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Biomedical subjects

M Barbagelatta

Publications and source records attributed to M Barbagelatta.

At least 19 recordsLinked to original sources
PubMed1998

Urethral recurrence of transitional cell carcinoma of the bladder. Predictive value of preoperative latero-montanal biopsies and urethral frozen sections during prostatocystectomy.

OBJECTIVE: The management of the male urethra after cystectomy for bladder cancer continues to be a dilemma. Patients who undergo a cystectomy require either urinary diversion or bladder substitution. Therefore, the use of the urethra to ensure voiding is important. On the other hand, the probable risk of urethral carcinoma recurrence is generally estimated at approximately 10%. The aim of this study was to assess the predictive value of preoperative urethral biopsies, and of frozen sections during cystoprostatectomy, in patients with invasive bladder cancer. METHODS: From 1982 to 1986, 118 male patients underwent a cystoprostatectomy for transitional cell carcinoma of the bladder. All patients underwent endoscopic latero-montanal biopsies 2 weeks preoperatively and urethral frozen cut section during radical prostatocystectomy. RESULTS: Carcinoma was observed in 12 patients on both examinations. All patients underwent en bloc urethrectomy during cystectomy. In the remaining 106 patients, the frozen cut margin was negative (including 9 with positive latero-montanal biopsies), and these patients had the urethra preserved. After a 10-year minimum follow-up, no recurrence was observed in these patients with negative frozen cut-section. No significant risk factors for urethral recurrence were found. Latero-montanal biopsies did not reveal a positive specificity, and this procedure was later abandoned in our institution (in 1986). CONCLUSIONS: The urethral frozen section was the only guideline used for simultaneously performing the urethrectomy. All male patients with negative frozen cut sections should be considered candidates for bladder substitution. A prophylactic urethrectomy is only indicated in patients with carcinoma (minimum carcinoma in situ) in the frozen urethral margin section during cystectomy.

Adult↗
PubMed1998

Correlation between p53 over expression and response to bacillus Calmette-Guerin therapy in a high risk select population of patients with T1G3 bladder cancer.

PURPOSE: The aim of this study was to determine if p53 status, assessed before intravesical bacillus Calmette-Guerin (BCG) therapy, can predict clinical outcome in a high risk population of patients with stage T1, grade G3 bladder cancer and if it can be used to select patients responsive to therapy. MATERIAL AND METHODS: After complete transurethral resection 35 patients with T1G3 bladder carcinoma received 6 weekly instillations of BCG and nonresponsive patients received a second course. After treatment cystoscopy and randomized biopsies of the bladder mucosa were performed. Pathologists had sufficient material to perform immunomarking in 25 cases using the peroxidase-antiperoxidase technique with antiprotein monoclonal antibody p53. The results were expressed in percentage of marked nuclei. We established 5% increment thresholds from 0 to 60%. Contingent tables were established, and chi-square and Fisher's exact test were performed for each 5% threshold. RESULTS: Median followup was 51.3 months (range 25 to 144). Of the 25 patients 8 (32%) did not respond to BCG therapy and 17 (68%) did. Immunomarkings were not statistically different between BCG responsive and nonresponsive patients for 0, 5, 10, 20, 35, 40, 45, 55 and 65 thresholds. Chi-square and Fisher's exact test were 0.91 and 0.83, 0.40 and 0.20, 0.58 and 0.29, 0.96 and 0.81, 0.80 and 0.88, 0.67 and 0.73, 0.91 and 0.83, 0.80 and 0.38, 0.69 and 0.32, respectively. CONCLUSIONS: Our results indicate that the percentage of p53 immunomarked cell cannot currently be used to predict clinical response to BCG therapy and, therefore, p53 over expression is not a viable indicator of T1G3 recurrence when using this treatment.

Aged↗
PubMed1997

Renal cell carcinoma of clear type: correlation of CT features with tumor size, architectural patterns, and pathologic staging.

The purpose of this study was to report the CT findings of renal cell carcinoma of clear type (RCCCT) and to determine if there are characteristic morphologic features in RCCCT with respect to tumor size, architectural patterns, and pathologic stage. The CT scans of 35 patients with RCCCT were reviewed retrospectively. The CT findings (tumor size, attenuation patterns, presence of calcifications, encapsulation, margins of neoplasms, venous involvement by neoplasms) were correlated with tumor size, architectural patterns, and pathologic staging. Of the 35 neoplasms, 28 (80 %) were solid, 4 (11 %) were papillary, and 3 (9 %) were cystic. Complete encapsulation was more frequent in lower pathologic stages (40 % in stages 1 and 2 vs 0 % in stages 3 and 4; p < 0.05). Venous involvement was less frequent with completely encapsulated neoplasms (0 of 10, 0 %) than with incompletely or nonencapsulated neoplasms (8 of 25, 32 %; p < 0.05). Encapsulated RCCCT are more likely to have lower pathologic stage. Nonencapsulated neoplasms are more likely to have a higher pathologic stage.

