Patient age and biological aggressiveness of endometrial carcinoma.

BACKGROUND: Advanced age is associated with a significantly worse prognosis of endometrial carcinoma patients. The aim of this study was to test whether age is a poor-risk factor in endometrial carcinoma because tumors arising in older patients are biologically different from those diagnosed in patients of an earlier age. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded samples from 136 previously untreated patients with endometrial carcinoma were studied by means of immunohistochemistry. The expression of molecular markers associated with hormone responsiveness (estrogen and progesterone receptors), proliferation (Ki67, C-ERB-B2, p53), invasiveness (E-cadherin) and apoptosis (BCL2 and p53) was analyzed. The obtained expression levels, together with all available clinical and pathological features were tested for correlations with the patients age and survival. RESULTS: Advanced patient age showed a direct correlation with tumor stage (r=0.29, p=0.0008) and mutant p53 expression (r=0.25, p=0.004), and an inverse correlation with E-cadherin expression (r=-0.28, p=0.001). Patient age above the 25th percentile (57 years) of the age distribution was significantly associated with a worse prognosis (p=0.018). CONCLUSION: It appears that with advancing age, endometrial carcinoma exhibits a more aggressive tumor phenotype, characterized by mutant p53 expression and down-regulation of E-cadherin expression, and that this, in its turn, results in tumors being diagnosed at a more advanced stage in older patients.

CT evaluation pre- and post-percutaneous ablation by radiofrequency of osteoid osteoma. Preliminary experience.

PURPOSE: Evaluation of bone remanagement after treatment by thermoablation of osteoid osteoma (OO) by CT scan. MATERIAL AND METHOD: Nine cases of OO (8 in the limbs, 1 in the pelvis) following biopsy were treated by CT-guided thermoablation. Clinical results, complications, density of tissues treated by CT scan (pre-postop, 6, 12 months) are evaluated. RESULTS: Absence of complications, regression of pain over 2 weeks, resumption of sports activity in 1 month. Bone density after treatment increases but even after 1 year it is much lower than normal levels. CONCLUSIONS: Bone remodeling after thermoablation of OO requires much time, the process is still visible 12 months later by CT scan. CT scan is an adequate method, not only for diagnosis and treatment, but also for follow-up, capable of evaluating in time the changes in density of the site of the lesion, which is useful for a comparison in case of postoperative pain of doubtful origin.

[Ultrasonographic study of the patellar tendon following bone-tendon-bone anterior cruciate ligament reconstruction arthroscopy]. / Studio ecotomografico del tendine rotuleo dopo prelievo osso-tendine-osso per ricostruzione artroscopica del legamento crociato anteriore.

The arthroscopic reconstruction of the anterior cruciate ligament requires the partial removal of the patellar tendon. US potentials in the assessment of residual patellar tendon after bone-tendon-bone removal were compared with those of CT and clinics. Mechanical resistance reduction of the residual tendon may be caused by removal modalities and size. This work was aimed at investigating the morphologic US patterns indicating "stability" of the operated tendon, which is mandatory for a risk-free functional recovery. Twenty patients were submitted to US of the operated tendon with contralateral comparison. In each patient tendon thickness and structure in the site of removal were studied, especially aiming at demonstrating diffuse or focal alterations of echogenicity. Middle third thickness and new tissue echostructure are fundamental US variables to define residual tendon "stability". The authors describe some US patterns of the surgical tendon to be considered as normal and not abnormal findings, provided that US be performed at least two months after surgery.

[Pneumothorax in multiple trauma. Radiologic and CT study]. / Pneumotorace nei politraumi. Studio radiologico e TC.

This study was aimed at evaluating the necessity to perform chest Computerized Tomography (CT) in multiple traumatized patients to diagnose pleuropulmonary lesions and, particularly, pneumothorax: the correct identification of this condition, although minimal, is important especially in prevision of long anesthesias and/or positive end-expiratory pressure (PEEP) therapy. This assisted respiratory technique improves arterial oxygenation but causes a barotrauma which may cause some complications; particularly, a small undetected pneumothorax can suddenly increase so as to cause pulmonary collapse with sometimes dramatic symptoms. Chest X-ray films and CT scans, performed in rapid succession on patient's admission in Emergency Ward, were compared in 21 subjects. CT is indispensable in case of severe chest parietal lesions which can mask the radiological evidence of pulmonary or pleural conditions, as it occurred in 3 of our cases. Moreover, CT resulted more reliable than chest X-rays (18 versus 10 correct diagnoses) especially in the detection of small antero-inferior pneumothorax flaps, in which direct radiological signs cannot be identified, in default of radio-geometrical assumptions. Indirect radiological signs of pneumothorax must be recognized but critically considered in order to avoid over-staging.

[Comparative characterization of the lipoprotein spectrum and status of free radical processes in the blood of rabbits exposed to external gamma-irradiation and cholesterol administration]. / Sravnitel'naia kharakteristika lipoproteinovogo spektra i sostoianiia svobodnoradikal'nykh protsessov v krovi u krolikov pri vneshnem gamma-obluchenii i vvedenii kholesterina.

Characteristic of lipoprotein spectrum and state of free-radical processes in the animals under action of ionizing radiation and cholesterin diet are comparatively studied. The content of lipids in the blood serum increases on the 5th day after irradiation and then decreases on the 15th and 30th days. Cholesterin diet increases the content of cholesterin under practically unchanged content of triglycerides in the blood serum in all the terms of investigations. Total decrease of the intensity of induced chemiluminescence of the blood serum and erythrocytes after irradiation is shown. Peroral introduction of cholesterin evokes differently directed changes in the light sum of chemiluminescence--a decrease in erythrocytes and increase in the blood serum.