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R Pisano

Publications and source records attributed to R Pisano.

At least 19 recordsLinked to original sources
PubMed2005

Gastric ciliated metaplasia. A study of 3406 gastrectomy specimens from dwellers of the Atlantic and the Pacific basins.

BACKGROUND: Ciliated cells in gastrectomies from patients dwelling in the Pacific and Atlantic basins have been reported previously. AIM: To compare all the results in an attempt to explain the findings. METHODS: Sections from 3406 gastrectomies were reviewed: 1966 and 1440 from the Atlantic and Pacific basins, respectively. Ciliated cells and intestinal metaplasia (IM) were recorded; IM was classified into focal or extensive IM. The total number of sections/gastrectomy was noted. RESULTS: In the Atlantic basin, 5% of specimens had ciliated metaplasia (CM); it was more frequent in intestinal carcinoma (IC; 9%) than diffuse carcinoma (DC; 3%) or miscellaneous gastric diseases (MGD; 3%). In the Pacific basin, the frequency of specimens with CM was 29%: it was more frequent in IC (43%) than in DC (16%) or MGD (10%). The difference between the frequency of CM in specimens with IC or with DC/MGD in the Atlantic and the Pacific basins was significant (p < or = 0.05). The presence of CM was influenced by age and the extent of IM in both basins, but not by sex or the number of sections investigated. CONCLUSIONS: CM-apparently an independent microscopic marker-was significantly higher in the Pacific than in the Atlantic basin. Environmental carcinogens involved in the evolution of IM and IC seem to be implicated in gastric ciliogenesis. Carcinogens that differ in nature and/or in strength in both basins might activate the latent natural genes encoding ciliated processes in gastric cells in patients subsequently developing gastric carcinoma, more notably of intestinal type.

Adult↗
PubMed2005

Extensive intestinal metaplasia in gastric carcinoma and in other lesions requiring surgery: a study of 3,421 gastrectomy specimens from dwellers of the Atlantic and Pacific basins.

BACKGROUND: Extensive intestinal metaplasia (EIM) has been reported in gastrectomies from patients dwelling in the Pacific and Atlantic basins. AIMS: To compare all the results in an attempt to explain the findings. METHOD: All sections from 3,421 gastrectomies were reviewed at various hospitals: 1946 in the Atlantic and 1475 in the Pacific basin. Sections with EIM showed IM encompassing one or more entire low power field (>or=5 mm in length/section) in one or more section. RESULTS: In the Atlantic basin, EIM was present in 18.8% (153 of 814) of specimens with intestinal carcinoma (IC) and in 10.3% (65 of 630) of those with diffuse carcinoma (DC). In the Pacific basin, EIM was found in 62.9% (412 of 655) of gastrectomies with IC and in 33.3% (160 of 481) of those with DC. The numbers of specimens with EIM were significantly higher in the Pacific than in the Atlantic basin for both carcinoma phenotypes, particularly among elderly patients (>or=60 years). CONCLUSIONS: The proportion of gastrectomies with EIM was higher among populations at a higher gastric cancer risk than in those with a lower cancer risk. EIM was mostly associated with IC rather than DC or with miscellaneous gastric diseases (841 control gastrectomies) in both basins. The proportion of gastrectomies with EIM was significantly higher in Vancouver than in New York and in Santiago de Chile than in Buenos Aires, even though these populations reside at approximately the same geographical latitude, but in different basins. Environmental factors seem to accelerate the evolution of EIM.

Age Factors↗
PubMed2005

Gastric glassy cells: a study of 3202 gastrectomy specimens from dwellers of the Atlantic and Pacific basins.

Fifteen years ago we detected gastric cells with glassy cytoplasm (GCs) in the human pyloric antrum. The frequency of these cells was subsequently investigated in sections from gastrectomies carried on in populations dwelling on the rim of the Atlantic and Pacific basins. In this work we compared the results obtained in these disparate geographic regions. We reviewed sections from 3203 gastrectomies (1942 in the Atlantic basin and 1261 in the Pacific basin). In the Atlantic basin 12/1942 (0.6%) of the gastrectomies had GCs, whereas in the Pacific basin 26/1261 (2.1%) of the gastrectomies had GCs. The difference was significant (p<0.05). The proportion of gastrectomies with GCs was higher in patients in Vancouver, Canada, than in New York, and higher in Santiago de Chile than in Buenos Aires, despite the fact that these populations reside at approximately the same geographic latitude. Previous studies with the same material indicated that both the extension of intestinal metaplasia and the frequency of ciliated metaplasia were significantly higher in the Pacific than in the Atlantic basin. Hence, the difference in the frequencies of GCs appears to be a new indication that dissimilar environmental exposures in the two basins might have influenced the histological make-up of the gastric mucosa.

