Atrioventricular block and pacemaker implantation in a 102-year-old patient.
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Journal Article↗
Biomedical subjects
P Romeo
Publications and source records attributed to P Romeo.
Image cytometry in nonproliferative fibrocystic breast changes. Ploidy evaluation and epidemiologic study.
OBJECTIVE: To determine the usefulness of image cytometry on fine needle aspirates from patients with fibrocystic changes (FCCs) to assess the subsequent risk of breast cancer. STUDY DESIGN: Thirty-five hundred archival cases with fine needle aspiration (FNA) biopsy were assessed to select nonproliferative FCCs of the breast (500 cases), also classified as type 1 (FCC I). DNA evaluation was analyzed by means of image cytometry on ductal epithelial cells and on apocrine metaplastic cells; 97 quantifications were performed. Cytometric variables investigated were: DNA ploidy, G0/G1 peak of diploid nuclei, S-phase fraction, 5cER, 2cDI and coefficient of variation. Two groups each with 15 years of follow-up were formed: Simple pathology (SP), fibrocystic changes alone; associated pathology (AP), FCCs plus breast cancer. Each was studied separately and compared. RESULTS: In SP cases the average ploidy was 2.2 for epithelial cells and 4.2 for apocrine cells. The proportion of G0G1 diploid nuclei was 100%. In the study of AP, the average ploidy was 2.2 for epithelial ductal cells and 4.1 for apocrine ones, for a slight increase in SPF. Ductal cells were diploid, while apocrine cells were tetraploid, with statistical significance of P < .05. For the epidemiologic study we calculated the proportion of patients with FCC I who developed cancer by referring to a historical cohort study, obtaining a relative risk of 0.7. CONCLUSION: Our results prove that DNA image cytometry applied on FNA cytology is a very useful, minimally invasive and reliable tool to determine higher activity and risk for development of breast cancer in FCC I and thus to establish the need for closer follow-up of these patients. In addition, apocrine metaplastic cells of the breast display a tetraploid DNA histogram, while the other karyometric variables remain in the range of normality.
Apocrine Glands↗
CYP2D6 genotype and antipsychotic-induced extrapyramidal side effects in schizophrenic patients.
OBJECTIVE: In order to evaluate whether poor metabolizers (PM) of debrisoquine are overrepresented among patients with acute dystonic reactions and chronic movement disorders associated with the administration of antipsychotic drugs, the CYP2D6 genotype was determined in schizophrenic patients. METHODS: Allele status for CYP2D6*3, CYP2D6*4, CYP2D6*5, and CYP2D6*6 as well as gene duplication was determined by allele-specific PCR, long-PCR and restriction fragment length polymorphism analysis (RFLP) in 119 schizophrenic patients (99 males and 20 females). All subjects were treated with antipsychotics metabolized, at least partially, by this isozyme. Sixty-three of the patients (52.9%) had a history of extrapyramidal side effects (EPS), while 56 (47.1%) had not experienced such problems (controls). RESULTS: Sixty-five patients (54.6%) were homozygous for a functional CYP2D6*1 allele, 44 (37.0%) were heterozygous for detrimental alleles, and 4 (3.4%), who carried two detrimental alleles, were classified as PM. In six patients (5.0%) duplication of a functional CYP2D6 gene was found, and they were consequently classified as ultrarapid metabolizers (UM). Homo- and heterozygous extensive metabolizers (EM) as well as UM were equally distributed between patients with and without EPS, whereas all the PM had a history of EPS. No significant differences in allele frequencies between the two groups were found. CONCLUSION: Although the results cannot be considered conclusive due to the small number of PM patients in our study, the PM genotype may be a predisposing factor for antipsychotic-induced EPS. Knowledge of the CYP2D6 genotype, before starting antipsychotic therapy, might be useful in identifying subjects at risk of developing EPS.
Adult↗
Lmo2 and GATA-3 associated expression in intraembryonic hemogenic sites.
