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Biomedical subjects

S Savva

Publications and source records attributed to S Savva.

13 recordsLinked to original sources
PubMed2004

Androgen receptor (AR) expression is an independent unfavorable prognostic factor in gastric cancer.

PURPOSE: To investigate the expression of sex steroid receptors in gastric cancer and to correlate their tumor expression profile with the clinicopathological parameters and overall survival of the patients. METHODS: Immunohistochemical methodology was employed in formalin-fixed paraffin-embedded sections from 86 patients with gastric carcinoma. Monoclonal antibodies against androgen (AR), estrogen (ER), and progesterone (PR) receptors were used. Survival rates were estimated by the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazards model. RESULTS: Fifteen (17.4%) cases of gastric adenocarcinomas were positive for AR, two (2.3%) were positive for PR and three (3.5%) were positive for ER. Significantly higher AR expression was found in tumors with metastases to lymph nodes (P = 0.03). Patients with AR-positive tumors (AR+) had worse prognosis than (AR-) patients (median survival 9 months vs 24 months, P = 0.03). Patients with AR- and heat shock protein 27 (HSP27)-positive tumors (AR+/HSP27+) had a median survival of 6 months, whereas (AR-/HSP27-) patients had a median survival of 42 months (P = 0.017). Multivariate analysis revealed that AR expression and UICC stage were independent factors of unfavorable prognosis (P = 0.037 and P = 0.0055, respectively). CONCLUSIONS: Identification of AR-positive gastric carcinomas in gastric biopsies may warrant a more aggressive therapeutic approach and anti-androgen or AR-targeted agents may represent a novel strategy in tackling this devastating malignancy.

Adult↗
PubMed2003

Localised gastrocnemius myositis in Crohn's disease.

A19-year-old woman presented with pain and tenderness in both calves associated with pyrexia and neutrophil leukocytosis. Gastrocnemius muscle biopsy showed a non-specific lymphocytic myositis and she was found to have positive c-ANCA, in the absence of other evidence of systemic vasculitis. Subsequent investigation of her gastrointestinal tract revealed extensive Crohn's disease. The myositis responded promptly to treatment with prednisolone 0.5 mg/kg. A review of the literature showed that localised calf pain in the setting of Crohn's disease can be caused by non-specific myositis, granulomatous myositis or vasculitis. It is proposed that the "gastrocnemius myalgia syndrome" be included in the typical - albeit rare - extraintestinal manifestations that may herald the appearance of inflammatory bowel disease.

Adult↗
PubMed2002

Expression of the 27-kDa heat shock protein (HSP27) in gastric carcinomas and adjacent normal, metaplastic, and dysplastic gastric mucosa, and its prognostic significance.

PURPOSE: The investigation of heat shock protein 27 (HSP27) expression in gastric cancer and adjacent normal, metaplastic, and dysplastic gastric mucosa and its correlation with clinicopathological parameters and survival of patients. METHODS: Immunohistochemical methodology was performed on formalin-fixed paraffin-embedded sections by using a monoclonal anti-HSP27 antibody. HSP27 expression was screened and compared in 86 cases of gastric carcinoma and adjacent normal, metaplastic, and dysplastic gastric mucosa. RESULTS: In the normal mucosa, HSP27 was detected in 68 out of 86 cases (79%) and was more intense in the surface and upper two-thirds of gastric foveolae. In dysplastic gastric mucosa, HSP27 immunoreactivity was usually higher than that of the adjacent normal epithelium and was parallel to the severity of dysplasia. HSP27 expression was found in 54 out of 86 (62.7%) gastric carcinomas and was significantly related to more than six metastatic lymph nodes ( P =0.03). HSP27 expression was also higher in tumors of advanced stage and in those of female patients. HSP27 expression was associated with shorter overall survival in univariate analysis ( P =0.04), but this relationship was not retained in multivariate analysis. CONCLUSIONS: Our findings indicate that: i) HSP27 is commonly expressed in normal gastric epithelium where it seems to exert a protective role; and ii) HSP27 is involved in gastric carcinogenesis and its expression appears to be associated with parameters of unfavorable prognosis and shorter overall survival.

Adult↗
PubMed2001

Comparison of 1-week vs. 2- or 4-week therapy regimens with ranitidine bismuth citrate plus two antibiotics for Helicobacter pylori eradication.

