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G Fabris

Publications and source records attributed to G Fabris.

At least 37 records · Page 2Linked to original sources

72-kilodalton type IV collagenase, type IV collagen, and Ki 67 antigen in serous tumors or the ovary: a clinicopathologic, immunohistochemical, and Serological study.

The immunohistochemical expression of 72-kDa type IV collagenase [matrix-metalloproteinase (MMP)-21], basement membrane component type IV collagen and proliferation-related antigen Ki 67 were investigated in 43 benign, borderline, and malignant serous tumors of the ovary. The results were compared with the histotypes of ovarian serous tumors and with their clinical behavior. Serum evaluation of MMP-2 was performed in 14 patients with cystadenocarcinoma and the data compared with that of a control group. The basement membrane (BM) was continuous in benign cystadenomas and in some borderline tumors, whereas it was discontinuous or absent in other borderline tumors, in borderline tumors with microinvasion, and cystadenocarcinomas. The percentage of MMP-2- and Ki 67-expressing cells increased from cystadenomas to borderline tumors, being the highest in malignant tumors; a frequent basal disposition of the MMP-2 cytoplasmic granules also was observed in cystadenocarcinomas. Statistical analysis demonstrated that MMP-2 expression was inversely related to BM integrity. Serum MMP-2 values did not differ from that of the control group. Cox regression analysis showed that tumor stage and grade were significant prognostic factors, whereas MMP-2 and Ki 67 immunohistochemical expression added no further significant information to the prognosis. The investigators conclude that the correlation between increasing MMP-2 expression and BM alteration gives support to the hypothesis of a direct role of the metalloproteinase in the process of destructive stromal invasion. MMP-2, type IV collagen, and Ki 67 immunodetection varied according to the histologic classification of ovarian serous tumors. However, neither these factors nor the serum evaluation of MMP-2 appear useful as prognostic predictors in this series.

Antibodies, Monoclonal↗

Treatment of benign prostatic hyperplasia with 5-alpha-reductase inhibitor: morphological changes in patients who fail to respond.

AIMS: To describe the prostatic adenectomy specimens of six patients with symptomatic benign prostatic hyperplasia (BPH) who failed to respond to long term treatment with a 5-alpha-reductase inhibitor, finasteride. METHODS: Histological sections from six cases of BPH who had been treated with finasteride were investigated. Five patients were prescribed 5 mg finasteride daily for six months and one patient 5 mg daily for 12 months. The patients underwent adenectomy as their urethral obstruction failed to resolve. Twenty cases of untreated BPH served as controls. RESULTS: In patients taking finasteride for six months the prostatic adenectomy specimens showed a reduction in the size of the prostate and an increase in the stroma:epithelial and stroma:lumen ratios compared with controls. The size of the ducts and acini was not as uniform as in the controls. In particular, some ducts and acini were still lined by a bistratified epithelium similar to that found in controls but lacked undulations at the epithelial border; other ducts/acini were atrophic. Some scattered clusters of small acini with a focally fragmented basal cell layer were observed in two of the five treated cases. One prostatic adenectomy specimen, from the patient treated for one year, showed extensive lobular atrophy and diffuse squamous and transitional cell metaplasia. At the periphery of the transition zone, there was a complex intra-acinar papillary-cribriform proliferation of clear cells without nuclear atypia, similar to clear cell papillary hyperplasia. The periurethral region showed stromal nodules in both patients and controls. CONCLUSIONS: Morphological evaluation of finasteride treated BPH showed changes in the lobules of the transition zone, but not in the periurethral stroma.

5-alpha Reductase Inhibitors↗

[Fluid attenuated inversion recovery sequences: indications in neuroradiology].

