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Biomedical subjects

D Antonioli

Publications and source records attributed to D Antonioli.

35 records · Page 2Linked to original sources
PubMed1994

Duodenal adenomas in familial adenomatous polyposis: relation of cell differentiation and mucin histochemical features to growth pattern.

We performed a clinicopathologic analysis of 74 periampullary and duodenal adenomas from 30 patients with familial adenomatous polyposis to evaluate the growth pattern, mucin histochemical profile, and degree and significance of Paneth cell and endocrine cell differentiation in these lesions. A trend toward more numerous adenomas was seen in patients with the longest intervals since their previous colectomies. Adenomas were most often clustered in the periampullary region and were numerous (> 20) in 40% of patients. Periampullary and duodenal adenomas were morphologically similar; both exhibited the same size-villous shape-dysplasia relationship as sporadic and familial adenomatous polyposis-associated colonic adenomas. Adenomas showed a heterogenous pattern of mucin production (mixed small intestinal-large intestinal types), with a shift toward the colonic type (sulfomucin) in lesions that were larger, villous, or severely dysplastic. Ninety-two percent of adenomas showed Paneth cell differentiation (average n Paneth cells/high power field = 24.5), and 99% showed endocrine cell differentiation (average n endocrine cells/high power field = 64.4). In general, the proportion of these specialized cell types was inversely related to size, villous shape, and degree of epithelial dysplasia. These results suggest that periampullary and duodenal adenomas in familial adenomatous polyposis arise from the neoplastic transformation of an undifferentiated stem cell that retains its ability for multidirectional differentiation.

Adenoma↗
PubMed1993

Effect of topical 5-aminosalicylic acid (5-ASA) therapy on rectal mucosal biopsy morphology in chronic ulcerative colitis.

Classic teaching emphasizes that chronic ulcerative colitis is characterized morphologically by the presence of fixed architectural and cellular mucosal changes that categorize the process as chronic. To examine the effect of topical 5-aminosalicylic acid (5-ASA) enemas on the presence of six histological features of chronicity in established chronic ulcerative colitis, 123 mucosal biopsies were taken prospectively at 1-month intervals, all from the same anatomic location (10 cm), from 14 patients treated with either 5-ASA or placebo enemas. The biopsies were evaluated for the presence of mixed inflammation in the lamina propria, crypt architectural abnormalities, basally located lymphoid aggregates, basal plasmacytosis, villiform surface epithelial configuration, and Paneth cell metaplasia. Overall, 29% of biopsies from 64% of patients were histologically normal (no chronic features, no active disease). Compared with patients treated with placebo enemas, patients treated with 5-ASA enemas showed a significantly higher percentage of normal biopsies (36% ASA group vs. 12% placebo group; p = 0.005) and a lower percentage occurrence of each individual histological feature of chronicity. In addition, patients treated with 5-ASA had a higher average number of normal biopsies per patient (3.0) than those treated with placebo enemas (1.3). Therefore, histologically normal-appearing mucosal biopsies do occur in established cases of chronic ulcerative colitis, and this finding is enhanced by treatment with 5-ASA enemas. Awareness of these results should prevent the presence of normal rectal mucosal biopsy findings in chronic ulcerative colitis patients from being misinterpreted as either evidence against this diagnosis or as representing focal skip areas characteristic of Crohn's disease.

Administration, Topical↗
PubMed1993

Esophageal squamous papillomas. A clinicopathologic study of 38 lesions and analysis for human papillomavirus by the polymerase chain reaction.

