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Biomedical subjects

A Costa

Publications and source records attributed to A Costa.

At least 397 records · Page 22Linked to original sources
PubMed1984

Indirect lymphography of the breast with iotasul: a vanishing hope?

Using a new aqueous nonionic contrast medium (Iotasul, Schering) we attempted visualization of axillary lymph nodes in patients with breast carcinoma. Intradermal infusion into the areola consistently opacified the subareolar plexus and latero-cranial lymphatic trunk. Axillary nodes were visualized in 78.6% of patients, but only 5.7% of surgically excised nodes were partially or totally opacified. Eleven patients underwent axillary lymph node dissection and histology confirmed metastases in 4, of which only two were detected by lymphography. Breast lymphography is inadequate for routine clinical application, and radical axillary dissection remains the mainstay for documentation of nodal metastases.

Breast Neoplasms↗
PubMed1984

Serum autoantibodies and thyroid lymphocytic infiltration in endemic goitre.

Patients with thyroid diseases from areas of endemic goitre in Northern Italy were examined for thyroid antibodies by passive haemoagglutination. Of 40 schoolboys with goitre only one had thyroid antibodies (AT) in the blood. Among 182 adults with grade 1-2 goitre, examined within an area of low endemia, the frequency of AT was 7%, not significantly different from that found in the 286 persons with thyroid 'O' living in the same area. Among 181 adults with grade 2-3 goitre, examined within an area of serious endemia, the frequency of AT was 16%; the percentage went up to 24% in 144 patients operated on for goitre. AT frequency was 36% in 87 patients with toxic goitre, more than 70% in 97 patients with Graves' disease and 17% in 60 patients with cancer of the thyroid. AT occurred three times more frequently in women than in men. Microsomal antibodies were more frequently detected than anti-thyroglobulin antibodies: the opposite was true in thyroid cancer. Lymphocytic infiltration (IL) of the gland was observed in 45% of the 464 simple goitres and in 52% of the 60 cancers of the thyroid: it was more frequent and intense in women. Among the 144 patients operated on for goitre the frequency and the titre of AT progressed in parallel with the intensity of the lymphocytic infiltration. Patients with a greater lymphocytic infiltration and higher AT had a higher TSH. Multinodular non-toxic goitre and autoimmune lymphocytic thyroiditis can be present in the same thyroid gland and the clinical expression will depend on which condition predominates.

Adolescent↗
PubMed1983

[Studies on iodine exchange in thermal therapy with salsobromoiodic water].

We have attempted a quantitative evaluation of the iodine taken in with the thermal waters from Salsomaggiore during therapeutic bathing, inhalation (dry and damp spray), or ingestion. For this purpose to 127I we have applied the metabolic parameters obtained through a 131I inhalation test and a 125I ingestion test. Of the iodine inhaled by aerosol 45% becomes exhaled; by 24 hours 2% is in the serum and in the extra-thyroid area of iodine distribution, 16% in the thyroid, 16% in the urine. By adding the amount of iodine exhaled to that found in the metabolic cycle of iodine, we find that about 21% of the inhaled iodine is still missing. This amount is trapped in the respiratory tract from where it disappears only very gradually. At the end of the 24 hours, therefore, in the metabolic cycle of the iodine we find 34% of that inhaled, whereas we find 87% of that ingested. The level of iodine in the serum reached in thermal therapeutic inhalation, never stays at a level which might alter the functioning of a normal thyroid. The amount of inhaled iodine which is excreted with the urine is usually eliminated during the first excretions. Experimental studies suggest that the iodine taken in during bathing in the thermal-pools mainly comes from iodine released from the water through the addition of hypochlorites, and is then inhaled through breathing the air just above the water.

Balneology↗
PubMed1983

Laser oncology in Italy: experimental research and clinical applications at the National Cancer Institute, Milan.

CO2, Nd:YAG, and argon lasers have been used for 5 years for experimental and clinical procedures at the National Cancer Institute of Milan under the auspices of the National Research Council. Experimental data regarding tumor cell spread through lymphatic and hematic channels and cell viability in the fumes after CO2 laser irradiation are reported. New advantages in the combined treatment modalities have been demonstrated, since the synergism between the low power argon laser beam and chemotherapeutic agents (anthracyclines) was assessed on cell cultures and the least toxic and the most effective doses of the drugs were identified. Due to the optical properties of the laser beam, physical measurements of the delivered energy and mathematical calculation of the energy per tissue volume unit to be ablated increase the precision in microsurgery especially when conservative managements are indicated. Main applications in surgical oncology, and comparison versus conventional methods, both with vaporization and excisional techniques, according to specific therapeutic protocols, in general surgery, otolaryngology, gynecology, and endoscopy, even on an outpatient basis, are finally illustrated in a series of 600 cases.

Animals↗
PubMed1983

Lack of efficacy of xeroradiography to preoperatively detect axillary lymph node metastases in breast cancer.

