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A Tamburini

Publications and source records attributed to A Tamburini.

52 records · Page 3Linked to original sources
PubMed1997

Imaging of somatostatin receptors by indium-111-pentetreotide correlates with quantitative determination of somatostatin receptor type 2 gene expression in neuroblastoma tumors.

We reported previously that the relative level of gene expression for sst2, a subtype of somatostatin receptors, was positively related to patient outcome in the childhood tumor neuroblastoma (NB). Because sst2 binds with high-affinity octreotide and its scintigraphic derivative, 111In-pentetreotide, we tested the hypothesis of whether NB tumor imaging with 111In-pentetreotide gives similar information to ex vivo measurement of sst2 expression. We, therefore, studied simultaneously nine NB tumors with 111In-pentetreotide single photon emission computed tomography and competitive reverse transcription-PCR for sst2, along with other prognostic markers. To quantitate the relative abundance of 111In-pentetreotide binding to NB tumors, we developed a simple semiquantitative method, based on the mathematical analysis of 111In-pentetreotide association to cancer cell receptors at different time points (4 and 24 h). We indeed found that the ratio between the activity in a manually extracted region of interest from pathological (ROIT) and background (ROINT) area was increasing between early and late acquisition only in affected tissues. The rate of this pathological increase was quite different among patients and significantly (P < 0.01) related to the abundance of sst2 gene expression, as measured by competitive reverse transcription-PCR on ex vivo tumor samples. Because we demonstrated that in 26 NB patients the density of sst2 is strongly related to survival (P < 0.0005) and apparently independent from N-myc oncogene amplification (P < 0.05), we propose that NB tumor imaging with 111In-pentetreotide may have not only a diagnostic but also a prognostic value.

Adolescent↗
PubMed1996

Minimally differentiated acute myeloid leukemia (AML-M0): a distinct clinico-biologic entity with poor prognosis.

FAB proposals for the diagnosis of AML-M0 represent the formal recognition of a distinct entity which has been described over the past few years by several authors and called minimally differentiated acute myeloid leukemia. By definition, AML-M0 includes acute leukemias which do not fit morphological and cytochemical criteria for the diagnosis of AML, and for which myeloid lineage assignment can be made by immunological assay showing positivity for MPO, CD13, and CD33 and negativity for lymphoid markers. Involvement of an early myeloid progenitor in the leukemic process is a possible theory hypothesized to explain the existence of such a form. Validity of this assumption has been based on the observation that AML-M0 frequently bears "stem cell" markers such as CD34, HLA-DR, Tdt, CD7, and promiscuous IgH/TCR gene rearrangements, which are thought to occur in uncommitted cells. Finally, AML-M0 very frequently carries cytogenetic abnormalities common to MDS or secondary AML, such as -5/5q- or -7/7q- deletions and or complex karyotype. In our experience, AML-M0 is also very often associated with the MDR phenotype, which in turn has been found strictly linked to "stem cell" features, especially in MDS. These biological aspects, altogether, translate into a very unfavorable prognosis, confirming even from a clinical point of view that AML-M0 is a distinct entity. In conclusion, "stem cell" markers, MDR phenotype, complex chromosome lesions, frequent occurrence in elderly patients, and intrinsic chemoresistance characterize AML-M0 and indicate the need for tailored treatments, possibly involving the use of MDR modulators and/or differentiating agents.

Humans↗
PubMed1996

[Adrenal cortex neoplasms in children: diagnostic and therapeutic difficulties].

Two cases of adrenal cortical carcinoma in the pediatric age group are reported: the first case regards a fourteen month old female patient which presented with virilization and Cushing's syndrome: the second case regards a twelve year old boy with severe hypertension. Histopathologic distinction between benign and malignant adrenal cortical neoplasms is difficult: the usual cytologic criteria of benignity and malignancy in relation to prognosis are not very helpful while tumor size and tumor invasion appear to be the more important prognostic factors. Therefore early diagnosis, which is easier in the pediatric age because of the more frequent presentation of these neoplasms with hormonal effects, is essential.

Adrenal Cortex Neoplasms↗
PubMedDate not supplied

Placental/umbilical cord blood: experience of st. Eugenio Hospital collection center.

BACKGROUND: Umbilical cord blood (UCB) contains stem cells and may be an alternative source to bone marrow and peripheral blood stem cells for allogeneic transplantation for the treatment of hematologic malignancies and genetic disorders. Many UCB banks have been established worldwide to quickly provide high quality materials for transplantation. Moreover, a detailed set of standards for cord blood banking have been drawn to guarantee the quality of the products. STUDY DESIGN AND METHODS: The aim of this study was to analyze our activity between 1998 and 2001, seeking to improve the number of suitable UCB units. Written informed consent was obtained from healthy women with an uncomplicated pregnancy. RESULTS: During the study period, we collected 1060 UCB units; 328 (31%) were banked, whereas 732 (69%) were discarded. The collections were performed in 73% vaginal deliveries and 27% of cesarean sections. The main reason for the exclusion was biological; in fact, a low number of nucleated cells and a low volume accounted for 71% of the total discarded units. Moreover, 20% of the units were discarded because of parental clinical reasons. CONCLUSIONS: Our study shows that maternal history must be completely reviewed before labor and obstetrical factors should be considered to improve the number of UCB units.

Cord Blood Stem Cell Transplantation↗
PubMedDate not supplied

Effect of laparoscopic fundoplication on gastroesophageal reflux disease-induced respiratory symptoms.

