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Biomedical subjects

D Santini

Publications and source records attributed to D Santini.

At least 163 records · Page 9Linked to original sources

[Pulmonary vascular disease in a newborn with complete transposition of the great arteries and intact ventricular septum. Case report (author's transl)].

The case of a patient, died at 48 hours after the birth, with transposition of the great arteries and pulmonary vascular disease grade 3 is described. The evaluation of VPD was carried out in several sections from each lung, stained with H&E and elastico-Van Gieson. These histologic features is strongly in opposition with previous reports, in which pulmonary vessels exhibits only grade 1 or even grade 0 (hypoplasia of the media) modifications at the birth. However, many authors underline that children of same age and associated defects had widely differing degrees of VPD. Because our histologic findings, it is advisable an open lung biopsy and the evaluation of pulmonary vascular disease to plan the type of repair also early in life.

Humans↗

Pulmonary hypertension in systemic lupus erythematosus: hemodynamics and effects of vasodilator therapy.

A case is reported of a 29-year-old woman with systemic lupus erythematosus (SLE) who developed clinical manifestations of pulmonary hypertension at a time when other manifestations of SLE were quiescent. She had a restrictive ventilatory defect but clear lung fields on chest x ray. Cardiac catheterization revealed severe pulmonary hypertension. Calculated pulmonary vascular resistance fell slightly after administration of oxygen and during infusion of vasodilators. Symptomatic improvement and a modest increase in right ventricular ejection fraction, as measured by radionuclide ventriculography, were noted following 1 week of oral hydralazine therapy. Clinically significant pulmonary hypertension is a rare complication of SLE and the increased pulmonary vascular resistance may not be entirely fixed. Cardiac catheterization and radionuclide ventriculography may be useful in assessing response to medical therapy.

Adult↗

Retrospective studies of early gastric cancer in a high incidence area of Italy.

Frequency and characteristics of early gastric cancer (egc) were evaluated in a retrospective study of 511 surgical specimens of gastric carcinoma. We observed a total of 46 egc in 40 patients. The predominant macroscopic type was IIc, followed by I and III. On the basis of histological appearance, 25 egc were of intestinal type and 15 of diffuse type. Seventy-six per cent of egc were localized at the lesser curvature of the stomach and in particular at the pyloric antrum. Twenty-two egc were limited to the muscosal layer. no relationship was observed between macroscopic type or histological characters, and tumour staging. As Italy can be considered a high-risk country for gastric carcinoma and because this disease is in many respects similar to that observed in Japan, it seems possible to obtain a reduction of the death rate for gastric cancer by increasing, as in Japan, the number of cancers diagnosed in the early phase.

Adult↗

Expression of AP-2 transcription factor and of its downstream target genes c-kit, E-cadherin and p21 in human cutaneous melanoma.

The AP-2 transcription factor plays a pivotal role in regulating the expression of several genes involved in tumor growth and progression of melanoma. We determined, by Western blot, variation in the level of expression of AP-2 and three of its downstream targets, c-kit, E-cadherin, and p21 in several human melanoma cell lines and, by immunohistochemistry, in a group of 99 histological samples including benign and malignant melanocytic lesions. A significant negative correlation between AP-2 expression level and tumor thickness was found. Moreover, AP-2 expression was positively associated with E-cadherin and c-kit expression. In contrast, there was a significant negative association between AP-2 and p21 expression levels. These findings suggest that p21 is independent of AP-2 transactivator function during the latest phases of melanoma progression. Finally, AP-2, c-kit, E-cadherin, and p21 expression levels did not show to be able to distinguish between dysplastic nevi and nevi without dysplasia. We conclude that changes in the expression of these proteins are involved in the later phases of melanoma progression, and may be responsible for the transition from local invasive melanoma to metastasis.

Blotting, Western↗

Experimental evaluation of Surgisis as scaffold for neointestine regeneration in a rat model.

The aim of the study was to evaluate the use of Surgisis (Cook Biotech Inc.), a porcine derived extracellular matrix already used in tissue engineering, as a scaffold for neointestinal regeneration in a rat model. A 3-cm length of tubular Surgisis graft was interposed with bilateral anastomoses in the middle of an isolated ileal loop of Sprague Dawley rats with an ileostomy. The grafts were harvested and analyzed using histology and immunohistochemistry at 24 weeks after operation. Macroscopic examination revealed neither stenosis nor adhesions in the area surrounding the neointestine. The regenerated small bowel showed a mean shrinkage of 30.7% (range 20%-40%). Histologic and immunohistochemical evaluation showed a well-developed three layers of mucosa and smooth muscle and serosa in the regenerated bowel wall that were similar to those of the normal bowel with evident neovascularization. Also, the regeneration of smooth muscle fibers and innervation were evident. The preliminary results of this study showed that Surgisis allowed rapid regeneration of mucosa and smooth muscle and therefore may be a promising material for the creation of a neointestine.

Anastomosis, Surgical↗

Invasive mycotic and actinomycotic oropharyngeal and craniofacial infection in two patients with AIDS.

Two cases of invasive oropharyngeal and craniofacial infection caused by fungal and actinomycotic pathogens are described in HIV-infected patients. Two women with a previous diagnosis of AIDS, one with non-Hodgkin's lymphoma and one with Candida oesophagitis, developed a subacute, invasive inflammatory process characterized by ulcerative necrotizing lesions spreading from the oropharynx up to the soft and hard palate, maxillary sinuses and nasal cavity, with extensive soft-tissue necrosis. Although presenting with a very similar clinical picture, infection was due to Actinomyces spp. in the first case, while an apparent dual fungal aetiology (Aspergillus flavus and Candida spp.) was demonstrated in the second patient. Both cases were characterized by remarkable diagnostic difficulties leading to a late final recognition (confirmed by histological examination), and by a partial response to antimicrobial treatment.

