Dietary patterns and risk of colorectal adenoma: a systematic review and meta-analysis of observational studies.

BACKGROUND: Current evidence suggests that dietary patterns may play an important role in colorectal cancer risk. The present study aimed to perform a systematic review and meta-analysis of observational studies exploring the association between dietary patterns and colorectal adenomas (a precancerous condition). METHODS: Pubmed and EMBASE electronic databases were systematically searched to retrieve eligible studies. Only studies exploring the risk or association with colorectal adenomas for the highest versus lowest category of exposure to a posteriori dietary patterns were included in the quantitative analysis. Random-effects models were applied to calculate relative risks (RRs) of colorectal adenomas for high adherence to healthy or unhealthy dietary patterns. Statistical heterogeneity and publication bias were explored. RESULTS: Twelve studies were reviewed. Three studies explored a priori dietary patterns using scores identifying adherence to the Mediterranean, Paleolithic and Dietary Approaches to Stop Hypertension (DASH) diet and reported an association with decreased colorectal adenoma risk. Two studies tested the association with colorectal adenomas between a posteriori dietary patterns showing lower odds of disease related to plant-based compared to meat-based dietary patterns. Seven studies identified 23 a posteriori dietary patterns and the analysis revealed that higher adherence to healthy and unhealthy dietary patterns was significantly associated risk of colorectal adenomas (RR = 0.81, 95% confidence interval = 0.71, 0.94 and RR = 1.24, 95% confidence interval = 1.13, 1.35, respectively) with no evidence of heterogeneity or publication bias. CONCLUSIONS: The results of this systematic review and meta-analysis indicate that dietary patterns may be associated with the risk of colorectal adenomas.

Nitric oxide assisted C60 secondary ion mass spectrometry for molecular depth profiling of polyelectrolyte multilayers.

RATIONALE: Secondary ion mass spectrometry (SIMS) with polyatomic primary ions provides a successful tool for molecular depth profiling of polymer systems, relevant in many technological applications. Widespread C60 sources, however, cause in some polymers extensive damage with loss of molecular information along depth. We study a method, based on the use of a radical scavenger, for inhibiting ion-beam-induced reactions causing sample damage. METHODS: Layered polystyrene sulfonate and polyacrylic acid based polyelectrolyte films, behaving differently towards C60 beam-induced damage, were selected and prepared as model systems. They were depth profiled by means of time-of-flight (TOF)-SIMS in dual beam mode, using fullerene ions for sputtering. Nitric oxide was introduced into the analysis chamber as a radical scavenger. The effect of sample cooling combined with NO-dosing on the quality of depth profiles was explored. RESULTS: NO-dosing during C60-SIMS depth profiling of >1 micrometer-thick multilayered polyelectrolytes allows detection, along depth, of characteristic fragments from systems otherwise damaged by C60 bombardment, and increases sputtering yield by more than one order of magnitude. By contrast, NO has little influence on those layers that are well profiled with C60 alone. Such leveling effect, more pronounced at low temperature, leads to a dramatic improvement of profile quality, with a clear definition of interfaces. CONCLUSIONS: NO-dosing provides a tool for extending the applicability, in SIMS depth profiling, of the widely spread fullerene ion sources. In view of the acceptable erosion rates on inorganics, obtainable with C60, the method could be of relevance also in connection with the 3D-imaging of hybrid polymer/inorganic systems.

Silver coins analyses by X-ray fluorescence methods.

The investigation on the differences occurring in the manufacture of silver coins allows to get information on their elemental composition and represents a powerful support to the methodology to identify the producing technologies, workshops being also instrumental to distinguish between original and counterfeit ones. Aim of the present work is to study recent and old silver coins through non-destructive X-Ray Fluorescence (XRF) analysis. The XRF was applied to extend the analysis to the deepest layers of the coins; for surface layers an X-ray tube or an electron beam were employed to induce the atom fluorescence to obtain information on the surface elemental composition. Moreover, a detailed study has been performed to evaluate the influence of the surface curvature on the measurement, by deducing a proper corrective factor to keep into account in the data analysis. The elemental atomic composition was measured for each coin, mainly by means of the X-ray tube excitation for the bulk and the electron Scanning Electron Microscope (SEM) microbeam probe for the surface patina analysis. Ionization was induced by an X-ray tube using an Ag anode for the bulk and by an electron microprobe for the surface composition. X-ray detection was performed by using a semiconductor Si device cooled by a Peltier system. The Ag L-lines X-ray yield is affected by coin surface morphology and geometry. The comparison between coin spectra and standard samples, shows that the Ag quantitative analysis is influenced by error of the atomic concentration lower that 10%.