The pathogenesis of esophageal squamous papilloma is not known, but chronic mucosal irritation and infection with human papillomavirus are two proposed etiologies. To investigate these hypotheses, we analyzed the clinical data and histological features of 38 esophageal squamous papillomas from 33 patients and performed the polymerase chain reaction technique for detection of several common human papilloma virus types on a subset of cases (n = 26) with sufficient available material. Clinically, males were affected more often than females (M:F ratio = 24:9); average age was 50 (range, 2-86 years). Most papillomas occurred singly (85%) and were located in the distal esophagus (70%). Patients with esophageal squamous papillomas, especially those with lesions in the distal esophagus, commonly had an associated chronic and often severe form of esophageal mucosal irritation such as esophagitis or Barrett's esophagus. Esophageal squamous papillomas were small polyps (average size, 0.5 cm) that we classified histologically into three types (exophytic, 50%; endophytic, 37%; spiked, 13%) based on the predominant shape of the squamous papillae. Fifty percent of the papillomas (13 of 26) tested, from 57% of patients (12 of 21), were positive for human papilloma virus, most commonly type 16 (nine of 13), less often type 16 and 18 together (3/13), and rarely type 6b/11 (1 of 13). We propose a multifactorial etiology in which the synergistic action of mucosal irritation and human papilloma virus may be necessary for the development of esophageal squamous papillomas.

Adolescent↗
PubMed1992

Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 expression in inflammatory bowel disease.

The etiology of ulcerative colitis (UC) and Crohn's disease (CD) remains enigmatic. Infiltrating intestinal macrophages are capable of producing the proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6). We investigated the presence of IL-6, TNF-alpha and IL-1 beta mRNA transcripts in inflammatory bowel disease (IBD), normal, and other inflammatory intestinal specimens utilizing the polymerase chain reaction (PCR). TNF-alpha mRNA levels did not very between inflammatory bowel disease and control specimens. IL-1 beta mRNA levels were highest in active UC and noninflammatory bowel disease inflammatory specimens while IL-6 mRNA levels were highest in active IBD specimens. Infiltrating T cells, macrophages, and B cells were identified as sources of IL-6 protein in inflammatory bowel disease specimens by immunofluorescent staining. IL-6 transcripts were elevated only in active inflammatory bowel disease specimens, suggesting that IL-6-mediated immune processes are ongoing in the inflammatory mucosal environment of CD and UC.

B-Lymphocytes↗
PubMed1991

[A consultation service for the correction of risk factors of atherosclerosis in hospitals].

Although the main risk factors for atherosclerosis have been clearly identified and their correction has demonstrated its efficacy, many subjects do not receive the corrective measures appropriate for their case. The authors describe a hospital service for the prevention of atherosclerosis, which is intended for both primary and secondary prevention as well as for epidemiological monitoring and above all the evaluation of the preventive strategies employed. The results after the service has been running for one year are reported. They appear to confirm the initial options. Cooperation with other people involved in prevention both inside and outside the hospital, is also a fundamental aspect of this task.

Arteriosclerosis↗
PubMed1990

Late recurrence of clear-cell adenocarcinoma of the cervix: case report.

In the last 10 years, new observations have been made of the biologic behavior of clear-cell adenocarcinoma of the cervix and vagina arising in young women exposed to diethylstilbestrol in utero. Of particular note is the tumor's capacity to recur after an extended disease-free interval following initial therapy. We report the case of a woman who had her first recurrence 17 years after initial therapy, presenting with metastatic disease to the lungs and cerebellum. This case represents the longest reported interval between primary therapy and recurrence and supports the conclusion made by others that women who have been treated for clear-cell adenocarcinoma of the cervix and vagina may remain at risk of disease progression for many years after initial therapy. Therefore, these women should continue to be monitored. We also recommend periodic chest x-rays for two reasons: 1) The lungs are the most common site of distant spread of disease; and 2) metastatic nodules may be amenable to curative surgical intervention.

Adenocarcinoma↗
PubMed1988

Ciliated metaplasia in the gastric mucosa. In an American patient.

We report the first case of ciliated gastric metaplasia found in a Caucasian American patient. Cilia were found in cystically dilated glands underneath a gastric adenoma. The rarity of ciliated metaplasia among Caucasians and its high frequency among the Japanese suggests a difference in the gastric mucosa in the two populations.

Adenoma↗
PubMed1988

[The readmission of schizophrenics: a retrospective study over 5 years].

Since the introduction of neuroleptics, the number of beds in psychiatric hospitals has decreased progressively, but, in the same time, the number of readmissions has increased. For schizophrenic outpatients, we can estimate that 68% will be readmitted during the 5 years following their departure from the hospital. In our retrospective survey, we have studied the different factors which influence the readmissions. We have shown, with a statistical significancy, that an agricultural background, a fulltime job and brief hospitalizations prevent the readmissions. However patients aged less than 30 years, with long hospitalizations and living alone have a high risk of readmission. The most frequent causes are patient's omission to take prescribed drugs, environmental conflicts and alteration in the familial situation.