It is now widely accepted that hemopoietic cells born intraembryonically are the best candidates for the seeding of definitive hemopoietic organs. To further understand the mechanisms involved in the generation of definitive hemopoietic stem cells, we analysed the expression of the hemopoietic-related transcription factors Lmo2 and GATA-3 during the early steps of mouse development (7-12 dpc), with a particular emphasis on intraembryonic hemogenic sites. We show here that both Lmo2 and GATA-3 are present in the intraembryonic regions known to give rise to hemopoietic precursors in vitro and in vivo, suggesting that they act together at key points of hemopoietic development. (1) Lmo2 and GATA-3 are expressed in the caudal mesoderm during the phase of intraembryonic precursors determination. (2) A highly transient concomitant expression is observed in the caudal intraembryonic definitive endoderm, suggesting that these factors are involved in the specification of intraembryonic hemopoietic precursors. (3) Lmo2 and GATA-3 are expressed within the hemopoietic clusters located in the aortic floor during fetal liver colonisation. Furthermore, a strong GATA-3 signal allowed us to uncover previously unreported mesodermal aggregates beneath the aorta. A combined in situ and immunocytological analysis strongly suggests that ventral mesodermal GATA-3 patches are involved in the process of intraembryonic stem cell generation.
Adaptor Proteins, Signal Transducing↗
DNA quantification as a prognostic factor in colorectal adenocarcinoma.
OBJECTIVE: To determine if DNA quantification, studied in cytologic samples obtained by fiberendoscopy, has predictive value in colorectal adenocarcinoma. STUDY DESIGN: Thirty patients with colorectal cancer diagnosed by cytology, endoscopy and microbiopsy, were selected. The study covered > 10 years. Smears were stained with progressive hematoxylin and processed by computer for DNA evaluation by image cytometry. RESULTS: Four different types of histograms that directly related to malignancy were obtained. These histograms were characterized by the value of entropy, and we established four grades of aggressiveness. Finally, we obtained two large groups: high and low grade of malignancy. We studied the survival times in both groups and used a Kaplan-Meier survival curve for the high grade group. We confirmed the results statistically and found that there was a significant relationship, with P < .05. CONCLUSION: We strongly advise the use of DNA quantification by image cytometry in daily surgery as a prognostic indicator of survival time in colorectal cancer.
Adenocarcinoma↗
[Pseudoaneurysm of the midcolic artery secondary to pancreatitis. Computerized tomography features after transcatheter embolization].
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Abdomen↗
DNA quantification as a prognostic factor in gastric adenocarcinoma.
OBJECTIVE: To determine if DNA quantification, studied in cytologic samples obtained by fiberendoscopy, has predictive value in gastric adenocarcinoma. The survival times of patients in whom the tumor was the cause of death were considered variables of interest. STUDY DESIGN: Twenty-nine patients with gastric cancer, diagnosed by cytology, endoscopy and microbiopsy, were selected. The study was done over more than 10 years. Smears were stained with progressive hematoxylin and processed by computer for DNA evaluation by image cytometry. RESULTS: Four different types of histograms that directly relate to tumoral malignancy were obtained. These histograms were characterized by the value of entropy. We established four grades of aggressiveness. Then we obtained two large groups: high and low grade of malignancy. We studied the survival times in both groups and constructed a Kaplan-Meier survival curve for the high grade of malignancy group. We confirmed the results statistically and found that there was a significant relationship, with P < .05. CONCLUSION: The use of DNA quantification by image cytometry is strongly advised in daily surgery as a prognostic indicator of survival time in gastric adenocarcinoma patients.
Adenocarcinoma↗
Awareness, treatment and control of hyperlipidaemia, hypertension and diabetes mellitus in a selected population of southern Italy.
