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1.
Med. infant ; 26(4): 351-357, dic. 2019. ilus, Tab
Article in Spanish | LILACS | ID: biblio-1047045

ABSTRACT

El maltrato infantojuvenil constituye un problema de salud pública, presenta consecuencias negativas en el adecuado desarrollo de los niños y adolescentes. Es consecuencia de una multiplicidad de factores individuales, sociales, psicológicos y culturales que puede incluso desembocar en la muerte del niño o adolescente. El objetivo fue realizar una descripción sociodemográfica e identificar posibles variables específicas de maltrato en la población que realizó alguna consulta al hospital y que fue derivada por el médico tratante al Consultorio Multidisciplinario de Protección Infantojuvenil (CMPIJ). Se trató de un estudio descriptivo, prospectivo de corte transversal, realizado entre julio de 2016 y mayo de 2017 en el Hospital de Pediatría Juan P. Garrahan. El criterio de inclusión fue la población que realizó alguna consulta al hospital, ya sea por sospecha de maltrato o por otros motivos y fue derivada por el médico tratante al CMPIJ. Se evaluaron 96 casos. el 67,7% de las sospechas fueron de abuso sexual infantil (ASI), el 22,9% de maltrato físico y el 9,4% de trastorno facticio aplicado a otro. En los casos de alta sospecha de ASI, el 75% de los pacientes eran de sexo femenino; en el 50% de los casos, el supuesto agresor era conviviente y el 50% de las madres refirió antecedentes de malos tratos en la infancia. En los casos de alta sospecha de maltrato físico, el 53% de los pacientes era de sexo masculino, en el 83,3% de los casos el supuesto agresor era conviviente y el 76,5% de las madres refirió antecedentes de malos tratos en infancia. Se concluye la importancia de contar con datos fidedignos en lo relativo al maltrato Infantojuvenil para permitir elaborar estrategias de prevención tanto a nivel asistencial como de Salud Pública (AU)


Child abuse is a public health problem with a negative impact on the adequate development of children and adolescents. It is a consequence of multiple individual, social, psychological, and cultural factors that may even result in the death of the child or adolescent. The aim of this study was to provide a sociodemographic description and to identify possible specific variables associated with abuse in the population that visited the hospital and was referred to the Multidisciplinary Child Protection Clinic (MDCPC). A prospective, descriptive, cross-sectional study was conducted between July 2016 and May 2017 at Hospital de Pediatría Juan P. Garrahan. The inclusion criterion was the population that visited the hospital, either for suspicion of abuse or for other reasons, who were referred to the MDCPC by the treating physician. Overall, 96 cases were evaluated; 67.7% of the suspicions were of childhood sexual abuse (CSA), 22.9% for child battering, and 9.4% for Munchausen syndrome by proxy. Among the cases with a high level of suspicion of CSA, 75% were female; in 50% of the cases the supposed aggressor lived in the household, and 50% of the mothers reported a history of child abuse. In the cases of a high level of suspicion of child battering, 53% of the patients were male, in 83.3% of the cases the aggressor was living in the household, and 76.5% of the mothers reported a history child abuse. In conclusion, trustworthy data on child abuse are necessary to develop prevention strategies at both the care and public health levels (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Child Abuse, Sexual , Child Abuse , Munchausen Syndrome by Proxy , Referral and Consultation , Cross-Sectional Studies , Prospective Studies , Surveys and Questionnaires
3.
Med. infant ; 16(4): 404-406, Dic 2009. Tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1342282