[Unusual non-neoplastic lesions in the "surgical pathology" of the thyroid]. / Lesioni inusuali non-neoplastiche in "surgical pathology" della tiroide.

This review aims to describe and assist in the categorization of most of the unusual non-neoplastic conditions, encountered in the surgical pathology of the thyroid. The conditions included are: normal intrathyroidal vestigial tissues/structures (i.e. rests of the ultimobranchial body and thyroglossal duct) and their relevant pathological derivatives (ultimobranchial body cyst, intrathyroidal lymphoepithelial cyst, thyroglossal duct cyst); mature intrathyroidal heterologous tissues/organs of either metaplastic or heterotopic origin (adipose tissue, striated skeletal muscle, cartilage, parathyroid glands, thymus, salivary gland tissue) and their relevant pseudotumoural lesions; varieties of metaplastic and non-metaplastic morphologic changes of the thyroid follicular epithelium (oncocytic, clear cell/signet ring cell, darkly pigmented cell, mucinous (myxoid), squamous, spindle cell); amyloid goiter; some reactive and/or degenerative cytologic and nuclear atypicalities (nuclear pseudoclearing and cell pleomorphism) as well as some hyperplastic or peculiar growth patterns (capsular pseudoinvasion; vascular invasion; papillary carcinoma-like and paraganglioma-like patterns) of benign conditions mimicking neoplasia; and finally. some pseudotumoural lesions of the stroma (pseudoangiosarcomatous vascular proliferation, and post-fine-needle aspiration spindle cell nodule). The pathogenetic mechanism, the morphologic interpretation, and the differential diagnosis of each of the above-listed conditions are discussed and pertinent illustrations for many of them are also provided. Lesions of thyroid tissue situated outside of the gland itself are not discussed.

Early genomics of learning and memory: a review.

The characterization of the molecular mechanisms whereby our brain codes, stores and retrieves memories remains a fundamental puzzle in neuroscience. Despite the knowledge that memory storage involves gene induction, the identification and characterization of the effector genes has remained elusive. The completion of the Human Genome Project and a variety of new technologies are revolutionizing the way these mechanisms can be explored. This review will examine how a genomic approach can be used to dissect and analyze the complex dynamic interactions involved in gene regulation during learning and memory. This innovative approach is providing information on a new class of genes associated with learning and memory in health and disease and is elucidating new molecular targets and pathways whose pharmacological modulation may allow new therapeutic approaches for improving cognition.

A third blind test of crystal structure prediction.

Following the interest generated by two previous blind tests of crystal structure prediction (CSP1999 and CSP2001), a third such collaborative project (CSP2004) was hosted by the Cambridge Crystallographic Data Centre. A range of methodologies used in searching for and ranking the likelihood of predicted crystal structures is represented amongst the 18 participating research groups, although most are based on the global minimization of the lattice energy. Initially the participants were given molecular diagrams of three molecules and asked to submit three predictions for the most likely crystal structure of each. Unlike earlier blind tests, no restriction was placed on the possible space group of the target crystal structures. Furthermore, Z' = 2 structures were allowed. Part-way through the test, a partial structure report was discovered for one of the molecules, which could no longer be considered a blind test. Hence, a second molecule from the same category (small, rigid with common atom types) was offered to the participants as a replacement. Success rates within the three submitted predictions were lower than in the previous tests - there was only one successful prediction for any of the three ;blind' molecules. For the ;simplest' rigid molecule, this lack of success is partly due to the observed structure crystallizing with two molecules in the asymmetric unit. As in the 2001 blind test, there was no success in predicting the structure of the flexible molecule. The results highlight the necessity for better energy models, capable of simultaneously describing conformational and packing energies with high accuracy. There is also a need for improvements in search procedures for crystals with more than one independent molecule, as well as for molecules with conformational flexibility. These are necessary requirements for the prediction of possible thermodynamically favoured polymorphs. Which of these are actually realised is also influenced by as yet insufficiently understood processes of nucleation and crystal growth.

