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The ultrastructural study of cutaneous biopsies in diabetic patients highlighted in different phases of disease a progressive alteration of extracellular matrix (E.M.). In the initial phase of disease the morphologic aspect showed an increased accumulation of proteoglycan biglycan, laminin, fibronectin and type IV collagen. These components are responsible for the lamina lucida expansion and are induced by TGF-beta. In the last phase of the disease, an accumulation and a defective organization of E.M. component arises. Type V collagen, normally not present in the skin, is observed. In patients with over ten years of diabetic history, the morphological aspect is defined by a progressive disorganization of E.M. The formation of a vicious circle is responsible for the progressive remodeling of E.M. This process may be linked to the not enzymatic glycosylation of E.M., due to several episodes of hyperglycemia, and to autoinductive mechanisms of TGF-beta. These mechanisms are responsible for the cytokine synthesis and for the E.M. inhibition of degradation.

75 patients with breast gross cystic disease and no cancer have been included in the study. For each patients serous and intracystic concentrations of MCA have been measured. The aim of the study is to assess whether if a relation between intracystic concentration of the marker and resistance and capability of cellular reproduction exists (confirmed by the release of the cyst). The analysis of intracystic values shows that synthesis of MCA is an intrinsic peculiarity of cytologic kind. It is apparently independent from inflammatory or hemorrhagic contemporary processes.

PSA has been measured out with highly sensitive method both in liquid of mammary cysts and in cytosol of neoplastic cells. Our data point out that dysplastic, metaplastic and anaplastic breast epithelial cells produce PSA. Such production is, probably, related to expression of hormonal receptors.

IAP marker was detected by radio-immunodiffusion in breast gross cyst fluid and in serum. No correlation was found between this antigen and cyst' cytological type, serum concentrations and acute phlogosis. In most cysts IAP was not valuable; on the other hand, high levels of glycoprotein were found only in the subgroup on relapsed class of apocrine cysts.

Ca 125 was assayed in serum and in breast cyst fluid of 78 patients with GCD. Levels of the marker in cyst fluid are generally < 30 U/ml. More significative results were found in relation to cysts relapse. In apocrine cysts relapse levels were higher than 270 U/ml, in serum cysts not relapsed levels were between 31-270 U/ml. Ca 125 could have a significative role in cell differentiation and its control.

Cathepsin-D was assayed in serum and in breast cyst fluid of 60 non neoplastic patients with GCD. The results are independent from cytological type or possible cyst relapse. Although the study confirms the high levels of Cat-D in breast cyst fluid no predictive value has been demonstrated. Its expression may be related to systemic endocrine factors.

This study carried on 61 patients with breast cancer confirmed the biological assumption of a higher malignancy in tumors with strong desmoplastic reaction. Patients in stage II A, II B and III presenting a marked desmoplastic reaction have a shorter DFS (disease free survival). Therefore, desmoplastic reaction may be considered a marker of local malignancy and metastatic process.

Ca 15-3 was assayed in serum and in breast cysts fluid of 78 non neoplastic patients presenting Gross Cysts (GCD). In apocrine cysts and in the mixed type (serous and apocrine, class III) relapse was indicated by high serum and intracystic levels of the marker. Ca 15-3, therefore, may discriminate in a group of cysts a higher cellular resistance as well as an increased cell proliferation. Results suggest an important role of the marker in the follow up of patients with GCD and for the early detection of cyst relapse.

An histological and E.M. study has been performed on rat's intestinal tract resection to evaluate CO2 laser effects. Necrotic effect of laser is evident up to 120 micron. While the intestinal tissue results normal at 480 micron from resection line. Muscular and fibrous components appear more resistant to damage while E.M. presents a new organization of its components forming a new compact and continue tissue. This new organization may be involved in the protection of the subepithelial spaces, and may have an important role in intestinal anastomosis scar process.

The authors carried an histological and ultrastructural study on rat kidney following polar excision by argon laser. The involvement of the remainder portion of the kidney was evaluated analysing the depth of the damage induced by the laser radiation. Restitution ad integrum was found below 360 micron thickness with a different involvement of the various kidney components. Glomeruli showed a deep damage caused by intravascular photocoagulation. On the contrary, tubular and extracellular damage was less serious and the damaged area extended for only 240 micron from the section, probably for a lack of absorbance of the argon radiation by clear and water-rich tissues.

In this study a good sensibility of ultrasound in identifying ductal disease was demonstrated. We evaluated the relationship between nipple discharge and ductal ectasia and the importance of the ectasia in maintaining nipple discharge. From our data the hypothesis of a possible role of oestroprogestinic hormones in the genesis or maintaining of ductal ectasia emerged.

The Authors report 4 cases very interesting for the differential diagnosis of phyllodes tumor, a breast tumor with a mainly local malignant potential. Such tumor, although presenting histologic, clinical and instrumental features which allow for a presumptive pre-surgical diagnosis, often has characteristics comparable to other breast pathologies with a different natural history. The Authors, after analyzing clinical, mammographic, echographic and histologic features of the tumor, suggest the most appropriate therapy for the local control of the lesion. Surgical excision should be carried at least 1 cm deep into the normal tissue to prevent local relapse related to an incomplete enucleation: in fact, the tumor is only apparently capsulated. Furthermore, the Authors believe a patients must undergo, after primary surgery, an adequate instrumental and clinical follow up for the early diagnosis of commonly occurring relapses.

Three cases of galactocele appeared as breast nodule during lactation are reported. From our experience and the recent literature, ultrasound shows a good reliability for the diagnosis of breast diseases during pregnancy and lactation in spite of oedema and breast turgidity, distinctive of these periods.

Nipple discharge, a rare clinical sign, is more frequently determined by benign breast diseases, but it can be associated to breast cancer; for this reason such clinical sign shouldn't be ignored. Cytologic examination together with breast examination and thermography are the correct oncologic approach for nipple discharge, because such way it is possible to select the patients for whom mammography or galactography are recommended as well as and breast biopsy depending on the galactographic data.

Different collagen types (I, III, IV, V) were identified in breast carcinoma desmoplastic tissue by ultrastructural analysis and immunoelectronmicroscopy. Type V collagen is present as a 12 nm. fibril in the stroma, either adjacent to the basement membrane or concentrated around the thicker fibers. Myofibroblasts, fibroblasts and tumor cells can be its major producers. Its possible function as a bridge between different collagens can be utilized, with different finality, by the same cells that have produced it. Furthermore, type V collagen can be involved in tumor invasion of the stroma and in all directional movements of tumor cells, as already demonstrated for other extracellular matrix components.

The Authors demonstrated the presence of tumour cells by an in vitro culture of the cells from the pellet of a postoperative saccate effusion, when no tumor cells were evident by the cytologic examination of the effusion. The ultrastructural features and the immunocytochemical characteristics of the cell line were analyzed and these data confirmed its malignant nature. It allowed a firm diagnosis, a correct therapy and prognosis.

The authors evaluated the advantages obtained utilizing FNAB with ultrasound in the needle aspiration of breast cysts. Echography can guide the aspiration up to its end in an effective and localized way. Cytologic examination of the cystic fluid confirmed the benign nature of the cyst. The association of needle aspiration and guided echography was related to a low number of relapses (19.8%). Among these relapses some risk factors have been found as well as a correlation between cystic fluid cytologic examination and relapses incidence has been determined.