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Biomedical subjects

G B Nardelli

Publications and source records attributed to G B Nardelli.

At least 19 recordsLinked to original sources
PubMed2006

Sertoli cell tumor: a rare case in an elderly patient.

Sertoli-Leydig cell tumors constitute < 1% of ovarian tumors, mostly in young women with virilization; however, not all present endocrine manifestations. A 72-year-old female presented with an abdominal mass and no signs of virilization. Total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy and selective pelvic lymphadenectomy was performed. The pathologic diagnosis was poorly-differentiated sex cord-stromal tumor with Sertoli cells. No adjuvant chemotherapy or radiation was administered. At 12-month follow-up the patient showed no evidence of disease.

Age Factors↗
PubMed2004

Intraepithelial G3 adenocarcinoma of the endometrium after tamoxifen treatment.

CASE REPORT: In this paper we describe a case of endometrial carcinoma observed in a post-menopausal patient who was treated with tamoxifen for 5 years after a mastectomy for cancer. She came to our department because of vaginal bleeding 2 years after the end of tamoxifen treatment. TREATMENT: She underwent hysteroscopy and a D and C. A polypoid endometrium completely filled the uterine cavity and was carefully removed by curettage; histology showed a highly undifferentiated neoplasia with a component of serous adenocarcinoma, which was likely to originate from endometrial polyps. OUTCOME: The patient underwent radical hysterectomy, but no residual tumor was found in the uterus or in the tubes, ovary, or pelvic nodes, in spite of its low differentiation grade and high potential aggressiveness, and even though the patient was already symptomatic. Two years after surgery the patient is disease free, which is consistent with the evaluation of the surgical specimen, but unusual in poorly differentiated neoplasms.

Adenocarcinoma↗
PubMed2002

Classification of oral clefts by affection site and laterality: a genotype-phenotype correlation study.

OBJECTIVES: The aim of this study was to classify the phenotypes found in a series of patients with non-syndromic cleft lip (CL) with or without cleft palate (CP) and isolated cleft palate. Additionally, the frequency distribution of cases belonging to families linked to markers on chromosomes 6 and 2 within these phenotypic patterns were estimated. DESIGN: A retrospective examination of all the available affected cases collected in Italy. SETTING AND SAMPLE POPULATION: Ninety-seven affected subjects aged 5-18 years belonging to 38 families were considered. Patterns were identified by variance of the cleft (lip, primary palate, secondary palate) and stratified according to the side of occurrence (right, left, or bilateral). Latent class analysis was used as main statistical tool for carrying out the results. RESULTS: Three homogenous classes were identified (P < 0.0001) by means of latent class analysis. Individuals were assigned to the most suited class. All three variables (lip, primary and secondary cleft palate) generated a specific class. Optimal findings were reported in cases having 'any isolated cleft lip' (class 1); 'secondary CP with or without bilateral/right primary cleft palate + bilateral/right cleft lip' (class 2); and 'left primary cleft palate + left/bilateral cleft lip with or without secondary CP' (class 3). Correspondence to the evidence of linkage to chromosome 6 showed that 9 of 10 cases presenting with 'right primary CP + right CL with secondary cleft palate' (class 2) belonged to a linked family. The same combination, but occurring on the left side (class 3), revealed that only three of nine cases belong to families linked to chromosome 6 (P-value = 0.02). The two patterns (right and left) never occurred in the same family. Three reliable groups were identified based on laterality and the presence of a cleft. A single right sided pattern displayed a statistically different distribution of linkage to chromosome 6 when compared with the homologous left side. CONCLUSION: Non-syndromic CL with/without CP can be classified according to laterality that can be under genetic control.

Adolescent↗
PubMed2001

Determining the best catheter for sonohysterography.

OBJECTIVE: To compare the characteristics of six different catheters for performing sonohysterography (SHG) to identify those that offer the best compromise between reliability, tolerability, and cost. DESIGN: Prospective study. SETTING: University hospital. PATIENT(S): Six hundred ten women undergoing SHG. INTERVENTION(S): We performed SHG with six different types of catheters: Foleycath (Wembley Rubber Products, Sepang, Malaysia), Hysca Hysterosalpingography Catheter (GTA International Medical Devices S.A., La Caleta D.N., Dominican Republic), H/S Catheter Set (Ackrad Laboratories, Cranford, NJ), PBN Balloon Hystero-Salpingography Catheter (PBN Medicals, Stenloese, Denmark), ZUI-2.0 Catheter (Zinnanti Uterine Injection; BEI Medical System International, Gembloux, Belgium), and Goldstein Catheter (Cook, Spencer, IN). MAIN OUTCOME MEASURE(S): We assessed the reliability, the physician's ease of use, the time requested for the insertion of the catheter, the volume of contrast medium used, the tolerability for the patients, and the cost of the catheters. RESULT(S): In 568 (93%) correctly performed procedures, no statistically significant differences were found among the catheters. The Foleycath was the most difficult for the physician to use and required significantly more time to position correctly. The Goldstein catheter was the best tolerated by the patients. The Foleycath was the cheapest whereas the PBN Balloon was the most expensive. CONCLUSION(S): The choice of the catheter must be targeted to achieving a good balance between tolerability for the patients, efficacy, cost, and the personal preference of the operator.