[Solitary ganglioneuroma of the ileo-cecal valve]. / Ganglioneuroma solitario della valvola ileo-cecale.

Ganglioneuromas may occur in the small and large intestine as either solitary lesions or, more commonly, as multiple lesions (ganglioneuromatosis). The former are very rare, whereas ganglioneuromatosis may be associated with von Recklinghausen's disease and multiple endocrine neoplasia (MEN) type II B. We described the clinicopathologic features of a case of solitary polypoid ganglioneuroma of the ileocecal valve. The lesion was endoscopically diagnosed in a 27 year old man, with a history of abdominal pain. No association with von Reckling-hausen's disease or MEN was identified. Mutational analysis for RET was negative. Microscopically, the tumor consisted of a proliferation of well differentiated Schwann cells and ganglion cells in the lamina propria. The solitary polipoid ganglioneuroma is invariably benign. It shows no evidence of recurrence after total excision.

Correlation between intestinal metaplasia of the gastric cardia and gastroesophageal reflux disease.

BACKGROUND/AIMS: IMC (intestinal metaplasia of the cardia) has been a subject of great interest, given the rapidly increasing incidence of adenocarcinoma in this location, over the past two decades. Whether this histological alteration is a consequence of gastroesophageal reflux disease, or a manifestation of an H. pylori-related multifocal atrophic gastritis, is unclear. Furthermore, whether IMC should be considered a premalignant lesion of gastric cardia is still unknown. We performed a prospective study in order to determine the prevalence of IMC in patients presenting for elective esophagogastric-duodenal endoscopy and to evaluate a potential association between IMC and some clinical, endoscopic and histological variables. METHODOLOGY: Biopsy specimens were taken from 105 unselected patients undergoing routine diagnostic endoscopy. Eight biopsies were taken from different sides, for histological evaluation: 1 above and 3 below the squamocolumnar junction, 2 from gastric fundus and 2 from gastric antrum. All specimens were stained with hematoxylin and eosin-Alcian blue and modified Giemsa to facilitate the detection of H. pylori. RESULTS: Eighty-six patients (50 males, 36 females) with a mean age of 46.5 years (range: 23-75 years), were included in the study. Twenty-one (24.5%) were found to have IMC; 4 (19%) of these had concomitant low-grade dysplasia of the cardiac mucosa. IMC was associated with: males (P = 0.04), endoscopic diagnosis of esophagitis (P = 0.02), histological diagnosis of esophagitis (P = 0.008), mucosa of the cardiac type (P = 0.02), chronic carditis (P = 0.002) and dysplasia (P = 0.04). There was no correlation with: age, reflux symptoms, activity of carditis, H. pylori infection of the cardia and intestinal metaplasia of the distal gastric mucosa. CONCLUSIONS: IMC is common in our area. It is associated with endoscopic and histological changes of gastroesophageal reflux disease, but not with H. pylori infection of the cardia. Although 19% of patients presented concomitant dysplasia (of low grade), long-term follow-up studies will be necessary to assess the effective risk of IMC for cancer transformation.

Genital human papillomavirus types in immunocompetent and immunodepressed women in northeast Italy: prevalence and cytomorphological correlations.

OBJECTIVE: We evaluated the prevalence of genital human papillomavirus (HPV) types in correlation with cytomorphological findings in patients at different risk for cervical intraepithelial neoplasia living in northeast Italy. METHODS: Exfoliated cervicovaginal cells from 943 women, who were divided into three groups, were analyzed by polymerase chain reaction. RESULTS: Overall, HPV prevalence rates were 7%, 38%, and 52%, respectively. The single most frequent type was HPV 16 (18%), followed by types 6, 31, 53, 58, 61, and novel/unidentified (5-7%); other types had a frequency <5%. Infection with multiple types was present in 12%. In HIV-infected women, HPV infection was correlated with lower CD4 level and higher viral load; HGSILs were correlated only with a lower CD4 count, and no correlations were found for LGSILs. CONCLUSIONS: HGSILs were associated with high-risk types, mainly HPV 16 (40%). LGSILs, instead, were associated with a broad spectrum of low-risk and high-risk types.