The acronym FLAIR refers to fluid attenuation inversion recovery sequences, which are T2-weighted MR pulse sequences with liquor signal saturation by a long TI. They are characterized by long TR and TE and therefore the acquisition time is very long in the conventional mode, while fast imaging (the Turbo mode) reduces acquisition time to less than 2 minutes. Our study was aimed at codifying the use of this type of sequence in neuroradiologic studies. All the exams were performed with an MR unit with a 1-Tesla magnetic field. We carried out 150 neuroradiologic exams with this pulse sequence on patients with cerebral, medullary or orbital conditions. This technique is very useful to study periventricular or cortical lesions in multiple sclerosis and in other multifocal cerebral conditions (e.g., multiple metastases or lacunar infarcts), but we pointed out the following other advantages: better definition of the extent of infiltrative white matter lesions (i.e., gliomatosis cerebri and lymphomas), better differentiation of cystic from necrotic cavities and exact characterization of cortical damage in cerebral ischemic lesions (useful also for the differential diagnosis). Moreover, FLAIR pulse sequences could diagnose some globe conditions, such as amelanotic uveal melanomas and malformations with no need of contrast agent administration. In contrast, they were useless to study deep ischemic areas, solid neoplasms, hemorrhagic lesions, poroencephalic areas, intrinsic medullary lesions and intra-orbital and extra-ocular conditions. In conclusion, the FLAIR technique is a major diagnostic tool in neuroradiologic MR studies because they overcome such limitations of Turbo SE PD sequences as blurring artifacts; moreover, their acquisition time is always very short. In some cases, FLAIR images are decisive for the diagnosis.

Brain Diseases↗

[Comparative assessment of conventional spin echo sequences and turbo spin echo in the study with magnetic resonance of the lesions of the spinal cord].

In the last few years, new magnetic resonance (MR) pulse sequences called Fast or Turbo Spin Echo (TSE) sequences have become available. This kind of T2-weighted images is particularly useful for the study of spondylosis and degenerative spinal conditions, because it both reduces involuntary motion artifacts and its acquisition time is shorter than that of conventional SE T2-weighted images. Our study was aimed at assessing the diagnostic gain of this new type of pulse sequences in intrinsic spinal cord conditions. Therefore, we acquired TSE and conventional SE sequences, consequently, in 36 patients with intrinsic spinal cord conditions, which were apparent on T2-weighted images, and then compared the sensitivity, contrast resolution, and depiction of lesion margins and extent in both acquisition techniques. The results of our study follow: even though all lesions were identified with both techniques, contrast resolution was higher with TSE than with conventional SE images. Lesion margins and extent were substantially equally depicted with both techniques. Finally, TSE sequences had the same, and sometimes even higher, diagnostic yield than conventional SE sequences: therefore, TSE can be considered the sequence of choice in the study of intrinsic spinal cord conditions.

Adult↗

Location of 72-kd metalloproteinase (type IV collagenase) in untreated prostatic adenocarcinoma.

The aim of the study was to investigate the location of the expression of 72-kd metalloproteinase (MMP-2) in relation to the distribution of type IV collagen in untreated prostatic adenocarcinoma (PAc). Twenty formalin-fixed, paraffin-embedded PAc cases, in which high grade prostatic intraepithelial neoplasia (PINhigh) was occasionally present, were immunohistochemically examined. Type IV collagen immunoreactivity showed the presence of a basement membrane (BM) at the epithelial-stromal junction. In cribriform and solid/trabecular PAc, the staining was focally disrupted. In acinar PAc, the BM immunostained by anti-type IV collagen was observed around the individual acini, with occasional thinning and fragmentation. Immunostaining for MMP-2 was heterogeneous in intensity and location. Cribriform and solid/trabecular PAc showed weak cytoplasmic immunostaining for MMP-2; both moderately and intensely stained cells were seen in the cell layer adjacent to the stroma; intense immunostaining was shown by small clusters of neoplastic cells or single neoplastic cells located in the stroma which also showed thinning and fragmentation of BM staining. In acinar PAc, weak cytoplasmic immunostaining for MMP-2 was seen throughout most areas of the tumours, whereas moderately and intensely stained cells were observed less frequently than in cribriform and solid/trabecular adenocarcinoma. Intense immunostaining of single or small clusters of neoplastic cells located in the stroma was rarely observed and, as for cribriform and solid/trabecular PAc, mainly located towards the periphery of the tumour nodules. BM stained by anti-type IV collagen was preserved in normal prostate and in PIN, some thinning being present in the latter. The pattern and intensity of immunoreactivity for MMP-2 in PIN was similar to that of cribriform and solid/trabecular PAc, whereas normal ducts and acini showed weak immunostaining in most of the secretory cells and moderate to strong immunoreactivity in scattered basal cells. Thus, MMP-2 appeared basically expressed in cells which lie in direct contact with the stroma. This underlined the importance of evaluating the MMP-2 location in relation to basement membrane degradation and tumour invasion.

