Biomedical subjects
Publications and source records attributed to G Coletti.
Primary epididymal lymphoma is an unusual observation. Only 2 cases of non-Hodgkin's lymphoma of the epididymis have been previously reported. We describe the clinical and pathologic features and management of a primary high-grade malignant lymphoma of the epididymis in which a tentative diagnosis of lymphoma was made on the basis of cytologic examination and immunochemical staining of the material obtained from an aspiration needle biopsy.
Isolated myocardial infarction of the atria is a relatively understudied and underestimated entity, rarely diagnosed in life. The pathological and clinical features in 10 cases of acute isolated atrial myocardial infarction are reported. They represent 3.5% of all myocardial necrosis out of a series of 2,704 consecutive autopsies in adults. The right atrium is more frequently involved than the left atrium (9:1). Pulmonary hypertension, with or without coronary arterial narrowing, is the major condition leading to isolated atrial infarction. Congestive heart failure, thromboembolic phenomena, and supraventricular arrhythmias are the most frequent complications of atrial infarction. The electrocardiographic findings are often non-specific and elusive and are not useful to a correct diagnosis. These observations suggest that isolated atrial myocardial infarction is a well-distinct entity with respect to ventricular myocardial infarction, since there are several differences between the 2 diseases in pathogenesis, diagnosis, clinical picture, and prognosis.
The Authors have investigated preneoplastic lesions and the problem of the identification of benign lesions considered with or without preneoplastic potential, comparing for the occasion the presence of transformation markers in these lesions with the positivity of tumor markers in neoplastic tissue. The dosages have been valued on neoplastic tissue (180 cases), dysplastic tissue (50 cases), on cystic fluid (70 cases), and on nipple discharge (80 cases). The data obtained show a marked positivity to the tumor markers and the ionic and hormonal content (K+, Na+ DHEAS, PRL evaluation). The positivity of some lesions, not properly preneoplastic (or atypical) towards some markers of neoplasia could show some differences of great interest between benignity and malignity.
A case of testicular specialized gonadal stroma tumor was evaluated by histologic, ultrastructural and immunohistochemical techniques in a young adult male patient. The neoplastic cells were organized in cords or tubular structures delimited by a basement membrane. The ultrastructural findings suggested a diagnosis of a partially differentiated Sertoli cell tumor. This was also supported by the presence of a vimentin rich cytoskeleton, which is normally present in Sertoli and Leydig cells. The tumor cells did not secrete steroid hormones, as suggested by clinical findings, as well as by hormonal, immunohistochemical, and ultrastructural observations.
Monoclonal antibodies were produced in mice immunized with proteins released into tissue culture fluid of human breast cancer cells maintained in vitro. One monoclonal antibody (SP-2) identified a Mr 90,000 antigen which appears to be a proteolipid. In immunoperoxidase assays, SP-2 reacted with 81 of 90 specimens of human breast cancer. It also reacted with 12 of 23 cancers of nonbreast origin but was unreactive with all normal tissues tested. The Mr 90,000 antigen, purified by immunoaffinity chromatography using SP-2, was used in an indirect binding inhibition assay for the detection of antigen in human serum. With this assay, 35 of 69 patients with breast cancer and 11 of 37 patients with benign breast lesions showed serum antigen levels above 6 units/ml. Patients with nonbreast cancers also demonstrated elevated levels of antigen in 32% of cases. The SP-2 defined Mr 90,000 antigen appeared to be distinct from carcinoembryonic antigen and other monoclonal antibody-defined breast cancer antigens of similar molecular weight. SP-2 may prove useful as a serum and/or tissue marker in breast pathology.
Very sensitive and precise analytical methods for measuring total porphyrin excretion and the relative amounts of different porphyrins in urine are required in order to monitor the biological effects of porphyrinogenic substances in workers and the general population. Many analytical steps of a HPLC method for measuring porphyrins as methyl esters in urine have been perfected. Sensitivity is 0.1 microgram/1 for each type of porphyrin, and average recovery is 92% in the range of 50-450 micrograms/liter porphyrins. The coefficient of variation is 3.4% within a series and 12.5% between series. Chemical oxidation before analysis and appropriate storing of the samples are the key points in achieving high quality results. The urinary excretion of porphyrins in healthy male workers varies within the range 21 to 161 micrograms/liter (95% limits of a group of 78 subjects). Concomitant factors, like drug use or liver disorders, were found to alter urinary porphyrin excretion. The proposed method permits the detection of extremely small alterations in porphyrin excretion resulting from occupational exposure to industrial chemicals such as, for example, mild coproporphyrinuria or early stages of chemical porphyria induced by polyhalogenated arylhydrocarbons.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Isolated rabbit heart with independent perfusion of a small left ventricular area was used to study the effect of manganese ions on aconitine-induced ventricular tachycardia. Manganese chloride 4 mM in Locke solution exhibited a constant preventive or suppressive effect versus aconitum-induced rhythm disorders. It is concluded that the interpretation of aconitine cardiotoxic effects on the sole basis of phase 3 modifications require further evidence, and that an increased diastolic depolarization rate may well explain, at least in this experimental model, the genesis of arrhythmias induced by this drug.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: Early diagnosis and surgical decision making are the key for survival in acute type A aortic dissection (AAD-A). As such, transesophageal echocardiography (TEE) is widely accepted tool in the diagnosis of AAD-A. METHODS: We used TEE in 49 cases as the sole diagnostic examination of AAD-A since November 1989. It was particularly useful intraoperatively to detect cerebral malperfusion during AAD-A repair. We were able to accurately monitor the blood flow of the aortic arch by using TEE for all patients throughout the operation. Only two patients developed severe cerebral malperfusion after the distal anastomosis was finished under deep hypothermic circulatory arrest. TEE showed that the malperfusion after the bypass was re-established. In both cases the expanded false lumen blocked the true lumen. We immediately switched the perfusion cannula from the femoral artery to the ascending aortic graft to create antegrade flow. RESULTS: The subsequent TEE showed only the flow in the true lumen. One patient recovered without any complication while the other suffered mild, temporary neurological defects. Cerebral malperfusion is a potential catastrophic complication of AAD-A, which may exist before surgery or be caused by the operation itself. CONCLUSIONS: We recommend continuous intraoperative TEE to monitor aortic arch flow during these operations. This allows immediate detection of cerebral malperfusion and prompt action can be taken to prevent irreversible brain damage.
