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M Melato

Publications and source records attributed to M Melato.

At least 37 records · Page 2Linked to original sources

Is flow cytometric evaluation of DNA degradation a reliable method to investigate the early postmortem period?

The time of death can be established by determining the length of the postmortem interval. Many methods have been proposed to achieve this goal. Flow cytometric evaluation of DNA degradation seems to be reliable for the first 72 hours after death. Our study evaluated the correspondence of the corruption process between in vitro and corpse tissues. We chose spleen tissue to perform our investigation because it is rich in nucleated cells. Results showed a precise correspondence between the two kinds of samples in the time period between 24 and 36 hours. The period from 36 to 72 hours is characterized by a much looser correspondence than that found in the first period. After the first 72 hours, DNA denaturation is massive and does not allow useful cytofluorimetric readings. The spleen does not seem to be the most suitable organ for this type of investigation because it tends to colliquate very rapidly. We therefore are evaluating other organs to identify a more suitable tissue source for the investigation of longer postmortem period using flow cytometry.

Aged↗

Primary intestinal cryptococcosis mimicking adenomatous polyp in an HIV-negative patient.

Primary cryptococcal infection is thought to arise in the lungs, whereas secondary lesions may be found anywhere in the body. Because intestinal involvement is rare, especially in nonimmunocompromised patients, little is known about this localization. Nevertheless, the intestinal tract has long been suggested a possible portal of entry of Cryptococcus neoformans, although the hypothesis has never been sufficiently documented. We report an isolated cryptococcosis of the sigmoid colon mimicking an adenomatous polyp. The lesion has an endoscopic interest, being the first of its kind reported in the literature, and a more important pathogenic interest, as it highlights a further pathway of cryptococcal infection, one of major importance in immunocompromised patients.

Adenomatous Polyps↗

[Villoglandular adenocarcinoma of the cervix uteri. A case report and analysis of the literature].

The authors described a case of villoglandular adenocarcinoma of the uterine cervix treated with radical hysterectomy (Piver type 2) and pelvic lymphadenectomy. The cytohistologic and clinical aspects of this rare neoplasia are debated also considering the literature data where, until 1996, 41 cases of villoglandular adenocarcinoma of the uterine cervix were reported (10 cases at Stage 0 and 31 cases at Stage IB), all with favorable prognosis.

Adenocarcinoma↗

[Origin and development of pathological anatomy in Trieste: a paradigmatic history].

The history of the Italian city of Trieste is somewhat unique. In 1382, being unable to compete with nearby Venice, it gave itself up to the Archduchy of Austria, which, while ensuring Trieste a certain degree of autonomy, did nothing to improve the town's economy. Things changed, however, after 1719, when Trieste was declared a Free Port. The city, at the time poor and lacking the human and economic resources that might have given life to the long-awaited trading activities, started to attract flocks of immigrant labourers and professionals, including many physicians. Thus, from mid-18th C onwards, Trieste witnessed the rise of a local class of physicians. Graduates from the major European universities of the times, these physicians were highly active in the rapid professional and cultural growth of the city. Being free from traditions or affiliations to specific medical schools, this unusually multicultural class of professionals provides a sample of the times' medical class which is particularly suitable for understanding what schools of thought dominated during that period. A number of publications, largely dealing with pathology, and many historical circumstances show that this newly formed class of physicians was influenced by the scientific method advanced by Morgagni in his De Sedibus. It is also clear that Morgagni's influence greatly benefited the city's doctors and soon turned them into fertile and original promoters of ideas, as well as highly skilled professionals. When the times became ripe to take on a specialist in pathology, both medical class and local authorities showed great interest in the field by making sure that the successful candidate, Dr. Simon Pertot, had all the resources and equipment necessary for the specialist to become a central figure in professional training and medical research in Trieste. Thus, the kind of clinical pathology where a single physician performed macroscopic examinations to identify his patient's cause of death gave way to a more specialised discipline which was able to transfer--to post-mortem examinations first and soon after to surgically removed tissues--the wealth of notions developed in the middle of the 19th C in the basic sciences of chemistry, microbiology and physiology, as had been advanced by the second founding father of the discipline, Virchow. Trieste, therefore, may be said to offer a unique example of the origins and development of pathologic anatomy in Central Europe. And the recollection of the city's experience promotes, in the modern pathologist, an awareness of belonging to a discipline which has always been the soundest leader in the advancement of medicine.