Adenocarcinoma↗

Apoptotic bodies in prostatic intraepithelial neoplasia and prostatic adenocarcinoma following total androgen ablation.

The frequency and location of apoptotic bodies (AB) were evaluated in hematoxylin- and eosin-stained sections of 12 radical prostatectomies from patients with prostatic adenocarcinoma pre-treated for 3 months with total androgen ablation. Results were compared with an untreated age-, morphology- and stage-matched control group. Treated prostates showed involutional changes, with cytoplasmic vacuolization and chromatin changes ranging from mild to severe condensation, similar to that observed in apoptosis. In treated benign prostatic epithelium, the mean number of AB was 1.64% (standard error (SE), 0.19%), 6.3 times greater than in the untreated group (mean, 0.26%; SE, 0.03%). AB were more frequent in the basal cell layer than in the lumenal cell layer, whereas in the untreated group, AB were almost exclusively found in the basal cell layer. In treated prostatic intraepithelial neoplasia (PIN present in 10 cases), the mean number of AB was 1.74% (SE, 0.04%), which was 2.56 and 2.32 times greater than in untreated low grade PIN (mean, 0.68%; SE, 0.15%) and high grade PIN (mean, 0.75%; SE, 0.11%), respectively. In treated and untreated PIN, the number of AB was greatest in the basal cell layer, less in the intermediate cell layer and lowest in the cell layer bordering the lumen. The mean number of AB in the 12 treated cancers was 1.35 times greater than in untreated cancers (1.80% [SE, 0.12%] versus 1.33% [SE, 0.32%], respectively). The number of AB in treated cases of the acinar pattern of cancer (present in 7 cancer cases) was 1.78 times greater than in untreated cases, and in treated cases of the cribriform pattern of cancer (present in four cases), the mean number of AB was 1.39 times greater than in untreated cases. The number of AB was greatest in the outermost cell layer, with progressive decrease in layers closer to the lumen. In the one treated case with solid/trabecular pattern of cancer, the number of AB was 1.08 times greater than in untreated cases. The gland lumina was rich in macrophages, sloughed secretory cells with degenerative features and AB. The number of AB in the lumina increased from normal epithelium through PIN to cancer, and was greater in treated cases than in untreated cases.

Adenocarcinoma↗

[Magnetic resonance in the assessment of perianal fistula].

This study was aimed at investigating the effectiveness of Magnetic Resonance Imaging (MRI) in the diagnosis of perianal fistulas, by comparing imaging findings with those provided by rectal examination (RE) or surgery. The present data refer to 20 patients with anorectal fistulas in whom 24 main fistulous tracks were found. The fistulas were classified according to Parks and Kennedy's criteria, based on their relationship to the sphincters. In the 15 surgical patients, 15 of 17 fistulas were correctly identified by MRI (88.2%). In one case the submucous path of the fistula was missed, while another patient was misdiagnosed as having an intersphincter fistula which turned out to be a transphincter one at surgery. In the 5 non-surgical patients, only 4 of 7 MR-detected tracks were identified at RE. An intersphincter fistula was missed on rectal examination but demonstrated by both MRI and endoscopy. A suprasphincter track in a patient who was initially asymptomatic and thereafter developed a perianal abscess, was missed at clinics but became apparent on MR images. In one case anorectal examination underestimated the extent of the fistulous track, which was thought to be low while MRI demonstrated it to be high. Twelve abscesses were seen on MR images, all of them classified at surgery. One posterior pararectal suppurative collection in a non-surgical patient was apparent only at MRI. In our experience, in agreement with the latest literature reports, MRI has proved to be a very reliable method in the assessment of anorectal inflammatory diseases. We believe that MRI may play a valuable role in the preoperative assessment of the complex conditions causing a high risk of recurrence or anal incontinence as a result of inadequate treatment.

