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Biomedical subjects

A Moretti

Publications and source records attributed to A Moretti.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Single dose of octreotide stabilize metastatic gastro-entero-pancreatic endocrine tumours.

BACKGROUND AND AIM: Somatostatin analogues are able to control symptoms and to detect tumour localisation in gastro-entero-pancreatic endocrine tumour patients. Few studies have evaluated the efficacy of somatostatin analogues in controlling tumoural growth during long-term treatment and, generally, a low efficacy has been reported in studies using multiple daily octreotide dosages. In the present study a single daily dose of octreotide (500 micrograms) for 1 year was used in the treatment of 10 patients with progressive gastro-entero-pancreatic metastatic tumour. PATIENTS: Ten consecutive patients (3 females, 7 males age range 40-62 years) were studied of whom 4 had Zollinger-Ellison syndrome (2 with MEN-1), 3 had a carcinoid syndrome, and 3 had a non-functional neuro-endocrine tumour. All patients, 6-12 months before octreotide treatment, showed tumour progression. In all patients, somatostatin receptor status was assessed by Somatostatin Receptor Scintigraphy and tumoural lesions by Magnetic Resonance Imaging. Appropriate tumoural markers were also evaluated. RESULTS: At the three-month control, two patients (non-functional) showed an aggressive progression of tumoural growth despite treatment and were excluded from the study. One patient was lost during follow-up. Of the 7 remaining patients, imaging evaluation studies revealed, after 1 year of treatment, stable disease in 6 patients, whereas a partial tumoural response was observed in one patient (gastrinoma). Biochemical tumoural markers decreased with respect to basal values of 53-78% in these seven patients at the end of therapy. CONCLUSIONS: These results suggest that one year of octreotide in a single daily dose (500 micrograms) is effective in the long-term stabilization of tumoural progression in metastatic gastro-entero-pancreatic tumour patients.

Adult↗
PubMedDate not supplied

[The hyoid bone in reconstructive laryngeal and cervical surgery].

The hyoid bone, with its complex system of connected muscles, ligaments and membranes, provides a highly resistant anchor point in all cases of larynx tumour surgery requiring a "pexy" to reconstruct the upper respiratory tract. This bone can also be important in reconstructive cervical surgery employing myocutaneous flaps, especially after extensive tissue removal, such as in locally advanced larynx tumours (primary T4 lesions or recurrences after partial or subtotal operations) and some primary or recurring malignant cancers of the thyroid, parathyroid or pharyngoesophageal tract involving the larynx. In this study the importance is underlined of preserving the hyoid bone in all cases of cervical surgery in which a strong anchor is needed for repair, due to the radical nature of intervention. The clinical-surgical data are reported of 39 patients, 38 of whom affected with epidermoid carcinoma of the larynx with various degrees of differentiation and 1 with "tall cell" papilliferous thyroid carcinoma, observed and treated over the last three years. In horizontal supraglottic laryngectomy (HSL), but particularly in subtotal larynx surgery with cricohyoidoepiglottopexy (CHEP) and cricohyoidopexy (CHP), the hyoid bone allows a sort of anastomosis to be performed, using residual cartilage to make a "neo-larynx". In reconstructive cervical surgery after extensive tissue removal, such as in forward widened total laryngectomy (FWTL), the hyoid bone offers an excellent anchor for myocutaneous pedunculate "repair" flaps, which may be thoraco-dorsal or free revascularized, to ensure continuity between the muscle tissue of the base of the tongue and of the flap itself. The hyoid bone and connected structures thus provide a real support apparatus whose great versatility, due to its resistance and extreme mobility, makes it particularly useful during the reconstructive phase of cervical surgery.

Adult↗
PubMedDate not supplied

Hypergastrinemia and enterochromaffin-like cell hyperplasia.

