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Biomedical subjects

G Muzzonigro

Publications and source records attributed to G Muzzonigro.

At least 37 records · Page 2Linked to original sources

[Endoscopic treatment of vesicoureteral reflux in adults with bovine collagen].

Endoscopic subureteral collagen injection has become widely accepted a practiced method for the treatment of vesico-ureteral reflux in children. The aim of this study was to evaluate the efficacy of the treatment in adult patients affected by vesico-ureteral reflux. We have selected 45 patients with primary e 10 patients with secondary reflux (tot. 76 ureters) treated by endoscopic subureteric injection of collagen. The success rate after one injection in primary reflux was 74%. 13 ureters required a 2nd or 3rd injection to achieves success. The minimum follow-up time for the successfully treated patients was 12 months; we did not observe no reflux in 92% of ureters. Endoscopic injection of collagen is a reliable alternative to open surgery.

Adolescent↗

[Gene p53 mutation and prognosis in bladder tumors].

The choice of treatment for bladder tumors is based on pathological criteria, i.e. staging and grading mainly. It has recently been observed that genetic alterations that involve activation of oncogenes and inactivation of suppressor genes can occur during tumorigenesis. p53 protein is coded for by a genes on chromosome 17, and is able to suppress malignant transformation and proliferation; it can be important in maintaining the integrity of DNA, when damaged during neoplastic disease. We have analyzed samples of transitional cell carcinoma of the bladder of 60 patients managed by conservative treatment; all the specimens have been stained for p53 protein. We could observe that the presence of the protein p53 is correlated with staging and grading and is associated with an increased risk of relapse and progression. Patients with transitional-cell carcinoma confined to the bladder that demonstrates nuclear p53 reactivity should be considered for protocols of adjuvant treatment.

Adult↗

[Diagnostic efficacy of free SPA/total PSA ratio in the diagnosis of prostatic carcinoma].

Prostate specific antigen, specific organ and tissue marker, is a glycoprotein present in serum in different molecular forms, i.e. not protein bound and bound to proteins (PSA-ACT and PSA-AMG). The total PSA is expressed by the sum of the non protein bound value (free-PSA) and PSA-ACT. The aim of our study was to evaluate the hypothesis that measurement of free/total PSA ratio may be helpful in the differential diagnosis of prostatic pathology. Our study was conducted on 350 patients, to whom the total-PSA, free-PSA and f/t PSA had been performed; 250 patients showed a total PSA between 2.5 and 10 ng/ml and 185 of them had symptoms of bladder out-flow obstruction. In all of the 250 patients digital rectal examination, transrectal ultrasound and prostatic biopsy were performed. 100 patients were controls. The cut-off to differentiate between benign and malignant prostatic disease was 16%. The pathologic diagnosis was related to the f/t PSA ratio, and in particular those patients with a f/t PSA lower than 16% were expected to be prostatic carcinoma, while those with a f/t PSA higher than 16% were expected to be benign prostatic hypertrophy. The diagnostic accuracy of the ratio was calculated, and it was observed that it was 88.65% in the diagnosis of benign prostatic hypertrophy, while in the diagnosis of prostatic carcinoma it was 84.5%. We can therefore assume that f/t PSA can add useful information on prostatic pathology, eventually sparing unnecessary prostatic biopsies.

Adult↗

Effects of neoadjuvant androgen deprivation therapy on prostatic cancer.

OBJECTIVES: In this study, we analyzed the involutive effects of androgen deprivation therapy on normal and neoplastic prostatic tissue, to investigate whether androgen deprivation prior to radical prostatectomy could reduce the incidence of extracapsular extension, positive margins, positive seminal vesicles and positive lymph nodes in patients with prostatic carcinoma. METHODS: We performed neoadjuvant androgen deprivation therapy (NADT) in 41 patients cT2N0M0 and in 21 patients cT3N0M0. Criteria to evaluate the effectiveness of NADT included prostate volume, tumor volume, serum prostate-specific antigen (PSA), staging, grading, histological modifications of the tumor, and evaluation of indices of cellular proliferation. RESULTS: We observed a decrease in prostate and tumor volume, as well as serum PSA; a down-staging effect was observed in 14.51% of cases. Evaluation of proliferating-cell nuclear antigen (PCNA) revealed a decrease of proliferative activity in treated prostatic carcinoma. The histological modifications after neoadjuvant therapy consisted of cellular necrosis with apoptotic phenomena, dense chromatin without nucleoli, absence of mitosis, inflammatory infiltrate, and interstitial fibrosis. Regressive aspects similar to those of neoplastic cells were observed in prostatic intraepithelial neoplasia. CONCLUSION: Our assessment of the biologic effects of NADT on tumoral activity of prostatic carcinoma led us to conclude that NADT can reduce the cellular proliferation of neoplastic cells.

Adenocarcinoma↗

Cryptorchidism and infertility: retrospective study of 18 post puberal patients affected with monolateral cryptorchidism.

The Authors report their experience on patients with monolateral inguinal cryptorchidism, comparing the clinical picture with the morphological pattern of both the testicular parenchima and the semen. Light and electron microscopic analysis of testicular biopsy and spermatozoa from the ejaculate have been taken into account. 4 patients out of 18 (22.2%) showed a normal spermiogram, while 14 showed a pathological spermiogram. The morphological study of the testicular parenchima showed a spectrum of lesions, most of which advanced, confirming that they are irreversible lesions of the germinal epithelium.

Adolescent↗

Renal oncocytoma. Pathological evaluation and clinical implications.

