Nosocomial transmission of tuberculosis.
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Cross Infection↗
Biomedical subjects
D Minucci
Publications and source records attributed to D Minucci.
Epidemiological aspects of vaginal intraepithelial neoplasia (VAIN).
In order to evaluate the natural history of Vaginal Intraepithelial Neoplasia (VAIN), its epidemiological characteristics and the risk of its evolving into Invasive Carcinoma, we studied direct vaginal biopsies from 376 outpatients, we ascertained the predominant disease site and investigated whether the lesions (uni or multicentric) were only vaginal, were present at both the cervix and the vagina or were an extension of cervical lesions (DES-like areas). Moreover, in cervical and vaginal biopsies from 265 patients, we compared the severity of intraepithelial neoplasia of the vagina and cervix. In our series, vaginal lesions accounted for over half (52.6%) of the alterations attributable to HPV infection, while VAIN accounted for 46.5%; in 84.8% of cases, VAIN was associated with HPV. In 49.8% of cases, biopsies were from the upper third of the vagina and in 74.8% the pathological areas involved both the cervix and the vagina. The DES-like zone accounted for 7.9% of cases, vaginal wall involvement being limited to the upper third. Finally, the comparison of histological findings, in the 265 patients, confirmed that in 69.8% cases vaginal and cervical lesions were of the same grade; in 18.8% vaginal lesions were more severe than cervical lesions. In our study a higher number of vaginal biopsies were taken than in previous years, and it is difficult to establish whether this depends on improved diagnostic methods or on changes in epithemiological factors, such as the reported increase in the incidence of HPV lesions. A systemic search for lesions and a study on their evolution are therefore required to clarify this aspect.
Adult↗
Colposcopy, colpocytology and the vaginal ecosystem. Oncological, bacteriological and hormonal evaluation in a series of 400 women.
The Authors retrospectively considered colpocytological and colposcopic findings in a series of 400 women, aged 16 to 83 years, presenting for the first time at the Oncological Gynaecology Unit of the Institute of Gynaecology and Obstetrics of Padua University between 1991 and 1992. In addition to oncological evaluation, the bacteriological profile and hormone status of cytological samples were formulated in all cases. The most common oncological finding was a cell morphology within normal limits (67%), followed by reactive and reparative changes (19%) and low-grade squamous intraepithelial lesions (SIL, 12%). Histological findings correlated well with the cytological diagnosis, though low-grade SIL was over-estimated. As for the bacteriological profile, a mixed flora was most frequent (56.7%) followed, especially in fertile age, by Döderlein's bacillus (20%) and vaginosis (15.5%). Colposcopy most frequently revealed ectopia and/or a normal transformation zone (50.7%) and dystrophic mucosa (21%). An abnormal transformation zone was more common among women with a moderate-to-abundant flora. Fifteen male partners were also checked: cellular changes typical of human papilloma virus infection were found in 40% and colposcopic findings compatible with said virus were observed in 26.6% of cases. These results confirm that colpocytology provides a complete and simultaneous evaluation not only of cell morphology, but also of the bacterial population and hormones in the vaginal ecosystem. It is therefore the method of choice in screening for cervical and vaginal neoplasms and an effective means for simultaneously evaluating vaginal flora and hormone status.
Adolescent↗
Risk of progression in low grade squamous intraepithelial lesions.
In order to evaluate the evolution of the low grade dysplasia using colpocytologic follow-up, 150 women, enrolled in this study, were submitted to yearly colpocytologic control for a period of four years. The rate of progression toward more severe forms was very low; three cases (2.14%) in the first year, one case (0.7%) in the second and two cases (2.32%) in the fourth. Eighty-eight per cent of the patients had cytologic signs of Human Papilloma Virus infection detected in cytologic and histologic examination.
Adult↗
Vulvar intraepithelial neoplasia. Epidemiological and clinical study of 45 cases.
We observed 45 cases of Vulvar Intraepithelial Neoplasia (VIN) histologically diagnosed which came to our observation between 1986 and 1991. The average age of the patients and the grade of the VIN lesions were evaluated. We also examined the eventual association with Papillomavirus infection, with non-neoplastic epithelial disorders in the adjacent areas and with intraepithelial neoplasias of the cervix and/or the vagina (CIN and/or VAIN). These data were studied in relation to the vulvoscopic pictures and symptomatology presented by the patients at the moment of diagnosis.
