Biomedical subjects
M Rusca
Publications and source records attributed to M Rusca.
[Minimal carcinoma of the breast].
For many years pathologists have argued about the definition and the biologic reasons of what is "early", "minimal" and "occult" breast cancer. Whether these terms really identify entities which today can be meaningful to clinicians and whether the prognostic significance of breast cancer measuring 1 cm or less in diameter should have implications in the treatment decision making will form the subject of this review.
Tissue polypeptide antigen and carcinoembryonic antigen in colon tumors: serum levels and immunohistochemical localization.
Patients with malignant and benign colon disease (59 colon cancer and 96 polyps) were studied by means of tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) tests. The evaluation of the circulating levels of the markers showed that the overall sensitivity for the TPA test was 57.6% and for the CEA test was 55.9%. Their specificities were 89.5% and 94.7%, respectively. The analysis of results indicated no considerable difference between CEA and TPA in detecting individuals with malignant diseases. There was only a slight difference in Dukes stages: in stages A and B, TPA sensitivity was higher than CEA sensitivity. On the contrary, in the group of patients with polyps, more false-positive results were obtained with the TPA test than with the CEA test. Immunohistochemical studies on the small group of patients (12 colon cancers) allowed us to evaluate the relationship between the staining positivity for the anti-TPA and anti-CEA antibodies and the circulating levels of the markers. The staining in some cases was not correlated either with the stage of cancer or the circulating TPA or CEA levels. This fact further shows the need to investigate the mechanism that determines the blood levels of many tumor markers. All the specimens examined were positive for TPA and CEA staining, but they were composed of varying proportion of positive and negative tumor cells. The degree of positivity was frequently variable not only between the specimens but also within the same specimen.
Quantitative characterization of the growth of the fetal kidney.
The time-dependent changes in the antero-posterior (A-P) diamter and length (L) of fetal kidneys has been evaluated by means of statistical analysis of measurements made during the third trimester in a normal population. Two hundred eighty pregnant women were examined between 22 and 40 weeks of gestation. Differences between operator-scanner combinations were evaluated. The relationships of the A-P diameter and length to menstrual age were determined in cross-sectional and longitudinal studies of kidney growth. The results obtained confirmed that measurements of fetal kidney can be used as an additional parameter in the routine assessment of fetal well being and to rule out kidney malformations characterized by changes in kidney size.
[Cholecystectomy in cirrhotic patients].
The Authors describe 19 patients affected by hepatic cirrhosis, treated because of cholecystic lithiasis during the period 1978-82 on a total number of 473 cholecystectomies performed. The hepatic damage was defined by hepatic function tests and biopsy. A 25% postoperative complications was observed in cirrhotic patients and only an 8% in the other 454 cholecystectomies. Mortality for the first group was 21% and 0,45% in the second group of patients. The data observed in the cirrhotic group seem related to frequent necessity of blood or plasma transfusion and jaundice in damaged livers. The high mortality and morbidity in cirrhotic patients suggest a surgical indication only for already complicated biliary lithiasis.
Histological and immunohistochemical study of the bronchial stump with flap coverage in an animal model.
OBJECTIVE: The purpose of our study was to evaluate the healing process of the bronchial stump after pneumonectomy reinforced with different pedicled flaps in an animal model. The specimens were analyzed by means of histology and immunohistochemistry. MATERIALS AND METHODS: We have considered 45 New Zealand White male rabbits that underwent a left pneumonectomy under general anesthesia. Nine animals had no bronchial coverage and represented the controls. The other 36 rabbits were divided into three groups of 12 and had bronchial coverage with either diaphragmatic, intercostal or pericardial flaps. The histological examinations were performed on the animals sacrificed 7, 14 and 30 days after surgery. Immunohistochemical analyses were done on the specimens on postoperative day 7 and 14. On postoperative day 7, the specimens were examined for expression of proliferating cell nuclear antibody (PCNA) expression. On postoperative day 14, neoangiogenesis was measured by CD31 expression. The measurements of antibody expression were done with a computer-assisted morphometric count and analyzed with the t test. RESULTS: On postoperative day 14, standard histology showed more evident neoangiogenesis in the bronchial stump specimens covered with intercostal and diaphragmatic flaps compared to pericardial flaps and controls. The immunohistochemical evaluation of PCNA by morphometric computer-assisted analysis did not show any statistically significant differences among the groups. The CD31 morphometric count revealed a higher and statistically significant antibody expression in muscular flaps compared to pericardial flaps and controls. CONCLUSIONS: Our study showed that bronchial coverage with a pedicled muscular flaps promotes the production of new vessels and gives the possibilities to optimize the healing process of a bronchial stump after pneumonectomy.
The effect of verapamil and diltiazem on alveolar type II cells during warm and cold metabolic ischaemia.