Renal oncocytoma is a benign tumour of renal tubular origin; oncocytes are transformed epithelial cells rich in mitochondria, probably representing senescent degenerative cellular changes. Most of renal oncocytomas usually follow a benign clinical course and partial nephrectomy or enucleation has been advocated as curative. By immunohistological staining of tissue sections using monoclonal antibodies (DBA, SBA, PNA, UEA, Cytocheratine), we can suppose the histogenetic origin of renal oncocytomas from a region other than the proximal tubular epithelium, and in particular from the collecting duct epithelium. We believe that it is most important to perform flow cytometry to study the chromosomal pattern of the tumour, once intra-operative frozen sections have advanced the suspicion of renal oncocytoma; if oncocytic cells show a diploid pattern, and the tumour mass is well circumscribed and has not an excessive diameter, we favour renal sparing surgery.

Adenoma, Oxyphilic↗

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↗

Prostatic invasive adenocarcinoma. Effect of combination endocrine therapy (LHRH agonist and flutamide) on the expression and location of proliferating cell nuclear antigen (PCNA).

Expression and location of Proliferating Cell Nuclear Antigen immunostaining in epithelial nuclei were assessed on histological sections from 32 cases of invasive adenocarcinoma of the prostate gland: 20 untreated and 12 treated with combination endocrine therapy or CET. The PCNA-positive nuclei showed homogeneous or granular types of staining or a mixture of both, and a gradation in the intensity of staining. Nuclei with homogeneous patterns appeared darker brown than the lighter granular and mixed patterns. Darker nuclei were more frequently noted, mainly among the epithelial cells adjacent to the stroma, in the untreated cases. In contrast, nuclei with pyknotic chromatin, unstained and corresponding to apoptotic bodies, were more frequently seen in the treated patients. For the untreated invasive adenocarcinomas, the mean proportion of PCNA-stained epithelial nuclei in the 10 cases with an acinar pattern (small and large) was 8.86% (SE 0.23%). The mean value in the 5 cases with a cribriform pattern was 11.76% (SE 0.52%), that is, greater than in the acinar pattern, and decreased from the nuclei in the basal position, or adjacent to the stroma, toward the lumen: 14.40% (SE 0.61%) in the basal position, 11.84% (SE 1.30%) in the intermediate and 9.26% (SE 0.66%) in the lumenal. In the 5 cases with a solid/trabecular pattern, the proportion of PCNA-positive nuclei was 15.74% (SE 2.30%), that is, higher than in all the other patterns, and decreased from the cell layer adjacent to the stroma (17.60%, SE 2.92%) toward the other layers (13.88%, SE 1.71%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Fine needle aspiration biopsy of the prostate gland: our experience concerning 101 cases with histological follow-up.

Our experience concerning 605 fine needle aspiration (FNA) biopsies performed between 1985 and 1988 is reported. FNA specimens of the prostate gland were compared to histological material in 101 cases: 37 patients underwent suprapubic prostatectomy, 15 radical prostatectomy, 28 transurethral resection, and 21 core needle biopsies. Adenocarcinoma was correctly diagnosed by using cytology in 39 out of 40 cases; benign prostatic hypertrophy was confirmed by histology in 54 out of 57 cytologically benign cases. The absolute sensitivity of the FNA biopsy was 98.2%; specificity was 98.1%; efficiency was 96%; and false negative rate was 6.6%. Our data support the value of transrectal aspiration biopsy as a precise and easy method for diagnosing prostatic cancer; the low false negative rate and the high number of correct diagnoses underline the great accuracy of the method.

Adenocarcinoma↗

[Radio-urodynamic evaluation of stress urinary incontinence in women].

This work is aimed at demonstrating the validity of conventional radiological procedures, correlated with urodynamics, in the study of female urinary stress incontinence. In a study population of 110 patients with a clinical-urodynamic diagnosis of stress incontinence, radiological evaluation was performed by means of retrograde cystography, bead chain cystourethrography, and voiding cystourethrography. Radiographic findings were correlated with urodynamic data, and in particular with urethral pressure profile (functional length of the urethra, maximum closing pressure, maximum urethral pressure). In all patients the posterior urethro-vesical angle values were higher than 100 degrees; moreover, a correlation was proven to exist between an increase in the angle of front urethral inclination, the lowering and mobility of the urethrovesical junction, and the severity of urodynamic findings. Furthermore, in the different stages of urodynamic severity , urethral funneling was most frequent, and the flattening of the posterior vesical floor in voiding cystourethrography. The high reliability of the radiographic findings, although obtained by means of conventional techniques, and the variability of the morpho-dynamic results confirm the importance of a combined radiographic and urodynamic study in the evaluation of stress incontinence.

Adult↗

Transforming activity of DNA extracted from human urological tumours.

The transforming activity of DNA extracted from one testicular cancer, one benign prostatic hyperplasia, two malignant prostatic adenocarcinomas, six renal cell carcinomas, two tumours of the renal pelvis, a specimen of normal urothelial tissue, two benign papillomas of the bladder and five malignant bladder carcinomas, was investigated using a DNA transfection assay on primary cultures of hamster kidney cells (HK cells) and mouse embryo fibroblasts (MEF cells). Transformation was scored under light microscope by the appearance of foci of morphologically transformed cells and by evaluating the ability of the transfected cells to from colonies in soft agar. Primary HK cells were unable to support transformation by human tumour DNA because of their very limited lifespan in vitro; MEF cultures, on the contrary, had a much more prolonged life: but were only abortively transformed by DNA from four out of six renal cell carcinomas and four out of seven malignant urothelial tumours, suggesting that transforming genes are present but not activated in the DNA from these urological malignancies.

Animals↗