Xeroradiography of the axilla was performed in 132 patients with operable breast cancer to investigate the status of the axillary lymph nodes. Pathologic findings were correlated with the results of clinical examination and xeroradiographic findings. Xeroradiography does not appear to have improved our ability to identify axillary lymph node metastases in patients with breast cancer.

Axilla↗
PubMed1983

Configuration of the methoxyimino group and penetration ability of cefotaxime and its structural analogues.

Among the different mechanisms by which bacteria are resistant to beta-lactam antibiotics, three are of major interest: production of beta-lactamase, modifications of the target penicillin-binding proteins (PBPs) and decreased permeability. Cefotaxime (CTX) is a recently synthesized cephalosporin derivative, active against beta-lactamase producing Gram-negative bacteria and possessing in the acylamino side chain a methoxyimino group in the syn-configuration. It has been compared for affinity to PBPs and penetration ability with its isomer possessing the same group in the anti-configuration and the corresponding demethoxyimino derivative. The anti-isomer, although resistant to beta-lactamase, is devoid of antibacterial activity (MIC for Escherichia coli higher than 500 micrograms/ml). The affinities of CTX and its analogues for the PBPs of several strains of E. coli have been determined in vivo and in vitro by competition experiments using intact cells and bacterial envelopes, respectively. Only minor differences in the affinity for the target PBPs were detected in vitro. However, in vivo studies proved that the 50% saturating concentrations for the PBPs were more than 100-fold higher for the anti-isomer than for CTX. The reported results suggest that a very simple structural modification of the CTX molecule greatly decreases the penetration ability of the antibiotic through the outer cell layers, thus dramatically affecting its antibacterial properties.

Binding, Competitive↗
PubMed1983

[Xeroradiography of axillary lymph nodes in patients with tumors of the breast].

The use of axillary xeroradiography for the detection of lymph node metastases from breast cancer was evaluated on 125 consecutive patients submitted to surgery and to axillary dissection. The clinical and xeroradiographic aspect of lymph nodes was related to their histological diagnosis. Axillary xeroradiography was useful in predicting the metastatic involvement of lymph nodes in a fair good percent of cases, but it gave sometimes unpredictable results due to the superimposition of superficial soft tissues and to the lack of reliable diagnostic criteria. For these reasons, axillary xeroradiography cannot be used as a primary procedure before surgery is performed, and the xeroradiographic diagnosis cannot be assumed as the unique prognostic factor in predicting the metastatic spread of the tumour. This technique may prove useful, however, for the study of the axilla in obese patients and for the evaluation of the size and of the relationships of an axillary mass.

Axilla↗
PubMed1983

Conservative surgical treatment for primary breast cancer.

The definition of conservative surgery should be limited to procedures preserving at least part of the breast. A randomized trial on conservative treatment of breast cancer, using in the control arm the Halsted mastectomy and in the second arm the QU.A.RT. method (quadrantectomy, axillary dissection, radiotherapy) was started in June 1973 at the National Cancer Institute of Milan. Patients with clinical or mammographic evidence of a breast cancer less than 2 cm in diameter without palpable lymph nodes (T1N0) were selected for the trial. The results lead to the conclusion that radical mastectomy appears to involve unnecessary mutilation in this kind of patients. Many problems are now connected with the future of conservative surgery of the breast. The first is the choice of cases, the second is multicentricity of breast cancer, the third is the risk of delayed carcinogenesis connected with the irradiation of the breast. Anyway, it is likely that a great proportion of breast cancers will benefit from a treatment which, without decreasing the survival rates, will be less multilating and therefore the quality of life will improve.

Breast Neoplasms↗
PubMed1982

Analysis of amniotic fluid proteins by isoelectrofocusing (IEF).

Among the most recent methods for investigation of proteins in biological fluids SDS Polyacrylamide-gel-electrophoresis and Isoelectrofocusing (IEF) have recently been introduced into laboratory practice. The present investigation has been performed on 20 samples of amniotic fluid obtained during normal pregnancies in the first and in the third trimester. The obtained results suggest that IEF analysis seems to have a selective advantage in allowing the separation of bands which can not be easily recognized with SDS electrophoresis. These bands detected by IEF and present in amniotic fluid during late pregnancy seem to be related to some low molecular weight lipoprotein fractions and we suggest that they might be used as a possible marker for monitoring fetal lung maturation. In conclusion we think that it would be of great interest to evaluate the usefulness of IEF analysis in examining A.F. obtained during pregnancies complicated by infections.

Amniotic Fluid↗
PubMed1982

Lymphnodal metastases from unknown primary tumors.