Adenocarcinoma, Clear Cell↗
PubMed1997

[Anatomic-pathologic diagnosis of ischemic colitis].

Ischemic colitis is caused by anoxia of the colonic and rectal wall due to defective regional blood supply. The pathology examination distinguishes acute obstructive and non-obstructive gangrenous ischemic colitis from chronic segmentary stenosing ischemia on the basis of the gross aspect and microscopic criteria and is necessary for differential diagnosis. Endoscopy, which is contraindicated in acute gangrenous ischemic colitis, provides a biopsy. Acute transitory ischemia can be distinguished from chronic stenosing colitis.

Arterial Occlusive Diseases↗
PubMed1995

[T1 G3 bladder tumors: the respective role of BCG and cystectomy].

Forty eight patients with T1 G3 bladder cancer were treated between 1975 and 1991. An associated carcinoma in situ in one third of cases. Twenty six patients received intravesical BCG instillations (an average of 2.5 courses of 6 instillations) with no local recurrence or metastases in 50% of cases (mean follow-up: 54 months). Thirteen patients developed recurrence after a mean disease-free interval of 8 months (range: 3 to 18 months: 7 with disease progression, 5 at an identical stage and 1 Ta. Six cystectomies were performed in this group over the following two years: 3 patients were cured with a mean follow-up of 33 months, 2 died from their cancer, 1 patient is alive with an urethral redux. In view of age and/or clinical context, 7 patients were treated by repeated resections and other local treatments: 3 relapsed without progression, 2 died from their cancer and 2 have been lost to follow-up. Twenty one cystectomies were performed as first-line treatment: 20 patients are recurrence-free with a mean follow-up of 47 months and one patient died from cancer within 6 months. T1 G3 bladder cancer should be considered to be a lesion with a poor prognosis, requiring active treatment. First-line BCG therapy is effective in 50% of cases, but cystectomy is required in the absence of response to BCG.

Adult↗
PubMed1994

[Non-seminomatous germ cell tumors of the testis. Role of the pathologist in the assessment of prognostic factors based on the specimen of orchiectomy. Proposal of an anatomopathological examination report defined by the Study Group of the Committee of Cancerology of the French Association of Urology].

Non-seminomatous germ cell tumors of the testis. Role of the pathologist in the definition of the prognostic factors based on examination of the orchidectomy specimen. Proposal of a pathological examination report form defined by the study Group of the Oncology Committee of the French Urological Association.

Carcinoma, Embryonal↗
PubMed1984

Renal immunopathology in renal cell carcinoma.

Signs of glomerulopathy, especially a nephrotic syndrome can occur in cancer patients, but the exact frequency of glomerular lesions is not well known in these patients. To define this frequency in a given type of malignancy we have studied the nephrectomy kidneys in 40 patients with renal cell carcinoma. Proteinuria, which was present in 7 cases, ranged from 0.15 to 1.5 g per 24 h. Reduction of the creatinine clearance greater than 50% was observed in 5 patients. Circulating immune complexes were detected in 11 of the 15 patients studied. Carcinoembryonic antigens were noted in 2 of 9 patients investigated. Research of alpha 1 foetoprotein carried out in 12 patients was always negative. HBs antigen or Hbs antibodies were detected in 6 of 29 patients studied. Light microscopic examination of the normal uninvolved kidney tissue showed obvious glomerular lesions (mesangial hypertrophy with or without deposits, with or without cell proliferation) in 7 patients (17.5%). Amyloid deposits were never observed. Immunofluorescence study revealed mesangial deposits in 35% of patients versus 5.4% of control subjects (P less than 0.0001). These deposits included C3 and/or IgM in 13 cases, IgA and C3 in one case. No fixation was observed, neither on tubules of normal tissue nor on carcinoma lesions. This report demonstrates that glomerular deposits are usually found in approximately one third of patients with renal cell carcinoma and that these deposits are located in the mesangial areas and not in the subepithelial space as it is often observed when glomerulonephritis is expressed by clinical symptoms.

Adenocarcinoma↗
PubMed1984

[Five years' use of CO2 laser in the treatment of cervical lesions: 475 treated cases (mainly dysplasias and carcinomas in situ)].