AIDS-Related Opportunistic Infections↗

Intermediate-sized filament proteins (keratin, vimentin, desmin) in metaplastic carcinomas, carcinosarcomas and stromal sarcomas of the breast.

The distribution of intermediate-filament (IF) proteins of the keratin, vimentin and desmin type in breast stromal sarcomas, carcinosarcomas, metaplastic carcinomas and phyllodes tumors has been compared using the avidin-biotin complex immunoperoxidase technique. Keratin reactivity was found in carcinomatous and pseudosarcomatous areas of all metaplastic carcinomas, in the cuboidal epithelial cells of carcinosarcomas and in the epithelial component of phyllodes tumors. Vimentin and desmin were detected in the sarcomatous portion of carcinosarcoma, focally in the stromal component of phyllodes tumors and not always in the stromal sarcomas. These data confirm that combined analysis of IF expression is a reliable and convincing way to differentiate stromal sarcomas, metaplastic carcinomas and carcinosarcomas in breast pathology.

Breast Neoplasms↗

Skeletal alkaline phosphatase as a serum marker of bone metastases in the follow-up of patients with breast cancer.

Immunoradiometric determination of the bone isoenzyme of alkaline phosphatase with a method provided by Hybritech Inc., San Diego CA (USA) was carried out in 145 female patients, 97 of whom with radically operated breast cancer and 48 with benign mammary cysts, in order to evaluate the correlation of serum levels with the metabolic process of bone rearrangement in patients with bone metastases. This study shows that skeletal ALP, having high specificity (86.48%) and sensitivity (78.6%) for early progression (the average anticipation time compared to scintigraphic detection was 101 days) could represent a valid marker for bone metastases in association with mucinous markers in the follow-up of patients operated for breast cancer. In addition, dynamic serum determination of skeletal ALP could be a valid help in monitoring the efficacy of therapy in patients with bone progression.

Alkaline Phosphatase↗

Composite gastric carcinoma and precursor lesions with amphicrine features in chronic atrophic gastritis.

A composite carcinoma of the gastric body consisting of endocrine and mucous epithelial cells with interspersed amphicrine cells is reported together with ultrastructural and immunocytochemical documentation of endocrine and nonendocrine differentiation. The tumor was associated with hypergastrinemia related to chronic atrophic gastritis (achlorhydria) and with multiple proliferative lesions, such as intramucosal microcarcinoid (IMC) and endocrine cell proliferations of the micronodular and linear type, which are currently regarded as carcinoid precursor changes. Ultrastructurally, a composite architecture with amphicrine features was demonstrated in the primary tumor, IMC, and liver metastases. On the other hand, the endocrine cell proliferations exclusively contained gastrin and enterochromaffinlike cells. Immunostaining with antibodies to calcitonin documented a number of positive cells both in the primary and in the metastatic sites. This is the first report of mixed exocrine-endocrine-amphicrine components both in a metastasizing carcinoma and in its precursor lesions in a chronic hypergastrinemic state. Unlike previously reported lesions, the endocrine component was unexpectedly composed of calcitonin cells, which are not usually present in the gastric mucosa.

Aged↗

Filamentous inclusions in nonneoplastic and neoplastic pancreas: an ultrastructural and immunogold labeling study.

Filamentous inclusions (FI) are unusual, irregularly shaped cytoplasmic inclusions, which are mostly found in acinar cell carcinomas of the pancreas and are consequently thought to be an abnormal zymogen granule type. This study describes identical inclusions in acinar, centroacinar, and small duct epithelial cells from nonneoplastic pancreas, as well as those found in tumor cells from a mixed acinar-endocrine pancreatic carcinoma. An ultrastructural and immunogold labeling demonstration indicates that these inclusions are aggregates of intermediate filaments immunoreacting with the anti-cytokeratin AE1/AE3 mixture and with V9 clone anti-vimentin monoclonal antibodies. Their pleomorphic appearance, variable immunoreactivity, and frequent association with lipid droplets and secondary lysosomes, mostly of the angulate type, led to the hypothesis that the FI undergo a degenerative remodeling pathway similar to that proposed for hepatic Mallory bodies. A survey of the literature on FI and human tumors suggests that they are a variably expressed ultrastructural feature of tumor cells originating from exocrine cell-containing tissues, namely the pancreas and gastrointestinal tract.

Carcinoma, Acinar Cell↗

[The tutorial dimension of clinical training of students].

The tutorial dimension of students' clinical education represents a mandatory point of the educational system in Campus Bio-Medico University of Rome. In the area of tutorial system the clinical tutor is the key figure of the cultural and methodological innovation actuated by Italian Medical Faculties and represents the conjunction ring between clinical and educational settings. The clinical tutor is able to achieve a real communication with students and patients, too. The present work want to be a specific review of literature about the significance of the clinical tutor figure in the educational setting of medical faculties and describes the ongoing experience of the tutorial system in Campus Bio-Medico University.

Clinical Competence↗

Colonic type adenocarcinoma of male urethra.

A case of rare primary adenocarcinoma of the bulbomembranous portion of the male urethra is presented. The histological and immunohistochemical characteristics of this tumor are identical to those of colon adenocarcinomas. The pathogenesis can be explained either by neoplastic degeneration of globet cells found in the urethral epithelium or by malignant degeneration of persistent glandular elements that are embryonal residues. The patient was successfully treated with transurethral prostatectomy and with a high dose of radiation therapy.

Adenocarcinoma↗