Anatomy↗

The lectin-binding sites for peanut agglutinin in invasive breast ductal carcinomas and their role as a prognostic factor.

The present study was designed to analyze the expression of lectin-binding sites for peanut agglutinin (PNA) in paraffin sections of primary invasive ductal carcinoma not otherwise specified and to consider PNA lectin histochemistry as a further aid in the prognostic evaluation of breast cancer. The expression of lectin-binding sites was studied using the avidin-biotin complex/ immunoperoxidase technique, and analyzed in relation to the different clinical, pathological, and biological parameters of the primary disease, i.e. the presence or absence of nodal metastases, pre- or post-menopausal age, size of the tumor, mitotic activity index, morphometric prognostic index, DNA content, S-phase fraction, and steroid receptor status. The results show significant differences in PNA binding patterns among malignant epithelial breast cells. There was no expression of PNA-binding sites in 14 out of 157 tumors, while 64 showed mostly apical (membrane) staining and 124 non-apical (membrane and/or cytoplasmic) staining. Apical staining was mostly observed in patients without lymph node metastasis, with positive steroid receptor status, and those who were postmenopausal diagnosis; non-apical staining was mostly observed in lymph-node-positive premenopausal patients negative for steroid receptors and with aneuploid tumor cells. Our results indicate that, in malignant breast cells, there is an alteration of cell-surface glycoconjugates, shown by heterogeneity within a histopathologically defined group, which is related to different properties of tumor cells. The apical PNA binding pattern indicates a better differentiation of tumor cells while non-apical PNA binding suggests a higher metastatic potential. Specific PNA lectin binding patterns should be considered as a further reliable prognostic factor in breast cancer.

Breast Neoplasms↗

Nuclear grade in invasive ductal breast carcinoma. Comparative study on nuclear grade and morphometric parameters, hormonal receptor status, flow cytometric analysis and lectin histochemistry.

Histologic and nuclear grading (NG) have been widely used to predict the prognosis in patients with advanced breast cancer. However, NG has been criticized as a non-standard (several grading schemes used) and subjective (significant interobserver variability) method for predicting the biologic behavior of this tumor. Our results on 106 invasive ductal breast carcinomas demonstrate that NG correlates with morphometric prognostic index (MPI) (p < 0.007) (lower value of MPI is connected with lower NG of 1-2 and better prognosis), with estrogen receptor (p < 0.0002) and progesteron receptor status (p < 0.04) (hormonal receptor positive tumors having lower NG). NG correlates with s-phase fraction (SPF), p < 0.04, values lower than 9.6% corresponding to lower NG. We consider NG to give important information about the biologic behavior of the tumors under observation, demonstrating a good correlation with more established parameters such as MPI and SPF.

Arachis↗

[Renal angiomyolipomas: atypical aspects in ultrasonography and computerized tomography].

As a rule, renal angiomyolipomas (AML) present with characteristic patterns on US and CT images. However, in a limited number of cases US and CT findings are atypical, so that no diagnosis can be made on their basis. The authors reviewed their personal series of renal tumors and now report the US and CT findings of 5 cases with atypical features on one or both examinations. Two patients had hyperechoic lesions with typical AML patterns, but no fatty densities were visible with CT. Both patients underwent surgery and histology which showed two AMLs with muscular and vascular components and very few fatty cells. Two cases were observed in patients with Bourneville disease. Even though the cases exhibited atypical features on US and CT images, the diagnosis was suspected on the basis of the well-known association of tuberous sclerosis with AML. One case presented with a complex cystic mass on US; CT showed a bleeding tumor. Even though no unquestionable diagnosis of AML could be made in this case, the hypothesis of a bleeding AML was considered in the differential diagnosis. Such atypical imaging features were related to low fatty content inside the lesion and to bleeding complications. Absent/low fatty component represented a cause of atypical lesion appearance on CT which showed a mass with soft-tissue density which could not be differentiated from a solid tumor. In these cases, AMLs remained typically hyperechoic on US images. Bleeding represented a cause of error mainly on US since the typical hyperechoic pattern was replaced by a iso-hypoechoic pattern. CT is helpful in these cases because it shows both the bleeding and possible low-density fatty areas.

