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E Fulcheri

Publications and source records attributed to E Fulcheri.

At least 19 recordsLinked to original sources
PubMed2003

Cranial trepanation in two skulls of early medieval Italy.

Cranial trepanation is a practice known since prehistory in various, often geographically distant populations. In this work are presented two early medieval trepaned skulls. The first skull comes from Canosa in Apulia (6th-7th c. AD; according to radiocarbon dating), the second is from Ticineto Alessandrino (5th-8th c. AD). The skull of Canosa shows a single perforation on the bregmatic quadrant of the right parietal, whereas the Ticineto skull presents three lesions of different shapes and sizes. Two perforations are on the left parietal and the other is on the right parietal. The lesions of the Ticineto skull can be referred to a therapeutic operation following a trauma, with survival of the individual. In the Canosa skull the absence of a healing reaction suggests a pathological process, without survival of the subject. Moreover, a particular ritual practice cannot be excluded (i.e. a post-mortem trepanation).

Craniocerebral Trauma↗
PubMed2002

Screening and treatment for cervical intraepithelial neoplasia (CIN) in HIV-infected women.

BACKGROUND: To determine: 1) whether the pathology correlates with the degree of immunosuppression, 2) whether there is a relation between pathology and antiretroviral therapies, 3) whether Papanicolau (Pap) smears correlate with colposcopic and histologic findings, 4) whether there is rapid genital disease progression after standard gynaecologic care. METHODS: Retrospective study. Immunologic, gynaecologic and virologic data were extracted either from patients charts or from laboratory testing. RESULTS: At first visit Pap smears resulted normal in 43.7% of the women, 8.4% of the patients had reactive and reparative changes, 2.8% atypical cells of undetermined significance, 33.8% low-grade squamous intraepithelial lesions and 11.3% high-grade squamous intraepithelial lesions. Patients with a normal PAP smear had higher CD4 cell count (318+/-191 cells/mL) compared to patients with squamous intraepithelial lesions (297+/-116 cells/mL) but the difference was not statistically significant (Mann-Whitney test). The distribution of cervical dysplasia was found to be similar regardless of antiretroviral therapy (chi(2) test). The sensitivity and specificity of Pap tests for detecting CIN were 94 and 80%. Twenty-two per cent of surgically treated women had persistent or recurrent disease. CONCLUSIONS: Lower CD4+ cell counts are not predictive of the presence of cervical dysplasia. All HIV-infected women, independently from their immunological and clinical conditions, need regular Pap smears with appropriate follow-up for abnormal cervicovaginal cytology, this could prevent nearly all deaths from cervical cancer.

Adult↗
PubMed2002

Vaginal micronized progesterone in continuous hormone replacement therapy. A prospective randomized study.

BACKGROUND: In the non-hysterectomized post-menopausal woman undergoing estrogen replacement therapy, the co-administration of a progestogen is mandatory to counteract the estrogenic proliferative effect on the endometrium. Metabolic and tissue effects of the various progestins vary with dosage and route of administration. This study was performed to evaluate the effects of selected progestins on the lipidic profile and endometrial morphology. METHODS: This is a prospective randomised study including 60 post-menopausal women undergoing hormonal replacement therapy (HRT). All patients received transdermic ethinil-estradiol in a continuous schedule. The utilized progestogens were: medroxyprogesterone acetate (MPA) 10 mg p.o. 12 days/month, transdermic nor-ethisterone acetate (NETA) 0.25 mg integrated in the ethinil-estradiol patches for the last two weeks of each cycle, micronized progesterone (MP) 100 mg transvaginally 12 days/month. RESULTS: None of the tested protocols significantly altered the lipidic profile of this group of patients. We noticed different effects on the estrogen stimulated endometrium elicited by the different progestinic regimens. While the cyclic administration of oral MPA or transdermic NETA more frequently resulted in endometrial atrophy, the trans-vaginal administration of MP more often induced (p<0.005 at six-month and p <0.001 after 1 year) a functional-like secretive endometrium. CONCLUSIONS: Micronized progesterone, cyclically administered in the form of a vaginal cream, offers an acceptable and effective alternative for women on continuous HRT wishing to maintain their monthly cycle.

Administration, Intravaginal↗
PubMed2001

Gestational choriocarcinoma arising in a cornual pregnancy.

A of a case of cornual pregnancy associated with initial transformation to choriocarcinoma is reported. Appropriate monitoring of HCG titers following conservative management of ectopic pregnancy is important not only to diagnose persistent ectopic gestation, but to avoid missing trophoblastic disease, albeit rarely.

Adult↗
PubMed2001

Standardized AgNOR analysis as a prognostic parameter in endometrial carcinoma, endometrioid type.

