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Biomedical subjects

S Corcione

Publications and source records attributed to S Corcione.

At least 19 recordsLinked to original sources
PubMed2001

An original approach in the diagnosis of early breast cancer: use of the same radiopharmaceutical for both non-palpable lesions and sentinel node localisation.

A modern approach to the surgical treatment of early breast carcinoma requires intraoperative localisation of non-palpable lesions and assessment of the lymph node status. Localisation of breast lesions can be achieved by intratumoural injection of a small amount of radiotracer and intraoperative use of a gamma probe (i.e. radioguided occult lesion localisation, or ROLL). Assessment of the lymph node status is possible by means of the sentinel node approach. To date, two different radiopharmaceuticals have been used for localisation of tumour and sentinel node. We now propose the use of a single nanocolloidal tracer (Nanocoll, with a particle size of less than 80 nm) which is labelled with technetium-99m for simultaneous performance of ROLL and sentinel node identification. The aim of this study was to evaluate the feasibility of this approach, which should be easier and more practical than the dual-tracer injection method. We have employed this new technique in 73 patients with non-palpable, cytologically diagnosed breast cancer and non-palpable axillary lymph nodes. In all patients the radiocolloid, in a total volume of 0.3-0.4 cc, was injected under sonographic or stereotactic guidance. Half of the dose was injected intratumourally and half superficially, but very close to the tumour. Because of the slow lymphatic flow in the breast, Nanocoll must be injected some time before surgery in order to enable adequate migration to the axilla. We injected colloid in the afternoon before surgery (16-23 h before the start of the operation, with an average interval of 18 h). An average dose of 130 MBq (range 110-150) was injected in order to have about 10 MBq of radioactivity when surgery commenced. Lymphoscintigraphy was performed after 15-19 h, with an average interval of 17 h. The procedure was always successful in permitting the localisation of occult breast lesions. Lesions were always localised at the first attempt, and were always contained within the surgical margins. Histological examination revealed all 73 resected lesions to be malignant: there were 64 cases of infiltrating carcinoma and nine of intraductal carcinoma. All breast lesions were therefore confirmed to be early breast cancer. We achieved sentinel node localisation in 71 out of 73, either at scintigraphy or with the intraoperative probe; in two patients, radiopharmaceutical migration was absent. Lymphoscintigraphy showed only axillary drainage in 52 cases, only internal mammary chain (IMC) drainage in nine cases, and combined axillary and IMC drainage in eight cases. In two cases, lymphoscintigraphy suggested the sentinel node was located inside the same breast (intramammary lymph node). All the visualised sentinel nodes were biopsied except for four that were localised in the IMC. Histological examination of the nodes showed metastases in 20 cases: in 15 cases there were micrometastases, and in five, macrometastases. In conclusion, this study has demonstrated the feasibility of the proposed procedure. Simultaneous performance of ROLL and sentinel node localisation using a single tracer represents a useful and practicable choice in the management of early breast cancer.

Aged↗
PubMed1999

Quantitative aspects of drugs of abuse in urine samples: intercollaborative studies conducted in the European Union.

A description of a quantification performance by laboratories taking part in two intercollaborative studies (surveys 1 and 2) carried out in 1993 (n = 195) and 1994 (n = 228), respectively, on urine drug testing in the European Union is presented. The performance of laboratories that quantified at least one substance (33.8% and 34.6% out of the total laboratories in surveys 1 and 2, respectively) is reported as a function of the analytic technique applied for quantification, the number of parameters investigated, the precision and accuracy of results obtained, and the influence of availability of reference material, including deuterated drug-standard analogue solutions provided in survey 2. Quantification of different drugs of abuse was mainly carried out by gas chromatography coupled to mass spectrometry (63.1% of analyses in survey 1 vs. 68.6% in survey 2). It should be noted about the data obtained that the results for quantification were not particularly satisfactory in terms of precision and accuracy (CV mean = 62.8 in survey 1 and 50.4 in survey 2 and error % mean = 12.7 in survey 1 and 18.6 in survey 2). The provision of reference materials increased the number of substances quantified (45.3% in survey 1 vs. 51.8% in survey 2) and improved the performance (CV mean of matching laboratories when quantifying matching substances: 50.1% in survey 1 vs. 35.5% in survey 2). The impact of a "learning factor" (the opportunity to be challenged a second time and to correct past errors) and the influence of the provision of deuterated analogues in survey 2 was investigated in a population of repeater laboratories that quantified both in surveys 1 and 2 (55 vs. 63 laboratories, respectively). According to the European experience reported, it may be observed that laboratories able to afford quantitative analyses provided better overall analytic performance. This is probably because quantification implies some validation of the analytic procedure. Participation in interlaboratory comparison programs also aimed at assessing the performance of quantitative analyses should be considered a quality asset for laboratories involved in drug testing.

