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Biomedical subjects

A Giuliani

Publications and source records attributed to A Giuliani.

252 records · Page 14Linked to original sources
PubMedDate not supplied

[Surgical treatment of toxic megacolon in ulcerative rectocolitis. Analysis of 16 patients].

The clinical aspects, surgical treatment and outcome of 16 consecutive patients treated for toxic megacolon secondary to ulcerative colitis at the 1st department of surgery at the university of Rome between 1976 and 1987 were reviewed. The surgical management consisted in total colectomy and immediate ileo-rectal anastomosis, without protective ileostomy in 14 patients and total colectomy with terminal ileostomy and ileorectal anastomosis in 2 patients, 5 months later. No postoperative mortality was observe the immediate complications were: anastomotic leakage, (one case) and rectal bleeding (three cases). The late complications were: ileo-anastomotic stump fistula and perforation (two cases). Protectomy, due to colitis recrudescence, in the rectal remnant 10 months after surgery. These results encourage the total colectomy with immediate ileorectal anastomosis for the treatment of toxic megacolon.

Adolescent↗
PubMedDate not supplied

Which rules for assembling short-term test batteries to predict carcinogenicity?

The main theme of this paper is to describe the basic requirements for assembling reliable batteries of short-term tests for carcinogenicity prediction. For this purpose, a subset of the data base generated by the International Program for Evaluation of Short-Term Tests for Carcinogens (IPESTTC) has been studied by different data-analysis methods. Much attention has been focused on the methodological dimensions of the problem, at the level of selection of both data and statistical techniques. Twenty-one of the most widely used short-term assays were considered. An exploratory study of the data base was first performed by factor analysis, showing similarities and dissimilarities between test performances and confirming our previous results obtained by cluster analysis. In this way the assays were divided into three groups on the basis of their responses to the chemicals. The Salmonella assay was in the central group, characterized by equilibrated performances in respect to sensitivity and specificity for carcinogens. Tests complementary to the Salmonella assay for sensitivity and specificity, respectively, were identified as well. A preliminary comparison of the IPESTTC results with the Gene-Tox data base is also presented. The test performances in respect to carcinogenicity prediction were then evaluated by discriminant analysis. When the subset of data was considered as a whole, the procedure resulted in a linear discriminant function able to correctly identify 84.2% of carcinogens and 83.3% of noncarcinogens. The correctly identified carcinogens summed to about 90% when adequate batteries of tests were used. This analysis yielded a number of observations. (1) Together with the selectivity indices (such as sensitivity and specificity), the operational complementarity between test performances must be ascertained and taken into account. (2) The batteries most effective at predicting carcinogenic activity were composed of three tests, one for each group. This finding converged with the fact that the three classes of assays were clearly differentiated for sensitivity and specificity, and in this sense were complementary to each other. (3) The performances of the batteries were not improved by adding more tests, but in several cases the opposite effect occurred. (4) Estimation of the probability of the chemicals of being carcinogenic, starting from qualitative genotoxicity data, is possible.

Animals↗
PubMedDate not supplied

Primary tumors of the small intestine.

From 1950 through 1984, 48 cases of primary tumors of the small bowel were treated at the First Surgical Clinic of the University, La Sapienza, of Rome. Forty-three were malignant and five were benign tumors: 13 in the duodenum, 16 in the jejunum and 19 in the ileum. Abdominal pain, weight loss and obstruction were the most common complaints at admission. Radiographic studies of the gastrointestinal tract were diagnostic in 48% of patients. Four benign tumors were leiomyoma of the jejunum or ileum, the other benign tumor was a Brunner's adenomatosis of the duodenal bulb. The tumors were adenocarcinomatous in 29% of the cases and 50% of them were located in the duodenum. The five-year survival of patients with adenocarcinoma was 11%. The fourteen lymphomas were distributed evenly throughout the small bowel: 40% of the patients with lymphoma were alive after five years. Malignant smooth muscle tumors were found in the jejunum and ileum, in these cases the five-year survival rate was 50%. All the carcinoid tumors were in the ileum. The best five-year survival rate, 66%, was seen in patients with this type of tumor. In the malignant group, the five-year survival rate after curative resections was 25% in patients with positive nodes and 75% in those without nodal involvement.

Adenocarcinoma↗
PubMedDate not supplied

[Plant antigens with immunological properties. III. Separation of a biologically active fraction in a grass pollen extract].