OBJECTIVE: To evaluate interobserver reproducibility of histologic grade in endometrial adenocarcinomas of endometrioid type (EC), to assess the relationships between nuclear grade and the amount of argyrophilic nucleolar organizer region (AgNOR) proteins and to determine the prognostic value of AgNOR proteins and the main clinicopathologic parameters. STUDY DESIGN: Architectural and nuclear grading were independently assessed by two pathologists in 64 formalin-fixed, paraffin-embedded surgical samples of EC obtained from an equal number of patients (age range, 38-84 years; mean, 63.5). Interobserver agreement was determined using the kappa statistic; discrepant cases were reviewed, and a consensus was reached. Standardized AgNOR analysis was performed according to the guidelines of the Committee on AgNOR Quantification, measuring the mean area of AgNORs per nucleus (NORA) by an image analysis system. RESULTS: The kappa values for interobserver agreement were substantial for architectural grading and moderate for nuclear grading. When NORA values were compared to the nuclear grade assessed by different observers, the most significant linear correlation (r = .713, P < .001) was found for the nuclear assessment obtained by consensus of the two pathologists. Moreover, statistical analysis allowed discrimination of architectural grade 1 from grade 2 and 3 EC. By the Kaplan-Meier method, the prognosis was worse for patients with higher NORA values (> 4.212 micron 2), while, by Cox multivariate analysis, AgNOR quantity emerged as an independent prognostic variable. CONCLUSION: Use of standardized AgNOR analysis may be an additional and objective tool in the assessment of histologic grade as well as a reliable method of determining prognosis in EC.

Adenocarcinoma↗
PubMed2001

[The role of the pathological anatomy museum: past glory, present crisis, and future prospects].

Scientific Museum and in particular pathology Museum were in the past an important landmark for Pathology and in general for Medicine. At present they are in a critical stage due to the technological progress, because they are considered by now obsolete compared to other didactic supports, so as for example CD-ROM or virtual presentations. In opposite these old collections are still very precious for Medicine, because they show old diseases, now disappeared or very rare, thanks to the therapeutic and diagnostic progresses. Furthermore they are very useful for teaching of Pathology to medical students and also to laboratory's technicians. The specimens may be used also for organisation of exhibitions, in graduate courses or medical updating courses, for a better popularisation of Anatomy or of some diseases of large environmental or social impact. For all these reasons we propose the creation of renewed museum structures and a protocol for the restoration of the specimens, which are often damaged owing to time and negligence.

Animals↗
PubMed2001

[Applications and advantages of a multimedia system for autopsies ].

This work evaluates the benefits and applications of computers and multimedia systems in post-mortem examination practice and, more in particular, in the definition of data collection protocols. We examined issues concerning the different aims of autopsy (e.g. diagnostic, scientific, educational, legal), and found that the pathologist's main duty is to acquire a large amount of data in the best possible way. However, despite the will to carry out detailed post-mortem examinations, many pathologic anatomy services face objective difficulties in doing so, especially due to understaffing, lack of time and high costs. The Institute for Pathologic Anatomy of the University of Genoa has developed software for data handling and for outcome reporting, a particularly important aspect in fetal-perinatal diagnosis. The system consists of a relational database in a client-server environment (Fourth Dimension) with two integrated parts. The first part, with unrestricted access, contains patients' personal data, including gender, age, time and date of death, hospital department of origin, person and department requiring the post-mortem examination, hour and time of autopsy, pathologist's name, and clinical diagnosis of death. Using a scanner, a copy of the autopsy application is also field, together with the patient's medical file and any diagnostic images useful to document the case history. The second part of the information system is accessible by pathologists only, and contains the autopsy report. This part is organized to balance two different needs: it allows sufficient space and freedom for autopsy description while providing guidelines for presentation of the report. The structure of the conventional autopsy protocol has been maintained, with subdivisions for all the organs and apparatuses according to topographic criteria. Before this part, a section is dedicated to external cadaver examination and anthropometric data; weight, shape, volume and texture are described for each organ, together with external and cut-surface features. A third section allows the examiner to report other observations not requested previously, while a final section is also provided for the epicrisis and for the formulation of the final diagnosis, the same as that reported in the first form. The database is coupled with an interactive system for collecting voice comments, thereby replacing the need for tape-recorders in the autopsy room. The user can recall a dictation window, dictate a text, check spelling and insert additional text. The database is also coupled to an image acquisition system, on the assumption that moving images allow a more faithful documentation of reality. Therefore, all rooms in which autopsies are carried out on fetuses or neonates have been equipped with a fixed camera linked to a monitor and a video-recorder. A PCB, used for image digitalization, recognizes up to 16,000,000 different colors. Guided by dedicated software, image files are transferred to a computer and then saved with the autoptic report. The database can be consulted and queried in two principle ways: by key words in the contents or main disease descriptions, or by individual words or phrases contained within the complete text of the reports. The present database system for autopsy reporting has proved itself useful in a pathological anatomy service. The combined presence of images and texts renders the system useful also as a research tool. By linking to a Web site dedicated to pathologic anatomy, it will be possible to display online rare cases involving diagnostic difficulties. The system offers great advantages for present and retrospective diagnostics, as well as for research and education purposes.

