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Biomedical subjects

R Zarcone

Publications and source records attributed to R Zarcone.

At least 55 records · Page 3Linked to original sources
PubMed1996

Ovarian pregnancies treated with methotrexate.

Medical therapy in ectopic and ovarian pregnancies in particular, can be a valid alternative to the surgical approach, since it can guarantee the reproductive function in a better way. More and more attempts with methotrexate, which can induce the death of both embryo and trophoblastic tissue, are being made. Both its administration and results are still under debate. In our case histories, three clinical cases are reported and two of them proved to be successful. In our opinion, apart from the method of administration, the prerequisites for a therapeutic success are: a small ovular sac (max 30 mm), no echographically visible embryo which corresponds to a six-week pregnancy. The success of the therapy, therefore, depends on the precociousness of the diagnosis.

Adult↗
PubMed1995

Trans-vaginal ultrasound examination of ovarian masses in premenopausal women.

OBJECTIVE: Two scoring systems based on trans-vaginal sonographic findings of ovarian tumors were evaluated with respect to the prediction of ovarian malignancy. STUDY DESIGN: In this retrospective study, 64 premenopausal non-pregnant patients with an ovarian tumor underwent trans-vaginal sonography from 1991 to 1993. In each women a numerical score was calculated using two methods. Method A included four variables: inner wall structure, wall thickness, presence of septa and echogenicity. The point scale ranged from 4 to 15 points. Method B included three morphological characteristics: volume, wall structure and septal structure, the point scale ranging from 0 to 12 points. The threshold values for predictability of malignancy were 9 and 5 points for methods A and B, respectively. RESULTS: The mean age of the patients was 32.2 years (range 22-44). The mean gravidity was 2.6 (range 0-5) in 45 women, 19 women being nulliparous. Fifty-five masses were surgically proven to be benign and 9 women had primary malignant tumors. Sensitivity and specificity for prediction of malignancy were 89% and 73%, respectively, for method A, and 89% and 70%, respectively, for method B. Positive predictive value and negative predictive value for malignancy were 35% and 97% for method A and 29% and 64% for method B. The mean morphology scores on benign and malignant masses, calculated by method A, were 6.94 +/- 2.36 S.D. and 12.0 +/- 2.4 S.D. (P < 0.01). The same scores, calculated by method B, were 4.16 +/- 1.16 S.D. and 9.44 +/- 2.96 S.D. (P < 0.01). We found a considerable overlap in the scores of different types of ovarian tumors. CONCLUSIONS: Both methods are easy to apply and provided explicit data. Method A was shown to be more effective. The number of false positive results was relatively high. The most important single sonographic characteristic of the malignant masses are the wall structure abnormalities.

Adult↗
PubMed1995

Role of HPV-DNA typing in women with cytological diagnosis of squamous atypia.

The study was performed in 293 patients (mean age 36 years old). Pap tests, colposcopy and target biopsy were performed in all patients. Results showed 100 cases of cellular atypia, 53 cases of CIN (36 CIN I, 10 CIN II, 7 CIN III) and 140 normal cases. The last phase of the study consisted in the collection of exfoliated cervical cells which were then subjected to "Enzo Pathogen DNA Probe assay" using HPV-DNA 6/11, 16/18 and 31/33/51 probes. The aim of this study was to evaluate the relationship between HPV type and neoplastic evolution. The results were not sufficiently convincing to support proposing HPV/DNA typing as the sole diagnostic method in lesions of the last section of the female genital tract.

Adult↗
PubMed1995

Epidermal growth factor receptor expression: is it the same in normal and malignant endometria?

Epidermal growth factor was investigated in normal and malignant tissues in order to detect possible differences in its expression. We used immunohistochemical techniques that employ murine monoclonal antibody 528. Thirty-nine patients (12 with normal endometria and 27 with endometrial adenocarcinomas) were examined. Epidermal growth factor receptor was seen in all normal uteri and in 27 uteri with adenocarcinoma. It was absent in 11 patients with cancer. No correlation was found between the intensity of immunohistochemical staining and histologic grade, depth of myometrial invasion and clinical stage.

Adenocarcinoma↗
PubMed1995

Treatment of cervix condylomata with alpha-IFN leucocytar.