Correlation between histological grade, MIB-1, p53, and recurrence in 69 completely resected primary intracranial meningiomas with a 6 year mean follow-up.

Sixty-nine intracranial, totally excised meningiomas were immunostained for MIB-1 and p53 protein expression. According to the 1993 WHO criteria, revised by Perry et al., the 69 meningiomas were classified into: grade I = 54 benign meningiomas, grade II = 10 atypical meningiomas, grade III = 5 malignant meningiomas. The patients were followed until death or for an average of 6.7 years. The 69 meningiomas were divided into two groups, according to the absence (n = 42) or presence (n = 27) of recurrences. In the last group we included 3 patients who died of meningioma recurrence. According to the percentage of MIB-1 positively stained cells, meningiomas were divided into three groups: <1% (n = 36), 1-10% (n = 28), >10% (n = 5). We found the MIB-1 labeling index (LI) <1% in 33 grade I (61%) and in 3 grade II (30%) meningiomas. On the other hand, 7 grade II (70%) and all grade III (100%) meningiomas presented a MIB-1 LI >1%. Correlation between histological grade and MIB-1 LI was statistically significant (p = 0.0006). The correlation between MIB-1 LI and follow-up was also highly significant (p < 0.001): the majority of meningiomas which did not recur (32/42 equal to 76%) were characterized by a low (<1%) MIB-1 LI. In the recurrence group MIB-1 LI was significantly higher than in the disease-free patients' group. Moreover, MIB-1 appeared to be a prognostic parameter not strongly related to the histological grade. In fact, it was significantly higher in recurrent histologically benign meningiomas, as compared with benign meningiomas without recurrence (p = 0.0006). Positive p53 protein expression (>1%) was shown in 26/45 meningiomas (57%), with an LI of 1-10% in 18 (40%) and an LI of >10% in 8 (17%) meningiomas. Although the p53 LI tended to be higher in atypical and malignant meningiomas, no significant correlation was found between the p53 expression and the recurrence (p = 0.05). The authors conclude that quantitative MIB-1 labeling is a useful technique in the routine diagnostic assessment of meningiomas, and helpful in obtaining more information about prognosis and thereby in planning the most suitable treatment.

[Impact of neoangiogenesis on the survival of patients of patients with stage Ib-IIb cervical carcinoma]. / Impatto della neoangiogenesi sulla sopravvivenza delle pazienti con carcinoma della cervice stadio Ib-IIb.

The survival of patients with cervical cancer has not improved much over the past few years. Cervical cancer is characterised by a degree of heterogeneity. Some patients undergoing surgery die a few months after diagnosis and treatment, whereas others live for longer and metastases only occur at a later stage. Over the past few years a new prognostic factor of cervical cancer has been identified. Neoangiogenesis can predict the possible metastasization of lymph nodes, disease-free survival, recidivation and therefore which patients require specific postoperative adjuvant therapies. This oncogenetic model, which also correlates the degree of neoangiogenesis with metastasization, and hence the level of tumour aggression, has been well demonstrated in lung cancer and skin melanoma. The microscopic discovery of increased tumour vascularization might be a useful independent prognostic factor in patients otherwise regarded as low risk. Cervical cancer with intense neoangiogenesis at an early phase may undergo rapid growth, early invasion and an increased capacity for metastasization. Neoangiogenesis is expressed as the density of microvessels inside the stroma of the neoplasm in invasive cervical cancer. It is predictive of recurrent disease and mortality independent of other prognostic factors. Patients with a high density of microvessels have a risk of fatal recidivation. The quantification of angiogenesis in primary tumours may be a useful prognostic factor in patients with cervical cancer. The quantification of neovascularization in neoplasms today is made easier by immunohistochemical staining procedures with greater specificity and sensitivity compared to conventional stains. It is to be hoped that this method will be used systematically by pathologists in biopsies to identify the most appropriate surgical and adjuvant therapies.

