was needed for an unquestionable diagnosis only in 9.5% of FNB and 3.9% of LCB cases. CONCLUSIONS: Our results confirm the literature data on how LCB can be considered a valid alternative to surgical biopsy (and, to some extent, to FNAC); in particular, its advantages are: moderate invasiveness, little patient discomfort and high diagnostic accuracy. Moreover, the procedure is short (5-10 minutes) and costs much less than surgical biopsies (1/2 to 1/4).

Adult↗
PubMed1998

Consistency achieved by 23 European pathologists in categorizing ductal carcinoma in situ of the breast using five classifications. European Commission Working Group on Breast Screening Pathology.

The increased detection of ductal carcinoma in situ (DCIS) by mammographic screening, the greater use of breast-conserving surgery, and the recognition that certain histological subtypes are associated with a greater risk of local recurrence has led to the formulation of several new classifications of DCIS in recent years. There are, however, no data concerning the degree of consistency with which these schemes can be applied by reasonable numbers of pathologists. Thirty-three cases of DCIS were thus examined by a working group of 23 European pathologists who categorized them using five recently published classifications: (1) that of the European Pathologists' Working Group based on differentiation (a combination of nuclear grade and cell polarization) with categories of poorly, intermediately, and well differentiated; (2) one based entirely on nuclear grade with categories of high, intermediate, and low, currently in use in the UK national and EC-funded breast screening programs; (3) the same classification in which only two categories, high nuclear grade and other, were used; (4) the Van Nuys system in which lesions are divided into high grade, non-high grade with necrosis and non-high grade without necrosis; and (5) a two-category classification based entirely on the presence or absence of comedo necrosis. Of the three systems with three categories, Van Nuys gave the highest overall kappa statistic of 0.42. Others gave similar values of 0.37 and 0.35 showing that assessing cell polarization in addition to nuclear grade neither improves nor worsens consistency. In all three systems, the middle category was associated with the lowest value for kappa. Of the two systems with two categories, that based on nuclear grade gave the highest overall kappa of 0.46 and that based on comedo necrosis the lowest of 0.34. The most robust histological features were thus high- and low-grade nuclei and necrosis as long as the latter did not involve the recognition of a comedo growth pattern. These values probably represent the maximum achievable, at least by reasonable numbers of pathologists in everyday practice. They are better than those previously reported for classification based entirely on architecture, but further improvement is needed.

Breast Neoplasms↗
PubMed1997

Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device.

OBJECTIVE: To evaluate the efficacy and tolerability of treatment with a levonorgestrel-releasing intrauterine device (IUD) in women affected by adenomyosis-associated menorrhagia. SETTING: Tertiary care center. DESIGN: Prospective, open, noncomparative study. PATIENT(S): Twenty-five women aged 38 to 45 years with recurrent menorrhagia associated with adenomyosis diagnosed at transvaginal ultrasonography participated in this study. INTERVENTION(S): An IUD releasing levonorgestel 20 mcg/day was inserted in each patient within 7 days of the start of menstrual flow. All of the patients were requested to compile a pictorial blood loss assessment chart each month. They underwent clinical and transvaginal ultrasound examinations 3, 6, and 12 months after IUD insertion. MAIN OUTCOME MEASURE(S): Menstrual pattern; serum hemoglobin, ferritin, and iron level changes. RESULT(S): One patient experienced IUD expulsion 2 months after device insertion and another requested removal of the IUD 4 months after insertion because of persistent irregular blood loss. Six months after IUD insertion, amenorrhea was observed in 2 patients and oligomenorrhea in another, spotting occurred occasionally in 7, and 13 had scanty but regular flow. One year of follow-up has been completed by the remaining 23 women: 2 with amenorrhea, 3 with oligomenorrhea, 2 with spotting, and 16 with regular flows. Significant increases in hemoglobin, hematocrit, and serum ferritin have been observed, but the lipid metabolism and clotting variables have remained unchanged. CONCLUSION(S): Our findings indicate that marked and safe relief from adenomyosis-associated menorrhagia can be obtained with the use of a levonorgestrel-releasing IUD.

Adult↗
PubMed1997

Immunohistochemical vs molecular biology methods. Complementary techniques for effective screening of p53 alterations in head and neck cancer.