Adult↗

Benign, borderline, and well-differentiated malignant intestinal mucinous tumors of the ovary: a clinicopathologic, histochemical, immunohistochemical, and nuclear quantitative study of 57 cases.

Mucinous ovarian tumors are still a subject of controversy because they can show either intestinal or endocervical differentiation. Morphologic distinction between borderline and malignant tumors is sometimes difficult, and their clinical behavior has not been definitively ascertained. We selected 10 mucinous cystadenomas (MCAs), 32 intestinal mucinous borderline tumors (IMBTs), and 15 well-differentiated mucinous carcinomas (MCCs), all with goblet cells, at least focally. In all cases, we studied the clinicopathologic features, mucin content, intermediate filament expression, and some nuclear quantitative features, namely, the volume-corrected mitotic index (M/Vi), percentage of nucleolated nuclei, mean number of nucleoli per nucleus, percentage of nucleoli touching the nuclear membrane, and mean nuclear area. The quantitative nuclear study included cytometric DNA analysis and the results were expressed as relative mean ploidy value (RMPV) and as diploid-tetraploid or aneuploid histograms. The results of the quantitative study were evaluated statistically. All patients had stage IA tumors, had received surgical therapy only, and were alive and well after a follow-up of more than 5 years. Light microscopic examination revealed that destructive stromal invasion was not present in any MCCs and that IMBTs and MCCs were easily recognizable using the Hart and Norris criteria, later expanded by Hart. Mucin histochemistry and intermediate filament immunohistochemistry failed to detect substantial differences between the diagnostic categories. DNA analysis demonstrated an increase in aneuploid tumors going from IMBTs to MCCs, but these differences were not statistically significant. On the other hand, nuclear quantitative morphology showed significant differences among the three groups of tumors for all features considered. Forward stepwise discriminant analysis highlighted that MCAs, IMBTs, and MCCs were contiguous but different categories. These data support the separation of IMBTs and MCCs into morphologically different categories as underlined by the results of quantitative nuclear morphologic analysis. The favorable outcome of all patients confirms the excellent prognosis of stage I IMBTs and suggests that well-differentiated MCCs without destructive stromal invasion at stage IA could be assimilated, in terms of prognosis and therapy, into stage I IMBTs.

Adenocarcinoma, Mucinous↗

Effects of combination endocrine treatment on normal prostate, prostatic intraepithelial neoplasia, and prostatic adenocarcinoma.

AIMS: To investigate the effect of combination endocrine treatment (CET) or luteinising hormone releasing hormone agonist and flutamide on non-neoplastic prostate, prostatic intraepithelial neoplasia, and prostatic adenocarcinoma. METHODS: The morphology, including the mitotic activity, of 12 radical prostatectomies from patients with prostatic adenocarcinoma pretreated for three months with CET was evaluated in haematoxylin and eosin stained sections and compared with an untreated age and stage matched control group. RESULTS: A differential effect on the non-neoplastic prostate was observed. In fact, the transition zone of the treated prostate showed simplification of the glandular lobules: the ducts and acini were small without undulations of the epithelial border and with a prominent basal cell layer. Within the peripheral zone there was inconspicuous branching of the ducts and acini which looked dilatated and lined by flattened atrophic epithelium. Prostatic intraepithelial neoplasia occurred in scattered ducts and acini in the peripheral zone of 10 of the 12 patients. The epithelial cell lining showed a prominent basal cell layer. A certain degree of secretory cell type stratification was always present. However, crowding was less evident than in the untreated prostate because of cytoplasmic clearing and enlargement as a result of coalescence of vacuoles. The treated adenocarcinomas had neoplastic acini which looked small and shrunken, and areas of individual infiltrating tumour cells separated by abundant interglandular connective tissue. The secretory cells of the nonneoplastic, prostatic intraepithelial neoplasia, and prostatic adenocarcinoma lesions had inconspicuous nucleoli, nuclear shrinkage, chromatin condensation, and cytoplasmic clearing. Apoptotic bodies were easily identifiable in all the cell layers. The lumina were rich in macrophages, sloughed secretory cells with degenerative features, and apoptotic bodies. Mitoses were not observed in any of the treated non-neoplastic prostate, prostatic intraepithelial neoplasia, or prostatic adenocarcinomas, whereas the mitotic frequency increased from non-neoplastic prostate through prostatic intraepithelial neoplasia up to prostatic adenocarcinomas in the untreated specimens. CONCLUSIONS: CET before radical prostatectomy causes regressive epithelial changes together with enhanced apoptosis and blocked mitotic activity.