ABSTRACT

El trasplante hepático en niños es un desafió tanto desde lo bio-médico como desde lo social-familiar. Es una patología crónica, ya que el paciente tiene requerimientos de medicación y dieta de por vida. El Hospital Garrahan como centro de referencia de salud pública de alta complejidad, atiende a niños de todo el país. Por lo cual para la atención médica, se debe tener en cuenta diferentes parámetros socio-culturales, para lograr una mejor atención del paciente y su familia. El seguimiento del paciente y la adherencia al tratamiento, hacen al resultado de la calidad de vida y, a la vida misma del paciente. Objetivo: Describir el funcionamiento y comparar las relaciones entre las variables: a) vinculares-familiares, b) sociales-económicos, c) adherencia al tratamiento, d) mortalidad en el seguimiento a largo plazo, de pacientes con trasplante hepático. Material y Método: comparativo, retrospectivo, transversal y obervacional. Se incluyeron a todos los pacientes que se les realizó trasplante hepático en el Hospital Garrahan desde Enero del 2000 a Agosto del 2006. Población en seguimiento: N= 203 niños y población fallecida: N=55 niños. Resultados: Se observó que el agrupamiento de las variables de dinámica familiar de la población en seguimiento es un 27% más favorable, que en la población fallecida. Las variables agrupadas desde lo socio-económico, nos demuestra que tiene una influencia estructural promedio de un 40% desfavorable en toda la población. No se observa un comportamiento en forma lineal, con relación a adherencia al tratamiento, esto es así, tanto para la población en seguimiento como la fallecida. En la variable adherencia al tratamiento, se observó que la población en seguimiento tiene un 9% más favorable, que en la población fallecida (AU)


Liver transplant in children is a challenge both from the biomedical and the socio-familial point of view. In this chronic pathology the patient has to meet medication and diet requirements for life. At the Garrahan Hospital, a tertiary healthcare referral center, children from all over the country are seen. As such, different socio-cultural parameters should be taken into account to improve care for the patients and their families. Follow-up of the patient and compliance to the treatment are of utmost importance for the quality of life of the patient. Objective: To describe the functioning of and comparison between the following variables: a) family relationships, b) socio-economic status, c) compliance to treatment, and d) childhood mortality in the long-term follow-up of patients who underwent liver transplantation. Material and Methods: A comparative, retrospective, cross-sectional, and observational study. All patients that underwent liver transplantation at the Garrahan Hospital between January 2000 and August 2006 were included in the study. Follow-up population: N= 203 children; Deceased: N=55 children. Results: In the category of family relationships results were 27% more favorable in the follow-up group than in the deceased group. Results in the category of socio-economic status showed that this factor has a mean structural negative influence of 40% in the whole population and a 7% increased tendency in the deceased group. As to compliance to treatment, no linear behavior was observed either in the follow-up group or in the deceased group. In the variable compliance to treatment, a 9% more favorable result was observed in the follow-up population compared to the deceased group (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Poverty , Liver Transplantation/mortality , Liver Transplantation/psychology , Family Relations , Cross-Sectional Studies , Retrospective Studies , Follow-Up Studies , Treatment Adherence and Compliance , Social Factors , Economic Factors
6.
Medicina (B.Aires) ; 65(5): 402-408, 2005. graf, tab
Article in Spanish | LILACS | ID: lil-445765

ABSTRACT

Orthotopic liver transplantation is the only definitive mode of therapy for children with end-stage liver disease. However, it remains challenging because of the necessity to prevent long-term complications. The aim of this study was to analyze the evolution of transplanted patients with more than one year of follow up. Between November 1992 and November 2001, 238 patients underwent 264 liver transplantations. A total of 143 patients with more than one year of follow up were included. The median age of patients +/- SD was 5.41 years +/- 5.26 (r: 0.58-21.7 years). All children received primary immunosuppression with cyclosporine. The indications for liver replacement were: fulminant hepatic failure (n: 50), biliary atresia (n: 38), cirrhosis (n: 37), chronic cholestasis (n: 13) and miscellaneous (n: 5). The indications for liver re-transplantation were: biliary cirrhosis (n: 7), hepatic artery thrombosis (n: 4) and chronic rejection (n: 3). Reduced-size liver allografts were used in 73/157 liver transplants, 14 of them were from living-related donors and 11 were split-livers. Patient and graft survival rates were 93% and 86% respectively. Death risk was statistically higher in retransplanted and reduced-size grafted patients. Growth retardation and low bone density were recovered before the first 3 years post-transplant. The incidence of lymphoproliferative disease was 7.69%. De novo hepatitis B was diagnosed in 7 patients (4.8%). Social risk did not affect the outcome of our population. The prevention, detection and early treatment of complications in the long-term follow up contributed to improve the outcome.


