Therapy of acute myelogenous leukemia in adults.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
A Neri
Publications and source records attributed to A Neri.
[Evolving electrocardiographic changes in massive neoplastic infiltration of the right ventricle. Description of a case and review of the literature].
We report a case of metastasis of lung carcinoma infiltrating the inferior left ventricular wall, the interventricular septum and the right ventricle. The metastatic invasion of the heart caused the appearance of pseudoischemic electrocardiographic changes, arrhythmias and eventually a conduction disturbances. The relevance of electrocardiographic changes as an indicator of cardiac metastasis in neoplastic patients is discussed.
Carcinoma, Squamous Cell↗
[Endarterectomy of the internal carotid. Clinical experience].
The authors report a clinical experience on 37 internal carotid endarterectomies of 33 patients classified as: group A (asymptomatic patients); 4 patients (13%), group B (RIA); 9 patients (27%), group C (stabilized neurological lesions); 19 patients (56%), group D (acute cerebral ischemia): 1 patient (3%). Sixteen thromboendarterectomies (43%) were carried on for the prophylaxis of neurological lesions, 20 (54%) to increase and balance the cerebral blood flow in patients with stable neurological lesions, 1 (3%) for acute cerebral ischemia. The overall operative mortality was 6%, the operative morbidity was 22%. The clinical follow-up concerned 26 patients: the overall mortality was 19%: in survivors the late results were excellent. The rate of postoperative stenosis was 18%: 80% of these arteries had been treated without a patch angioplasty.
Aged↗
[Dorsolumbar arachnoid cysts. A case report].
The authors discuss a case of thoracic-lumbar arachnoidal cyst, which was not diagnosed for a long period, despite an obvious presentation with back pain and sphincteral problems. The importance of new diagnostic techniques, such as nuclear magnetic resonance (NMR) is underlined.
Aged↗
[Primary angiosarcoma of the thyroid gland. Presentation of a clinical case].
A case of angiosarcoma of the thyroid, the most rare tumor of this gland, is discussed. The existence of this form has been denied by many authors, but recent immunochemical analyses (endothelial Factor VII related antigen) and electron microscopy (Weibel-Palade bodies) confirm definitively its vascular origin.
Aged↗
Ras oncogene mutation in multiple myeloma.
The frequency of ras (H-, K-, and N-ras) and c-myc oncogenes was investigated in multiple myeloma (MM). By means of the polymerase chain reaction (PCR)/oligonucleotide hybridization method, DNA from 56 tumor biopsies was analyzed for the presence of activating mutations involving codons 12 and 61 of the H-, K-, and N-ras genes and codon 13 of the N-ras gene. Mutations, involving the N- or K-ras genes, were detected in 18 of 56 (32%) cases of which 12/43 (27%) were at diagnosis and 6/13 (46%) were after treatment. In some cases, multiple mutations affecting different ras alleles were detected. Direct nucleotide sequence analysis of PCR products indicated that a more heterogeneous nature of the base pair changes than previously shown for other tumors along with a preferential involvement of N-ras codon 61. The heterogeneity of MM cases with respect to the presence of ras oncogenes prompted an analysis of possible correlations with different clinico-pathologic characteristics of MM from which a correlation between the presence of ras oncogenes and a partial or complete lack of response to therapy emerged. The frequency of activating rearrangements or mutations of the c-myc gene were studied by Southern blot analysis and PCR sequencing, respectively. However, contrary to previous reports involving mostly MM cell lines, no structural alterations of the c-myc gene were found. These results indicate that ras, but not c-myc, oncogenes are activated in vivo in MM cells, representing the first oncogene alteration that has been associated at appreciable frequency with this type of malignancy. While the mechanism of occurrence and biological role of ras activation in MM remains to be elucidated, the preliminary correlations observed in this study between the presence of ras oncogenes and poor therapeutic response suggest that further investigations of the possible prognostic significance of these alterations are necessary.
Base Sequence↗
Immunologic and molecular evaluation of residual disease in B-cell chronic lymphocytic leukemia patients in clinical remission phase.