The alteration of cytosolic free calcium concentration is an important event during cellular ischaemia. Calcium channel blockers have been shown to be beneficial during experimental ischaemic organ protection. To investigate the mechanisms of this protection, the behaviour of type II pneumocyte cultures, subjected to warm and cold metabolic ischaemia (6 h), was studied. The cells were incubated in electrolytic solutions and treated with high doses of verapamil (10 mg/l) or diltiazem (100 mg/l). Alveolar type II epithelial cells were removed from adult rat lungs using the modified Dobbs' method. Cell viability was determined by analysis of the total protein content, and from the rate of protein synthesis as indicated by the [35S]methionine uptake assay. The results show that verapamil does not have a direct cytoprotective or cytotoxic effect on the incubated cells, but diltiazem seems to be toxic to the cells, especially during cold ischaemia when the toxicity is significant (P < 0.05). Thus, the protection from ischaemia previously attributed to calcium channel blockers is ascribed to action on the blood vessels resulting in vasodilatation, rather than to a direct influence on cytosolic free calcium homeostasis.
Pulmonary endothelial cell modifications after storage in solid-organ preservation solutions.
During lung preservation, the vascular endothelium is probably the first site of damage and these lesions are considered the main limiting factor in solid-organ preservation. In the present study, the ultrastructural changes in the endothelial cells of human pulmonary artery hypothermically stored (at 4 degrees C) for 6 and 12 h in Euro-Collins, University of Wisconsin and Ringer-lactate solutions were compared. The arteries obtained from three patients who underwent pneumonectomy were divided into 20 segments and preserved in the three solutions mentioned. The specimens, which were fixed in osmic acid, were examined using transmission electron microscopy. Transmission electron microscopy indicated that the cells stored in the University of Wisconsin solution either for 6 or 12 h were the best preserved, while the most severely damaged cells were those stored in Euro-Collins solution, even after just 6 h. The cells stored in Ringer-lactate showed an intermediate level of damage. The data from an ultrastructural grading scale, which quantified the damage to the cytoplasm, mitochondria and nucleus, were in broad agreement with the general transmission electron microscopy observations. Analysis of variance of the grading scale data showed that there were statistically significant differences between the groups after both 6 and 12 h storage (P < 0.05).
Preliminary study on thymidine labelling index in human non-small cell lung cancer.
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[Comparison between a diet with mainly vegetal protein content and a diet with mainly animal protein content in hepatic cirrhosis].
Eight cirrhotic patients were studied in a randomized crossover single blind study in order to compare the effects of two isocaloric, and with equal amount of protein diets on nitrogen balance and on the portal systemic index. One diet was 2:3 vegetable protein to total protein content (diet V) and the other 2:3 animal protein to total protein content (diet A). Each diet was changed every three weeks. Five patients followed the VAV scheme and three the AVA scheme. The mean values of the porto systemic index were almost the same with the two diets while the value of the nitrogen balance was less negative with the diet A than with the diet V, showing an increasing trend, more marked with the diet A, at every consecutive time of observation. The variance analysis was not significant for any of the two diets. Diet V was well tolerated.
[The spastic pelvic floor syndrome: its diagnosis and treatment].
The spastic pelvic floor syndrome, caused by a paradox contraction of the sphincteric apparatus at defaecation instead of relaxing, leads to constipation with difficult evacuation. Forty patients (15 males and 25 females, average age 49 years, age range 15-78) affected by serious chronic idiopathic constipation, underwent, at our Institute, from June 1989 to September 1990, the following instrumental examinations: anal manometry; electromyography of the pelvic floor; proctogram; intestinal transit time; anorectal endoscopy; in addition, in 6 cases at risk for colorectal cancer, left colonoscopy. Fifteen patients showed dyskinetic functioning of the voluntary sphincteric apparatus. The following diagnostic methods proved to be of fundamental importance: proctogram, which revealed failure to open of the anorectal angle at defaecation (mean values: at rest 88.93 degrees +/- 6.62; at defaecation 88.93 degrees +/- 9.44); electromyography of the pelvic floor, which showed the anomalous contraction of the external anal sphincter. These patients were treated by means of an air inflated endoampullary balloon to evoke the sensation of a stool and its subsequent expulsion. The correct evacuating function was resumed definitely in 9 patients (60%); for the remaining 6 patients, regular sessions of re-education are still necessary. The spastic pelvic floor syndrome is a major cause of constipation and requires an accurate diagnostic method of investigating the correct functioning of the recto-pelvic region by means of the above-mentioned methods.(ABSTRACT TRUNCATED AT 250 WORDS)
[Computerized management as an adjunct to rhinomanometry].
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[Rhinomanometric evaluation and orthognathodontic diagnostic-therapeutic significance. 1].
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