Subject(s)
Liver Transplantation , Postoperative Complications , Argentina/epidemiology , Postoperative Complications/mortality , Postoperative Complications/physiopathology , Epidemiologic Methods , Graft Survival , Immunosuppression Therapy , Reoperation , Graft Rejection/etiology , Time Factors , Treatment Outcome , Liver Transplantation/mortality
7.
Medicina (B.Aires) ; 65(5): 402-408, 2005. graf, tab
Article in Spanish | BINACIS | ID: bin-123240

ABSTRACT

Orthotopic liver transplantation is the only definitive mode of therapy for children with end-stage liver disease. However, it remains challenging because of the necessity to prevent long-term complications. The aim of this study was to analyze the evolution of transplanted patients with more than one year of follow up. Between November 1992 and November 2001, 238 patients underwent 264 liver transplantations. A total of 143 patients with more than one year of follow up were included. The median age of patients +/- SD was 5.41 years +/- 5.26 (r: 0.58-21.7 years). All children received primary immunosuppression with cyclosporine. The indications for liver replacement were: fulminant hepatic failure (n: 50), biliary atresia (n: 38), cirrhosis (n: 37), chronic cholestasis (n: 13) and miscellaneous (n: 5). The indications for liver re-transplantation were: biliary cirrhosis (n: 7), hepatic artery thrombosis (n: 4) and chronic rejection (n: 3). Reduced-size liver allografts were used in 73/157 liver transplants, 14 of them were from living-related donors and 11 were split-livers. Patient and graft survival rates were 93% and 86% respectively. Death risk was statistically higher in retransplanted and reduced-size grafted patients. Growth retardation and low bone density were recovered before the first 3 years post-transplant. The incidence of lymphoproliferative disease was 7.69%. De novo hepatitis B was diagnosed in 7 patients (4.8%). Social risk did not affect the outcome of our population. The prevention, detection and early treatment of complications in the long-term follow up contributed to improve the outcome.(AU)


Subject(s)
Liver Transplantation , Postoperative Complications , Argentina/epidemiology , Epidemiologic Methods , Graft Rejection/etiology , Graft Survival , Immunosuppression Therapy , Liver Transplantation/mortality , Postoperative Complications/mortality , Postoperative Complications/physiopathology , Reoperation , Time Factors , Treatment Outcome
8.
Med. infant ; 9(2): 109-117, jun. 2002. graf, tab
Article in Spanish | LILACS | ID: lil-517347