Data Collection↗
PubMed1998

Modulation of biomarkers in minimal breast carcinoma: a model for human breast carcinoma progression.

BACKGROUND: The widespread use of diagnostic breast imaging has yielded an increase in the detection of in situ, microinvasive, and small invasive carcinomas and has provided opportunities to study the earliest stages of breast carcinoma development. The authors of this report analyzed the pathobiologic features of 577 minimal breast carcinomas (MBCs), including in situ carcinomas and invasive carcinomas < or =1 cm, according to the definition given by Hartmann in Cancer (1984;53:681-4). METHODS: Estrogen and progesterone receptors (ER and PR), proliferation index (PI), and p53 and neu expression were studied by immunohistochemical technique and measured by quantitative image analysis in 99 pure in situ carcinomas (ISCp); in 105 mixed invasive/in situ carcinomas, with a separate analysis of in situ (ISCm) and invasive (ICm) components; and in 373 invasive carcinomas < or =1 cm (IC). Follow-up data were available for 164 invasive carcinomas. RESULTS: A progressive increase in the levels of hormone steroid receptors, from the lowest in ISCm to the highest in IC, was observed (ER, P< 0.001; PR, P=0.005). Levels of PI and p53 expression were higher in ISCm than in the other categories (PI, P=0.007; p53, P=0.046). Overexpression of neu was greater in ICm than in IC (P=0.013). Younger women (< or =40 years) with invasive carcinoma had worse biologic profiles, with lower ER (P < 0.001) and higher PI (P=0.021), neu (P=0.008), and p53 (P=0.040). It was demonstrated clinically that PI and neu were the biologic markers with the highest predictive prognostic values in univariate analysis (PI for recurrence, P < 0.015; neu for recurrence and overall survival, P < 0.001 and P < 0.007, respectively) and in multivariate analysis (neu for recurrence and overall survival, P < 0.007 and P < 0.017, respectively). CONCLUSIONS: Biologic phenotypes of MBC can be interpreted as reflecting a dimension of neoplastic progression capacity that is independent of tumor size. This study suggests that biologic markers can be integrated with traditional pathologic indicators for accurate staging of patients.

Biomarkers↗
PubMed1998

Analytical approaches of European Union laboratories to drugs of abuse analysis.

We report a survey on urine drug testing within a total of 269 laboratories of the European Union. Clinical laboratories predominated over forensic laboratories (59.5% vs 28.5%). Screening without identification/quantification was the common approach used by clinical laboratories, whereas screening with identification/quantification was the approach used by almost all forensic laboratories. Screening was primarily performed by immunoassay in both types of laboratories. Gas chromatography coupled to mass spectrometry was the main analytical method used for specific identification/quantification of drugs, but other methods (including immunoassays) were also used. Cutoff values applied varied by laboratory type, country, and method used. A high percentage of laboratories did not use or report cutoff values. Overall, countries of the European Union vary significantly in regards to drugs tested, analytical approach, and screening and identification cutoff values. It is recommended to clearly state the analytical method and the cutoff values used when reporting results for drugs of abuse testing.

Clinical Laboratory Techniques↗
PubMed1991

Diagnostic potential of double contrast arthrography of the knee with the digital technique.

Experience with digital radiography applied to double contrast arthrography of the knee performed with a photostimulable phosphor plate is reported. The image processing technique used to improve the digital image is described, and some theoretical considerations are discussed. A preliminary comparison is also made between arthrographic images obtained with conventional screen-film systems and the digital system, especially in respect of the image quality and visualization of the soft tissue structures least well demonstrated with conventional arthrography.

