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Biomedical subjects

S Dessole

Publications and source records attributed to S Dessole.

At least 37 records · Page 2Linked to original sources

Immunohistochemical evaluation of a new epithelial antigen, Ber-EP4, in ovarian cancer: preliminary results.

OBJECTIVE: To assess the immunohistochemical expression of Ber-EP4, a new epithelial antigen in ovarian cancer. METHODS: We studied 25 cases of ovarian cancer in which Ber-EP4, CEA and CA 125 were investigated by an immunohistochemical method. We evaluated the correlations between immunohistochemical positivity and grading, histotype and stage of disease. RESULTS: CEA was positive in 5 out of 25 cases (20%), CA-125 in 17 out of 25 cases (68%) and Ber-EP4 in 14 out of 25 cases (56%). Ber-EP4 was mainly present in mucinous tumors in comparison to serous tumors (78.6% vs. 50%). Ber-EP4, as well as CA-125, were directly proportional to tumor differentation (70% of positivity in G1 vs 37.5% in G3 for the former and 80% in G1 vs 50% in G3 for the latter, respectively), whereas CEA showed no relevant difference regarding the grading. There were no differences among the three antigens studied with regard to clinical stage. CONCLUSIONS: In our study Ber-EP4 was positive in 14 out of 22 cases (63.6%) of the primary epithelial ovarian cancers studied. The presence of this antigen seems to be related to histotype and grading but not to clinical stage.

Adult↗

Prognostic value of p53, c-erb-B2 and MIB-1 in endometrial carcinoma.

OBJECTIVE: To assess the immunohistochemical expression of p53 protein, a tumour suppressor gene of the oncogene c-erb-B2 and MIB-1 proliferation marker (Ki-67 antigen) in endometrial carcinoma. METHODS: We studied 29 cases of endometrial carcinoma in which the p53, c-erb-B2 and MIB-1/Ki-67 antigens were investigated by an immunohistochemical method. We evaluated the correlations among the immunohistochemical positivity and the grading, depth of myometrial invasion, stage of the neoplasia and follow-up. RESULTS: Both p53 and c-erb-B2 were positive in 16 out of 29 cases (55.2%), whereas MIB-1 was positive in 19 out of 29 cases (65.5%). All these three antigens showed a positive correlation with the grading, myometrial invasion and FIGO stage. Regarding follow-up, p53, c-erb-B2 and MIB-1 were, respectively, positive in 100%, 83.4% and 66.7% of neoplasias of patients who died of disease whereas they were positive in 40%, 40% and 60%, respectively, of tumours of patients with no evidence of disease. CONCLUSION: The overexpression of p53, c-erb-B2 and MIB-1 seem to indicate a more malignant tumour phenotype.

Antigens, Nuclear↗

Microsatellite analysis at 10q25-q26 in Sardinian patients with sporadic endometrial carcinoma: identification of specification patterns of genetic alteration.

BACKGROUND: Loss of heterozygosity (LOH) at chromosome 10q25-q26 has been reported previously in endometrial carcinoma (EC), suggesting the presence of tumor suppressor gene(s). Nevertheless, frequency of genome-wide microsatellite instability (MSI) has been demonstrated higher in EC than in other common malignancy, mostly due to defective DNA mismatch repair. The authors further evaluated the role of the chromosome 10q25-q26 in endometrial tumorigenesis as well as the clinical significance of any observed genetic alteration in sporadic EC. METHODS: Paired normal and tumor samples from 94 Sardinian patients with sporadic EC at various stages of disease were screened by polymerase chain reaction (PCR)-based microsatellite analysis. Genomic DNA was isolated from paraffin embedded tissues and amplified by PCR using microsatellite markers spanning approximately 14 cM at 10q25-q26. Microsatellite instability was studied at four loci mapping to different chromosomal locations. RESULTS: Thirty-two (34%) EC patients were found negative for genetic alterations within the 10q25-q26 region. Among the remaining 62 (66%) EC cases, the authors identified 1) a minimum consensus region of LOH of approximately 1 cM, between D10S610 and D10S542 markers; and 2) a subset of tumors with prevalence of instability at 10q25-q26 (10qMI+), as expression of the presence of a MSI+ phenotype. CONCLUSIONS: The authors' data establish the existence of significant correlations between disease stages and 10qMI+ (with or without MSI+). However, longer follow-up and additional studies are required to define the clinical significance of these findings as prognostic factors. Moreover, the minimum region of LOH at 10q25-q26 will be further analyzed for identifying the putative tumor suppressor gene involved in EC pathogenesis.