The main viruses responsible for condyloma, a venereal disease, are the HPV 16 and 11. The stages of HPV infection are under the control of the immunitary system, which is inhibited by the virus itself. For this reason, the therapy of cervical condylomatosis is, at present, based on the use of interferon. The purpose of this study was to appreciate the activation of the immune system after therapy with interferon. We treated 12 women suffering from cervical condyloma and exocervical CIN with increasing doses of natural alpha-IFN injected intramuscularly, and also applied to the vagina. The clinical response to the therapy was total in 7 cases, partial in 4 cases and unsuccessful in I case. We also evaluated the percentage of inflammatory cells in the peripheral blood and at the level of the condylomatous lesions, After treatment the absolute and percentage number of inflammatory cells increased. Besides, at the level of the lesion the CD1 and CD4 cells also increased.

Adult↗
PubMed1995

[Incidence of HPV and CIN in HIV positive women].

Cervical intraepithelial lesions associated with genital human papilloma virus (HPV) infection occur with increased frequency and severity among women with immunodeficiency. In this study, we considered 24 HIV-seropositive and 12 HIV-seronegative women. Each woman was interviewed and underwent a cytologic and colposcopic evaluation. Then colposcopic and cytologic findings were correlated with histologic and differences between HIV-seropositives and seronegatives were analyzed. Ten (41%) of 24 HIV-seropositive and one (9%) of 12 HIV-seronegative women had human papilloma virus infection. Among seropositives, eight (34%) had cervical intraepithelial (CIN): of those eight, 5 had CIN I, 2 CIN II and 1 CIN III. There (24%) of the 12 HIV-seronegative had CIN: two had CIN I and one CIN II. Six of the HIV-seropositive women were found to have multicentric disease (two or more sites). The objective of this study is to determine the relationship between human immunodeficiency virus (HIV) and human papilloma virus infection, sexual habits, reproducive history, and risk of cervical intraepithelial neoplasia (CIN). The results of this study suggest that cervical intraepithelial neoplasia is a common finding in HIV-infected women. Papanicolaou tests should be effective for detecting cervical disease in this population.

AIDS-Related Opportunistic Infections↗
PubMed1995

Malignant melanoma of the vagina in pregnancy: description of a clinical case.

Vaginal melanoma in pregnancy is a rare but extremely malignant tumour for which the prognosis is worsened by the fact that pregnancy increases the secretion of Melanocyte-Stimulating Hormone (MSH). The clinical case is described of a malignant vaginal melanoma in a 27 year-old woman in her 38th week of gestation, who was referred for slight vaginal bleeding. Clinical examination revealed a 3 cm pedunculate tumour on the anterior wall of the vagina. Vaginal cytology suggested a melanoma and instrumental examination failed to reveal any lymph node involvement. The vaginal tumour was removed during a caesarean section and subsequent histological examination identified it as a Breslow Stage II malignant melanoma. A 24-month follow-up showed the patient to have been completely cured.

Adult↗
PubMed1994

Viral type and CD1+ cells in HPV-induced lesions.

In vivo, HPV infection can display varying symptom complexes. At present 60 types of HPV are known, and some seem to be more efficient oncogenic agents than others. In particular, HPV 16 and 18 appear the types with the greatest oncogenic potential, being frequently found in cases of intraepithelial cervical neoplasia (CIN) and/or invasive carcinoma of the cervix. Many authors suggest that they might induce cell-mediated immunodeficiency into the lesions. This investigation was conducted on 15 women aged 17 to 40 (mean, 27.8). On the basis of cytological examination, colposcopy and biopsy, HPV-induced lesions were diagnosed. Biopsies were performed periodically for six months for HPV detection and typing. In addition, the cells of Langerhans were imaged by the indirect immunoperoxidase method. Variations in their number according to the HPV type involved were observed.

Adolescent↗
PubMed1994

Role of magnesium in pregnancy.

The importance of magnesium in pregnancy has been emphasised by several studies. Magnesium is considered a membrane-stabilizing ion and a permeability regulator acting at an intracellular level which intervenes in the oxidative phosphorylation and oxidation reduction processes as well as in enzymatic synthesis and activity. The authors performed a double-blind study in which 15 mmol of magnesium or placebo were administered to the treatment and control groups respectively. There were more cases admitted to hospital in the control group than in that treated with magnesium. Even if there is not a large body of data which supports improved fetus development as a result of magnesium supplementation during pregnancy, the authors suggest that pregnant women with a high risk of gestosis and premature labour should receive additional magnesium.