Adult↗
Vulvar invasive and intraepithelial neoplasia. Comparison of some epidemiological and clinical data.
We have compared some of the epidemiological and clinical data of 45 patients affected by Vulvar Intraepithelial Neoplasia (VIN) and of 42 patients affected by Invasive Vulvar Neoplasia who came to our observation between 1986 and 1991. We have evaluated and compared the average age in the two groups of patients, their vulvoscopic pictures and the symptomatology referred at the time of the patients' diagnosis.
Adolescent↗
Colposcopic pictures of Abnormal Transformation Zone (ANTZ): colpocytological and histological findings.
The Authors have examined the correlation between the colposcopic pictures of the Abnormal Transformation Zone (ANTZ), in its varying degrees, and the colpocytological and histological examinations in order to seek a better definition of the indications of carrying out aimed biopsies. From our results a good agreement has been observed from the colpocytological and histological examination and the colposcopic pictures of the ANTZ. In patients with colposcopic images of ANTZ G2 the colpocytological examination diagnosed a CIN 3 in 80.6% of cases, invasive carcinoma in 6.4%, and in histologic examination CIN 3 in 71% and microinvasive carcinoma in 10.7%. Instead in the ANTZ G1, CIN 3 was revealed colpocytologically in 7.9% of the cases and histologically in 7.3%. Among these last, in half of the cases, the focuses of CIN 3 were present at the level of third inferior of the cervical canal. Finally, in ANTZ G0 there was cytological evidence in 6.6% of cases of CIN 3 with a histological correspondence of 3.9%. In particular the focuses of CIN 3, small and limited, had resulted from biopsies carried out on some glandular openings not clearly attributable to ANTZ G1. With regard to the opportuneness of carrying out aimed biopsies, mandatory in the cases of ANTZ G2, we feel it would be useful to carry them out also for ANTZ G1, above all if alterations are diagnosed at the colpocytologic examinations, and in ANTZ G0 if colpocytological alterations are present. Therefore integrating colposcopic and colpocytologic examinations and aiming the biopsies would seem to lead to good diagnostic reliability and adequate successive personalized treatment.
Adult↗
Beta-interferon topical treatment in low and high risk cervical lesions.
In a series of 131 patients we evaluated the effects of medical therapy with beta-Interferon cream in patients with cervical Human Papilloma Virus (HPV) infection, which in some cases, was associated with CIN. Treatment consisted of the direct daily application of 1,000,000 IU beta-Interferon cream to colposcopically positive areas over a period of 15 days. At intervals of 1, 6, 12 and 24 months following treatment, cytohistological tests were carried out to assess the effects of treatment. At the 24-month control, the overall percentage for regression was 79.57% of cases. Regression was observed in 58.33% of patients with cytohistological changes associated with HPV without atypia, and in 69.85% of patients with HPV with atypia (38.9% total regression). The regression pattern for CIN lesions was as follows: in CIN lesions, regression occurred in 85.36%, in CIN II in 84.20%, and 37.5% of CIN III cases showed total regression.
Administration, Topical↗
Diathermic loop treatment for CIN and HPV lesions. A follow-up of 130 cases.
In order to evaluate the therapeutic value of Diathermic Loop Excision (DLE), the Authors consider the colpocytohistological follow-up findings (at 3, 6 and 12 months) made in a series of 130 women who underwent DLE for CIN and cervical HPV lesions. The percentages of regression of the lesions, ranging from 84.9% and 93.7% for CIN lesions, and from 62.9% to 71.0% for HPV lesions, confirm that DLE is a rational and effective technique in the treatment of circumscribed cervical intraepithelial neoplasia and HPV lesions.
Adult↗
The accuracy of colposcopically directed biopsy in the diagnosis of cervical intraepithelial neoplasia.
In order to evaluate the accuracy of colposcopically directed biopsy in the diagnosis of Cervical Intraepithelial Neoplasia (CIN), in a series of 164 patients we compared findings from histological serial section of colposcopically directed biopsy with those from histological serial section of the entire lesion after diathermic loop excision. Colposcopically directed biopsy allowed a correct diagnosis to be made in 73 to 76.3% of cases, depending on the importance of the cervical lesion.