UNLABELLED: The enterochromaffin-like (ECL) cells, the most frequent endocrine cells of the oxyntic mucosa of the stomach, are under the trophic stimulus of gastrin. These cells undergo a hyperplastic increase in variety of hypergastrinemic diseases. The most widely accepted nomenclature for the description of hyperplastic proliferation has been retrospectively arranged in a sequence presumed to reflect a temporal evolution of the proliferative process. A comparative, prospective study aimed to verify, in human hypergastrinemic diseases such as atrophic body gastritis (ABG), Zollinger-Ellison syndrome (ZES) and antral gastrin cell hyperfunction (AGCH), the effect of exposure of ECL cells to different pattern of gastrin hypersecretion, is lacking. To this purpose, we studied a series of consecutive patients with ABG, ZES and AGCH at the time of first diagnosis. MATERIAL AND METHODS: The patients included in this study (124 ABG, 18 ZES and 10 AGCH) were selected on the basis of two previously performed screening studies aimed to diagnose these diseases. All patients at the time of diagnosis underwent gastroscopy, with multiple biopsies of the gastric body mucosa for the evaluation of qualitative pattern of ECL cells hyperplasia, and basal fasting gastrin determination. A sample of hypergastrinemic patients from each group was further investigated by meal-stimulation of gastrin secretion and quantitative morphometry for CgA positive gastric body endocrine cells. RESULTS: AGCH patients showed only the normal or simple hyperplasia pattern. In the ZES group, simple and linear grades accounted for 38.4 percent and 46.1 percent, respectively. MEN-I patients showed only these two patterns. The majority of ABG patients showed the presence of micronodular pattern (59.7 percent). A correlation analysis between fasting gastrin levels and grade of hyperplasia (r = 0.5580, p < 0.0001), indicates that the greater the gastrin levels, the higher is the degree of severity of ECL hyperplasia pattern. In conclusion, our data support the role of gastrin as the selective contributor to the progression of ECL cell hyperplasia in humans.

Adolescent↗
PubMedDate not supplied

[The surgical treatment of laterocervical adenopathies due to malignant cervicofacial tumors].

Head and neck malignant tumors show a high tendency to spread to cervical lymph nodes. Therefore, surgical approach to these neoplasms is primary tumor exeresis associated with functional or radical neck dissection, unilaterally or bilaterally at the same time, in relation to T site and N stage. In this paper the validity of such approaches is evaluated by correlating clinical and histopathologic N involvement in 168 patients with head and neck malignancies, observed in a 5-year period (1986-1990), and submitted to radical (65 pts.) and functional (198 pts.) neck dissection. The histopathologic findings showed 31 patients (14.7%) with N0+ (false negatives). The incidence of occult latero-cervical metastases confirms the importance of elective functional neck dissections in N0 patients with head and neck malignant tumors even though the risk of performing many unnecessary surgical procedures may be considerable (180 cases out of 211 in the Authors experience). Rare false positives (overall 4 cases) did not represent a significant clinical problem while N3 showed massive neoplastic invasion with extracapsular spread.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[Surgical treatment of post-thyroidectomy laryngeal paralysis].

A not infrequent complication of thyroid surgery is laryngeal nerve palsy with transitory or permanent deficiency of cordal motility. A very frequent cause of this condition is total thyroidectomy. Peripheral mono-or bilateral palsy in these cases may either occur, in adduction or abduction, and be complete or not complete. Therefore, different strategies in order to restore respiratory and phonatory functions are required. The Authors describe the main otorhinolaryngologic procedures used for the surgical treatment of laryngeal palsy, particularly for bilateral adducted ones. Their 10-year experience is also reported.

Adolescent↗
PubMedDate not supplied

Association between hepatitis C virus and mixed cryoglobulinemia [see comment].

The prevalence of hepatitis C virus (HCV) RNA and of antibodies to HCV in an unselected series of 42 mixed cryoglobulinemia patients was investigated in this study. HCV RNA was detected by the polymerase chain reaction technique, and HCV antibodies by two enzyme-linked immunosorbent assays (Chiron ELISA HCV, Second Generation, Emeryville CA, USA; Wellcome Diagnostic, England). HCV RNA was found in 86% of the mixed cryoglobulinemia patients. Using either the Chiron ELISA or the Wellcome ELISA, HCV antibodies were present in 90% of the same samples; anti-HCVAb seropositivity was confirmed in all cases by immunoblot assay (Chiron RIBA HCV, Second Generation Assay). A striking correlation between HCV RNA and anti-HCV antibody seropositivities was recorded. HCV RNA in mixed cryoglobulinemia patients was not correlated with the presence or absence of biopsy-proven liver involvement. These results suggest that the association between HCV and mixed cryoglobulinemia is not fortuitous, and therefore that HCV may have an etiopathogenetic role in this disorder.

Adult↗
PubMedDate not supplied

[Thyroid gland involvement in cancer of the larynx].