Colposcopy, cytology and HPV-DNA testing in HIV-positive and HIV-negative women.

In this study we examined the incidence of colposcopic-colpocytologic findings and analyzed Human Papilloma Virus (HPV)-DNA testing by Polymerase Chain Reaction (PCR) in 104 Human Immunodeficiency Virus (HIV) serous positive women (Group 1) and 218 HIV-negative women (control Groups 2 and 3). The aim of the study was to evaluate the most appropriate and efficacious diagnostic methods for screening programs for cervical cancer in HIV-positive women. For Group 1 we also considered the value of CD4+ T-lymphocytes and morphologic and molecular follow-up from 3 to 6 months. The results showed that the abnormal transformation zone (ANTZ) was present in 66.3% of the cases in Group 1 compared with 31.4% in control-Group 2 (p<0.001), and with 58.93% of the cases in control-Group 3 (p=0.257); intraepithelial squamous lesions (SIL) were found in 50% vs 5.66% (p<0.001) and vs 56.25% of the cases (p=0.433), respectively. In 28.85% of the HIV-positive patients the first cytological screening exam was not evaluable due to inflammation but in 56.67% of the cases colposcopy revealed ANTZ. The subsequent colpocytological checkup after therapy showed 10 cases (30%) of low risk squamous intraepithelial lesions (LSIL) and two cases (6.6%) of high risk squamous intraepithelial lesions (HSIL). HPV-DNA testing by PCR was positive in 53.8% of the cases in Group 1, in 6.6% in control-Group 2 and in 42% in control-Group 3. In HIV-positive patients multiple HPV genotypes were simultaneously present in 21.43% of the cases and high risk genotypes were present in 70% of the cases of HSIL. In Group 1, 36.61% of the cases had lesions of the lower genital tract. The value of CD4+ T-lympocytes was <200 cells/ml in 30% of the cases of HSIL. Our data, like those of other Authors, confirm a high incidence of HSIL, abnormal colposcopic findings, and HPV infections in HIV-positive women with respect to control-Group 2, while there was not much difference between Group 1 and control-Group 3. Such frequency again suggests that an integrated morphological diagnostic approach with colposcopy-colpocytology in the screening of immunosuppressed subjects would be worthwhile.

Lhermitte duclos disease and Cowden disease: clinical, pathological and neuroimaging study of a case.

The authors report the case of a 26-year-old female patient affected by Lhermitte Duclos disease and Cowden disease. Preoperative MRI allowed a correct diagnosis which was confirmed by pathological examination. The authors stress the possibility that Lhermitte Duclos and Cowden disease be a single phakomatosis; for this reason all the patients affected by Lhermitte-Duclos should be screened for the presence of multiple hamartomas or malignant neoplastic lesions typical of Cowden disease.

Myofibroblastoma of the breast with hemangiopericytoma-like pattern and pleomorphic lipoma-like areas. Report of a case with diagnostic and histogenetic considerations.

Myofibroblastoma (MFB) of the breast is an uncommon benign spindle cell tumor which may exhibit a wide spectrum of histological features. We report an unusual case of MFB of the male breast, showing cellular areas with a hemangiopericytoma-like pattern similar to that observed in solitary fibrous tumor (SFT) and extensive fibromyxoid areas containing numerous atypical stromal cells. The association of these atypical cells with mature adipocytes and microcystic and/or myxoid degenerative changes resembled pleomorphic lipoma-like and myxoid liposarcoma-like features, respectively. To our knowledge, these peculiar morphological findings have not been previously reported in MFB of the breast. They should be recognized to avoid confusion with other mesenchymal tumors, especially with hemangiopericytoma, pleomorphic lipoma (PL), spindle-cell lipoma (SCL) and myxoid liposarcoma. A case of MFB of the breast showing morphological features also commonly seen in SFT and PL/SCL is further morphological evidence in support of the speculation that the mesenchymal tumors of the breast, also known under the terms benign spindle cell tumors, fibromas, SFTs, SCLs and MFBs, are histogenetically related lesions.

Correlated expression of BCL-2 protein, estrogen receptor, cathepsin D and low growth fraction (PCNA) in intracystic papillary breast carcinoma.