Adenocarcinoma↗

Intratesticular serous cystadenoma of borderline malignancy. A pathological, histochemical and DNA content study of a case with long-term follow-up.

A 61-year-old man presented with a painless right testicular swelling of 6 months duration. A right orchiectomy was performed and pathological examination showed an intratesticular serous borderline tumour (SBT). Immunohistochemical staining was positive for carcinoembryonic antigen, LeuM1, B72.3, S100-protein, Ca125, cytokeratins AE1/AE3 and vimentin, suggesting a Müllerian origin or differentiation. DNA image analysis revealed an aneuploid histogram. The favorable outcome of the patient confirms that testicular SBTs behave as non-aggressive tumours, even when characterized by aneuploid DNA content.

Biomarkers, Tumor↗

Percutaneous treatment of lumbar disc herniation.

Nine hundred and eighteen patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels (150 of whom were treated at two levels): 185 patients were treated with Onik's automate discectomy. Chemonucleolysis was carried out on 733 patients (79.8%) and automated discectomy in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy was an effective method of management in 74.6% of the cases. The availability of several therapeutic methods has allowed us to respond in a more appropriate way to the patient's requirements and, in the case of failure, offer a more flexible therapeutic spectrum, and to consider surgery as the last resort. As regards the relation between enzymatic nucleolysis with chymopapain and disc nucleoaspiration, we feel that the two should not be in competition, for the indications are precise for both methods: in the enzymatic treatment, the hernia can be medium-large sized, in a sub- or extra-ligamentous position. The treatment of patients with moderately severe symptoms is preferable. In disc nucleoaspiration, the hernia must be small-sized.

Chymopapain↗

Clinical usefulness of estrogen receptor immunocytochemistry in human breast cancer.

We assessed the reliability of the immunocytochemical assay of estrogen receptor (ER-ICA) as a marker of clinical outcome. Relapse-free interval (RFI) and overall survival (OS) according to ER-ICA status were retrospectively evaluated on a series of 210 patients who had undergone surgery for primary breast cancer between January 1985 and December 1988. ER assay by the dextran-coated charcoal method (DCC) was also performed in 189 tumors. A significant positive correlation was found between the DCC and ER-ICA assays, with an overall agreement of 79%. ER-ICA status showed a prognostic predictive power with respect to OS and RFI in the whole series of patients and in the subset of node-positive patients. It was also a marker of outcome with respect to OS in the subsets of node-negative patients and patients with tumors < or = 2 cm in diameter. Moreover, the predictive value of the ER-ICA assay was higher than that of the DCC assay in the present study. These findings emphasize the clinical usefulness of the ER-ICA assay as a measure for prognosis.

Adult↗

Determination of blood constituents reference values in broilers.

Eight hundred broilers were examined to define the reference values of nine blood constituents (total proteins, albumin, total and free cholesterol, triglycerides, aspartate aminotransferase (AST), alkaline phosphatase (ALP), calcium, and phosphorus). The broilers, coming from 20 different commercial poultry operations, were equally divided into different groups according to age (21 and 45 days), strain (Arbor Acres and Hybro), sex, and sampling season (summer or winter). Age and sampling season were the variation sources that most influenced the values of the hematochemical variables examined. The interaction of age with strain influenced total proteins total and free cholesterol, triglycerides, and ALP. The interaction of age with sampling season influenced all hematochemical constituents except triglycerides. Reference limits defined by .975 and .025 fractiles were computed for each blood constituent according to the significance of different variation sources and their combinations. Reference limits defined herein could be used as indicators of metabolic and health conditions of a poultry farm.