Numerous diseases that require surgical treatment often occur in the thyroid, one of the most important organs in the neck. An example of such pathologies are benign and malignant neoplasms. It is still not well known, however, if certain secondary malignant neoplasms may also arise there. While this pathology is relatively frequent, and often asymptomatic, the incidence of secondary lesions observed clinically in the thyroid is much lower than that found in series based on necroscopy. The thyroid may be involved by metastatic spreading of systemic malignant neoplasms (of the kidney, breasts, lung, colon, rectum, etc.) or by direct extension of laryngeal, hypopharyngeal or esophageal cancer, the latter being more frequent. In this paper the Authors report their experience with regard to the incidence of tumorous involvement of the thyroid in 23 patients (22 of which were males between the ages of 48 and 69--average age, 65) under observation for laryngeal cancer from 1986 to 1990. All the patients had an epidermoid carcinoma of the larynx that, due to its location and size, required a hemithyroidectomy or an isthmectomy associated with laryngectomy (20 total laryngectomies with hemithyroidectomies and 3 subtotal laryngectomies with isthmectomy). Upon pathologic examination, 7 thyroid specimens (30%) revealed tumorous involvement of the thyroid and in those cases of males who had undergone total laryngectomy with hemithyroidectomy, thyroid involvement was found. In 5 cases, tumorous involvement was immediately evident upon microscopic examination (1 case of solitary tumor metastasis and 4 of direct extension).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[HIV infection and nosocomial risk: experience at the ORL Clinic of Pisa].

The risk of nosocomial risk of HIV infection and the problem of preventative measures to adopt has been modifying how workers in the health field deal with patients. In fact, the increased spreading of HIV infections within our population has led to the establishment of a national protocol of preventative measures by which no patient can be considered "safe". Consequently, the likelihood that contact with any patient can lead to infection causes the health care worker to look upon the patient as a potentially dangerous enemy, thus leading to a decline in the quality of health care. On the other had, although the risk of a health care worker being infected by HIV during routine work is low, preventative measures must be taken both during examination and during surgery. Unanimous agreement exists in regard to what measures are to be taken to prevent cutaneous and mucosa exposure of workers whenever the risk of accidentally coming into contact with the blood and/or other biological fluids exists. On the other hand, the use of an anti-HIV screening for all patients in order to distinguish between infected and non infected subjects is still subject to debate. Some feel such screening is unacceptable because it would deny sero-positive patients adequate care and could give rise to both false positives and false negatives while others propose routine screening feeling it to be helpful both to those who are sero-positive and to health care workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Association of primary malignant neoplasms of the larynx and the lung. 12 years of clinical experience].

Laryngeal and pulmonary cancers present a certain agreement in regard to annual incidence. When studied separately these tumors show certain similarities and differences and they are of particular interest when they arise in the same subject. The association of laryngeal and pulmonary neoplasms is one of the most common associations among multiple primitive malignant tumors and represents an important problem in terms of prevention and diagnosis. The present study involves 18 cases of associated tumors observed from January 1, 1977 and December 31, 1988. All the subjects involved were males, average age 62 years, who had been treated for laryngeal cancers, mostly laryngeal epidermoid carcinoma. Pulmonary cancers (simultaneous, synchronous, metachronous) were diagnosed in all these subjects and one patient presented 2 autonomous bronchial lesions which arose in different periods. On the whole, 8 out of 18 patients (44.4%) are still alive and of these 6 (33%) enjoy good health more than 1 year after treatment for the pulmonary tumor. After reporting some considerations regarding the neoplastic association between the larynx and the lungs and about the increased risk of pulmonary neoplasm in those patients treated for supraglottic lesions, the authors hypothesize that these neoplasms are simultaneously present in both organs more frequently than previously thought. The authors assert that laryngeal tumor patients must be considered as a potential carrier of pulmonary cancer. Therefore, both before and after treatment (particularly in the first 6 months after surgery and/or radiotherapy) the patient must be carefully observed.

Adult↗
PubMedDate not supplied

Eosinophilia, granuloma formation, migratory behaviour of second stage larvae in murine Toxocara canis infection. Effect of the inoculum size.