ABSTRACT

El trasplante hepático (TH) constituye la única alternativa terapéutica para numerosas enfermedades hepáticas avanzadas. Los adelantos en la técnica quirúrgica y en la inmunosupresión desarrollados en los últimos años permitieron mejorar la sobrevida. En la evolución a largo plazo de los pacientes trasplantados pueden presentarse complicaciones de diversa severidad. Objetivo: analizar la evolución a largo plazo de los pacientes trasplantados con un seguimiento mayor de 1 año post-TH. Material y Métodos: Durante el período 11/92-11/01 se realizaron 264 TH en 238 pacientes. De estos pacientes 143 (157 TH) fueron seguidos más allá de un año post-TH. La mediana de edad (m.a más menos DS) fue de 5,41 años más menos 5,26 (r:0.58 - 21.7 años); 76 pertenecían al sexo femenino. Catorce (9.79 por ciento) recibieron un re-TH. Fueron excluidos los pacientes que no habían cumplido todavía un años post- TH o los que fallecieron antes de ese lapso de seguimiento. Las indicaciones de TH fueron: falla hepática fulminante (FHF) (n:50); atresia de vías biliares (AVB) (n:38); cirrosis (n: 37); colestasis crónica (n: 13) y otras (n: 5). Las indicaciones de Re-TH fueron: cirrosis biliar (n: 7); trombosis de la arteria hepática (n: 4) y rechazo crónico (n: 3). En 73/157 TH se utilizaron injertos reducidos: 14 donantes vivos relacionados (DVR) y 11 biparticiones hepáticas. Se sometieron a análisis estadístico variables potenciales de morbimortalidad. Resultados: La sobrevida global fue: pacientes 93 por ciento: injerto: 86 por ciento. El re-TH y el injerto reducido fueron las variables de mayor significación para aumento del riesgo de muerte en nuestra población. El déficit de talla y masa ósea se recuperó anes de los 3 años post-TH. La incidencia del síndrome linfoproliferativo (SLP) fue del 7.69 por ciento, su diagnóstico y tratamiento temprano permitió una evolución favorable en la mayoria de los casos.


Subject(s)
Child , Adolescent , Follow-Up Studies , Indicators of Morbidity and Mortality , Liver Transplantation/adverse effects , Data Interpretation, Statistical
9.
Anal Quant Cytol Histol ; 22(3): 213-7, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10872037

ABSTRACT

OBJECTIVE: To evaluate proliferative activity in a set of gliomas and to compare the quantitative data obtained by a real-time processor with the labelling index (LI) and mitotic index (MI). STUDY DESIGN: Ki-67 immunostaining was performed on paraffin-embedded specimens from 42 cases of glioblastomas, 17 cases of anaplastic astrocytomas and 14 cases of low grade astrocytomas. Nuclear positivity was calculated as LI and by a real-time image processor for quantitative evaluation. MI was also calculated at 10 high-power fields. The data obtained from glioblastomas were compared with those from anaplastic and low grade astrocytomas. To all the data was applied the Pearson test to verify the correlation between counting and quantitative values and between proliferative markers and survival. RESULTS: A positive trend from low grade astrocytomas to glioblastomas was found for Ki-67 (LI and quantitative values) and MI, with highly significant differences between the three grades of gliomas considered. A good correlation between LI and quantitative values of Ki-67 was found. Very little relationship resulted between survival and Ki-67 LI. No relationship was found between survival and quantitative values of Ki-67. CONCLUSION: Ki-67 allowed effective separation of astrocytic tumors with different grades of malignancy. Quantitative evaluation of color information by means of a real-time processor proved to be a useful, objective and fast way to obtain readings, useful for grading purposes but not for prognostic evaluation.


Subject(s)
Astrocytoma/pathology , Brain Neoplasms/pathology , Astrocytoma/chemistry , Astrocytoma/classification , Brain Neoplasms/chemistry , Brain Neoplasms/classification , Cell Division , Humans , Image Processing, Computer-Assisted , Immunohistochemistry , Ki-67 Antigen/analysis , Mitotic Index , Prognosis
10.
Anal Quant Cytol Histol ; 18(5): 374-82, 1996 Oct.
Article in English | MEDLINE | ID: mdl-8908309

ABSTRACT

OBJECTIVE: To determine whether nuclear morphometry can confirm or add useful information to classic clinicopathological prognosticators to identify the subpopulation of breast carcinoma patients with node-negative (N-) disease, at high risk of disease relapse. STUDY DESIGN: On the basis of results obtained by clinicopathologic evaluation of a group of patients with N- breast cancer, on a test group of 56 cases (32 patients disease free and 24 with relapse), we performed a morphometric analytical study of nuclei using the Shape Analytical Morphometry (SAM) software system; 20 nuclei for each case and 17 morphometric parameters for each nucleus were analyzed. RESULTS: The SAM system allowed us to quantify shape differences in nuclei in terms of contour irregularities and asymmetries along with evaluation of nuclear dimensions. Dimensional and analytic parameters were subjected to univariate (Student's t test) and multivariate (Hotelling's test) analysis. Multivariate discriminant analysis showed that an exact forecast of disease relapse could be made in 77% of patients with N- breast cancer by using a set of six both analytic and dimensional parameters. CONCLUSION: These results confirm that nuclear pleomorphism is the result of both contour irregularities and shape asymmetries and that even though they should be considered preliminary results, they stress the importance of quantitative shape evaluation.