Age Factors↗

[Gas gangrene. Clinical considerations, prognosis and therapeutic prospects in our experience].

The prognosis of gas gangrene is changing as the means of treatment become more accurate and are implemented earlier. The authors, in their work referring to 10 cases of gas gangrene, point out to the extreme fastness of debridement and immediate exeresis, of wide-spectrum antibiotic protection and of caloric balance, associated to a treatment using trace elements. The importance of hyperbaric oxygen therapy seems to be increasingly proven with time. Lastly, in their general experience of treatment, the authors suggest the use of a specific frequency soft laser therapy, which might speed up the process of tissue repair.

Adult↗

Immunohistochemical expression of c-erbB-2 in human breast cancer by monoclonal antibody: correlation with lymph node and ER status.

c-erbB-2 Protein expression was investigated in a series of fifty primary breast cancers by means of a specific monoclonal antibody and immunocytochemistry. Specific staining was observed at the plasma membrane level of neoplastic cells, according to the reported localization of c-erbB-2 protein. Sixty-four percent of tumors scored positive, with a variable amount of stained cells. The rate of protein expression was found to exceed the reported gene amplification. No relationship was observed between c-erbB-2 protein staining and age, menopausal status or histologic subtypes. An inverse association was found between c'erbB-2 protein staining and estrogen receptor content of tumors, assayed by immunocytochemistry. A positive relationship was observed between c-erbB-2 protein expression and presence of axillary node metastasis. These findings suggest that c-erbB-2 protein expression is a marker of tumor aggressiveness and that its prognostic power deserves further investigation both in node-positive and node-negative patients.

Adult↗

Assessment of proliferative rate of breast cancer by Ki-67 monoclonal antibody.

The proliferative activity of 163 primary breast cancers was assessed by immunocytochemistry with the mouse monoclonal antibody Ki-67, which recognizes a nuclear antigen expressed in all phases of the cell cycle except for Go. The overall frequency distribution of Ki-67 staining was of exponential type, with percentage of positive staining cells ranging from 0.3 to 88.3%, with a median value of 10.1%. No relationship was observed between Ki-67 values and menopausal status of patients. A significant positive correlation was found between Ki-67 values and tumor grade, especially mitotic grade. Estrogen Receptors (ER) were assayed by immunocytochemistry with ER-ICA method and by dextran-coated charcoal method (DCC) in 129 and 141 tumors, respectively. A negative correlation was found between the ER content by both methods and Ki-67 score. Eighty-nine percent of cases with Ki-67 value less than 10.1% contained more than 10% ER-ICA-positive cells. Progesterone receptors (PgR) were assayed by immunocytochemistry with PgR-ICA method and by DCC in 62 and 141 tumors, respectively. A negative correlation was observed between the PgR content by both methods and Ki-67 score. No correlation was found between Ki-67 score and lymph node involvement by tumor. These findings suggests that Ki-67 score could be used as an independent prognostic marker, useful to distinguish different risk for recurrence within the two clinically heterogeneous groups of N- and N+ patients.

Adult↗

High-dose contrast-enhanced computed tomography (CECT) with iopamidol in the detection of cerebral metastases. Tolerance of the contrast agent.

Intravenously administered iodinated contrast media have been demonstrated, since early experience with computed tomography of the brain, to improve clinical value of the procedure for detecting intracranial lesions. There is no universal agreement about the amount and the method of administration of the contrast medium. Many authors maintain that the use of large doses gives better results for the diagnosis of tumors and metastases. The purpose of this paper is to evaluate the tolerance of iopamidol administered by rapid intravenous infusion in a large number of patients undergoing contrast enhanced computed tomography to detect brain metastases. The authors examined 969 consecutive adult patients suffering from lung cancer, brain metastases have been detected in 17% of cases. Adverse reactions to contrast media occurred in 3 patients. Non ionic contrast media are recommended in this diagnostic procedure.

Adult↗