Demonstration of mucinous-like carcinoma-associated antigen in bone marrow and lymph node biopsies from patients with breast carcinoma.

Two hundred and fifty bone marrow and 140 lymph nodal biopsies were analyzed immunocytochemically, using a mouse monoclonal antibody b-12 (M Ab b-12), which reacts with MCA (mucinous-like carcinoma-associated antigen). The presence of MCA in bone marrow specimens was demonstrated in 102 out of 105 (97.1%) breast cancer metastases, 5 out of 8 (62.5%) gastric cancers, 5 out of 6 (83.3%) colon cancers, 3 out of 5 (60%) prostate cancers, 11 out of 26 (42.3%) lung cancers and 25 out of 30 (83.3%) unknown primary cancers, while no positivity to anti-MCA antibody was found in 30 cases of normal bone marrow biopsies, 5 cases of non epithelial malignancies and 30 cases of hemolymphoproliferative disease. Normal lymph nodes and non-epithelial lymph node metastases did not show any reaction to M Ab b-12; on the contrary MCA positive staining was observed in 75 out of 75 (100%) lymph nodal metastases in breast cancer. These results suggest that application of M Ab b-12 in immunohistochemistry is valid for the detection of bone marrow and lymph nodal micrometastases of epithelial origin.

DNA content in human colon cancer and non-neoplastic adjacent mucosa.

DNA content was determined by flow cytometry in a series of 51 paired fresh tissue samples of primary colorectal carcinomas and the respective non-neoplastic adjacent mucosa in order to assess the relationship between DNA ploidy and the most commonly used prognostic factors. Aneuploidy was observed in 70.6% of the tumors and more than one aneuploid peak was present in 3.9%. Aneuploid tumor frequency was higher in left (93.3%) and right colon (64.7%) cancers than in rectal carcinomas (60.0%), and multiple aneuploid clones were detected more frequently in men than in women and in patients with advanced disease (Dukes stage D). Non-neoplastic mucosa adjacent to aneuploid tumors showed aneuploidy in 4 out of 51 samples (7.8%). The mucosa adjacent to diploid cancers had only diploid characteristics. Ploidy did not correlate with histological abnormalities. These findings suggest that DNA content as determined by flow cytometry needs further study with adequate follow-up to evaluate possible correlations with relapse-free and overall survival. Furthermore the aneuploidy of non-neoplastic mucosa provides evidence for a field defect in mucosa adjacent to colorectal cancer and supports the concept that this alteration may be of influence on carcinogenesis.

Preliminary study on oncogene product immunohistochemistry (c-erbB-2, c-myc, ras p21, EGFR) in breast pathology.

The expression of oncogene products related to cell growth (c-erbB-2, c-myc, ras p21, EGFR) was investigated in benign (15 cases) and malignant breast lesions (20 cases) by means of immunohistochemistry using the avidin-biotin-peroxidase technique with polyclonal and monoclonal antibodies. The aim of this study was to evaluate the relationship between the staining positivity and various morphological and biological features, such as tumour type, grading, hormone receptor status and cell kinetic parameters. In benign breast lesions, as expected, the kinetic parameters were low, both for Ki-67 and LI. All the specimens showed a diploid condition (the DI being equal to 1) and we found a limited degree of immunoreactivity for all the growth factors and oncogene products. In breast cancer we studied the distribution of immunohistochemical positivity for EGFR, c-erbB-2, c-myc, ras p21 and Ki-67, which was related to age, nodal status, ER and PgR receptor status, LI, DI and histopathological grading. A significant positive correlation was found both between ras p21 expression and nodal status and ER-ICA positivity. We observed a strong correlation between LI and Ki-67 and an inverse relation between Ki-67 and ER expression. These findings suggest the importance of studying the relationship between prognostic factors which may provide preoperative prediction in the biological behaviour of breast cancer, not only on biopsy specimens, but also on fine needle aspirates.

Plasma and tissue CEA and TPA markers in operable breast cancer. Preliminary results.

CEA and TPA were studied in sera and in histologic specimens of 200 patients with benign (77) or malignant (123) breast pathology. The frequency and expression of the two markers was different in benign and in cancer tissues. Histologic positivity and high levels of circulating markers were observed more frequently in cancer patients than in patients with benign disease. Tissue positivity for the two tumor markers did not always correlate with elevated levels of circulating markers. Positive CEA and TPA incidence was higher in tissue samples than in serum samples. In the breast cancer group, among 33 patients with histologic positivity for CEA, only 5 cases had circulating CEA levels higher than 5 ng/ml; among 91 patients with histologic positivity for TPA, only 45 cases showed circulating levels for TPA higher than 95 U/l. These findings confirm that tumor size, secretory characteristics and vascular supply are factors affecting the achievement of high circulating marker levels. Combined marker measurement in serum and tissues can provide more information about the presence of a given tumor marker. A limited evaluation of the prognostic meaning of the study of combined CEA and TPA in sera and in tissues was carried out during the follow-up of 60 evaluable patients. Only 5 patients had cancer relapses in the first 12 months from surgery; in 2 of 5 patients TPA was positive initially and at the time of recurrence, in serum as well as in tissues. Circulating CEA gave negative findings in all relapsed patients; 2 of them showed weak positivity only in the histologic staining at the time of presentation.

Surgical treatment of abdominal aortic aneurysm in association with horseshoe kidney. Three case reports and a review of technique.