Subject(s)
Breast Neoplasms/pathology , Cell Nucleus/ultrastructure , Lymph Nodes/pathology , Female , Humans , Karyometry/methods , Mitotic Index , Prognosis , Survival Analysis
11.
Eur J Cancer B Oral Oncol ; 32B(2): 91-6, 1996 Mar.
Article in English | MEDLINE | ID: mdl-8736170

ABSTRACT

In the histological grading of oral squamous cell carcinoma (OSCC) nuclear features are very important. Nevertheless evaluation is usually performed in a subjective and not highly reproducible way. The aim of this work was to investigate the relationship between nuclear shape and survival in 30 cases of carcinoma of the tongue. All the patients were divided into two groups: short-term survival and long-term survival. Twenty nuclei for each tumour were submitted to a morphometrical study by the shape analytical morphometry (SAM) software system. It was thus possible to evaluate not only nuclear dimensions but also nuclear contour irregularities and nuclear shape asymmetries. Multivariate discriminant analysis (MDA) of the quantitative parameters obtained by the morphometrical study distinguished the patients of the two groups with only a 10% error; moreover successful cluster analysis was performed by using Fourier parameters. Both these sets of results were achieved mainly owing to the parameters for contour irregularities.


Subject(s)
Carcinoma, Squamous Cell/ultrastructure , Cell Nucleus/pathology , Tongue Neoplasms/ultrastructure , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Survival Rate
13.
Anal Quant Cytol Histol ; 16(5): 345-50, 1994 Oct.
Article in English | MEDLINE | ID: mdl-7840840

ABSTRACT

Eighteen cases of astrocytomas diagnosed as grades 1-3 of malignancy were studied with analytical morphometry to determine if different grades can be discriminated by size and shape parameters related to the nuclei. The shape analytical morphometry system was used to calculate dimensional measurements and express shape irregularities through quantitative parameters. With the shape asymmetry evaluator procedure, nuclear symmetry was evaluated. All parameters subjected to univariate and multivariate strategies were the same in easily distinguishing grade 1 from the others. Grades 2 and 3 could not be discriminated completely by either dimensional or with analytical parameters revealing strong similarities of nuclear shape and dimensions.


Subject(s)
Astrocytoma/ultrastructure , Cell Nucleus/ultrastructure , Astrocytoma/classification , Discriminant Analysis , Humans , Multivariate Analysis , Reproducibility of Results , Software
14.
Boll Soc Ital Biol Sper ; 70(10-11): 271-9, 1994.
Article in English | MEDLINE | ID: mdl-7702831

ABSTRACT

Histological grading of oral squamous cell carcinoma (OSCC) is usually evaluated in a semiquantitative way and this causes a low grade of reproducibility of this prognostic evaluation. The aim in this preliminary phase is to investigate the relation between nuclear shape (studied by an analytical procedure) and histological grading to evaluate the weight of nuclear shape and dimension in grading formulation. Nine cases of OSCC were studied (3 cases of G1, G2 and G3 respectively) with 20 nuclei for each case. All the tumors were localized on the lip. Histologic grading according to the Bryne system was performed. Each nucleus was submitted to a morphometrical study by the SAM (Shape Analytical Morphometry) system which, apart from dimensions allows us to evaluate nuclear contour irregularities and nuclear shape asymmetry. Nuclei of squamous cell carcinoma show a progressive increase in dimensions (area, perimeter and diameter) from G1 to G3. Nuclei of G3 carcinoma are characterized by the most irregular shape. Size differences (mean value) are significant to differentiate G1 nuclei from G2 and G3 nuclei while shape parameters are useful in distinguishing G3 nuclei from G1 and G2. Multivariate discriminant analysis showed that by using only nuclear parameters it is possible to correctly classify about 80% of nuclei. This study, using quantitative methods, confirmed nuclear pleomorphism to be the most important feature in grading evaluation.