Archives↗
PubMed2000

Oxytocin receptors in human adenocarcinomas of the endometrium: presence and biological significance.

Oxytocin receptors (OTRs) are expressed in endometrial cells and oxytocin (OT) participates in endometrial functions. In cancers derived from other OT target tissues, such as breast and neural tissues, the expression of OTRs and the antiproliferative effect of OT on cancer cells has been previously observed. This study was therefore designed to search for OTR expression and the OT effect in endometrial carcinomas. To demonstrate the presence and the location of OTRs and OTR mRNA immunocytochemical, reverse transcriptase-polymerase chain reaction (RT-PCR) and in situ hybridization (ISH) procedures were employed in a series of human adenocarcinomas of the endometrium. Using an anti-OTR monoclonal antibody (IF3), OTRs were demonstrated in the large majority of endometrial carcinomas (82%), with a pattern of positivity varying from diffuse to focal, according to tumour differentiation. The OTR gene was demonstrated in 78% of the cases by RT-PCR and its presence was confirmed in selected cases by ISH. Moreover, in a human endometrial carcinoma cell line (COLO 684) OTR was demonstrated by immunofluorescence and RT-PCR and it was observed that OT treatment (10(-11)-10(-7) M) significantly inhibited cell proliferation. Neither toxic effects nor apoptosis were induced by OT treatment. The addition of an inhibitor of protein kinase A (PKA) to the culture medium abolished the antiproliferative effect of OT, suggesting that cAMP via PKA could be the intracellular mediator of the OT effect, as previously observed in breast and neural tumours. In conclusion, this study presents evidence of OTR expression in human endometrial carcinomas and of an OT antiproliferative effect on human endometrial cancer cells in vitro. It is further suggested that OT and OTR may be involved in the regulation of endometrial cells, not only in physiological conditions but also in a neoplastic context.

Adenocarcinoma↗
PubMed2000

Color Doppler sonography of uterine arteriovenous malformation.

Arteriovenous malformation of the uterus is a rare but potentially life-threatening lesion. We report a case of arteriovenous malformation of the uterus in a 19-year-old nulliparous woman. The diagnosis was made with color Doppler sonography and was confirmed histologically. Color Doppler sonography helps differentiate uterine arteriovenous malformation from other entities that have a similar appearance on gray-scale sonograms.

Adult↗
PubMed2000

[The placenta].

Explore the source record for details and available documents.

Confidentiality↗
PubMed2000

[Endometrial adenocarcinoma appearing during tamoxifen therapy. Report of a clinical case].

Tamoxifen is a non-steroid estrogenic antagonist, used in post-surgical therapy of breast cancer. It interferes with endocrinous promotion of breast cancer. Tamoxifen could determine endometrial, even carcinomatous, alterations. The case of a postmenopausal patient surgically treated for breast cancer and successively treated with tamoxifen (20 mg/die), is reported. She underwent ultrasonographic and hysterosonographic endometrial evaluation and finally a hysterectomy with bilateral annessiectomy. This case seems to confirm tamoxifen possible carcinogenical effects on the endometrium.

Adenocarcinoma↗
PubMed2000

[Placental histopathology and perinatal surveillance].

The histological examination of the placenta helps to better understand both pathological pregnancies and fetal growth defects, therefore the true beneficiary of the histological diagnosis is the newborn. Of the 492 newborns born between the 1o April and 30 June 2000 we analyzed 142 placentas, following a modified Macpherson e Szulman's protocol. Only 73 of the 142 newborns have been hospitalized in the pathological division. The placental histological diagnosis of the remaining 69 hospitalized in "Rooming in" showed that only 10 placentas were in the normality; 22 placentas showed alterations referable to a dysmetabolic, dysglicicemyc and hypertension maternal pathology without there being lesions that could interfere with the development and maturation of the fetus; 37 placentas showed indicative lesions of hypoxic and ischemic fetal sofference of varing gravity. These data show how the histological examination of the placenta has many benefits in the immediate care of newborns, in subsequent evaluations and in the pediatric age.

Female↗