Adult↗

Radial scar of the breast: mammographic enigma in pre- and postmenopausal women.

OBJECTIVE: The aim of the study was to investigate the incidence and the mammographic features of the lesions suggestive of radial scar (RS). METHODS: We reviewed 31883 mammograms of women in pre and postmenopause and we found 23 (0.072%) images suggestive of RS. Twelve out of 23 (52%) women were in premenopause and 11 out of 23 (48%) in postmenopause, respectively. Histologic diagnosis was made on the surgical biopsy specimen. RESULTS: We described mammographic features of these lesions. On 23 biopsy specimens of mammograms suggestive of RS, histology pointed out 11 (48%) radial scars, 3 (13%) sclerosing adenosis and 9 (39%) carcinomas. CONCLUSIONS: In our case histories we found 11 (0.034%) radial scars among 31883 performed mammographies. Mammographic findings suggestive of RS provide remarkable diagnostic problems because numerous aspects at mammography suggestive of this lesion can be found also both in case of sclerosing adenosis and carcinomas making differential diagnosis impossible. The finding of mammographic features suggestive of RS imposes performance of targeted surgical biopsy for the correct diagnosis.

Adult↗

Interposition of fallopian salpinges in the treatment of sigmoidovaginal fistula, secondary to vaginal hysterectomy with failure of previous repair.

A 50-year-old woman, para 4, suffering from uterine fibromatosis and recurrent menometrorrhagia, underwent vaginal hysterectomy with preservation of salpinges. About 15 days after surgery, hydrosoluble contrast enema showed sigmoidovaginal fistula; after about two months there was failure of surgery repair by the rectal endoscopic technique. A month later, we performed repair surgery by the abdominal approach interposing fallopian salpinges between the sigmoid and the vagina. About two months later, a enema showed absence of fistula and today the women is free from disease.

Colon, Sigmoid↗

A second hysterosalpingography reduces the use of selective technique for treatment of a proximal tubal obstruction.

OBJECTIVE: To assess whether a second hysterosalpingography (HSG) can permit tubal patency, reducing the use of selective salpingography in patients with proximal tubal obstruction. DESIGN: Prospective study. SETTING: University hospital. PATIENT(S): The study population consisted of 360 infertile women. INTERVENTION(S): In patients with unilateral or bilateral proximal tubal obstruction, a second HSG was performed after about 1 month. In those cases with persistent obstruction, an immediate selective salpingography and tubal catheterization were performed. MAIN OUTCOME MEASURE(S): Tubal opacification. RESULT(S): Forty patients underwent a second HSG procedure for proximal tubal occlusion. Among these, 24 achieved bilateral tubal patency. Thus, repetition of a conventional HSG after 1 month avoided unnecessary salpingography in 60% of patients. CONCLUSION(S): In infertile women with proximal tubal obstruction, we believe it is best to perform a second HSG. HSG is easy to carry out and subjects patients to a lower dosage of radiation and fewer risks than selective salpingography. The latter technique should be reserved for unsuccessful cases.

Adult↗

Utility of bipolar electrocautery scissors for abdominal hysterectomy.

OBJECTIVE: This was an evaluation of usefulness of bipolar electrocautery scissors for abdominal hysterectomy. STUDY DESIGN: Fifty women with uterine fibromatosis underwent abdominal hysterectomy: 25 randomly selected patients were operated on with conventional technique and the other 25 patients were operated on with bipolar electrocautery scissors. In both groups operating time, number of ligations, and blood loss were assessed. Data were compared by analysis of variance and chi(2) test as appropriate. RESULTS: In the bipolar group the average operating time was 25% shorter than in the conventional group (P <.01), and the number of ligations and the amount of blood loss were significantly reduced (P <.01). There was no increase in the complication rate. CONCLUSIONS: Bipolar electrocautery scissors were confirmed to be safe and useful for open surgery by reducing the operating time and blood loss without increasing postoperative morbidity. Thus their use would lower the cost of surgery.