The purpose of the present study was to assess the degree of awareness, treatment and control of hyperlipidaemia compared with hypertension and diabetes mellitus in a selected population of southern Italy. All participants to a cardiovascular disease prevention campaign examined between April 1994 and July 1995 were screened for hyperlipidaemia, hypertension and diabetes mellitus. Subjects received also ECG, echo-Doppler of carotid arteries and filled in a questionnaire concerning personal and familial cardiovascular diseases, smoking habit and drug consumption. Of the 742 participants, 327 were found to have hypertension, 73 to have diabetes mellitus, 287 to have mild hyperlipidaemia and 322 to have moderate-severe hyperlipidaemia. Among hypertensive subjects, 60.2% were aware of their condition, 53.5% were treated and 15.6% had their blood pressure controlled at the recommended level (< 140/90 mmHg). Among diabetic subjects, 76.7% were aware, 64.4% treated and 19.2% reached fasting blood glucose level of less than 7.77 mmol/l (140 mg/dl). Only 24.0% of subjects with mild hyperlipidaemia were aware of their condition. Of the subjects found to have moderate-severe hyperlipidaemia, 64.9% were aware, 32.3% were treated and 9.0% had plasma cholesterol and triglycerides concentration of less than 6.45 and 5.65 mmol/l (250 and 500 mg/dl), respectively (cutoffs chosen to separate mild from moderate-severe hyperlipidaemia). These results show that mild hyperlipidaemia is almost neglected whereas awareness of moderave-severe hyperlipidaemia is quite widespread and comparable to that of hypertension and diabetes mellitus. Prevalence of treatment and control of moderate-severe hyperlipidaemia is, however, much lower than that of hypertension and diabetes.
Adult↗
Prognostic value from DNA quantification by static cytometry in breast cancer.
OBJECTIVE: To determine if DNA quantification on fine needle aspiration (FNA) has predictive value in breast cancer. STUDY DESIGN: Forty-nine patients with breast cancer were selected for this study because of their common characteristics. The smears were studied using image cytometry. RESULTS: With the type of histogram and value of entropy, two large groups, with high and low degrees of malignancy, were obtained. Survival was utilized as a variable of interest. Kaplan-Meier survival curves for both groups were formulated, and the results were supported with statistical data. CONCLUSION: The survival differences between both groups were statistically significant (P < .001), thus demonstrating the predictive value of DNA quantification.
Biopsy, Needle↗
Cytologic differentiation grade and malignancy DNA index in prostatic adenocarcinoma.
OBJECTIVE: To compare the predictive value of cytologic differentiation grades traditionally used for adenocarcinoma of the prostate with the malignancy grades obtained by DNA quantification. STUDY DESIGN: Of a total number of 156 cases of cancer of the prostate, 54 were selected for DNA quantification by image cytometry. They were studied cytologically, separating well, moderately and poorly differentiated cases. We obtained Kaplan-Meier survival times based on the cytologic grade. Then DNA quantification was carried out, and cases were selected on the basis of their different malignancy grades. The relative survival curves were obtained. Survival times based on cytologic grade were compared with those from DNA quantification. RESULTS: There was no statistically significant difference in survival times between moderate and poorly differentiated cases, so they were included in the same group. Between well and moderately differentiated cases there were differences related to survival that were significant at P < .01. With respect to DNA quantification, a survival difference between low and high grade malignancy occurred at P < .001. CONCLUSION: DNA quantification clearly allows better prediction of survival than does cytologic grading alone.
Adenocarcinoma↗
Variability in the rate of 6-mercaptopurine methylation in the erythrocytes, liver and kidney in an Italian population.
OBJECTIVE: The polymorphism of erythrocyte thiopurine methyltransferase (TPMT) is genetically regulated as an autosomal codominant trait, and so should be congenital. RESULTS: We tested this hypothesis by measuring TPMT activity in erythrocyte preparations from adults and newborns and observed polymorphic distribution of TPMT activity in the adult and newborn erythrocytes. The activity of TPMT was higher in red cells from the newborns than adults. The frequency distribution of TPMT activity was also investigated in the liver and kidney. In the kidney, TPMT activity fell into two subgroups, whereas in the liver the distribution pattern was more complex. The activity of TPMT in erythrocytes and liver from the same subject was correlated, but the values of only half the cases fell within the 95% confidence limits, suggesting that the control of hepatic and/or erythrocyte TPMT is multifactorial.