Adolescent↗
Cytological patterns of primary malignant uterine fibrous histiocytoma. A case report.
The Authors have reported the cytological patterns of malignant primitive uterine fibrous histiocytoma of a 57 year old woman. The endometrial cytological sampling was performed by an aspiration technique using a feeding-tube; a necrotic-haemorrhagic background filled with hymphocytes and polymorphonuclear leukocytes, and a mixture of highly anaplastic histiocytic and fibroblastic type cells, associated with undifferentiated small round cells, has been described. The result of the histological examination performed on the surgical specimen was the following: polymorphic malignant neoplasia characterized by spindle-like and giant plurinucleated cells, phagocytosis features, endoluminal polypoid growth, wide infiltration of the miometrium two thirds deep, vascular space invasion of the uterine wall and the hilus of the ovaries. The histological features and immunohistochemical analysis were consistent with malignant fibrous histiocytoma in the pleomorphic variety.
Female↗
Immunohistochemical reactivity of a monoclonal antibody prepared against human ovarian carcinoma on normal and pathological female genital tissues.
The reactivity profile of the monoclonal antibody (MAb) MOv18, raised against a poorly differentiated ovarian carcinoma specimen, was studied on normal tissues and tumors from the female reproductive system and on the kidney, which like the oviducts, vagina and uterus, also derives from the intermediate mesoderm. The obtained results indicate that MOv18 recognizes an epitope present on the normal epithelium of the oviducts, on 14-week old fetal kidney and, focally, on proximal and distal tubules of normal adult kidney. A strong reactivity was found on ovarian carcinomas, on invasive squamous carcinomas of the cervix and on endometrial carcinomas and hyperplasias. The antigen recognized by MOv18 (CaMOv18) therefore seems to be an epithelial cell marker associated with intermediate mesoderm differentiation, which can be derepressed during the neoplastic transformation of the ovary and the uterus.
Adult↗
Cytologic and colposcopic examination in the diagnosis of penile HPV infection.
In this study, the Authors take into consideration 70 male partners of women who showed (after medical and/or surgical therapy) cervical and/or vaginal relapsing and/or persistent lesions associated with HPV infections. Fifty-two (74%) of the male partners resulted "positive" for HPV genital infection by the colposcipc and/or cytologic examination. The histological examination of target biopsy performed on o macular lesion revealed slight-moderate dysplasia associated with HPV atypical alterations. persistent and/or recurrent cervical-vaginal HPV infection. For the therapy to be successful, we cannot overlook a diagnostic and therapeutic course that fits the couple.
Adult↗
Oncogenes in gynaecological cancers.
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Breast Neoplasms↗
[Endometrial changes in the presence of a progesterone-releasing IUD. Cytological evaluation].
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Adult↗
Recurring gynaecologic cancer treated with photodynamic therapy.
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Aged↗
Diagnostic problems of cervico-vaginal infections by HPV.
The diagnostic problems of cervico-vaginal infections by HPV have been considered. The colposcopic and cytological diagnoses have been compared with the histological one in order to evaluate the diagnostic reliability of the two methods of screening, and to seek evidence of those colposcopic and cytological aspects which, even if not pathognomic, are suggestive of HPV infection. The association between viral changes and CIN and the correlated problems have also been examined. The importance is underlined of screening and following up of HPV infections by the integrated use of colpocytology and colposcopy and of eventual aimed histologic checking as an improved prognostic evaluation, considering the potentiality of the evolutive risks of such infections.
Adolescent↗
Cytological and histological features in a case of endometrial adenocarcinoma.
We have examined a case of endometrial adenocarcinoma in which the cytological sample was indicative for a histotype which was not the predominant component in the histological examination of the uterus. The cytological diagnosis was: pattern concerning adenocarcinoma poorly differentiated; the histological diagnosis was: moderately differentiated endometrial adenocarcinoma. The Authors underline the usefulness of the integration of histological and cytological examinations for a better prognostic evaluation of endometrial adenocarcinoma.
Adenocarcinoma↗