Adolescent↗
PubMed1994

[Ovarian neoplasms and tumor markers].

This is an experience about the utility of CA125 in diagnosis, staging, prognosis, and therapeutic response of ovarian cancer. The patients were 21 (the ages range was 38-66). They had an epithelial cancer (10 serous, 3 mucinous, 2 endometrioid, 6 non specific). The quantitative test of CA125 was performed with purified monoclonal antibody OC125 pre and post antineoplastic treatment. The reduction of CA125 was in connection with the neoplastic regression. Perservering or increasing values were related to neoplastic stasis or to non-responsive neoplasia, respectively. Even if the method we used was specific its sensibility is lower in patients with smallest residue disease.

Adult↗
PubMed1994

HPV and HIV: HPV-DNA identification of colpocytologic smears in HIV positive females through "in situ" hybridization technique.

Test statistics show a progressive increase of AIDS cases which can be attributed to heterosexual intercourse. Cervicovaginal withdrawals were carried out on 18 HIV positive women for identification of HPV-DNA through "In Situ" hybridization with three probes 6-11 (A); 16-18 (B); 31-33-51 (C). 61% of patients tested positive at DNA Probe as follows: A = 27.27%; B = 18.18%; C = 72.72%. HIV could act as cofactor in increasing HPV manifestations. In future, the number of AIDS cases in Italy will depend on its prevalence among the sexually active population. Therefore, the most useful intervention, will be the prevention of transmission through heterosexual intercourse.

Adolescent↗
PubMed1994

Therapeutic prospects of natural alpha interferon from normal human leucocytes in the treatment of genital condylomata in HIV positive women.

Various Authors underline that HIV positive women have a higher CIN incidence and a higher prevalence of HPV. HIV could act as cofactor in the proliferation of HPV manifestation, because of a hypothetical deficit of local immunity. 5 HIV positive patients have been examined: 3 of them presenting vulvocondylomas and/or VIN were treated with 1.000.000 IU alpha IFNn three times a week for three weeks. 2 of them presenting CIN and/or HPV were treated with a two-phase therapy: A) Induction therapy: 3.000.000 IU 3 times a week for three cycles. B) Maintenance therapy: 1.000.000 IU 3 times a week for three months. IFN was the primary treatment for viral lesions, even though an improvement of prognostic indices (CD4, CD4/CDB, 2M), has shown its usefulness in association or in alternative to AZT.

Adolescent↗
PubMed1994

[Cystic hygroma: 2 case reports and review of the literature].

Cystic hygroma, an infrequent malformation of the lymphatic system (5 cases per 1000 abortions with CRL greater than 3 cm), was observed in 2 cases which prompted the present study. The Authors also present a brief review of the literature on this topic. After reviewing the hypothetic pathogenesis of the lymphatic obstruction which underlines this pathology, the paper focuses on the association of hygroma and anatomical and chromosomic alterations. The various anatomopathological and echographical findings are then described. Special attention is drawn to the diagnosis of cystic hygroma, after which the two case studies are illustrated. The prognosis of this pathology is pessimistic and the patient and specialist have to choose between immediate abortion or waiting for the inevitable outcome of gestation.

Adult↗
PubMed1994

[Current conservative surgery in cervical intraepithelial neoplasia].

5 years (1989-1993) experience of cervical conization including 57 cases, has been reviewed. The mean follow-up was 33 (6-60) months. Mean age was 34.6 (range 21-57) years. Mean height and diameter of the cones were 2.5 +/- 0.3 cm and 1.5 +/- 0.4 cm, respectively. In 55 cases there were free margins of the cones. Cytological diagnosis was CIN I for 8 patients, CIN II for 21 patients, CIN III for 22 patients, CIN+HPV for 6 patients. In 40 of the 57 patients suspected of having a cervical intraepithelial neoplasia on cytology and on colposcopy, the histology was confirmative. Bleeding (the most common pre and postoperative complication) was observed in 6 cases (11.7%). In three patients a new conization was necessary and in the other two patients hysterectomy was necessary. No significant differences were noted in the pregnancy outcome following either treatment in five patients.

Adult↗