Adolescent↗
DNA quantification as a prognostic factor in prostatic adenocarcinoma.
OBJECTIVE: To determine if DNA quantification on fine needle aspiration (FNA) has a predictive value in cancer of the prostate. STUDY DESIGN: Fifty-four patients with cancer of the prostate during the years 1979-1989 were selected; all were diagnosed by FNA. The smears were studied using image cytometry. RESULTS: With the type of histogram and value of entropy, two large groups with high and low degrees of malignancy were obtained. Survival was utilized as a variable of interest. Kaplan-Meier survival curves for both groups were formulated, and the results were supported with statistical data. CONCLUSION: The survival differences between both groups were statistically significant (P < .001), thus demonstrating the predictive value of DNA quantification.
Adenocarcinoma↗
Differential transcription, without replication, of non-structural and structural genes of human parvovirus B19 in the UT7/EPO cell as demonstrated by in situ hybridization.
Erythroid progenitor cells are the main target for B19 parvovirus infection. The UT7 cell line demonstrates a marked erythroid differentiation on induction by erythropoietin (EPO) (UT7/EPO cells) and therefore appears to be a potential target for B19 parvovirus. We aimed to evaluate the presence and localization of B19 nucleic acids in UT7/EPO cells by in situ hybridization. Three digoxigenin-labelled probes were used: two recognized specifically the non-structural region of the B19 genome and one probe was structural region-specific. In our experiment UT7/EPO cells were not permissive to B19 infection. Transcription led to nonstructural and structural gene transcripts without DNA replication or capsid protein synthesis.
Base Sequence↗
[Correlation of waist-to-hip circumference ratio and cardiovascular risk factors in a population of Southern Italy].
AIM: To evaluate the relationship between body mass index (BMI), body fat distribution and some coronary heart disease risk factors like hyperlipidemia, hypertension and cigarette smoking. STUDY DESIGN: Cross-sectional. PLACE: Tiriolo, a little town close to Catanzaro, of prevalent rural economy. PARTICIPANTS: Volunteers, both males and females, aged more than 30 years and living in Tiriolo. MEASUREMENTS: Body weight and height with subjects in ordinary street clothes and without shoes. Systolic (SBP) and diastolic blood pressure (DBP) by a zero-random sphygmomanometer. Total (TC) and HDL cholesterol (HDL-C) using fingerstick capillary sample technology by a Cholestech analyzer. Waist circumference (W), measured midway between the lower rib margin and the iliac crest, and hip circumference (H) measured at the widest point over the greater trocanthers. Smoking habit by questionnaire. RESULTS: Females had higher values of SBP, DBP, BMI and HDL-C and lower of TC/HDL-C ratio and W/H ratio. Age was similar in both sexes. Females had lower prevalence of hyperlipidemia and cigarette smoking and higher prevalence of hypertension. BMI was strongly associated to blood pressure levels whereas W/H ratio was correlated to TC/HDL-C ratio. CONCLUSION: BMI and W/H ratio give complementary information, useful to assess the cardiovascular risk profile. The simplicity and quickness of these measurements should lead to their large utilization both in epidemiological prevention studies and everyday clinical practice.
Adipose Tissue↗
Intimal plus media thickness of common carotid arterial wall in subjects with hypertension.