The expression of BCL-2 protein was evaluated immunohistochemically in 23 intracystic papillary carcinomas (IPCs) of the breast. Twenty-two patients were female and one male, aged 49-90 years (median 72). Twenty-one cases had a benign behaviour, while two cases developed local recurrence. Of the 23 tumours, 19 (82%) were immunoreactive for BCL-2, the majority of positive carcinomas showing intense cytoplasmic staining of more than 50% neoplastic cells. The intensity of BCL-2 expression was significantly correlated with prognostic markers such as estrogen receptor (ER) positivity (p = 0.001), cathepsin D (CD) reactivity in the neoplastic cells (p = 0.001) and low growth fraction, evaluated by proliferating cell nuclear antigen (PCNA) immunostaining (p = 0.008). An inverse relationship was also found between BCL-2 and p53 protein (p = 0.001). Three cases of high grade (G3) IPC expressed p53, high PCNA index, and CD (the latter only in the stromal cells), but no immunostaining for BCL-2 and ER. Thus, absence of BCL-2 expression in high grade IPC was associated with ER-negative, rapidly proliferating and p53-positive immunophenotype. All high grade tumours showed invasion of the cystic wall. Local recurrence developed in one of these. The authors conclude that BCL-2 immunoreactivity in IPC is related with tumour grade and with a range of molecular markers of favourable prognosis such as ER positive status, CD expression in the neoplastic cells, and low PCNA index. These findings are consistent with the indolent clinical course and the very favourable prognosis of IPC of the breast.

Gastric antral vascular ectasia (the watermelon stomach): a brief case report.

Herein, the endoscopic and histological features of a case of gastric antral vascular ectasia (watermelon stomach) occurring in a 76-year-old woman are described. The condition, first recognized by Jabbari et al in 1984, is a rare but important cause of severe gastrointestinal blood loss and chronic iron deficiency anemia. Differential diagnosis from portal hypertensive gastropathy, treatment and outcome of the watermelon stomach are discussed.

Correlation of alpha 2 beta 1 integrin expression with histological type and hormonal receptor status in breast carcinomas.

Interactions between cells and extracellular matrix are mediated in part by a family of alpha beta heterodimeric molecules known as integrins. Immunohistochemical studies have shown that benign hyperplastic/neoplastic mammary epithelium expressed high levels of alpha 2 beta 1 collagen/laminin receptor. In contrast, malignant cells of breast carcinoma exhibited marked diminuition or loss of the alpha 2 beta 1 integrin. A correlation has been suggested between the loss of the alpha 2 beta 1 expression and the increased invasiveness of neoplastic cells. This study investigated the expression of alpha 2 beta 1 integrin and its extracellular ligand collagen TV by using monoclonal antibodies on the cryostat section of 124 invasive mammary carcinomas. Two patterns of alpha 2 beta 1 immunoreactivity, i.e. pericellular and basolateral, were identified in breast carcinomas and correlated with their histological type. In most invasive ductal carcinomas of no special type (NOS), integrin staining tended to decrease in both pericellular and basolateral aspects. Loss of basolateral staining for alpha 2 beta 1 integrin corresponded closely to the loss of immunoreactivity for collagen IV. Mucinous and medullary carcinomas showed strongly alpha 2 beta 1 pericellular staining, but no basolateral reactivity or collagen IV expression. Only two of the infiltrating lobular carcinomas expressed strong pericellular reactivity. In 82 ductal carcinomas NOS, the abnormally low expression/absence of alpha 2 beta 1 integrin correlated with estrogen and progesterone receptor negativity (p < 0.04 and p < 0.002, respectively). No correlation between integrin expression, histological grade, nodal involvement and proliferative activity was found. The results of the present study suggest that changes in alpha 2 beta 1 expression correlate with the histological type and hormonal receptor status in breast carcinomas. The clinical implications of these findings remain to be elucidated.

Colposcopy, colpocytology and the vaginal ecosystem. Oncological, bacteriological and hormonal evaluation in a series of 400 women.