Granular cell tumor (GCT) is a relatively rare neoplasm, and almost always benign in its prognostic behavior. Location of this tumor in the breast presents serious problems for differential diagnosis, both from a clinical point of view and at gross pathological examination, because of its resemblance to carcinoma. Fine needle aspiration biopsy and intraoperative frozen section examination may not be of any further help. The histogenesis of these lesions has been widely debated in the past, but no universally accepted conclusion has been reached. Most GCTs appear to be derived from Schwann cells, but many different neoplastic and non-neoplastic lesions show granular cell changes. Therefore, GCT should not be considered as a single entity but as the result of a cytoplasmic change due to still unknown metabolic alterations that may occur in various cell types. No firm conclusions can be drawn regarding the suspected hormonal influence on the development of breast GCT. The authors describe three typical cases of breast GCT that occurred in patients of different ages, and discuss the most important questions concerning this lesion.
The Authors report on a rare case of malignant conjunctival epibulbar fibrous histiocytoma with orbital invasion. Fibrous histiocytoma is a tumour of mesenchymal origin, which, although among the most common adult age soft tumours, appears very rarely at the conjunctival level. In fact the most frequent site is the orbit. So far only 15 cases concerning conjunctiva have been described in the Literature only 4 of those have been reported as malignant. We observed a male patient, who 6 years ago, at the age of 53, noticed a neoformation on the temporal portion of the bulbar conjunctiva. In June 1988, after three successive operations, with a histological diagnosis of inflammatory granuloma, he came to our Clinic, where, because of the characteristics of the orbit infiltrations, only a partial excision was carried out for a biopsy. The histological examination, associated with immunohistochemical techniques, gave the result of malignant fibrous histiocytoma. Consequently in, July 1988, the patient underwent an exenteratio orbitae. To date, the patient enjoys good health without a trace of recurrence. Besides the clinical presentation of the case, histopathological and immunohistochemical findings concerning this type of lesion are presented and discussed, with a comparison of our findings with those reported in the literature.
Infective acute mediastinitis is a postoperative complication reported in 0.5-1% of patients undergoing open chest operations. The treatment of choice for this life-threatening complication is still a matter of debate. The aim of this study was to retrospectively analyse the efficacy of different therapeutic approaches in the treatment of postoperative infective mediastinitis. In the 2nd Division of Cardiac Surgery, from October 1986 to May 2000, 10,234 patients underwent cardiac surgery operations. In 42 patients (0.4%) the operation was complicated by acute infective mediastinitis requiring surgical treatment. On the basis of the treatment opted for, these patients were subdivided into 5 groups: 23 patients underwent continuous iodopovidone (Betadine) mediastinal irrigation (GL) associated with surgical omentoplasty in 8 patients (GLO); 5 patients underwent isolated omentoplasty (GO), and 4 patients were treated with a pectoral muscle flap (GF). In 8 patients other different procedures were performed (GS). There were no deaths in GF and GS despite 24% and 20% mortality reported among patients who underwent mediastinal irrigation (GL) and isolated omentoplasty (GO), respectively. The mean hospital stay was 15 +/- 1 days in GF, 16 +/- 1 days in GS, 25 +/- 11 in patients who underwent omentoplasty and 27 +/- 14 in patients who underwent mediastinal irrigation. Predictors of death were low cardiac output syndrome (P < or = 0.009) and respiratory insufficiency (P < or = 0.032) when found before treatment. Our study suggests that surgical omentoplasty should be the treatment of choice in deep mediastinal infections, whereas wound sterilisation, associated with surgical chest wall reconstruction, seems to be a better procedure in superficial infective disease. A more extended clinical series would be needed to confirm these preliminary data.
In an autopsy study of 2569 subjects, during the period 1971-1988, 289 cases of myocardial infarction were found. On the basis of morphological and histological data 8 (2.8%) of such cases were diagnosed as isolated right ventricular myocardial infarction. Clinical data relating to these 8 cases were also considered. The right ventricular myocardial infarction may be secondary to acute or chronic pulmonary hypertension, in the setting of massive pulmonary thromboembolism or cor pulmonale, especially in the presence of right ventricular hypertrophy and with normal or stenotic coronary arteries. Isolated right ventricular myocardial infarction is clinically underestimated due to the great difficult to make a correct diagnosis in life. The low accuracy of the standard electrocardiographic records does not allow to pose a diagnosis of isolated right ventricular myocardial infarction.
Explore the source record for details and available documents.