Subject(s)
Carcinoma, Squamous Cell/pathology , Cell Nucleus/pathology , Mouth Neoplasms/pathology , Humans
15.
Acta Cytol ; 38(3): 341-6, 1994.
Article in English | MEDLINE | ID: mdl-8191823

ABSTRACT

The aim of this work was to seek quantitative parameters other than dimensions to describe nuclear shape and, by this means, to determine the sum of contour irregularities and large asymmetries and seek a connection with the biologic behavior of the tumor. Nuclei of the cells obtained from 57 aspiration smears of breast cancers were studied. Dimensional parameters (area, perimeter, maximum diameter and roundness factor) and analytic parameters were computed by the Shape Analytical Morphometry software system to evaluate both contour irregularities and asymmetry of nuclear shape. All the tumors were subdivided according to their diameters into two groups: T1 tumors, the maximum diameter of which was < 2 cm (18 cases), and T2 tumors, the maximum diameter of which was > 2 cm and < 5 cm (39 cases). Among T1 tumors, both dimensional and analytic parameters were highly significant (P < .001) in distinguishing tumors with (N+) and tumors without (N-) axillary metastases, while among larger tumors (T2) only the analytic parameters showed degrees of significance, albeit variable. It could be inferred that in smaller tumors, aggressiveness is related to an increase in nuclear dimensions and shape distortions more so than in larger tumors.


Subject(s)
Breast Neoplasms/pathology , Cell Nucleus/pathology , Lymphatic Metastasis/pathology , Biopsy, Needle , Breast Neoplasms/surgery , Female , Humans , Lymph Node Excision
17.
Transplantation ; 56(6): 1325-30, 1993 Dec.
Article in English | MEDLINE | ID: mdl-8278997

ABSTRACT

Clinical pancreatic islet transplantation requires cold storage of islets for some hours. The best solution for cold storage will be that which maintains islet viability for the longest time. We have examined the viability of rat and human islet after storage at 4 degrees C for up to 6 days in Hanks' balanced salt solution, University of Wisconsin solution (UW), and 2 modified versions of this last solution, Sumimoto D (SD) and histidine-lactobionate (HL). The integrity of cold-stored rat and human islets of Langerhans has been examined using supravital stains and electron microscopy. In addition, the viability of cold-stored rat islets was tested by intraportal transplantation into syngeneic streptozotocin-induced diabetic recipients. The in vitro studies showed good preservation of islets stored in UW, SD, and HL for up to 72 hr. In comparison, storage for periods as short as 24 hr in HBSS markedly reduced islet integrity. The transplantation studies showed that rat islets cold stored in HBSS solution for 24 hr were not able to reverse experimental diabetes, whereas those stored in the other 3 solutions for 24 hr successfully reversed diabetes within 1 week of transplantation. After 48-hr cold storage, only islets preserved in HL solution were uniformly capable of producing functioning islet grafts. None of the tested solutions was able to maintain islet viability sufficiently to allow successful transplantation after more than 48 hr of cold storage. These experiments demonstrate that good islet viability is maintained for up to 24 hr of storage in UW, SD, and HL, and even after 48-hr cold storage in HL solution, whereas preservation in HBSS solution was deleterious to islet viability within 24 hr.