In present paper a partial biochemical study concerning two grass pollens (Poa pratensis and Phleum pratense) is carried out. On Sephadex G-75 three fractions were detected by an extract from the grass pollens. Only the third fraction shows a biological activity and biochemical findings are in agreement with the presence of four polipeptidic subfractions of different molecular weights ranged between 10,000 and 14,500. Specific additionals trials (ultracentrifugation, disc-electrophoresis, thyn-layer electrophoresis, isoelectric-focusing, immunological studies) are carried out to confirm the observed nature of prevalent material in pollens.

Antigens↗
PubMedDate not supplied

Fluctuations in levels of various gangliosides in the different tracts of the oviduct of the frog (Rana esculenta) during the reproductive cycle.

The ganglioside content and pattern have been followed in the different tracts (rectus, convoluted and uterine) of the frog oviduct during the reproductive cycle. The main variations we observed are: a) average higher levels of ganglioside sialic acid in the preovulatory phase, with two peaks in March and April for the convoluted and rectus tract, respectively, and a more homogenous behaviour for the uterine tract; in all three tracts of the oviduct a minimum coincident with the ovulation has been found; b) a balanced presence of sulfolipids and gangliosides in the uterine tract: in fact sulfolipids, whose variations have been determined in a previous work, are higher when gangliosides are lower and vice versa, maintaining nearly constant the total negative charge due to these glycolipids; c) an alternate fluctuation of monosialo- and disialo-gangliosides in the preovulatory phase and a net trend toward the increase of monosialo- and the decrease of disialogangliosides in the postovulatory phase; trisialo-gangliosides are in general less represented and show less marked variations; d) the presence of particular gangliosides in particular moments of the reproductive cycle: Fuc-GM1, a fucosylated ganglioside, is higher than the more represented GM1 during the ovulation, while GD1 alpha, a ganglioside with a sialic acid residue linked to GalNAc, is steadily present in all three tracts after ovulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Differential effects of recombinant interferon-alpha and 5-fluorouracil against colon cancer cells or against peripheral blood mononuclear cells.

Comparative studies on the suppressive effects of recombinant interferon-alpha (IFN-alpha), 5-fluorouracil (5-FU), or IFN-alpha + 5-FU have been performed in vitro on colon carcinoma cells (HT-29 cell line) and PHA-stimulated mononuclear cells (MNC) of peripheral blood obtained from healthy donors. IFN-alpha was used at 500 U/ml against HT-29 cells and at 1000 U/ml against MNC on day 1 of culture; 5-FU was used at 250 microM against HT-29 and at 1400 microM against MNC on day 2 of culture. The results show that: (a) IFN-alpha inhibited MNC and HT-29 cells by 13.4% and 32.9%, respectively; (b) 5-FU inhibited MNC and HT-29 cells by 54.7% and 87.0%, respectively; (c) IFN-alpha + 5-FU resulted in a stronger inhibition of HT-29 cells (i.e., 96.1%). In contrast, that combination was significantly less suppressive than 5-FU alone when MNC were used as targets (i.e., 35.9% inhibition). Natural cell-mediated cytotoxic activity relative to 10(6) MNC was not markedly altered by all agents alone or in combination. Moreover, treatment with IFN-alpha, 5-FU or IFN-alpha + 5-FU resulted in a marked increase in the number of HT-29 cells positive for the CEA surface antigen. These data seem to provide further rational support of the clinical use of IFN-alpha + 5-FU in colorectal cancer, based on the differential toxicity of this drug combination on tumor versus normal immunocompetent cells.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[False positive results in breast diagnosis after treatment].

The authors referring to a case with a false positive diagnosis which recently came to their observation, describe the clinical, mammographic and echographic patterns to be considered in order to reach a differential diagnosis between benign and malignant lesions of the breast, which occur on surgical scars following quadrantectomy and subsequent radiotherapy. In particular, after an attentive research of the data reported in literature and after careful evaluation based on their personal experience, they conclude that the traditional clinical evaluation occupies a very prominent role in the follow-up of patients who underwent breast cancer surgery. They also believe that the diagnostic techniques, undoubtedly useful and necessary, must always be subjected to a critical evaluation in order to avoid, to the maximum, the possibility of diagnostic errors.

Breast Neoplasms↗
PubMedDate not supplied

[A modified Thal cardioplasty in the management of advanced esophageal achalasia].

A modified esophagocardioplasty with gastric patch in the treatment of advanced achalasia is presented. The technique was employed in 4 patients from 1977 through 1993 and satisfactory results were obtained in follow up studies up to 16 years. This procedure provides better passage through the esophagogastric junction with preservation of the antireflux mechanism.

Adult↗
PubMedDate not supplied

[Surgical strategy in gastric cancer in aged patients].