Adult↗
PubMed1983

Primary hepatocellular carcinoma following non-A, non-B posttransfusion hepatitis.

In 1964 a 42-year-old woman was hospitalized with clinical and laboratory signs of posttransfusion hepatitis five weeks after administration of six whole blood transfusions. During the following 17 years anicteric chronic liver disease was repeatedly documented by elevations of serum aspartate aminotransferase (SGOT) and alkaline phosphatase enzymes. In 1981 hepatomegaly, progressive jaundice, and a serum alphafetoprotein level of 516,000 ng/ml were observed. Percutaneous liver biopsy showed a primary hepatocellular carcinoma (PHC). Serologic examinations failed to reveal markers for hepatitis B virus including HBsAg, anti-HBs, and anti-HBc by radioimmunoassay; antibody to hepatitis A virus was also absent. This sequence of events demonstrates a presumptive association of PHC and the agent(s) of non-A, non-B viral hepatitis.

Alkaline Phosphatase↗
PubMed1981

Evolution of diethylstilbestrol-associated genital tract lesions.

The evolution of the colposcopic manifestations of adenosis involving the cervicovaginal hood and vagina was determined by the long-term follow-up of 173 diethylstilbestrol-exposed women. Serial gross observations in conjunction with histopathologic data showed that adenosis is a dynamic lesion that undergoes progressive squamous metaplasia over time. Ultimately, adenosis may disappear completely, to be replaced by normally glycogenated mucosa. A schema for the evolution of adenosis is presented.

Cervix Uteri↗
PubMed1980

Carbon dioxide laser therapy of cervical intraepithelial neoplasia: factors determining success rate.

Sixty patients with biopsy proven CIN were treated with CO2 laser. Severity of the lesion was equally divided among all three grades of CIN. All patients were biopsied immediately after laser therapy and at six and twelve weeks past treatment. Persistence or absence of disease was evaluated with respect to severity of disease, size of lesion, method of applying laser, whether the endocervical canal was involved, whether only the lesion or the entire transformation zone was lasered, and depth of laser effect. The persistence of disease was 36.7 percent after therapy. Success was not related to severity of disease, size of lesion, or whether the endocervical canal was involved. It was related to depth of coagulation necrosis, method of applying the laser bean, and if the entire transformation zone was treated.

Adolescent↗
PubMed1978

Vaginal and cervical squamous cell dysplasia in women exposed to diethylstilbestrol in utero.

Two hundred and fifty patients were examined because of a history of in utero exposure to diethylstilbestrol (DES) or because of the presence of physical findings suggesting such exposure. One thousand biopsies were examined for the presence of neoplasia and then compared to the colposcopic findings. There were no cases of glandular or squamous cell carcinoma. Fifteen (6 per cent) of the patients had squamous cell dysplasia. The degree of dysplasia was mild in 11 and moderate in only 4 (1.6 per cent) of the women. The majority of the cases of dysplasia involved the cervix, whereas the vagina was involved in only four cases, with simultaneous cervical dysplasia in three of these. Patients with cervical mosaic and white epithelium had dysplasia on biopsy much more frequently as compared with patients with similar colposcopic appearances in the vagina. Our results suggest a low incidence of significant squamous precancerous change in the DES-exposed population and provide evidence that colposcopic data concerning dysplasia pertinent to the cervix cannot be applied without modification to the evaluation of dysplasia in vaginal adenosis.

Adolescent↗
PubMed1976

Vaginal adenosis. Factors influencing detection in a colposcopic evaluation.