Adult↗

Coexistence of a heterotopic pregnancy associated with a homolateral ovarian cyst in a patient submitted to elective abortion.

The authors describe the case of a right tubal pregnancy of delayed diagnosis in a 31-year-old nullipara, who was submitted to voluntary termination during the 7th week of pregnancy and who presented a homolateral ovarian cyst. Two weeks later the patient presented pelvic pain and intraperitoneal fluid layer, while plasma beta-hCG was 1,262 IU/ml. The case history was complicated by recent termination surgery and presence of an ovarian cyst, but a plasma beta-hCG assay and transvaginal ultrasonography oriented the diagnosis towards a previously unrevealed heterotopic pregnancy. The fallopian tube and the ovarian cyst were removed by laparoscopy. The case points out to the fact that, though rare, heterotopic pregnancy must always be considered one of the possible complications of spontaneous pregnancy.

Abortion, Induced↗

[Mercury determination in human amniotic fluid].

BACKGROUND: One of the components of Ag amalgam is mercury which, owing to its organic derivatives, can pass into the organs and biological fluids. One particularly interesting but worrying aspect of this transition is the possibility that mercury may pass through the placental barrier and reach the fetus. The aim of this study was to evaluate the concentration of total mercury in human amniotic fluid and compare it with the number and occlusal extension of fillings using Ag amalgam. METHODS: A group of 56 pregnant women were selected due to undergo amniocentesis. A dental check-up was carried out in each patient to identify the number and extension of amalgam fillings. Mercury levels in the amniotic liquid were assayed using a spectrophotometer with atomic absorption and a FIAS-amalgam technique. RESULTS: Mercury concentrations in the samples examined ranged from a minimum of 0.00 ng/ml to a maximum of 2.55 ng/ml, mean 0.44 +/- 0.53 ng/ml. The correlations between the variables examined were evaluated by calculating the coefficient of linear regression. No direct relationship was found with mercury levels. The data obtained were used to construct a model of logistic regression showing scant statistical significance (p = 0.05) between the number of fillings and mercury levels, whereas the occlusal extension of dental repairs was significantly correlated with metal concentrations (p < 0.05). CONCLUSIONS: The authors recommend that silver amalgam should be used with considerable caution during pregnancy.

Adult↗

Lipoprotein metabolism during normal pregnancy.

OBJECTIVE: We sought to investigate the changes in circulating serum lipids and lipoproteins, including lipoprotein (a), and low-density lipoprotein size in women during normal pregnancy. STUDY DESIGN: Twenty-two women (mean age, 31 +/- 5 years; 13 primiparous subjects) were studied during uncomplicated pregnancy with normal outcome. Twenty-four nulliparous women of similar age (31 +/- 4 years) were studied as control subjects. RESULTS: Serum triglycerides and total and low-density lipoprotein cholesterol increased significantly during pregnancy in all women. Women with changes in low-density lipoprotein during the second and third trimesters showed a more marked increase in serum triglycerides, and this effect was slightly more evident in the multiparous subjects. No other differences were evident between primiparous and multiparous women apart from high-density lipoprotein cholesterol levels, which were slightly decreased in the latter subjects. CONCLUSIONS: Our results show that during normal pregnancy, the increase in plasma triglycerides may lead to the appearance of the atherogenic dense low-density lipoproteins in a subgroup of women. We suggest that the observed changes in low-density lipoprotein patterns during pregnancy might be used to identify those women who later in life will have these atherogenic small and dense low-density lipoproteins.

Adult↗

The prevalence of coeliac disease in infertility.

An increased incidence of reproductive problems, including infertility, miscarriage, low birth weight newborns, and shorter duration of breast-feeding, are known to exist in women with coeliac disease; some of these conditions are improved by a gluten-free diet. We have tried to ascertain the prevalence of coeliac disease in 99 couples who were being evaluated for infertility, compared with the known prevalence of silent disease in the population of Northern Sardinia, in which it is endemic. Of all women, four tested positive for at least two out of three markers: immunoglobulin A (IgA) antigliadin, immunoglobulin (IgG) antigliadin, and anti-endomysium antibodies, and underwent a jejunal biopsy; three had histological evidence of coeliac disease. One male partner was positive for two markers, and had a diagnostic jejunal biopsy. The prevalence of coeliac disease in infertile women seems higher (three out of 99, 3. 03%) in the study group than in the general population (17 out of 1607, 1.06%), and particularly in the subgroup with unexplained infertility (two out of 25, 8%, P < 0.03). Screening for coeliac disease should be part of the diagnostic work-up of infertile women, particularly when no apparent cause can be ascertained after standard evaluation.

