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Biomedical subjects

A Rocca

Publications and source records attributed to A Rocca.

At least 73 records · Page 4Linked to original sources
PubMed1991

Cisplatin in advanced salivary gland carcinoma. A phase II study of 25 patients.

A prospective Phase II study was carried out to test cisplatin (CDDP) as a single agent in salivary gland carcinomas. CDDP was administered (100 mg/m2) every 3 weeks to 25 consecutive patients with either recurrent or locally advanced salivary gland carcinoma. Six patients had received prior chemotherapy, and the other patients had had only surgery or radiation therapy or no treatment at all. The response rate was 18% (95% confidence interval [CI], 6% to 41%). Response duration was between 5 and 9 months. Median overall survival time was 14 months. CDDP is a moderately active drug in salivary gland carcinomas. It should be included in multidrug regimens to be tested in prospective studies, which are difficult to carry out due to the rarity of these tumors.

Adult↗
PubMed1991

Recognition of HLA-B27 by mouse cytotoxic T-cell clones: a transgenic mouse model.

As a basis for the characterization of mouse T cells involved in the recognition of xenogeneic HLA molecules, a panel of HLA-B27-reactive cytotoxic T-cell clones was generated upon stimulation by cells from HLA-B27-transgenic mice. The HLA-B27-induced T-cell response was found to comprise two categories of clones: some recognizing HLA-B27 independent of H-2 molecules expressed by the target cells (unrestricted clones), others recognizing HLA-B27 in an H-2-restricted manner. The unrestricted clones exhibited diverse specificities, as judged from their various cross-reactivities with other xenogeneic (HLA) or allogeneic (H-2) molecules. In addition, although most of the unrestricted clones were able to react with both mouse and human HLA-B27-transgenic mice. The HLA-B27-induced T-cell which reacted only with HLA-B27-positive mouse, and not human cells. These findings illustrate that both H-2-restricted and unrestricted T cells with diverse specificities contribute to HLA-B27-xenorecognition.

Animals↗
PubMed1991

Analysis of primary HLA-specific cytotoxic T cell response in graft-draining lymph nodes--a transgenic mouse model for in vivo recognition of human MHC antigens.

In order to characterize primary anti-HLA cytotoxic T cells and especially those involved in graft rejection, we have utilized a transgenic mouse model. Mice (non-transgenic and HLA-transgenic) were grafted with spleen cells originating from H-2-matched transgenic mice expressing HLA-B27 molecules, and cells from graft-draining lymph nodes were tested in CML assay to investigate the primary in vivo induced CTL responses. The results showed that HLA-B27 molecules were able to raise strong primary xenogeneic CTL responses. Results from split-well analysis indicated that although recognition of HLA-B27 by primary CTL induced in nontransgenic recipients is predominantly unrestricted by H-2, a small fraction (ranging from 2% to 27%) of the primary in vivo induced CTL is able to recognize HLA-B27 in an H-2-restricted manner. HLA-specific H-2-restricted CTL had never so far been demonstrated in the primary T cell response. Thus the protocol used in our study for the generation of a primary CTL response seems to provide not only a more appropriate representation of cytotoxic T cells sensitized by a graft, but also to be a more sensitive approach than the usually used in vitro mixed lymphocyte culture.

Animals↗
PubMed1991

[Fractures of the orbital floor. Apropos of a homogeneous series of 70 patients].

The authors report their experience based on a homogeneous series of 70 fractures of the orbital floor. Different anatomo-clinical forms were defined in particular fractures of the orbital floor, accompanying an "internal pivoting" of the cheek bone, which by their incarceration mechanism resemble the trap-door fractures. The blow-out fracture associated with the lower orbital margin also raises therapeutic problems. After a clinical and CT study, the authors recommend treatment via the lower orbital approach using silastic implants. The different sequelae are described clinically and are appraised medically and legally.

Adult↗
PubMed1989

[Somatosensory evoked potentials in the evaluation and follow-up of patients with cervical vertebral and spinal cord injuries].