Horseshoe kidney is a rare congenital anomaly that can create various technical problems during surgery for repair of abdominal aortic aneurysm. The diagnosis of this anomaly should be confirmed preoperatively in order to plan surgical strategy. Nowadays, in more than 90% of all cases, ultrasonography, contrast computerized tomography, urography, and angiography are the best instrumental methods of detecting this anomaly in association with abdominal aortic aneurysm. The transperitoneal approach assures the best exposure of the kidney, the ureters, the aneurysm, and both iliac vessels, but the renal isthmus can pose a problem in reimplanting aberrant renal arteries. When it is known preoperatively that renal revascularization should be performed, the left extraperitoneal approach is a better choice. In any event, the coexistence of horseshoe kidney and abdominal aortic aneurysm does not preclude the treatment of the latter. In elective surgery of abdominal aortic aneurysm, the morbidity and mortality rates in the presence of horseshoe kidney are much the same as those in the presence of normal kidneys. The best results in this kind of surgery are obtained by adapting one's surgical technique to each anatomical variant that is encountered.

[Value of thermography in the postoperative control in direct arterial surgery]. / Valore della termografia nel controllo postoperatorio in chirurgia arteriosa diretta.

21 patients suffering from arteriopathy of the lower extremities and treated with a variety of surgical techniques and arterial recanalization have been studied by means of pre- and post-operative angiography and thermography. After analysing the results, the value of thermography, particularly as regards assessment of the surgical results and subsequent long-term controls, is confirmed.

[Value of modern diagnostic technics in rupture of the spleen]. / Valore delle moderne indagini diagnostiche nella rottura di milza.

Personal experience is reported of the latest instrumental techniques used to diagnose ruptures of the spleen following a closed abdominal trauma. Particular interest was taken in patients with unclear clinical symptoms who were given a series of surgical and/or non-surgical tests in order to diagnose ruptured spleen in the asymptomatic phase. Tests analysed included: peritoneal injection-douche, laparoscopy, angiography, scintiphotography, echography and CAT scanning.

[Use of single-layer anastomoses in intestinal surgery; experimental and clinical studies]. / L'impiego delle anastomosi a strato unico nella chirurgia intestinale. Contributo sperimentale e clinico.

Reference is made to an experimental and clinical investigation of single-layer intestinal anastomoses. The techniques of Gambee, D'Onofrio, Lembert, Halsted Connel were applied in six groups of 10 rabbits. The survival and weight data, gross and microscopic inspection, and the stenosis index showed that the best results were obtained with Halsted's, D'Onofrio, and Gambee's techniques. An account is also given of a clinical series of 124 patients in which Halsted's technique was employed.

[Usefulness of sequential isotopic cholangiography in biliary surgery follow-up]. / Utilità della colangiografia isotopica sequenziale nel follow-up dell chirurgia biliare.

Personal experience in the follow-up of 39 patients subjected to bile duct surgery is reported. The results indicated that sequential isotopic cholangiography is less effective as a supplementary examination in the postoperative period by comparison with its use in preoperative diagnosis. It does, in fact, constitute the only possibility of visualising the main biliary pathway in subjects who have been operated for biliodigestive anastomosis, with the exception of invasive methods, such as PTC, itself out of the question in the execution of periodic postoperative controls.

Sequential computerized hepatobiliary imaging during percutaneous transhepatic biliary drainage.

Sequential computerized hepatobiliary imaging was performed in 11 jaundiced patients before, during, and after biliary decompression. The rates of plasma clearances and radionuclide accumulation in liver cells and biliary tree were calculated, in addition to the uptake and retention index.

On the myoepithelium of human salivary glands. An immunocytochemical study.

This study investigated the immunocytochemical characteristics of normal myoepithelial cells (MECs) of human major and minor salivary glands using the LSAB method. Other human exocrine glands were used as controls. Immunoreactivity of MECs was observed exclusively with fully differentiated smooth muscle antibodies (a-SMA; SMMS-1; CALP; hCD) and with epithelial markers (cytokeratins) Ck14 and Ck17. This epithelial-muscular immunophenotype was similarly expressed in the MECs of other human exocrine glands used as control. In the salivary MECs, we did not observe evidence for neuroectodermic phenotype (S-100 protein, GFAP, NSE). On the contrary, positivity was observed for S-100 protein in Mecs of control glands (mammary, bronchial and sweat glands). Immunoreaction for extracellular matrix markers (fibronectin, laminin and collagen IV) and vimentin always were negative. Our data show that in normal "non transformed" MECs of the salivary glands the smooth muscle phenotype is in a state of complete differentiation, while the epithelial phenotype expresses only Ck14 and Ck17. This double and simultaneous immunoreactivity represents a differential marker of MECs from the epithelial basal cell (EBCs).

Accounting for water quality effects of future urbanization: diffuse pollution loads estimates and control in Mantua's lakes (Italy).

The three shallow lakes of Mantua (Upper, Middle and Lower) formed by the Mincio River are today classified by Italian water authorities as sensitive areas, after, in the second half of the 20th century, the hydrologic regime of the lakes was heavily modified, and the influence of industrial activities operating in the 1960s--without much environmental consideration--created a substantial decline in the water quality of the lakes. The City of Mantua is one of the most vital industrial centers of Northern Italy, and development plans are under way, that should approximately double the extension of the urban and industrial area within the next 20 years. This paper deals with estimating the effects of the aforementioned urbanization on the future water quality of the three lakes.

[Breast needle-biopsy. Personal experience]. / L'agobiopsia mammaria. La nostra esperienza.

A personal series of 133 mammary needle biopsies is presented. Cytological specimens were obtained by aspiration via a thin needle from solid neoformations. The causes in which this form of examination was used are described and the extent to which the findings influenced surgery is explained. The method was found to be diagnostically sound and easy to perform. It may be regarded as a useful addition to other instrumental techniques in the diagnosis of breast swellings and in reducing the percentage of error.

[Masson's tumor of the fingers]. / Tumeur de Masson des doigts

The authors report three cases of glomus tumour of the fingers and conclude, from the angiographic appearance, that the glomus tumour presents direct and indirect signs suggesting the lesion.