The trend of the National mortality rate for gastric cancer in the general population and in the old people between 1955 and 1990 was studied. A decreased incidence of mortality in the general population whereas an increased mortality rate in elderly was found. Between 1990 and 1994, 17 patients over 70 years of age were operated on for gastric cancer. The influence of the ASA classification on postoperative complications was then evaluated registering a significant statistical difference between patients included in ASA III group and or > and major complications and mortality (P = 0.044). The surgical strategy in the management of elderly patients with gastric cancer is also discussed.

Adenocarcinoma↗
PubMedDate not supplied

Age-related changes of neuro-endocrine-immune interactions in healthy humans.

Numerous interactions exist among the nervous, endocrine and immune systems, mediated by neurotransmitters, hormones and cytokines. The function of these systems shows patterns of circadian rhythmicity and a number of age-related changes in the 24-hour hormonal and nonhormonal rhythms have been found in older human beings. The aim of this study was to evaluate the presence of altered integration among the nervous, endocrine and immune systems in older adults. Cortisol, melatonin, thyrotropin-releasing hormone (TRH), thyroid-stimulatinghormone (TSH), free thyroxine (FT4), growth hormone (GH), insulin-like growth factor I (IGF-I) and interleukin 2 (IL-2) serum levels were measured and lymphocyte subpopulation analyses were performed on blood samples collected every four hours for 24 hours from seven healthy young subjects aged 36-58 years (mean age +/- s.e. 45.28 +/- 3.31) and from seven healthy old subjects aged 65-78 years (mean age +/- s.e. 68.57 +/- 1.91). There was a statistically significant difference between the groups in the observed values of CD20 (total B cells, higher in the young subjects, t = 2.48, P = 0.028) and CD25 (activated T cells with expression of the alpha chain of IL-2 receptor, higher in elderly subjects, t = -2.23, P = 0.045); DR+ T cells were also higher in elderly subjects, T=34.0, P=0.01). There was no statistically significant difference in the observed values of CD2(total T lymphocytes), CD4 (helper/inducer T cells), CD8 (suppressor/cytotoxic T cells), CD4/CD8 ratio, CD16 (natural killer cells), HLA-DR (B cells and activated T cells), TcR delta 1 (epitope of the constant domain of delta chain of T-cell receptor 1), cortisol, melatonin, TRH, TSH, FT4" GH, IGF-I, IL-2. In the group of younger subjects a clear circadian rhythm was validated for the time-qualified changes of all the factors studied, with the exception of CD16, FT4 and IL-2. In the group of elderly subjects a clear circadian rhythm was validated for the nyctohemeral changes of CD2 (with a phase delay of three hours), CD8, CD4/CD8 ratio, CD16, CD25 (in opposite phase), cortisol (with a phase delay of one hour), melatonin, TSH (with a phase delay of one hour) and GH (with a phase advance of one hour). The results of the current study show that aging is associated with enhanced responsiveness of the T cell compartment and alterations in temporal architecture of neuro-endocrine-immune system.

Adult↗
PubMedDate not supplied

[Residual gastric mucosa after gastrectomy: development of precancerous lesions].

The gastric remnant can be regarded as a model to investigate the events of gastric carcinogenesis of intestinal type. Histologic changes precursor of the malignancy develop in higher incidence in the postoperative stomachs than in non-resected ones. 316 patients hemi-gastrectomized for peptic ulcer were assessed by an endoscopic-histologic study to provide further informations on the sequential chain of histologic lesions that precede the development of cancer. The anastomosis was by far the commonest diseased area at endoscopy, particularly in the patients with a Billroth II resection (p < 0.0004). The 10% of the 233 patients biopsied evidenced a normal gastric mucosa, in the others Superficial Gastritis 74%, Chronic Atrophic Gastritis 36%, Cystic Dilatation 52%, Foveolar Hyperplasia 29%, Intestinal Metaplasia 39%, moderate-severe Dysplasia 6% as single abnormality or variously associated were observed. The stoma was the most damaged area at histology. The occurrence of the DC, the FI and the IM at the anastomotic site was significative (p values between 0.02 and 0.001). The earliest postoperative histologic lesion was the CAG, evidenced, in mean 13 years after operation, the latest the DC observed in mean 18 years after surgery (p < 0.004). The IM, the IF, the CD, and the dysplasia in association with the CAG were observed at postoperative intervals shorter when non-associated with CAG (respective p value: NS, < 0.03, < 0.0002, NS). The probability of transition from an histologic lesions to a more advanced one in our patients was similar to that of a non resected population at medium--high risk of gastric cancer.

Female↗