The purpose of this study was to correlate p53 gene alterations and their expression in 85 head and neck squamous cell carcinomas. Genomic p53 was amplified with the polymerase chain reaction (PCR) from formalin-fixed, paraffin-embedded tissues. Exons 5 through 8 were screened for mutations by means of non-isotopic single-strand conformation polymorphism (SSCP) analysis. p53 expression was detected by means of immunohistochemistry (IHC) with the p53 monoclonal antibody DO-7. Twenty-three lesions (27%) showed both SSCP variants and DO-7 immunostaining, whereas 37 (44%) demonstrated both SSCP normal patterns and negative staining. Twenty-five lesions (29%) were discordant, including 12 IHC-positive (14%) and 13 SSCP-positive (15%) lesions. However, discordant IHC-negative, SSCP-positive lesions could have been easily interpreted after sequencing of the abnormal samples. Had these been screened with IHC only, all nonsense or frameshift p53 mutations would have been missed. IHC-positive, SSCP-negative lesions were interpreted in light of current models of p53 immunodetection. Had these been screened with SSCP or sequencing only, a sizeable number of tumors expressing p53 protein abnormalities would have been undetected. Therefore, simultaneous use of both methods increases the number of p53 abnormalities detected, and is warranted.

Antibodies, Monoclonal↗
PubMed1997

Pre-operative assessment of bladder endometriosis.

The aim of our study was to verify the reliability of transvaginal ultrasonography in the pre-operative evaluation of bladder endometriosis. Six patients with suspected bladder endometriosis were studied. At referral to our department all six women underwent magnetic resonance imaging (MRI), transabdominal and transvaginal ultrasonography, cystoscopy and descending urography. Subsequently all the women underwent transperitoneal cystotomy and excision of endometriotic lesion at laparotomy. In three patients the bladder endometriotic lesions were continuous with adenomyosis in the anterior uterine wall. Histological examination confirmed the endometriotic nature of bladder nodule in all cases. Abdominal ultrasonography visualized the detrusor neoformation in all the patients but was less precise than transvaginal ultrasonography and MRI in defining the size of the lesions, infiltration of the detrusor and continuity with extravesical lesions. Transvaginal ultrasonography was more accurate and versatile than abdominal ultrasonography. The better image resolution allowed an accurate structural analysis of the bladder wall lesion. Furthermore, involvement of the uterovesical septum could be evaluated and adjacent myometrial infiltration recognized. MRI, although very precise, was less versatile than transvaginal ultrasonography and less accurate in establishing the margins of the lesions as perilesional fibrosis is visualized less clearly than areas containing haematic material. Urography was aspecific but still useful to evaluate the integrity of the upper urinary tract and ureters. In conclusion, in our patients transvaginal ultrasonography was found to be the most accurate technique in the diagnosis of bladder endometriosis.

Adult↗
PubMed1997

Muramyl dipeptide and IL-1 effects on sleep and brain temperature after inhibition of serotonin synthesis.

The role of the interactions between serotonin (5-HT) and muramyl dipeptide (MDP) and interleukin-1 (IL-1) in sleep control and thermoregulation was evaluated. To this purpose, MDP and IL-1 were injected intracerebroventricularly at dark onset into freely moving rats pretreated twice intraperitoneally with para-chlorophenylalanine (PCPA) (300 mg/kg), which depletes brain 5-HT and causes insomnia. Fever and slow-wave sleep (SWS) enhancement induced by 150 pmol MDP were completely blocked in PCPA-pretreated rats. Only the first phase of the biphasic increase in SWS induced by 2.5 ng IL-1 was suppressed by PCPA pretreatment, whereas fever remained unaffected. These results suggest that 1) MDP effects on both sleep-wake activity and brain cortical temperature are mediated by the serotonergic system; 2) the mechanisms mediating the first and the second phases of IL-1-induced SWS excess are different: 5-HT could be involved in the first phase, but not in the second one; and 3) the 5-HT system does not appear to be involved in IL-1-induced fever.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1997

Elastofibroma dorsi: sonographic findings.