Intimal plus media thickening has been described to be associated with several cardiovascular risk factors. Aim of the present study was to evaluate the intimal plus media thickness in male subjects with hypertension compared to age matched males normotensive controls. Twenty subjects with hypertension, defined as systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 95 mmHg and/or use of antihypertensive drugs, and forty age matched controls have been enrolled. Intimal plus media thickness has been measured from B-mode echography images by a computer. Plasma lipids have been measured by routine methods. A zero random sphygmomanometer has been used to detect blood pressure. Intima plus media thickness resulted enlarged in subjects with hypertension compared to normotensive controls. The thickening of intima-media complex seems related to atherosclerotic lesions, therefore its early detection by noninvasive techniques might improve the identification and the monitoring of high risk hypertensive subjects.
Blood Pressure↗
Carcinomatous solitary pulmonary nodules: evaluation of the tumor-bronchi relationship with thin-section CT.
To investigate the value of computed tomography (CT) for depicting the relationship between carcinomatous solitary pulmonary nodules and the bronchial tree and predicting the results of various bronchoscopic biopsy techniques, the authors retrospectively reviewed CT scans from 27 consecutive patients with solitary pulmonary nodules associated with a positive bronchus sign. All patients underwent bronchoscopy and transbronchial biopsy. Macroscopic demonstration of the tumor-bronchi relationship was obtained in 18 patients. Five basic types of tumor-bronchus relationships were identified with CT: (a) bronchus cut off by the tumor, (b) bronchus contained within the tumor, (c) bronchus compressed by the tumor, (d) thickening and smooth narrowing of the bronchus leading to the tumor, and (e) thickening and irregular narrowing of the bronchus leading to the tumor. The diagnostic yield of transbronchial forceps biopsy and bronchial brushing was significantly higher in nodules characterized by a cut-off or contained bronchus. Transbronchial needle aspiration was performed in six patients, and results were positive in five, all of whom had a compressed or thickened bronchus. These results confirm that yield of transbronchial biopsy is determined by the type of tumor-bronchus relationship and the biopsy technique performed.
Adult↗
Chronic bronchial collapse and lower lobe atelectasis. Computed tomographic-bronchoscopic correlation.
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Aged↗
[Contribution of computerized tomography to the diagnosis of patients with non-calcified solitary pulmonary nodule, without known neoplasm].
We define a solitary pulmonary noncalcified nodule (NPS) as a single focal rounded or ovoid lesion in the lung parenchyma, less than 4 cm in diameter, without associated adenopathy, atelectasis or pneumonia. An NPS, in the absence of a known primary malignancy, can be lung cancer (NPSM), a metastasis of unknown origin (NPSMT), or a benign lesion (NPSB). The best approach to the management of NPS and the value of CT are still controversial and uncertain. The finding on cross-section CT of a bronchus leading directly to, or contained within, the nodule is called "positive CT bronchus sign" (CT-BS). Our study was aimed at investigating the usefulness of CT bronchus sign, as studied on thin-slice (2 mm thick) CT sections, in order to establish the most appropriate diagnostic sequence in patients with solitary noncalcified pulmonary nodules (NPS). We evaluated 47 NPS (9 NPSB, 34 NPSM and 4 NPSMT) with thin-slice CT to detect the presence of CT bronchus sign. Seventeen cases had CT-BS (15 NPSM; 1 NPSB; 1 NPSMT); of them, 13 were diagnosed by means of transbronchial biopsy and brushing (TBB). Only one case (NPSM) of the 30 (19 NPSM; 3 NPSMT; 8 NPSB) without CT-BS, was diagnosed by TBB. TBB was negative in the 9 NPSB. The CT-BS is not pathognomonic of malignancy; in fact, the sign was observed in NPSB (one tuberculoma) too. Our results suggest that the CT bronchus sign is valuable in predicting the success of TBB in malignant solitary pulmonary nodules. On the other hand, it seems to be useless for NPSB. Therefore, to establish the most appropriate diagnostic sequence, thin-section CT should be performed in each patient with peripheral noncalcified lung lesions to plan whether TBB or transthoracic needle aspiration should come next. If biopsy results are poor, either surgery or the "wait and watch for growth" approaches can be suggested. The choice can be guided by the presence of predisposing factors for cancer or infection.
Adult↗