Somatosensory evoked potentials have been serially recorded in 21 patients with cervical spinal cord injury. Each patient received the SEP test and a full neurological examination within 1 day after admission, after surgery, and 3-6 weeks following admission. Further SEP test and clinical evaluation were carried out 3-6 months after injury. Neurological status was graded according to the Sunnybrook Scale. In all patients we evaluated latency and amplitude of SEPs obtained from both median and tibial nerve stimulation. Immediately following injury SEPs were absent in 6 patients, abnormal in 10, and normal in 5 patients. No surgery was carried out in patients with normal SEPs where myelography and CT scan could not demonstrate surgical lesions. Four patients had some distal motor improvement but SEPs still absent, one had traceable SEPs following surgery but no motor improvement. Surgery was performed in all 10 patients with abnormal SEPs: 7 patients improved following surgery. In two patients SEPs showed an early postoperative recovery with subsequent late clinical improvement. The SEP technique is well suited to the non invasive study of spinal cord condition and serial recording in patients with spinal cord injury. Although SEPs are of limited clinical value when absent immediately following trauma, the presence of well preserved median and tibial SEP in the postinjury period indicates the best prognosis for motor and sensory functions.

Adolescent↗
PubMed1989

The surgical treatment of intracranial abscesses today.

The indications and the results of different surgical procedures for the management of intracranial abscesses are dealt in a cooperative study. Two series, amounting 68 patients altogether, collected in epidemiologically homogeneous areas with high percentage of rural population without adequate medical control, are appraised. Due to the high rate of chronic lesions, particularly in the pre-CT scan era (1968-1975), radical excision was required in 70.6% of cases. Overall postoperative mortality was 14.7%: 7.3% during the hospital stay, mostly due to pyrogenic ventriculitis in patients with large deep located abscesses, and 7.4% for different complications, both intra- and extracerebral, at home or other institutions several months after surgery. 29% of patients recovered completely and 45.6% have only minor disability, only 10.3% remained severely crippled and dependent. The results of the surgery, both in terms of operative mortality and functional recovery seem to depend on the neuropathological background rather than on the kind of therapeutic procedure implemented. Even though it must be acknowledged that at present conservative and minor surgical procedures are more often successfully used, radical excision still appears to keep far from negligible indications.

Adolescent↗
PubMed1988

Interstitial irradiation therapy of supratentorial gliomas by stereotaxic technique. Long term results.

We report the long term results of interstitial irradiation therapy in patients suffering from malignant supratentorial gliomas. The radioisotopes implanted by stereotaxic technique were Au198 grains in solid tumors and Y90 colloidal solution in a cystic tumor. The therapy was always well tolerated. Minimum survival time after implantation was 9 months, maximum exceeded 52 months. In all cases interstitial irradiation therapy solved or drastically diminished the severe secondary epilepsy from which all the patients suffered.

Adult↗
PubMed1988

Photodynamic therapy of malignant brain tumors: clinical results of, difficulties with, questions about, and future prospects for the neurosurgical applications.

Photodynamic therapy (PDT) has been applied in a variety of oncological fields with good results. In neurosurgery, the clinical series are limited and the number of treated patients is not statistically significant. This work examines the results of PDT performed in our clinic and discusses some difficulties and causes of failure of this method in neurosurgical patients. Eight patients with malignant brain tumors underwent PDT. All had been treated previously by operation and radiation therapy and one patient had also received chemotherapy. At 24 hours after the i.v. injection of hematoporphyrin (5 mg/kg body weight), the tumor was removed as radically as possible and the residual tumor bed was exposed to either 630-nm light from an argon-dye laser or 600- to 680-nm light isolated from the emission of a quartz-halogen lamp. The type of sensitizer, the irradiation methods, and the peculiarities of glial tumors are examined as possible causes of failure. The longer survivals of some patients with glial tumors treated by PDT may make this treatment suitable when traditional therapies fail.

Adult↗
PubMed1988

[Treatment of chronic hip dislocation in adults by recentered total prosthesis. Apropos of 43 cases].