Adult↗

Liver cirrhosis and liver cancer. A study of their relationship in 2563 autopsies.

A sample of 2,563 cases of liver cirrhosis diagnosed among 26,879 autopsies performed consecutively in the years 1976/85 was considered in order to study the morphologic feature of the liver cirrhosis and their relationship with primary liver cancer (PLC) outbreak. The study showed that age of patients affected by cirrhosis is a significant risk factor for PLC. In fact, in the 10 years considered, the observed mean annual increase of age at death of the cirrhotic patients was associated with an increase in PLC cases. This may be explained as a well known consequence of the conversion of micronodular type of cirrhosis to mixed and macronodular ones (for which cancer complication is more frequent) but also as a statistically significant higher risk of PLC in the older group of patients affected by micronodular cirrhosis. The older age of cirrhotic patients at death observed in the last few years in the Trieste area is probably correlated to a general European trend: our results, although relative to a restricted geographic area, seem to be of interest in order to identify better the patients at risk of PLC among those affected by cirrhosis.

Aged↗

Stroke-cirrhosis relationship: an autopsy study in a heavy drinking population.

A positive association between alcohol consumption and stroke incidence has been clearly established. The present study evaluated the frequency of stroke in a sample of 500 autopsied patients affected by liver cirrhosis mainly due to chronic alcohol abuse as confirmed by the histologic pattern mostly of mixed and micronodular types. Frequency of stroke was compared to that of 4,741 non-cirrhotic patients autopsied in the same period. Our findings demonstrate that stroke frequency, especially when due to thromboembolism, decreased significantly in cirrhotics. Therefore, hepatopathy is a crucial event in alcoholic patients. Nevertheless the concomitant presence of liver cirrhosis, in studies dealing with this subject, is not being currently evaluated.

Age Factors↗

[Malignant hemangioendothelioma of the liver and the living conditions-related and occupational factors].

Malignant hemangioendothelioma of the liver (MHL) is of great interest for epidemiologists in view of its scanty and well-defined etiological factors. The paper presents epidemiological data on MHL in the Trieste area obtained at 46050 autopsies performed in 1969-1988. The results confirm the inference on extremely rare occurrence of MHL sporadic forms, each new case being indicative of emergence of new environmental or occupational oncogenic factors in relevant area.

Adult↗

Occurrence of liver cirrhosis among autopsies in Trieste.

The reports of 26,879 autopsies performed at the Institute of Pathological Anatomy at the University of Trieste during 1876-85 (70% of all deaths that occurred in the Province) were examined, and 2563 cases of liver cirrhosis were found. Analysis of the sample allowed us to make the following conclusions: (i) The prevalence of cirrhosis at autopsy is high in Trieste and shows no tendency to decrease, as has been inferred by some clinical studies. (ii) The increasing average age at death over the decade studied appears to be unrelated to the new, early treatments adopted for hepatopathic patients, since a similar yearly increase in mean age at death was seen for the whole population of the Province. The combination of a high incidence of cirrhosis and increasing average age of patients will probably result in an increasing occurrence of hepatocellular carcinoma. (iii) The observed male:female ratio (2.3) is analogous to that of alcohol drinkers in the Province and thus suggests a role of alcohol abuse in the development of cirrhosis. The distribution of markers of hepatitis B virus in the population of Trieste, which is very similar in the two sexes, supports this hypothesis.

Age Factors↗

Intraglomerular metastases. A possibly maldiagnosed entity.

Intraglomerular metastases are rare. We observed a case of lung cancer which gave rise to liver metastases and to exclusively intraglomerular kidney metastases, mimicking angio-endotheliomatosis. Differential diagnosis and histological features of the lesion are discussed.

Adenocarcinoma↗

Malignant angioendotheliomatosis (Angiotropic lymphoma) of the gallbladder.

We present a case of malignant angioendotheliomatosis of the gallbladder, the first reported. Diagnostic problems connected with this rare malignancy are underlined. Immunohistochemical studies were useful in providing further evidence of the lymphoid nature of the neoplasm and avoiding possible misdiagnosis. We suggest that the term "angiotropic lymphoma" might be more appropriate to define this malignancy.

Aged↗