Evaluation of different diagnostic methods to detect Echinococcus multilocularis in the final host.
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Biomedical subjects
Publications and source records attributed to P Calderini.
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This study reports interim data on post-operative morbidity, hospital mortality and duration of hospital stay of Italian patients undergoing extended lymph-node dissection combined with a pancreas-preserving technique for gastric cancer. Of the 218 patients admitted to one of eight general and/or university hospitals in North Italy, 118 were enrolled in the trial. Eligible patients presented with proven primary adenocarcinoma of the stomach without clinical evidence of distant, peritoneal and/or liver metastasis, or metastasis in para-aortic and retropancreatic nodes at intraoperative biopsy. Patients underwent the extended procedure as described by the Japanese Research Society for the Study of Gastric Cancer, following the Maruyama pancreas-preserving technique. A strict quality control system was used to ensure the performance of a standard surgical treatment. A surgeon of the reference centre (M.D.), who stayed at the National Cancer Center Hospital in Tokyo to learn the D2 technique from a specialist Japanese surgeon, became the trial supervisor and assisted each surgeon in all the Italian participating centres. The patients were staged according both to the TNM system and to the General Rules for the Gastric Cancer Study in Surgery and Pathology. Post-operative surgical complications developed in 21 patients (17.8%). The non-surgical complication rate was 2.5%. Reoperation was necessary in six patients (5%), all of whom survived. The 30-day mortality rate for the eligible group was 2.5%. The overall hospital mortality was the same. Total gastrectomy was associated with a slightly higher operative mortality (4.5% vs 1.3%). Only one patient died from an anastomotic leak. The rate of leakages was higher after total than after distal gastrectomy (15.9 vs 5.4%); the association of splenectomy and pancreatectomy worsened the morbidity rate. D2 lymphadenectomy with pancreas-preserving technique, when performed at experienced centres, seems a feasible and safe technique for the radical treatment of gastric cancer in selected Western patients.
Microbiological, cytological, histopathological, and immunohistochemical investigations were carried out on four dairy cows affected by Serratia marcescens mastitis. The animals under study were from a herd of 120 lactating cows bred in the province of Rome. In the above herd, S. marcescens mastitis showed a prevalence of 20.8%. S. marcescens was the only bacterial agent isolated, prior to and after slaughter, from the teat milk, the mammary gland and the supramammary lymph nodes of the four cows under study. Cytologically, the four subjects exhibited high cell counts in their milk, with an average of up to 5,570,000 cells/ml in S.marcescens-infected quarters. Macroscopically, nodular lesions were apparent scattered throughout the mammary parenchyma, with enlargement of the regional lymph nodes. Histologically, a chronic, non-purulent mastitis, characterized by a marked fibrous tissue proliferation and the coexistence of corpora amylacea within the glandular alveoli, was observed in association with chronic hyperplastic lymphadenitis involving the supramammary lymph nodes of the four cows. Immunohistochemically, S. marcescens was demonstrated, by means of monoclonal antibodies, both in the mammary gland and in the supramammary lymph nodes from these four animals.
We report a clinical case of a double primitive tumour (right kidney clear cell carcinoma and gastric carcinoma) in two brothers. There is no history of cancer in the parents. Both patients were previously affected by gastric ulcer. No report of association between the two neoplasms was found in literature. The age of the patients (61 and 70 years) and the singleness of the kidney tumour seem to exclude the case of a familial kidney cancer. The neoplastic transformation of the gastric ulcer is instead a quite frequent report with an incidence of about 1%. Alterations of oncogenes or tumour suppressor genes shared from both neoplasm are at present still unknown. Nevertheless molecular analysis of patients' neoplastic genome could point out typical chromosome translocations/deletions or gene mutations.
The prognostic value of breast cancer proliferative activity was evaluated in 385 women operated for primary, non-metastasised mammary carcinoma. Cell kinetics was measured using two immunohistochemical techniques. Cells in S-phase of cell cycle were labelled in vitro by incubation of fresh tissue fragments with 5-bromo 2-deoxyuridine (BrdU), a thymidine analogue. Nuclei of cells in active DNA synthesis were stained by an anti-BrdU monoclonal antibody (Mab). Cells in interphase and mitosis were detected with Ki-67, a Mab that is known to react with a nuclear antigen present in G1/S/G2/M phases of cell cycle, but not in resting cells. This reagent provides a means of evaluating the growth fraction of neoplastic cells. BrdU was incorporated in a proportion of tumour cells ranging from 0.1 to 65.5% (median 6.8%). In the panel of tumours presented in this report the median percentage of Ki-67 positive cells (Ki-67 score) was 9.0% (range 0.1-77%). The relationship between disease-free survival (DFS), BrdU labelling index, Ki-67 score and 13 different clinico-pathological variables was investigated by multivariate analysis, using the Cox proportional hazards model. Axillary node status (P = 0.009) and Ki-67 score (P = 0.038) emerged as independent prognostic factors. Nodal status and tumour growth fraction allowed division of patients into groups at different risk of relapse: tumours with a proliferative index below the median value showed a lower recurrence rate than tumours with a high proliferative activity (P < 0.001). In particular, no relapse occurred in pN0 patients bearing carcinomas with a Ki-67 labelling < 9.0% 4 years after surgery. These findings suggest that the evaluation of proliferative activity in breast cancer enhances the probability of correctly predicting outcome after surgery and could be of assistance in the planning of adjuvant therapies.
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The prognostic value of estrogen receptor (ER) status in primary breast cancer was evaluated in 208 women subjected to Halsted radical mastectomy. The correlation between ER status, node involvement and disease-free interval after surgery was analyzed in detail. Forty-seven out of 127 ER-positive patients received hormonal adjuvant therapy, whereas the 81 ER-negative patients did not. Similar recurrence rates were found in ER-negative and untreated ER-positive patients, suggesting that the natural course of disease was not related to ER status. ER-positive patients who received hormonal adjuvant therapy showed a significantly longer disease-free interval than both ER-negative and untreated ER-positive patients, even though a higher frequency of node involvement was found in ER-positive tumors. Since only hormone-treated ER-positive patients showed a significantly lower recurrence rate, it is felt that ER status cannot be used as an independent prognostic factor.
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