Adult↗
PubMed2001

Ultrasound-guided mammotome vacuum biopsy for the diagnosis of impalpable breast lesions.

OBJECTIVES: To assess the diagnostic accuracy of ultrasound-guided mammotome vacuum biopsy in impalpable breast lesions. METHODS: Seventy-three patients who presented with impalpable breast lesions that were suspicious for malignancy at mammography and/or sonography were included in the study. In the first instance the women underwent ultrasound-guided fine-needle aspiration cytology, then, 3 days later, histological biopsy with an ultrasound-guided mammotome device. The patients with both cytological and histological diagnoses of malignancy underwent surgery; those with a negative (for malignancy) cytological diagnosis, but with a histological diagnosis of atypical hyperplasia or sclerosing adenosis, underwent surgical biopsy. RESULTS: The diagnostic accuracy of fine-needle aspiration cytology was 67.2%; the sensitivity was 86.7%, the specificity was 48.4%, the negative predictive value was 78.9% and the positive predictive value was 61.9%. In comparison, the diagnostic accuracy of histological sampling by mammotome vacuum biopsy was 97.3%; the sensitivity was 94.7%, the specificity was 100%, the negative predictive value was 94.6% and the positive predictive value was 100%. Thus there was a statistically significant difference in diagnostic accuracy between fine-needle aspiration cytology and mammotome vacuum biopsy (67.2% vs. 97.3%; chi2 test, P < 0.001). The 2.7% (2/73) failure rate of mammotome biopsy was likely to be due to an error in the positioning of the needle. The subsequent surgical biopsy proved that two cases, negative for malignancy by mammotome biopsy, were in fact malignant. CONCLUSIONS: Our data confirm the value of sonography for the diagnosis of breast carcinoma in the preclinical phase and the efficacy of ultrasound sampling using a mammotome device to confirm the diagnosis in impalpable breast lesions.

Adult↗
PubMed2001

Placental and fetal pulsatility indices in gestational diabetes mellitus.

OBJECTIVE: To assess the usefulness of placental and fetal Doppler velocimetry in the surveillance of gestational diabetes mellitus (GDM). STUDY DESIGN: We studied 89 patients with GDM. All fetuses underwent umbilical, fetal descending thoracic aorta and fetal middle cerebral artery pulsatility index (PI) assessment. Doppler results were not used for management. We correlated PI with route of delivery and with the following perinatal complications: small size for gestational age, cesarean section (CS) for acute fetal distress (AFD), respiratory distress syndrome, hyperbilirubinemia, hypocalcemia, hypoglycemia, macrosomia and stay in a neonatal intensive care unit. RESULTS: Seventy-seven patients (87%) had normal Doppler measurements, while 12 (13%) showed one or more abnormal measurements. The greatest incidence of CS for AFD (42% vs. 16%, P < .001), as well as neonatal hyperbilirubinemia (25% vs. 10%, P < .001) and hypoglycemia (25% vs. 5%, P < .001) was reported among the women with abnormal Doppler measurements. CONCLUSION: Fetal placental hemodynamics are normal in most cases of GDM. In a small percentage of cases we observed abnormal fetal placental PI associated with a higher incidence of perinatal complications. Hence, the finding of abnormal PI must induce the physician to carry out more intensive obstetric care of women with GDM.

Adult↗
PubMed1991

Angular pregnancy. Clinical management.

A case of angular pregnancy was diagnosed by ultrasound examination after curettage of abortion hemorrhage. The rarity and clinical management of this condition are discussed, as well as the importance of ultrasound investigation for early diagnosis.

Abortion, Induced↗
PubMed1989

ER-D5 antigen immune radiometric assay in breast cancer research.

A trial of 185 breast cancer tissues has been developed to characterize receptor negative tumors. We observed the ER-D5-Ag availability to recognize the hormone sensitivity inside the receptor-negative patient groups. In Pre-M ER--ve patients, we observed 26.9%-29.4% of D5+ve cases and in PgR--ve 50% of D5+ve cases. In Post-M ER--ve patients, we observed 31.2%-36.5% of D5+ve cases and in PgR--ve 53.2% of D5+ve cases. The reproducibility of our results suggests the relevance of an additional investigation to characterize the hormonal sensitivity of receptor-negative breast cancer tissues.