Experimental infection of mice with Toxocara canis provides one of the best models for immunological and pathological studies of the visceral larva migrans syndrome. Blood eosinophilia, the migratory behaviour of second stage larvae and granuloma formation were studied in Swiss mice infected with Toxocara canis. Eosinophilia, spleen, liver and lung indexes were followed during a primary infection with different inoculum sizes (500 and 1500 eggs) while the migratory behaviour of larvae was studied in a primary infection with 1500 eggs over a period of 4 months. In mice infected with three challenges of 1500 eggs in order to elicit a strong inflammatory reaction in the tissues, a histopathological study was carried out. The results showed that eosinophilia, spleen and lung indexes (but not the liver index) were influenced by the parasite inoculum size. The migratory behaviour study showed that larval recovery was maximal three days post-infection, from the liver and lungs; the peak recovery from the skeletal muscles and brain being on days 15 and 30 post-infection, respectively. The histopathological study revealed the formation of granulomas in all the tissues examined (liver, lungs, kidneys, spleen, lymph nodes, myocardium etc.) but not in nervous tissue or in the retina of the eye. Granulomas in the lungs were larger than those found in the liver. The implications of these results are discussed considering host-parasite inter-relations.

Animals↗
PubMedDate not supplied

Indirect immunofluorescence (IFA) on kinetoplasts of Trypanosoma theileri for serological diagnosis of systemic lupus erythematosus (LES) in the dog.

An indirect immunofluorescence technique was developed to detect antibodies to ds-DNA in a dog affected by Systemic Lupus Erythematosus (LES). The assay was based upon the use of the antigen substrate Trypanosoma theileri, isolated from samples of bovine blood and maintained in culture tubes. Slides were prepared by the drop method and maintained at -20 degrees C until used. This T. theileri immunofluorescence test, evaluated with positive and discriminant results in a previous study on human sera affected by LES, was used for the first time in the diagnosis of canine LES. The results indicate that T. theileri IFA is specific and reliable.

Animals↗
PubMedDate not supplied

Breathing pattern assessment in normocapnic and hypercapnic patients in chronic obstructive pulmonary disease.

Thirty-six patients, 24 normocapnic (mean age +/- SD: 60 +/- 10) and 12 hypercapnic (mean age +/- SD: 64 +/- 9) were compared with a control group (10 volunteers, mean age +/- SD: 46 +/- 8) for the following patterns of respiratory drive and respiratory timing: (1) mean inspiratory flow (Vt/Ti); (2) mouth occlusion pressure 100 ms after the onset of inspiration (P 0.1) and minute ventilation (Ve); (3) inspiratory duty cycle Ti/Tt). The data suggest COPD "respiratory patterns" which may be characterized by the following features: (1) increased mean inspiratory flow (Vt/Ti); (2) increased P 0.1 (in absolute values), P 0.1/Ve and P 0.1/Vt/Ti; (3) reduction in inspiratory duty cycle (Ti/Tt). Changes are more evident in inspiratory duty cycle among hypercapnic pts. When respiratory obstruction becomes worse and hypercapnia appears, the Ti/Tt decrease could be explained by a reduction in diaphragm muscle work, that can prevent the failure of diaphragmatic contractility.

Adult↗
PubMedDate not supplied

Effect of ergolines on neurotransmitter systems in the rat brain.

The interaction of nicergoline with various monoaminergic receptors and its effects on monoamine turnover were studied in specific rat brain areas in comparison with those of its metabolites, 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol (MMDL) and 10-methoxy-6-methyl-ergoline-8 beta-methanol (MDL). Nicergoline showed marked in vitro affinity for alpha 1-noradrenergic receptors (IC50 = 0.2 nM), less for alpha 2, S1 and S2 (IC50 about 10(-7) M). Its strong interaction with alpha 1-receptors was confirmed in vivo. The affinity of the other ergolines for alpha 1-receptors was lower than that of nicergoline. The level of monoamine metabolites (HVA and DOPAC for dopamine, MOPEG-SO4 for noradrenaline and 5-HIAA for serotonin) was taken as a measure of their turnover in the rat brain. A single dose of nicergoline (20 mg/kg, s.c.) strongly enhanced noradrenaline turnover, less that of dopamine. These effects, probably due to the interaction with alpha-receptors, were more marked after parenteral than oral administration. MMDL shared nicergoline's effect on dopamine and MDL that on noradrenaline, but they were less active than the parent compound. The most interesting results were obtained after chronic treatment (6-7 weeks) with rather low doses: 5 mg/kg b.i.d. of nicergoline and equimolar doses of the metabolites. Nicergoline and MMDL both enhanced dopamine turnover, especially in mesolimbic areas. In conclusion, the present report confirms and extends previous results on nicergoline's effects on catecholamine turnover and shows that its metabolite MMDL shares its effects on dopamine. Finally, it is particularly interesting that both ergolines were more effective in old than in young rats.

Animals↗