Forty-three total hip prostheses were inserted in 33 adults suffering from a chronic high dislocation of the hip. Ten patients had a bilateral arthroplasty. The authors decided to keep in this series only hips presenting with a very considerable upward displacement of the femoral head of type IV in Crowe, Maini and Ranawat's classification. All the hips were treated in the same way with pre-operative planning using template tracings to anticipate problems of length and choice of implant. The acetabular cup was placed in the old acetabulum with downward displacement of the femur. The results were studied in 39 prostheses with a mean follow-up of five-and-a-half years (two years to nine-and-a-half years). The mean age of the patients was 48 and-a-half years (28 to 76 years). A satisfactory result was obtained in 79.5 per cent of cases. The mean downward displacement of the femur was 4.8 cm. Complications included one death from pulmonary embolus, two phlebitides, two fractures of the femoral shaft and four dislocations. There were nos cases of sepsis or neurological complications. The authors advise the use of custom-made implants, consider the tactical problems relative to the opposite hip. It is concluded that the value of the method often lies in the transformation of the life of these young patients by a "functional miracle", but the operative indications need to be considered carefully, since the procedures are sometimes extensive, often difficult and always require technical skill.

Adult↗
PubMed1988

[Multifocal fractures of the mandibular symphysis. Apropos of 3 cases].

Three patients presented with multiple site fractures of mandibular symphysis, associated in two cases with a bilateral subcondylar fracture. Treatment was by multiple solid osteosynthesis of mandibular body combining miniaturized screw plates and steel wire osteosynthesis. Emphasis is placed on the interest of a stable solid osteosynthesis of mandibular symphysis by screw plate, combined with osteosynthesis using a steel wire passing through the hole of a plate and into the small basilar bone fragment, allowing in this way the restitution of a perfect morphology of symphysis.

Adolescent↗
PubMed1987

Induction of H-2-specific antibodies by injections of syngeneic Sendai virus-coated cells.

The capacity of the B cell immunoglobulin receptor to recognize complexes of Sendai viral and H-2b antigens was investigated by studying the antibody response to injections of syngeneic Sendai virus-coated (SV+) spleen cells in C57BL/6 (B6) mice. Almost all mice produced alloreactive anti-H2 lymphocytotoxic antibodies. In contrast, such antibodies were found very exceptionally in mice injected with normal (SV-) cells or with Sendai virus (SV) only. The reaction pattern of the cytotoxic antibodies induced was variable and ranged from almost anti-private to widely cross-reactive serotypes. The results of reactions on H-2-congenic, -recombinant and -mutant mouse strains, and of capping and immunoprecipitation experiments showed that the cytotoxic antibodies were directed against H-2 class I molecules. The anti-H-2 antibodies exhibited enhanced binding for SV+ target cells, but absorption experiments showed that this was not the result of cross-reactions with cell surface Sendai viral determinants or with a molecular complex of H-2 plus SV. This conclusion was supported by the observation that syngeneic SV+ cells were not the predominant targets for the induced lymphocytotoxic antibodies. Our results do not support the existence of MHC-restricted antiviral antibodies, but show the induction of anti-class I H-2 alloantibodies by injections with syngeneic SV-coated cells. We present a model for regular induction of anti-H-2 antibodies without intentional alloimmunization.

Animals↗
PubMed1987

[Cardiotoxicity of 5-fluorouracil. Personal cases and review of the literature].

Two cases of 5-Fluorouracil (5FU) cardiotoxicity, chest pain with changes in ECG the former, and myocardial infarction the latter, are described. Review of literature shows the existence of 49 cases of cardiotoxicity due to 5FU (38 angina = 77.5% 8 myocardial infarction = 16.3%). This complication seems due to a "coronary toxicity" whose onset is very precocious and not dose-dependent. Since 5FU therapy could result very dangerous when cardiotoxicity occurs, it is strictly advisable to withdraw further administration of the drug. As a matter of fact 18 patients out of 21 who again were treated with 5FU, had more serious complications which resulted in 3 myocardial infarctions (2 deaths).

Aged↗
PubMed1986

Iatrogenic lumbar pseudomeningocele.

The authors describe two cases of pseudomeningocele after surgery for herniated lumbar disc. In order to prevent this rare complication, they suggest to suture the dura and to put on it oxycel or gelfoam every time there is a fluid leakage. The patient has to be placed in Trendelenburg's position for about seven days.

Adult↗