Antibodies, Monoclonal↗
PubMed1989

A cytoplasmatic estrogen receptor related protein (ER-D5 Ag) in breast cancer.

A monoclonal antibody against an Estrogen Receptor Related Protein (EG-D5 AG by Amersham) was analyzed in evaluating hormone dependence in 188 breast cancers, in addition to current index of steroid receptors. The Authors observed that the concentration of this new Antigen is not related with PgR but with ER concentration. In fact, increasing the ER values, increases the concentration of ER-D5 Ag, showing a good correlation between these two tumoral markers. In regard to Progesterone Receptor ranges, the ER-D5+ves were equally distributed between PgR-ves and PgR+ves Our experience suggests the application of ER-D5 Ag as R-ves tumor screening marker and emphasizes the importance of a second level in determining therapy and prognosis in breast cancer.

Antibodies, Monoclonal↗
PubMed1988

Spontaneous intraventricular haemorrhage in utero.

The authors report three cases of unexplained prenatal intraventricular haemorrhage (IVH) in three term infants. In the first two cases the suspected diagnosis of prenatal IVH was made a few hours after delivery, in accordance with the ultrasonographic feature of clots in the ventricles, whereas in the third case prenatal ultrasonography was suggestive of hydrocephalus with intraventricular clots.

Brain↗
PubMed1988

Vulvar hormonal receptor modifications during topical steroid treatment.

Four groups of 92 patients steroid pre-treated and non-treated vulvar tissues at delivery, during episiotomy, were used in determining androgen, estrogen and progesterone receptors. In 24 central specimens ER and AR concentrations turned out to be quite low when compared to the endometrium and the breast; PgR were much higher in both the cytoplasm and the nucleus, with a statistically significant difference. After estrogen, testosterone and progesterone topical treatment we observed interesting receptor status modifications which emphasize the use of vulvar receptors as marker during local therapy.

Administration, Topical↗
PubMed1988

Receptor levels in breast cancer.

This report provides information regarding the relative importance of ER and PgR alone and both, as markers, in 352 breast cancers. We observed that the presence of ER not involves the presence of PgR, while the presence of PgR assumes an estrogenic action even if the lowest. In addition the presence of PgR+ depends also on ER negative-detectable (91.42% of the cases) such as we were able to observe that PgR+ was associated with ER negative-undetectable, only in 8.57% of cases. Moreover within the positivity of the couple of ER/PgR, the prognostic value is correlated at ER+ levels, while the predictive value is correlated at PgR+ levels.

Breast↗
PubMed1987

Ultrasound evaluation in the follow-up of ovarian cancer today.

From October 1982 through December 1986, standardized abdominal-pelvic sonography was performed on 257 patients with ovarian cancer scheduled to undergo surgery (laparoscopy, laparotomy). This U.S. test was evaluated by a gynaecologist who was informed of the clinical diagnosis and the findings of physical examination. The Authors selected 110 patients with ovarian cancer, underwent a second look laparotomy, for both diagnostic and therapeutic purposes. The sensitivity (53%), the specificity (68%), the predictive value (78%) and the accuracy 71.8%) of ultrasound for detecting disease have been evaluated to assess its usefulness as a non invasive diagnostic modality in these patients.

Adenocarcinoma, Mucinous↗
PubMed1987

Determination of ER in ovarian cancer using monoclonal antibody technology.

The Monoclonal Antibody technology has been used in 29 cases of ovarian cancer. The immuno-enzyme-assay detected positive levels of estrogen cytoplasmatic receptor in 51.8% of the cases as well as in the nuclear (51.8%). Moreover, the ER/EIA technique screened positive levels of Total ER (ER/t) in 72.4% versus 65.5% obtained by DCC-method. 24.1% of the cases had negative ER/t levels observed by EIA. The monoclonal antibody anti-ER is a very interesting method for studying hormone-dependent tissue, because it uses an immunological binding to antigenic protein (receptor).

Adult↗
PubMed1987

Estradiol and progesterone binding in uterine leiomyomata and pregnant myometrium.

In order to verify the endogenous steroid influences on the myometrium, we compared the receptor status in 18 specimens of uterine leiomyomata and 31 specimens of pregnant myometrium. 17-beta-Estradiol and Progesterone receptors were assayed in the cytosol and nuclear extracts. In the uterine leiomyomata we observed the following mean values: PgR/c 279 fmol/mg, PgR/n 89 fmol/mg, ER/c 52.5 fmol/mg, ER/n 12.3 fmol/mg. In the pregnant myometrium we observed the following mean values: PgR/c 5.86 fmol/mg, PgR/n 166 fmol/mg, ER/c 0.76 fmol/mg, ER/n 1.65. It was concluded that direct correlation between estrogen power and progesterone receptor replenishment in the nucleus exists.

Cell Nucleus↗