This study evaluates residual disease in 28 B-cell chronic lymphocytic leukemia (B-CLL) patients who obtained a clinicohematologic remission after intensive chemotherapy. Sixteen of 28 patients (57%) showed a normal number of circulating B-lymphocytes, as demonstrated by the low percentage of mouse rosette-forming cells (M-RFC), surface immunoglobulins (SIg), and CD24-positive cells. Clinically, a lower number of relapses occurred in this group of patients compared to those with a persistent expansion of peripheral B-cells (P less than 0.05). In order to assess monoclonality of the residual peripheral B-cell population, the distribution of SIg light chains was investigated on the B-cell-enriched fraction of 15 of these 16 cases. Only six of them had a kappa/lambda ratio which ranged between 1.7:1 and 3:1, whereas the remaining patients still displayed a clearly imbalanced kappa/lambda Ig light chain distribution. On the other hand, the analysis of the configuration of the Ig heavy chain gene region, performed in nine cases (including five of the above six cases), showed the persistence of a rearranged pattern in all cases tested but one. Therefore, residual monoclonal B-cells were found also in the majority of cases which displayed the lowest kappa/lambda ratio, a normal bone marrow lymphocytosis and a long-lasting clinical remission. Studies at the DNA level confirm that a remission is rarely achieved in this disease in spite of intensive and prolonged chemotherapy. Nonetheless, the follow-up of B-CLL patients by conventional immunologic markers may be helpful to better define response to therapy and to predict the occurrence of clinical relapse.
B-Lymphocytes↗
Expression of cell differentiation antigens as a prognostic factor in acute leukemia.
Explore the source record for details and available documents.
Acute Disease↗
More about the etiology of fever.
The patient with fever requires special attention and care. A basic understanding of fever is essential for early and effective treatment.
Fever↗
Obstructive sleep apnea (OSA)-implications in maternal-fetal medicine. A hypothesis.
During the past fifteen years the obstructive sleep apnea syndrome (OSAS) has become widely recognized as a quite common disorder with a wide range of serious clinical complications (1, 2, 3). This syndrome arises as a result of sleep related changes in upper airway muscle function and progressive narrowing of the oropharyngeal lumen. The resulting hypoxia (or asphyxia) leads to an arousal response that terminates the initial obstructive event. The exact incidence and prevalence of OSAS is currently unknown. Lavie (4) concluded its prevalence to be 1.26 percent. Others (5, 6) found that the prevalence of heavy regular snoring (taken as an index of at least a partially obstructed airway) increased with age including 40 percent of women and 50 percent of men over 60 years of age. Polygraphically documented OSAS showed incidence of 0.99 percent in an unselected population. Postmenopausal women have frequent episodes. of OSA in contrast with their premenopausal counterparts, who very rarely have any apnea. Since we could not find in the literature any documented OSAS studies in pregnancy, we would like to base our hypothesis on our previously published clinical observations and our recent findings. In the present paper we would like to suggest that pathophysiologic changes of OSAS prolonged throughout many weeks of pregnancy may have an adverse effect upon the feto-placental unit.
Adult↗
High-dose Ara-C (HiDAC) plus asparaginase in elderly patients with acute non-lymphocytic leukemia: a pilot multicentric study by the Italian Cooperative Group GIMEMA.
A multicentric prospective pilot study using three different schedules of high-dose Ara-C at dosage of 3 g/m2 every 12 hours during 3 h of infusion was undertaken by the Italian Cooperative Group GIMEMA in order: 1. to evaluate the safety and efficacy of such treatment in previously untreated ANLL patients more than 50 years old; 2. to investigate whether the addition of a standard maintenance treatment after consolidation with 4 courses of DAT (Daunorubicin + Ara-C + 6-Thioguanine) could improve the duration of complete remission (CR) and the proportion of long-term survival. Overall 43/125 evaluable patients (34.4%) achieved CR. 32/125 died during the induction phase, the remaining 50 patients (40%) failed to achieve CR. As for the toxicity, the most significant toxicity of all schedules was hematologic. No substantial neurological or cardiac toxicity was observed. The multivariated analysis of several pretreatment characteristics revealed that age more than 60 yr, male sex and presence of infections at diagnosis were the most significant adverse factors for achievement of CR. The median duration of DFS for all responders was 9 months, with relapse-free survival at 4 yr estimated at 29%. The addition of maintenance treatment to consolidated patients had no advantages in respect to the control group, even though the statistical analysis revealed a p = 0.058. However, because of the small number of randomized patients, no conclusions can be drawn concerning the importance of maintenance treatment.
Aged↗
Placenta previa and congenital cardiac anomalies.