Arthrography↗
PubMed1991

[Double-contrast arthrography of the knee: a digital technique study].

From October 1989, in our Radiology Department, digital radiographic techniques have been applied to double-contrast arthrography of the knee. In this preliminary work we examine the diagnostic contribution of computed radiography to arthrographic findings by comparing image quality of conventional and digital radiographs using a dedicated Philips unit. The digital unit is compatible with all the extant radiographic equipment in our department and automatically supplies two images, the first one resembling a conventional radiograph, the second one characterized by a broader exposure range that allows a clear visualization of soft tissues. To obtain high-quality radiographs the processing curves of the system were modified, in particular by shifting the curve leftward, thus reducing its slope, and by amending the parameters related to spatial frequencies. The changes in the reading curves made these images more useful: they were more homogeneous and allowed a better evaluation of fine details. Relative to the second type of images, characterized by both edge enhancement and a broader recording range, it was enough to shift the curve along the X-axis to compensate for a moderate image overexposure. Keeping in mind that the aim of this preliminary work was not compare the two techniques from a diagnostic point of view, in the authors' opinion the two yield similar information for the diagnostic evaluation of meniscal traumas. On the contrary, if the same principles are applied to the evaluation of capsulo-ligamentous components, digital arthrography appears to be more accurate than the conventional technique, the latter being deceptive especially in the evaluation of cruciate ligaments.

Arthrography↗
PubMed1988

Circumscribed lytic lesions of the thalassaemic skull.

Solitary or multiple circumscribed osteolytic areas are described in seven patients, selected from 250 patients with homozygous beta-thalassaemia (Cooley's anaemia). On X-ray examinations, these areas appear as purely osteolytic lesions with well-defined margins not associated with sclerosis. The possible mechanisms are discussed.

Adolescent↗
PubMed1986

[Direct radiographic magnification of the hand: study of erosions in rheumatoid arthritis].

Plain films and direct magnification radiographs of the hands were performed in 34 patients affected by rheumatoid arthritis, using mammographic x-ray tube, achieved with 0.1 mm microfocus, and 1.85 X magnification factor. Direct magnification radiography has provided essential or useful diagnostic data in 44% of cases, particularly in recognizing early skeletal erosions. Nevertheless direct magnification radiography must be used only in those cases in which traditional mammographic techniques do not supply satisfactory results.

Adult↗
PubMed1985

[Xanthogranulomatous pyelonephritis. Radiological and ultrasonographic aspects].

Clinical, radiological and ultrasonographical features of three cases of xanthogranulomatous pyelonephritis, one of which in a child, are reported. Presurgical diagnosis of xanthogranulomatous pyelonephritis is difficult and infrequent to date (10-14% of cases according to different workers). This complaint is generally mistaken for other types of kidney infections or tumours. The use of ultrasonography and computed tomography in particular help recognition of the disease and above all help to assess its extra-renal spread: something that has only recently been made possible.

Adult↗
PubMed1985

[Value of double-contrast arthrography in the verification of meniscal pathology of the knee. Our experience].

The authors face the problem of accuracy, specificity and sensitivity of double-contrast arthrography in meniscal injury of the knee. They report the results obtained in a clinical-statistic and retrospective investigation on 206 patients. The final diagnoses were obtained by arthrotomy (105 cases) by arthroscopy (70 cases) and clinically with a follow-up of 6 months (31 patients). Diagnostic accuracy (94,5%), sensibility (92%), specificity (98,7%) and predictive values on positives (99%) and negatives (87,5%), confirm double-contrast arthrography as a highly accurate examination. A specific diagnosis can be made only when the diagnostic modalities are correctly applied and the arthrographers are qualified.

Arthrography↗
PubMed1985

[Direct magnification in mammography with a 0.3 millimeter focus].

The authors emphasize the value of mammography with a 0.3 millimetres microfocus-tube with a magnification system. This technique is limited to those large lesions increasing "twilight effect". For a better study of all breast's lesions the use of fine microfocus-tubes is suggested, as it results also from the latest literature.

Adenofibroma↗