The Authors retrospectively considered colpocytological and colposcopic findings in a series of 400 women, aged 16 to 83 years, presenting for the first time at the Oncological Gynaecology Unit of the Institute of Gynaecology and Obstetrics of Padua University between 1991 and 1992. In addition to oncological evaluation, the bacteriological profile and hormone status of cytological samples were formulated in all cases. The most common oncological finding was a cell morphology within normal limits (67%), followed by reactive and reparative changes (19%) and low-grade squamous intraepithelial lesions (SIL, 12%). Histological findings correlated well with the cytological diagnosis, though low-grade SIL was over-estimated. As for the bacteriological profile, a mixed flora was most frequent (56.7%) followed, especially in fertile age, by Döderlein's bacillus (20%) and vaginosis (15.5%). Colposcopy most frequently revealed ectopia and/or a normal transformation zone (50.7%) and dystrophic mucosa (21%). An abnormal transformation zone was more common among women with a moderate-to-abundant flora. Fifteen male partners were also checked: cellular changes typical of human papilloma virus infection were found in 40% and colposcopic findings compatible with said virus were observed in 26.6% of cases. These results confirm that colpocytology provides a complete and simultaneous evaluation not only of cell morphology, but also of the bacterial population and hormones in the vaginal ecosystem. It is therefore the method of choice in screening for cervical and vaginal neoplasms and an effective means for simultaneously evaluating vaginal flora and hormone status.

Endometrial cytology for the prevention and early diagnosis of endometrial neoplasias.

One hundred and forty women, aged between 46 and 70 years, were submitted to periodic colpocytologic, colposcopic and cytologic endometrial checking. None of the patients had been treated by estrogenic therapy. We evaluated the possible morphologic modifications of the endometrium over time by periodic cytologic checks, personalized on the basis of the anamnestic and actual risks of the patients. From the data it was noted that the endometrium in pre- and in post-menopause may present changes in the absence of substitutive therapies. In fact in women in post-menopause we found 33% of atrophic endometria at first check, going down to 22.3% at the second, while the incidence of hyperplasia increased slightly. At the second check we always diagnosed 2 cases (2.6%) presenting atypia, confirmed by subsequent curettage. At the third check an increase was observed of atrophic endometria (41.8%) and a reduction of focal hyperplasia (4%). Among women in pre-menopause there was a high incidence of endometria with focal hyperplasia, 37.5% at the first check, 40.6% at the second and 39.6% at the third; hyperplasia in 11.5% of cases at first check, 12.5% at the second and 6.3% at the third; presence of atypia in 1.5% of cases at the second check and 3.2% at the third. Curettages subsequently confirmed diagnosis in these last three patients. In the cases where small fragments of endometrial tissue appeared in the cytological sample we found good agreement between histologic and cytologic diagnoses; the latter slightly overestimated focal hyperplasia and diffuse hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hemostatic parameters in patients with type IIA and IV hyperlipoproteinemia]. / Parametri emostatici in soggetti iperlipoproteinemici di tipo IIA e IV.

In order to assess the interrelationships between the lipemic and the haemostatic balance the Authors studied the behaviour of some thrombotic markers in hyperlipemic subjects. The series consists of 35 subjects (15 m, 20 f, mean age 56 +/- 9 years) suffering from primary polygenic hyperlipoproteinemia of type IIA (23 cases) and type IV (12 cases) (cholesterol and triglyceride values exceeding respectively 250 and 180 mg%); 38 control subjects matched for sex, age and body weight were also examined; all the subjects were without hepato-renal and endocrine-metabolic disorders as well as without clinical signs of arteriosclerotic vasculopathy. For each subject the Authors performed the assay of the fasting plasma levels of total cholesterol (TC), triglycerides (TG) (enzymatic methods), fibrinogen (F) (coagulometric method), factor VII (coagulometric method) (F VII), antithrombin III (AT III) (chromogenic method), tissue activator of plasminogen (tPA), beta-thromboglobulin (BTG) and D-dimer (D-D) (ELISA method). The type IIA hypercholesterolemic subjects showed a not significant trend in a thrombophilic sense of the markers (increase of F, F VII, BTG and D-D, decrease of AT III); the type IV hypertriglyceridemic subjects exhibited a significant (0.05) increase of factor VII, BTG and D-D compared to the control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)