BACKGROUND: Helicobacter pylori eradication therapies based on ranitidine bismuth citrate have recently been introduced in clinical practice. AIM: To compare the efficacy of three regimens containing ranitidine bismuth citrate given for 1, 2 and 4 weeks, combined with two antibiotics for the first week, in the eradication of H. pylori. METHODS: Eighty-six consecutive patients (50 duodenal ulcer disease, 36 non-ulcer dyspepsia) with H. pylori infection were offered three eradication regimens: (a) 1-week group (n=28), ranitidine bismuth citrate 400 mg b.d. for 7 days; (b) 2-week group (n=29), ranitidine bismuth citrate 400 mg b.d. for 14 days; and (c) 4-week group (n=29), ranitidine bismuth citrate 400 mg b.d. for 28 days. In all patients, clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. were given for the first week. Endoscopy was repeated 1 month after the end of treatment and eradication was considered to be successful if both rapid urease test and histology were negative. RESULTS: Overall, H. pylori was eradicated in 84% (72/86) patients on intention-to-treat analysis, whereas the per protocol cure rate was 89% (72/81). Eradication rates were 23/27 (85%) (95% confidence interval (CI): 66-96%), 25/27 (92%) (95% CI: 76-99%) and 24/27 (89%) (95% CI: 71-98%) in the 1-, 2- and 4-week groups, respectively, on per protocol analysis, and 25/28 (82%) (95% CI: 63-94%), 25/29 (86%) (95% CI: 68-96%) and 24/29 (83%) (95% CI: 64-94%), respectively, on intention-to-treat analysis (P > 0.05, N.S.). No significant differences were observed between groups concerning duodenal ulcer healing, resolution of symptoms and adverse effects. CONCLUSIONS: The 1-week regimen with ranitidine bismuth citrate, clarithromycin and metronidazole is effective in H. pylori eradication. Prolongation of treatment with ranitidine bismuth citrate for 2 or 4 weeks does not achieve a statistically significant more favourable outcome.

Adult↗
PubMed1999

Giant cell fibroblastoma: an entity or a reactive phenomenon?

The histological and immunohistochemical features of four tumors displaying the characteristic pattern of Giant Cell Fibroblastoma (GCF) are presented. Three of them were found in association with classical and/or myxoid dermatofibrosarcoma protuberans, while the fourth tumor was a retroperitoneal malignant hemangiopericytoma where foci with features of GCF were found. Typical sinusoidal spaces and the bizarre mononuclear and multinucleated cells in close association to blood vessels presenting a wide spectrum of lesions of their walls are also described. These last changes led us to believe that GCF-like lesions might not always characterize an entity but could often represent a host reaction of the connective tissue to locally aggressive or malignant tumors.

Adult↗
PubMed1993

Atlas personality.

The paper concerns individuals who, as children, were asked to provide comprehensive psychological support for their family of origin. They cared for others before being taken care of themselves. They took on adult responsibilities from a very young age with the result of missing important aspects of their childhood. They became very sensitive and responsive to the needs of their parents and tried desperately to protect and stabilize their chaotic, angry and erratic families. They were anxious, depressed and crushed by the assumption of a role that was clearly beyond their abilities. The Atlas personalities retained their excessive sensitivity and concern for the emotional well-being of others into their adult life. As adults, they were persistently depressed and anxious and unaware of their own needs.

Adolescent↗
PubMed1989

Invasive balantidiasis presented as chronic colitis and lung involvement.

A unique case of chronic balantidiasis is described, presenting with chronic colitis and inflammatory polyposis of the rectum and sigmoid colon and an intrapulmonary mass. Histology of the colonic polyps showed Balantidium coli, and both Aspergillus and Balantidium coli were found in the aspirate of the pulmonary mass. The patient was treated with doxycycline HCl 100 mg/day for 10 days with complete clinical recovery and marked improvement of the endoscopic appearance of the colonic mucosa.

Aged↗
PubMedDate not supplied

Activation of the ras genes in malignant and premalignant colorectal tumors.

The activation of ras genes has been established as one of the steps in the process of colon tumorigenesis. These genes are converted into active oncogenes by point mutations in codons 12, 13, and 61, although a more complex way has also been shown, through alteration of gene expression. In order to investigate the spectrum of ras gene mutations, we examined 78 colorectal polypoid adenomas and 76 primary colorectal adenocarcinomas for codon 12 point mutations in K-, H- and N-ras, using a PCR-RFLP assay. K-ras mutations were found in 42.3% (33/78) of adenomas and in 36.8% (28/76) of carcinomas. Statistically significant association (p=0.043) was found between the frequency of K-ras mutations in mixed adenomas larger than 2 cm, compared to smaller mixed adenomas. On the other hand, adenocarcinomas harbored more frequently mutations, when indicating development from adenoma (p=0.016), in higher grade of differentiation (p=0.001) and in females with tumor located proximal to the rectosigmoid (p=0.013). No mutations were found in H-ras. The incidence of N-ras mutations was 1.3% in adenomas and adenocarcinomas (1/78 and 1/76 respectively). Based on our results, we propose the possibility that K-ras-dependent tumor development results in the formation of less aggressive neoplasms, than the process of K-ras-independent carcinogenesis. Our findings and other previous reports indicate that K-ras mutations might be a secondary stress-effect from extrinsic or intrinsic stimulatory factors and that these mutations are not necessarily involved in the malignant transformation of the cell.

Adenocarcinoma↗