The authors have used the CO2 laser for the treatment of cervical lesions since 1979. 475 cases were treated, of whom three-quarters were suffering from dysplasia or carcinoma in situ. The cases were discovered by smears from the cervix and vagina and by colposcopy and were confirmed by biopsy. The ways in which the treatment could be conducted depended on the site and not on the severity of the lesion so long as cases of micro-invasion were excluded. When the lesion was sited on the ectocervix the treatment consisted, after taking a small biopsy for histological checking, in the destruction of the lesion using a laser attached to a microscope. When the lesion was endocervical conisation had to be carried out using a laser attached to an apparatus held in the hand. Colposcopic examination carried out 15 to 20 days after treatment made it possible to discover whether the treatment had been complete or not. Recurrences are characterised by the return of colposcopic and cytological abnormalities. Sometimes these are only cytological and may occur 6 to 18 months after treatment. After 5 years the level of recurrences is remarkably low and is less than 4 per cent. Secondary complications such as haemorrhage are very rare, and the morphology of the cervix is hardly changed except in a few cases. The operator must know very well indeed how to use the colposcope to undertake such treatments successfully,

Adult↗
PubMed1983

[Pseudocoarctation caused by a calcified intra-aortic mass].

Weak or absent lower limb pulses and a thoracic systolic murmur in a fifty-seven-year-old woman with hypertension suggested coarctation. Thoracic X-Ray showed a narrowing of the thoracic aorta over 10 cm due to an intraluminal calcified aortic mass. The remaining aorta and its branches were normal. Histologic examination of the operative specimen found atherosclerotic lesions with thrombosis. This very unusual condition seems to represent an individual entity of which a few cases have been reported in the literature.

Aorta, Thoracic↗
PubMed1983

[Adenocarcinoma of the appendix. Apropos of 11 new cases].

The authors review 11 new cases of adenocarcinoma of the appendix and 220 other cases drawn from the literature. In the first series, 6 patients presented with abscess or perforations. The tumor was proximal in 5, distal in 2, medial in 2, and total in 2. It extended to the cecum in 4 cases and to the lymph nodes in two. The clinical picture was one of appendicitis in seven patients, an iliac growth in three and occlusion in one. The diagnosis was made by the surgeon in four cases, and by postoperative histological examination in seven. The authors stress the need to open the appendix at operation, to take frozen sections in the event of any doubts, and systematic postoperative histological examination of operative specimens. Appendectomy is a poor solution, even accompanied by partial cecectomy, the survival rate at five years being only 20 %. It is only licit for a unperforated, proximal mucosal or submucosal tumor. The best solution is immediate or secondary right hemicolectomy, for which the survival rate, of 45 % at five years, is close to that of other forms of colic cancers.

Adenocarcinoma↗
PubMed1983

[Fatal herpetic hepatitis in an apparently healthy adult].

The authors report the case of a 46-year old patient who died from fulminant herpetic hepatitis. No cause of immuno-depression was documented in this patient. No skin or mucosal herpetic lesion was found except a questionable urethritis. Herpes virus was demonstrated in the hepatocytes by electron microscopy and isolated from the serum. It was identified as herpes virus hominis type II. The low titer of circulating antibodies did not permit the distinction between herpetic primo-infection and reactivation. The features of the hepatic injury are discussed and compared with previous reports. An active diagnostic approach of herpetic hepatitis is considered.

Acute Disease↗
PubMed1982

[Calcifying obstructive disease of the descending thoracic aorta].

The authors present the first surgically treated case of calcifying obstructive disease of the descending thoracic aorta. The diagnosis was based upon the coexistence of an aortic isthmus coarctation syndrome together with massive calcifications seen by chest X-ray. The aetiology remains uncertain but the authors tend in favour of an atheromatous aetiology. Cure was obtained by simple surgical treatment.

Aorta, Thoracic↗
PubMed1982

[Aortic dissection and Horton arteritis].

Aortic dissection in a 61-year-old woman treated symptomatically and with a fatal outcome within three months by extension to the arch of the aorta and its major vessels, and as a direct result of haemopericardium. The association with temporal arteritis, presenting before the aortic complication by prolonged headache with raised sedimentation rate and painful inflammation of both temporal arteries, was confirmed by histopathological examination of the aorta. This revealed giant cell arteritis independent of atheromatous lesions. The association of aortic dissection and temporal arteritis is very rare. Clinical and pathological examination of the smaller arteries and in particular the craniocephalic arteries is therefore justified in all cases of aortic dissection. When it affects the aorta, temporal arteritis may favor aortic dissection as a result of changes in the media.

Aortic Dissection↗
PubMed1980

[Granulomatous nephropathy of tuberculous origin revealed by prolonged fever (author's transl)].

In a 66-year-old female patient with a past history of tuberculosis, prolonged fever at 38 degrees C accompanied by a strong increase in ESR ultimately led to the diagnosis of renal cyst. Biopsies of renal tissue and of lymph nodes taken during surgery showed renal granulomatosis without caseum. Despite negative bacterial findings and anergy to tuberculin, an anti-tuberculous treatment was administered and the patient recovered.

Aged↗