Aged↗
PubMed2003

Quantitative determination of paclitaxel in human plasma using semi-automated liquid-liquid extraction in conjunction with liquid chromatography/tandem mass spectrometry.

This paper describes a high-throughput sample preparation procedure combined with LC-MS/MS analysis to measure paclitaxel in human plasma. Paclitaxel and an internal standard were extracted from plasma by a semi-automated robotic method using liquid-liquid extraction. Thereafter compounds were separated on a RP C18 column. Detection was by a PE Sciex API 3000 mass spectrometer equipped with a TurboIonSpray interface. The compounds were detected in positive ion mode using the mass transition m/z 854.6-->286.2 and m/z 831.6-->263.2 for paclitaxel and the internal standard, respectively. The limit of quantitation for paclitaxel was 1 ng/ml with an imprecision of 5.2% following extraction of 0.1 ml of plasma. Linearity was confirmed over the whole calibration range (1-1000 ng/ml) with correlation coefficients higher than 0.99 indicating good fits of the regression models. The inter and intra-day precision was better than 9.5% and the accuracy ranged from 90.3 to 104.4%. The assay was simple, fast, specific and exhibited excellent ruggedness.

Animals↗
PubMed2000

[Endoscopic mucosectomy in incipient gastric malignant lesions].

BACKGROUND: Endoscopic mucosectomy is a routine treatment mode for benign and malignant gastric lesions. The prognosis of patients with endoscopically treated early gastric cancer does not differ from patients subjected to surgical gastrectomy, when the indications for endoscopic mucosectomy are respected. AIM: To report the experience in endoscopic mucosectomy for early gastric cancer. PATIENTS AND METHODS: Between 1990 and 1997, 12 lesions in 10 patients, aged 48 to 107 years old, were treated with endoscopic mucosectomy. Clients were followed for 1 to 72 months after the procedure. RESULTS: Treated lesions ranged in size from 7 to 20 mm. Ten patients had differentiated carcinomas, one had an undifferentiated carcinoma and one had a primary gastric carcinoid. Endoscopic appearance was II a in six lesions, II c + II a in two, II a + II c in one. II c in one, I in one and II c + III in one. In two patients, the tumor persisted and were subjected to oncologic surgery. In one of these no malignant lesion was recognized in the pathological specimen. The other patient had a multicentric carcinoma that was already detected by endoscopy. Neither had lymph node metastases. Endoscopical and pathological follow up in the other 8 patients has not shown persistence or reappearance of malignant lesions during a follow up ranging from 3 to 72 months. CONCLUSIONS: Endoscopic mucosectomy can be a valuable therapeutic alternative in early gastric cancer.

Adenocarcinoma↗
PubMed1999

[Oncologic post-resection reconstruction of mandibular defects].

BACKGROUND AND AIM: If not reconstructed, mandibular defects resulting from oncological surgery can leave major functional and cosmetic sequelae which may impede these patients from returning to professional and family life. Reconstruction may be immediate or deferred, but the authors clearly recommend immediate reconstruction. METHODS: An analysis is made of the different techniques used for the reconstruction of mandibular defects, specifying those which are currently used and the situations in which they are applied. The advantages and disadvantages of microsurgical flaps and pedicled flaps are emphasised. The immediate use of endosseous implants is also discussed. RESULTS: The results of the various types of reconstruction are compared from a cosmetic and functional point of view. The latter includes a study of the quality of speech, deglutition, mastication and labial competence. Mastication is studied in two types of patients: those with osteointegrated implants with neomandibular reconstruction and those in whom osteointegrated implants were not used. All these patients survived 5 years after surgery. CONCLUSIONS: The authors recommend the immediate reconstruction of mandibular defects. Microsurgical flaps and pedicled flaps can be used for this purpose. Bone flaps may be used for endosseous titanium implants, whereas osseous flaps which do not provide a sufficient guarantee of rehabilitation should not be used. Implants should be inserted during oncological surgery, since postoperative radiotherapy may alter osteointegration of titanium implants are then used. The overall survival of these patients depends on the margins of local resection which are much wider using these techniques.

Dental Implantation, Endosseous↗
PubMed1999

Diffuse acute cellulitis with severe neurological sequelae. A clinical case.