In a colposcopic evaluation of DES-related genital abnormalities, biopsy-proven adenosis was detected in the vaginal walls or hood in 84.5% of 220 women. Patient selection (DES history only vs prior examination) did not significantly influence the detection rate for adenosis. However, the detection rate of adenosis in the vaginal walls showed highly significant correlations with the presence of cervical ectopy and/or hood and with the colposcopic appearance of the area biopsied. Using colposcopy, the columnar pattern had a diagnostic accuracy of 94.4%; mosaic pattern, 85.5%; and white appearance, 68.0%. Differences in the histologic features of mucosal surface glandular tissue, squamous metaplasia, and nonglycogenated squamous mucosa were related to specific colposcopic patterns and helped to account for the variation in the accuracy of the three appearances in detecting adenosis. Biopsy specimens of the hood were not necessary to achieve a high yield of adenosis although we obtained evidence that the hood contains microscopic features typical of vaginal adenosis. Epithelial atypicality in the vagina (moderate squamous cell dysplasia) was demonstrated in only 1 patient.

Adolescent↗
PubMedDate not supplied

Heterotopic ossifications subsequent to knee arthroplasty.

The occurrence of heterotopic ossifications constitutes a rare but possible complication in knee arthroplasty surgery. The authors retrospectively reviewed data for more than 250 patients submitted to knee arthroplasty with the purpose of ascertaining the incidence of the occurrence of heterotopic ossifications after surgery and of understanding any clinical repercussions and possible risk factors. A total of 14 cases of heterotopic ossifications were observed out of 276 knee arthroplasties (4.7%). Lesions were grade 1: 4, grade II: 3, grade III: 7. The authors stress the importance of local factors as compared to general ones and the need to adopt a respectful surgical method, avoiding notching or excessive trauma to the periosteum, as well as the need to define parameters in order to single out subjects at risk and in whom prophylaxis should be administered.

Adult↗
PubMedDate not supplied

Algorithm for the treatment of calcific tendinitis in the rotator cuff: indications for arthroscopy and results in our experience.

Calcific tendinitis of the rotator cuff is a relatively frequent pathology and at times, in some phases, it is a disabling one: for this reason, numerous therapeutic options have been proposed. The authors propose an algorithm for the classification and treatment of calcific tendinitis and report their experience with arthroscopic treatment over a three-year period from 2001 to 2004. Based on the algorithm proposed, out of a total of 126 shoulders affected with calcific tendinitis of the rotator cuff for which debridement was indicated, 106 us-guided percutaneous surgeries (EPT), and only 20 arthroscopies were performed. Arthroscopy is indicated, on the basis of the algorithm that we followed, in patients affected by chronic and persistent calcific tendinitis who did not benefit from the execution of previous types of non-surgical treatment for a period of at least 6 to 12 months. Shoulder instability was found to be present in 8 patients out of 20 treated arthroscopically. After arthroscopy, short- and medium-term results were always positive with the exception of one case that evolved into adhesive capsulitis. Based on an analysis of this series, we were able to confirm the usefulness and clinical applicability of an algorithm to classify and treat calcific tendinitis of the rotator cuff; we also confirmed the role of arthroscopic treatment that in cases which did not respond to conservative procedures proved to be effective in resolving symptoms.

Adult↗
PubMedDate not supplied

Comparative and experimental study on different tendinous grasping techniques in rotator cuff repair: a new reinforced stitch.

Arthroscopic repair of wide rotator cuff ruptures is burdened by a percentage of recurrences that is greater than the repair carried out when an open technique is used. One of the main reasons for this difference can be searched for in the minor hold of stitching on the tendinous aspect obtained with arthroscopic repair. In fact, when an open technique is used, good hold can be guaranteed by using reinforced stitches such as the modified Mason-Allen. Thus, arthroscopic repair technique on the tendinous aspect, particularly in wide and massive injuries, must be improved. It was the purpose of this study to compare a new reinforced stitch that can easily be obtained in arthroscopy (simple stitch that orthogonally crosses a horizontal stitch previously knotted on the tendon: SS-HL), with traditional stitches (simple stitch, mattress-stitch and modified Mason-Allen stitch). Tests were carried out on sheep infraspinatus tendons in order to evaluate the resistance of pull-out. The SS-HL stitch showed resistance to loading that was similar to that when the modified Mason-Allen was used, but it was greater than that shown by the simple stitch (+48%) and the mattress stitch (+35%).

Animals↗