This study was designed to evaluate the association of placenta previa (PP) with cardiac anomalies in the fetus/neonate. The study group (n = 82 babies) was compared to a control group (n = 82) matched for maternal and gestational age. Five babies of the study group expired within 24 h of delivery, and postmortem examination was carried out in 4 of them. The living children of the control and study group (51 of the 77 babies) underwent complete cardiac workup including physical examination, ECG, chest X-ray and echocardiography. The incidence of congenital cardiac anomalies in the study group was significantly higher (Fisher exact test, p = 0.025). The obstetrician should refer the pregnant woman with PP for echocardiographic studies.
Adult↗
Premature separation of placenta in a patient with idiopathic thrombocytopenic purpura.
The most common autoimmune hemolytic disorder encountered during pregnancy is idiopathic thrombocytopenic purpura. Premature separation of the placenta is one of the most serious complications in the second half of pregnancy. Since the association of the two is not known, the aim of the present paper is to present such a case and to draw the attention of the obstetrician to this possibility.
Abruptio Placentae↗
Minimal residual disease in acute lymphoblastic leukemia detected by immune selection and gene rearrangement analysis.
We have developed an assay for the detection of malignant residual cells in the bone marrow from patients with B- or T-lineage acute lymphoblastic leukemia (ALL) in clinical remission. This assay involves an immune selection step followed by immunoglobulin or T-cell receptor gene rearrangement analysis and allows the detection of one contaminating tumor cell out of 1,000 normal bone marrow cells. We have examined the bone marrow of 11 patients with adult ALL in remission over a 24-month period. Five patients relapsed in the bone marrow and one in the CNS. The assay allowed the detection of minimal residual disease in four of five patients that subsequently relapsed in the bone marrow, 1.5 to 9 months before the relapse became morphologically and clinically manifest. Residual disease was not found in the bone marrow from patients in continuous remission and from the single patient who relapsed in the CNS. We conclude that the ability of the assay described here to detect minimal residual disease with high specificity can provide information for further understanding of the biology of ALL and hopefully for the clinical management of patients with this disease.
Adolescent↗
[Update on chronic lymphatic leukemia].
Explore the source record for details and available documents.
Antigens, Differentiation, B-Lymphocyte↗
[Clinical case. Pulmonary embolism].
Explore the source record for details and available documents.
Aged↗
Preoperative staging of primary breast cancer. A multicentric study.
This article reports on a consecutive series of 3627 breast cancer (BC) patients undergoing preoperative staging by chest x-ray (CXR), bone x-ray (BXR) or bone scintigraphy (BS), and liver ecography (LE) or liver scintigraphy (LS). The detection rate (DR) of preclinical asymptomatic distant metastases depended on the T and N category (TNM classification system), and was very low (CXR: 0.30%, BXR: 0.64%, BS: 0.90%, LE: 0.24%, LS: 0.23%). The sensitivity, determined after a 6-month follow-up, was below 0.50% for all tests. The highest value (0.48%) was recorded for BS, which also had the lowest specificity (0.95%). The entire preoperative staging policy using the studied tests seems questionable due to poor sensitivity and an extremely low DR of distant metastases.
Breast Neoplasms↗
Influence of dietary fats on pancreatic phospholipids of chronically ethanol-treated rats.
Male rats were given liquid diets by pair-feeding for 24-30 days, and phosphatidylinositols in pancreas were analyzed as derivatives of diacylglycerols and fatty acids. Addition of arachidonic acid or changing the fat component (35 energy %) in the liquid diet from olive oil/corn oil to oil from Borago officinalis, which contains 22% gamma-linolenic acid, increased the fraction of arachidonoyl-containing species. This fraction was decreased by more than 50% by substituting ethanol for 36 of the 47 energy% provided by carbohydrate. A smaller difference between ethanol-fed and control rats was seen in the composition of phosphatidylcholines and phosphatidylethanolamines. There was no difference in the composition of phosphatidylinositols when fat, instead of ethanol, was used to substitute the 36 energy % in the diet containing olive oil/corn oil. Substituting ethanol for 28 of 35 energy% provided by fat as corn oil in a liquid diet had no effect on the fraction of arachidonoyl-containing species. The results indicate that the effect of ethanol on phosphatidylinositols in pancreas is not due to a deficiency of arachidonic acid, and that the effect of the ethanol-containing diet is not due to the lowered carbohydrate content. However, high contents of fat or of ethanol appear to be necessary for the effect.
Animals↗