The incidence of head and neck odontogenic infections considerably diminished in the last decades due to appropriate antibiotic therapy. Herein we describe a case of acute diffuse facial cellulitis following tooth extraction in a patient with no apparent risk factor. During the acute process, injury was caused to the hypoglossal, vagal, glossopharyngeal and recurrent nerves of both sides. For this reason the patient currently has a nasogastric line for enteral feedings and a tracheotomy tube, which significantly affects his quality of life.

Cellulitis↗
PubMed1999

[Immunoglobulin rearrangement in the differential diagnosis of primary gastric lymphoma].

BACKGROUND: The traditional methods to distinguish Chronic Follicular Gastritis and Primary Gastric Lymphoma do not allow an adequate definitive diagnosis in a significant number of cases. The molecular Biology diagnostic methods are based on the rearrangement of immunoglobulin genes. The polymerase chain reaction (PCR) specifically amplifies this rearrangement and allows molecular analysis of minimal tissue samples obtained with endoscopical biopsies. AIM: To test the usefulness of this PCR method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma. MATERIAL AND METHODS: We analyzed the endoscopical biopsies of six Chronic Follicular Gastritis cases and eight surgically treated Primary Gastric Lymphoma cases, six with the correct diagnosis in the endoscopical biopsies and two with a diagnosis of Chronic Follicular Gastritis. RESULTS: A policlonal immunoglobulin rearrangement was found in the six cases with Chronic Follicular Gastritis. A monoclonal arrangement was found in 5 of 6 biopsies with the diagnosis of Primary Gastric Lymphoma. The same monoclonal rearrangement was observed in the two biopsies incorrectly diagnosed as Chronic Follicular Gastritis. CONCLUSIONS: PCR analysis of immunoglobulin rearrangement is a useful method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma.

Chronic Disease↗
PubMed1999

Papillary carcinoma of the base of the tongue. Case clinic.

Ectopic lingual thyroid tissue is an uncommon developmental anomaly. Tumours of identical pathological characteristics as those arising in the eutropic thyroid tissue, may be present in ectopic locations. There are very few cases of malignant tumours reported in the literature. Here we report a review of this pathology and we describe a case of a papillary carcinoma of the base of the tongue, located in ectopic lingual thyroid tissue, in a 66 year-old white man, complaining of dysphagia and oral bleeding. Surgical treatment was carried out, consisting of radical resection of the right hemineck, tumour resection, right hemiglossectomy and total thyroidectomy. Postoperative treatment with 131I and substitutive thyroid hormonal therapy was prescribed.

Aged↗
PubMed1996

A comparative study between the gastric mucosa of Chileans and other dwellers of the Pacific basin.

A total of 3,289 sections of 120 gastrectomy specimens from Chile were reviewed. Intramucosal cysts were found in 61.7% of the specimens, ciliated metaplastic cells in 33.3%, large vacuolated cells in 20.8% and extensive intestinal metaplasia in 51.7%. The frequency of these non-neoplastic changes was significantly higher in specimens with early adenocarcinoma of intestinal type than in those with early adenocarcinoma of diffuse type or having a peptic ulcer. Similar results have been recorded in other inhabitants of the Pacific basin, but not inhabitants of the Atlantic basin. Interestingly, the gastric cancer incidence in the various populations studied in the Pacific basin is much higher than in those studied in the Atlantic basin. Environmental factors acting in Chile appear to have induced those non-neoplastic changes in the gastric mucosa. The question arises as to whether environmental factors (promoters?) acting in Chile (as well as in Japan, in Hawaii and in New Zealand) have favored the necessary non-neoplastic mucosal conditions required for the subsequent development of gastric adenocarcinoma (in particular of intestinal type.)

Adenocarcinoma↗
PubMed1996

[Toxic megacolon secondary to ischemic colitis. Report of a case].

We report a 67 years old male that consulted due to bloody diarrhea of several months of evolution and emaciation. According to endoscopic and radiological findings, the diagnosis of severe ulcerative colitis was made. Fifteen days after admission, the patient was subjected to an emergency total colectomy due to a toxic megacolon. The pathological study showed an ischemic colitis with extensive longitudinal ulcers in the antimesenteric border, presence of granulation tissue with inflammation and transmural fibrosis. Intestinal transit was reconstituted six months later and after 12 months of follow up the patient is in good conditions.

Aged↗
PubMed1996

[Anatomopathological study of 86 gastric adenomas. Experience in 14 years].