Prognosis and adequate therapy of lymphnodal metastases from unknown tumors are still uncertain. At the Milan Cancer Institute 71 patients with neoplastic adenopathies of unknown origin were hospitalized between 1965 and 1979. Men were 45 and women 26 with a M/F ratio of 1.7: 1. Most of patients were aged 51-70 years. Laterocervical adenopathies were the more frequent, followed by supraclavicular, axillary, inguinal, submandibular and retroperitoneal ones. In 11 cases the primary tumor was subsequently found (3 cases in tongue, 3 in rhinopharynx. 2 in lung. 2 in breast and 1 in thyroid). Of the remaining 60 cases, only histologic diagnosis of the metastasis was available and the primary tumor has never been found. Squamous cell carcinoma was the most frequent histologic type, followed by adenocarcinoma, undifferentiated carcinoma and malignant melanoma. No significant relationship between histologic types and lymphnodal sites could be demonstrated. In different cases treated with all possible combined therapies (surgery, chemotherapy and radiotherapy), no correlation between survival and therapy was possible. 35 patients (58.3%) were dead 18 months after diagnosis. No significant correlation between survival and histology was either shown. The natural history of these tumors remains unclear and any specific therapy cannot be proposed to be scheduled in such cases.

Adult↗
PubMed1981

Breast cancer: primary tumor characteristics related to lymph node involvement.

From November 1st 1977 to August 31st 1978, 842 consecutive patients with operable breast cancer were observed at the National Cancer Institute of Milan. Characteristics of the primary tumor and the status of regional lymph nodes were evaluated at clinical and postsurgical examination: it was found that qualitative characteristics of the primary were properly defined by clinicians, who usually overestimated maximum diameter of the primary. The status of regional lymph nodes is not reliable at clinical examination: 34.5% of clinically uninvolved nodes were found to contain metastatic growth at histologic examination. Age of patients, maximum diameter of the primary, histologic type and quadrant of origin of the primary tumor were significantly related to the frequency of regional node metastases. Multifactorial analysis showed that the last three factors were independent variables, while age, which is significant by itself, loses importance when adjusted by at least one of the other three factors. Frequently of extension of node metastases beyond the lymph node capsule was found to be related to the number of involved nodes: maximum diameter, histologic type and site of origin are significantly related to the frequency of extracapsular invasion. This study confirms that the evaluation of the status of regional lymph nodes is not reliable at clinical examination and indicates that characteristics of the primary may be useful in predicting regional lymph node involvement. The direct correlation between the number of involved nodes and the frequency of infiltration beyond the capsule suggests that prognosis of patients with positive nodes depends more on this factor than on the number of involved nodes.

Adult↗
PubMed1981

DNA content and kinetic characteristics of non-Hodgkin's lymphoma: determined by flow cytometry and autoradiography.

The determination of DNA content and [3H]thymidine labeling index was carried out on malignant lymph nodes from 74 patients with non-Hodgkin's lymphoma. Analysis of cellular DNA content was performed using propidium iodide as DNA-specific fluorescence dye. The ploidy was expressed as the DNA ratio between the relative DNA content of the human lymphoid G0/1 cells to that of chicken red blood cells. Forty-five of the 74 non-Hodgkin's lymphomas (61%) were aneuploid populations and the majority of these (91%) showed a hyperdiploid DNA content. A higher frequency of aneuploidy (72%) was observed in tumors with unfavorable histology than in those with a favorable histology (55%). Moreover, among aneuploid lymphomas heterogeneous populations were observed in 24% of the cases. The evaluation of flow cytometric data using Fried's deconvolution procedure showed no statistically different frequency of G0/1, S and G2 + M cells between the two groups of tumors with favorable and unfavorable histology. on the contrary, a statistically different frequency of G0/1 and S cells was observed between the two groups of tumors with low and high labeling indices (P less than 0.01). A correlation was found between autoradiographic and flow cytometric determination of S phase cells (P less than 0.001).

Aneuploidy↗
PubMed1981

Labeling index as a prognostic marker in non-Hodgkin's lymphomas.

The labeling index (LI) was determined at the time of initial diagnosis of 88 untreated adults with non-Hodgkin's lymphomas. The frequency distribution of low (less than or equal to 4%) and high (> 4%) LI between tumors with nodular and diffuse histologic patterns was significantly different (P < 0.001): The median LI was about four times greater for diffuse lymphomas than for nodular lymphomas. LI was not correlated with either disease extent or systemic symptoms. In patients with tumors of low LI, complete remission occurred in 86% of those with modular lymphomas and in 74% of those with diffuse lymphomas. These values were significantly different from the 17 and 39% observed respectively for nodular and diffuse lymphomas with high LI. Patients with low LI had greater actuarial 4-year survival than did those with high LI (P < 10(-7)). Highly significant differences between the two kinetic groups were also observed within nodular and diffuse patterns. However, whereas the difference for nodular lymphomas was independent of histologic subtype and stage, this was not always true for all subtypes of diffuse lymphomas. LI could be a useful marker to identify prior to treatment the patients who could enter complete remission and have favorable survival. Its clinical relevance as a prognostic factor appeared superior to the Rappaport histologic classification and pathologic stage, especially in patients with nodular histology.

Actuarial Analysis↗