Subject(s)
Islets of Langerhans , Organ Preservation Solutions , Solutions , Tissue Preservation/methods , Adenosine , Allopurinol , Animals , Cold Temperature , Diabetes Mellitus, Experimental/surgery , Evaluation Studies as Topic , Female , Glutathione , Histidine , Humans , In Vitro Techniques , Insulin , Islets of Langerhans/physiology , Islets of Langerhans/ultrastructure , Islets of Langerhans Transplantation , Isotonic Solutions , Microscopy, Electron , Raffinose , Rats , Rats, Inbred Strains , Time Factors , Transplantation, Isogeneic
19.
Int J Gynecol Cancer ; 2(6): 307-13, 1992 Nov.
Article in English | MEDLINE | ID: mdl-11576274

ABSTRACT

In recent years, borderline epithelial tumors of the ovary have been investigated by morphometric techniques to allow for a differential diagnosis from benign and malignant neoplasms. In order to enhance this discriminant power, we have applied a new analytical procedure to the evaluation of the nuclear shape in epithelial ovarian tumors. Sixty nuclei of benign ovarian serous neoplasms, 60 nuclei of serous borderline tumors and 60 nuclei of serous carcinomas (18 cases in all) were examined using the software system SAM (Shape Analytical Morphometry). The morphometric procedure consisted of three different phases: (i) extraction of nuclear fundamental curve: this is a function curve giving the smoothing of the original contour by two parametric equations (separately for x and y values as dependent variables); (ii) evaluation of nuclear contour irregularities by Fourier analysis; (iii) evaluation of nuclear shape asymmetry by SAE (Shape Asymmetry Evaluator): this is the ratio between the length of a segment of a parabola interpolating the original curve points and a straight line joining its extremities for a 180 degrees barycentric rotation according 10 degrees steps. All the obtained independent parameters were submitted to statistical analysis. Nuclei of borderline tumors showed dimensional parameters which were intermediate between those of benign and malignant tumors. Both the asymmetry and the irregularities of nuclear contour were greatest in carcinomas.

20.
Pathol Res Pract ; 188(4-5): 517-23, 1992 Jun.
Article in English | MEDLINE | ID: mdl-1409082

ABSTRACT

Laryngeal Intraepithelial Neoplasia (LIN) is graded in 3 levels (LIN Grade I-II-III), corresponding to the classic aspects of mild, moderate and severe dysplasia-in situ carcinoma, on the basis of the number and position of mitoses and of the undifferentiated or atypical cells limited to the basal or extended to the intermediate or the superficial layers of epithelium. In order to reduce the subjective imprecision of these parameters we have applied not only traditional dimensional evaluators but also procedures of analytical morphometry to the nuclear shape. By using the software system S.A.M. (Shape Analytical Morphometry) we have examined fifty nuclei of the basal layer in LIN grade I, II and III, fifty nuclei in normal laryngeal mucosa and fifty nuclei in invasive carcinoma of the larynx (twenty-five cases in all). Normal and dysplastic nuclei did not show any dimensional differences, while the carcinomatous nuclei were significantly larger. An asymmetric distortion of the nuclear contour was noted in the moderate and severe dysplasia, but not in carcinomatous cells. Also the Fourier parameters, increased in severe dysplasia, decreased dramatically in carcinomatous cells which showed nuclei with minor contour irregularities than the normal cells. These findings outline the discriminative power of the analytical morphometry and suggest a possible correlation between nuclear shape and cell biology.


Subject(s)
Carcinoma in Situ/pathology , Laryngeal Neoplasms/pathology , Carcinoma in Situ/classification , Carcinoma in Situ/diagnosis , Cell Nucleus/ultrastructure , Diagnosis, Computer-Assisted , Epithelium/pathology , Epithelium/ultrastructure , Humans , Laryngeal Mucosa/pathology , Laryngeal Mucosa/ultrastructure , Laryngeal Neoplasms/classification , Laryngeal Neoplasms/diagnosis , Software
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