AIM: To analyze the clinical presentation, pathological aspect and treatment of gastric adenomas. PATIENTS AND METHODS: Retrospective analysis of 75 patients aged 26 to 88 years in whom a gastric adenoma was diagnosed. RESULT: Seventy one patients had elevated endoscopical lesions and two had depressed or flat lesions. Ninety percent of lesions were located in the gastric antrum. Pathological study detected 6 focal carcinomas within the adenomas and 5 concomitant carcinomas located elsewhere in the stomach. Fifty four patients were subjected to endoscopical resection. Among patients with focal carcinomas, a gastrectomy was performed in four and endoscopical resection in two. CONCLUSIONS: Gastric adenomas must be considered in the differential diagnosis of gastric elevated lesions and may be confused in early gastric cancer. There is a histological resemblance between adenomas and gastric dysplasia described by several authors though only in our cases and in the Japanese literature the adenoma is referred to as mostly a polypoid sessile lesion.

Adenoma↗
PubMed1994

[Primary gastric lymphoma. Analysis of 86 cases].

We report the retrospective analysis of 86 patients with primary gastric lymphoma diagnosed in a period of 12 years, that constitute 5.6% of malignant gastric lesions diagnosed in that lapse. Upper gastrointestinal endoscopy diagnosed a malignant lesion in 93% and lymphoma in 36% of cases. Endoscopic biopsies disclosed malignant lesions in 79 cases (93%) and were diagnostic of lymphoma in 70 (82%). All patients were operated, including the seven subjects in which the biopsy did not show malignant lesions; the surgical indication of the latter was based in clinical grounds. The macroscopic examination of the surgical piece showed ulcerated lesions in 45 (52%) and mixed lesions (ulcerated and protruded with and without multiple erosions) in 15 (18%) patients. Seventeen patients (33%) had an early lesion of the MALT type (mucosa associated lymphoid tissue) and 87% of lesions were of low or intermediate histological type.

Adolescent↗
PubMed1991

[Bilateral signet ring cell carcinoma of the breast: case report].

Signet ring cell carcinoma of the breast is a rare type of tumor characterized by the presence of numerous cells containing large intracellular and little extracellular amounts of mucin. These tumors show an unusual metastatic pattern, involving serosal surfaces and have a poor prognosis with a mean survival time of 50 months. This paper reports the case of a 39 year old woman with a bilateral signet ring cell carcinoma who developed metastases in bone, lung and peritoneum. Combined surgery, radiotherapy and chemotherapy was used but the patient died 2 years and 3 months after diagnosis.

Adenocarcinoma, Mucinous↗
PubMed1991

[Needle aspiration cytology in euthyroid uninodular goiter].

Fine needle aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totaling 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadequate for diagnosis. In 39 of the 41 patients with a benign (negative) cytology result, the histopathological diagnosis confirmed the absence of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected malignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of erythroid goiter and could help reduce significantly the number of patients who need to be surgically intervened.

Adolescent↗
PubMed1990

[Early stomach cancer: the experience of the Hospital John Kennedy in Valdivia. 1976-1989].

We report our experience with 19 patients with early gastric cancer in Valdivia, a southern province of Chile. All patients had symptoms and 15 had a preoperative biopsy. A mean of 39 days elapsed between biopsy and surgery. An emergency operation was performed in 3 patients. The mean lesion size was 10 cm2. An intramucous location was present in 9 patients and a submucous one in 10. Infiltration of the first lymph node barrier was observed in only 1 patient. A type P.1 resection was performed in 68% of patients, a type 2 resection in 11% and a type 3 in 5%. Recurrences were observed in 3 patients and 2 of them died. 5 year survival rate was 100% and 7 year survival was 68%.

Adult↗
PubMed1990

[Gastric cancer in the province of Valdivia (Chile) 1977-1987].

The pathologic records of Hospital Kennedy in Valdivia include 391 cases of gastric cancer between 1977 and 1987, with a yearly incidence of 35 cases. Mean age was 58 years; 97% of males and 93% of females were 40 years or older. Surgery had been undertaken in 70%, with resection performed in 63%. Advanced lesions were found in 83% of cases, with a mean size of 35 cm (vs 15 for early lesions). Complete resection of the first lymph node barrier was performed in 83% of patients, of the second in 7%; and of the third in none. Curative surgery was felt to have been performed in 37% of patients. These data suggest the need for earlier detection of gastric cancer in our population.

Adult↗