Adult↗

Follow-up of 32 hypothalamo-hypopituitary patients treated with pulsatile gonadotropin-releasing hormone or human menopausal gonadotropin.

In a clinical retrospective study, a follow-up of hypothalamo-amenorrheic patients treated firstly with gonadotropin-releasing hormone (GnRH) pump stimulation and secondly with human menopausal gonadotropin (hMG) was performed. Thirty-two hypothalamo-amenorrheic patients, 24-38 years old, were submitted to 103 GnRH stimulation cycles. Seven, with polycystic ovaries (PCO) on ultrasound, were stimulated with hMG after one or several unsuccessful pump cycles. Ovulation was confirmed by a luteinizing hormone (LH) surge or triggered by human chorionic gonadotropin in 80 out of 103 cycles (77.7%/cycle) leading to 62 timed sexual intercourses and 17 intrauterine inseminations (IUI). Twenty-one pregnancies (26.3%/cycle) terminated in eight abortions (38.1%/pregnancy) and 13 deliveries (40.6%/patient). hMG stimulation, in the seven PCO patients (six IVF, one IUI), led to four additional deliveries in three patients. Five patients became pregnant spontaneously after pump failure (n = 2) or unsuccessful IVF (n = 3). Combining all cycles, 17 deliveries were obtained in 16 patients. No case of ovarian hyperstimulation syndrome (OHSS) was observed. GnRH is an efficient and safe treatment of hypothalamo-amenorrheic-induced anovulation. Following GnRH or hMG ovarian stimulation, spontaneous ovulation and conception may be restored in certain hypothalamo-amenorrheic patients.

Adult↗

The value of serum CA 125 and association CA 125/CA 19-9 in endometrial carcinoma.

One hundred and twelve women with endometrial carcinoma were studied with serum sampling to determine preoperative and postoperative levels of CEA, CA 15-3, CA 19-9, TPA and CA 125. After surgical treatment 88 patients had stage I, 8 stage II, 14 stage III and 2 stage IV disease. Before treatment the sensitivity of CEA, CA 15-3, CA 19-9, TPA and CA 125 was 22.3% (25/112), 32.1% (36/112), 22.3% (25/112), 45.5% (51/112), 33.9% (38/112), respectively. According to pathological stage a statistically significant difference between intrauterine (96 cases) and extrauterine disease (16 cases) was noted only for CA 125 (28.1% vs. 68.7%) and CA 15.3 (28.1% vs. 56.2%). In relation to histological grading CA 125 rises progressively from well-differentiated cases to poorly-differentiated tumors. During the follow-up the most reliable marker was CA 125: values more than 35 U/ml of this marker resulted positive in 50% of relapsed cases and only in 5.1% of disease-free cases, thus demonstrating a high specificity. The association of various markers during the follow-up allowed us to reveal interesting results only for the CA 125/CA 19-9 combination. In fact the combined use of these markers permitted a high sensitivity (83.3%), with only 12.8% false positive cases, so with a high specificity.

Adenocarcinoma↗

Immunohistochemical expression of BerEP4, a new epithelial antigen, in endometrial carcinoma: correlation with clinical parameters.

OBJECTIVE: To assess the immunochemical expression of BerEP4, a new epithelial antigen in endometrial carcinoma. METHODS: We studied 45 cases of endometrial carcinoma in which the BerEP4, CEA and TAG-72 antigens were searched by an immunohistochemical method. We evaluated the correlations among the immunohistochemical positivity and the grading, histotype, stage and receptorial status of the neoplasia. RESULTS: CEA was positive in 29 out of 45 cases (64.4%), TAG-72 in 17 out of 45 cases (37.7%) and BerEP4 in 31 out of 45 cases (68.9%). Both TAG-72 and CEA were inversely related to the grading while, with regard to the histotype, CEA resulted as highly positive in the 5 cases of adenoacanthoma. CONCLUSION: BerEP4 did not show any correlation with grading, histotype, stage of disease or receptorial status of the carcinoma.

Antigens, Neoplasm↗