OBJECTIVE: Elastofibroma dorsi is a rare, slow-growing reactive pseudotumor of connective tissue typically located in the subscapular region. We report the sonographic characteristics of three cases of elastofibroma dorsi. CONCLUSION: The sonographic appearance of elastofibroma dorsi consists of arrays of interspersed linear or curvilinear hypoechoic stands against an echogenic background. These findings reflect the alternating pattern of fibroelastic streaks and fat that is also detected with other imaging techniques and found on pathologic specimens. In the proper clinical setting, a prospective sonographic diagnosis can obviate the need for further imaging assessment and biopsy.

Adult↗
PubMed1997

Altered circadian blood pressure profile and renal damage.

Introduction. The relationship between arterial hypertension and renal damage has long been recognized. In 1836, Bright reported an association between cardiac hypertrophy and contraction of the kidney [1] and 40 years later Gull and Sutton [2] suggested that the renal damage in patients with arterial hypertension could be the consequence of vascular hypertensive alterations.

Journal Article↗
PubMed1997

[Morgagni's hernia in infancy].

Morgagni's hernia is an uncommon type of diaphragmatic hernia fairly exceptional in pediatric age. A case of Morgagni's hernia, observed by chance in a 15-month-old infant, is presented. The authors present the fundamental embryogenic stages of the diaphragm and stress the clinical manifestations and diagnostic procedures to reach the diagnosis, as well as the advantages of early treatment in order to prevent possible complications.

Hernia, Diaphragmatic↗
PubMed1997

Metastatic tumor of the spermatic cord from a primary silent colorectal adenocarcinoma.

Tumors of the spermatic cord are indeed rare and 91% are of mesenchymal origin. Nearly all epithelial tumors are metastases with the primary tumor located in the gastrointestinal tract, prostate, kidney. In 9.5% of cases, initial symptoms are localized to the metastatic site prior to the discovery of the primary tumor. When a diagnosis of epithelial malignant tumor of the spermatic cord is made an investigation for the primary site must be performed. We report a case of metastatic tumor of the right spermatic cord occurring as first clinical manifestation of a silent adenocarcinoma of the sigmoid colon.

Adenocarcinoma↗
PubMed1996

Muscarinic receptor subtypes in the medial preoptic area and sleep-wake cycles.

To clarify which muscarinic receptor subtype(s) mediate changes in sleep and cortical temperature (Tcort) induced by carbachol microinjections into the medial preoptic area (MPA), pirenzepine, tripitramine and +/- p < > -fluorohexahydro-sila-difenidol (p-F-HHSiD), which are highly selective muscarinic M1, M2 and M3 antagonists, respectively, were microinjected into the MPA of rats. Whereas pirenzepine (3.45 and 7.08 nmol) and p-F-HHSiD (3.90 and 7.80 nmol) were without effect, tripitramine (0.67 and 3.37 nmol) enhanced wakefulness, decreased slow wave and desynchronized sleep, and raised Tcort with the higher dose. The data suggest that in the MPA only M2 muscarinic subtypes may be functionally important in mediating the cholinergic effects on sleep and thermoregulation.

Animals↗
PubMed1996

Enhancement of HSV-DNA infectivity, in Vero and RS cells, by a modified calcium-phosphate transfection technique.

Infectivity of herpes simplex virus (HSV) DNA was assessed by employing the calcium-phosphate transfection technique described by Chen and Okayama, originally applied to increase the efficiency of plasmid transfection by N, N-bis (2-hydroxyethyl)-2-aminoethane sulfonic acid (BES). The experimental conditions and efficiency of this transfection procedure were evaluated comparing the viral progeny titers obtained by the Chen and Okayama transfection method using DNA from wild-type strains of HSV-1 and HSV-2, as well as from mutant strains, with the viral progeny obtained by the most widely used transfection technique introduced by Graham and van der Eb. Furthermore, recombinant virus production was evaluated in marker transfer and marker rescue experiments, comparing both transfection techniques, using DNA fragments cotransfected with whole viral DNA into African green monkey (Vero) or rabbit skin (RS) cells. The viral production obtained from HSV-DNA transfected cells was enhanced approximately 1000-fold when the Chen and Okayama procedure was applied.

Animals↗