Laparoscopic fundoplication controls heartburn and regurgitation, but the effects on the respiratory symptoms of gastroesophageal reflux disease (GERD) are unclear. Confusion stems from difficulty preoperatively in determining whether cough or wheezing is actually caused by reflux when reflux is found on pH monitoring. To date, there is no proven way to pinpoint a cause-and-effect relationship. The goals of this study were to assess the following: (1) the value of pH monitoring in establishing a correlation between respiratory symptoms and reflux; (2) the predictive value of pH monitoring on the results of surgical treatment; and (3) the outcome of laparoscopic fundoplication on GERD-induced respiratory symptoms. Between October 1992 and October 1998, a total of 340 patients underwent laparoscopic fundoplication for GERD. From the clinical findings alone, respiratory symptoms were thought possibly to be caused by GERD in 39 patients (11%). These 39 patients had been symptomatic for an average of 134 months. They were all taking H2-blocking agents (21%) or proton pump inhibitors (79%). Seven patients (18%) were also being treated with bronchodilators, alone (3 patients) or in combination with prednisone (4 patients). Median length of postoperative follow-up was 28 months. In 23 patients (59%) a temporal correlation was found during 24-hour pH monitoring between respiratory symptoms and episodes of reflux. Postoperatively heartburn resolved in 91% of patients, regurgitation in 90% of patients, wheezing in 64% of patients, and cough in 74% of patients. Cough resolved in 19 (83%) of 23 patients in whom a correlation between cough and reflux was found during pH monitoring, but in only 8 (57%) of 14 of patients when this correlation was absent. Cough persisted postoperatively in the two patients who did not cough during the study. These data show that pH monitoring helped to establish a correlation between respiratory symptoms and reflux, and it helped to identify the patients most likely to benefit from antireflux surgery. Following laparoscopic surgery, respiratory symptoms resolved in 83% of patients when a temporal correlation between cough and reflux was found on pH monitoring; heartburn and regurgitation resolved in 90%.

Adult↗
PubMedDate not supplied

[Single-stage laparoscopic surgery of cholelithiasis and choledocholithiasis in 268 unselected consecutive patients].

AIMS: The introduction of laparoscopic cholecystectomy (LC) has modified the treatment of gallstones and common bile duct (CBD) stones. Aim of this prospective study was to evaluate the results of single stage laparoscopic management of gallstones and CBD stones. PATIENT AND METHODS: From January 1991 to October 1999, CBD stones were present at intraoperative cholangiography in 268 patients (pts) (169 females, 99 males, mean age 55.6 years, range 12-94 years) out of 2693 undergoing LC (10%) for gallstones. CBD stones were unsuspected in 123 (45.9%) and suspected in 145 (54.1%). RESULTS: CBD exploration was successful in 264 cases (98.5%) (transcystic 164, choledochotomy 100). Four pts were converted to open surgery (1.5%). Retained stones in 15 patients (5.7%), were treated by ERCP/ES (6 pts) and by percutaneous endoscopic/fluoroscopic stone removal (6 pts). Spontaneous stones passage occurred in 2 pts, one patient is waiting for treatment. Major morbidities were hemoperitoneum (4 cases) and cystic duct bile leakage (3 cases). One high risk patient died postoperatively. Recurrent stones were observed in 5 pts (1.9%), at 1, 4, 8, 18, 26 months respectively after T-tube removal, and were treated by ERCP/ES in 4 cases. Spontaneous stone passage occurred in 1 case. CONCLUSIONS: LC and CBD exploration has shown to be safe and feasible with low morbidity and mortality. The rationale of this approach is to solve two problems during the same procedure, limiting the role of endoscopic sphincterotomy to the treatment of residual ductal stones.

Adolescent↗
PubMedDate not supplied

[172 consecutive total gastrectomies for gastric cancer with Roux-en-Y loop reconstruction and without fistulization of the esophago-jejunal anastomosis].

In the treatment of gastric cancer total gastrectomy (TG) is one of the most important operation and the esophagojejunal anastomotic leakage is the most important early complication. In our series of 172 consecutive TGs (all controlled with Gastrografin-Rx in fifth postoperative day) we did not have any anastomotic fistula, independently from age, stage, type of limphadenectomy and visceral demolition. We believe that the correct technical performance is the most important factor in the esophagojejunal anastomosis.

Adult↗
PubMedDate not supplied

[Metal endoprosthesis in the treatment of acute neoplastic occlusion of the colon. Our experience].

BACKGROUND: Acute large-bowel obstruction represents a surgical challenge whose management is controversial, usually requiring emergent surgery in adverse circumstances with increased morbidity and mortality compared with elective situations. METHODS: We report our experience with self-expanding metal stents in the initial management of acute neoplastic colorectal obstruction. From December 2000 to February 2003, insertion of self-expanding metal stents under endoscopic and fluoroscopic guidance was attempted in 22 patients, in 9 as primary palliative measure (group A) whereas in 13 as a bridge to surgery (group B). RESULTS: Stenting was technically successful in 20 patients. There were 2 perforations, and one patient died as a consequence. Nine of the 11 patients in the group B underwent elective colonic resection while in two patients with advanced malignancy the stent was considered as a definitive palliative treatment. In all 10 patients with ultimate prosthesis (8 group A, 2 group B) two dislocations and one recurrent obstruction were noted in the mean follow-up of 12 months. CONCLUSION: Self expanding metal stents represent a good option in the treatment of large bowel obstruction, providing time for a complete preoperative evaluation and mechanical bowel preparation as well as for restoring patient's general conditions thus avoiding emergency surgery with considerably lower morbidity and mortality rates. In patients with advanced cancer, they provide an alternative to surgery with satisfactory results.

Acute Disease↗
PubMedDate not supplied

[Prognostic factors of gastric neoplasms: experience with 1,074 cases undergoing surgical treatment at a single center].

AIM: The aim of our study was to identify clinicopathological predictors of survival among patients undergoing potentially curative resections for gastric carcinoma. PATIENTS AND METHODS: From January 1987-March 2004, 1074 patients have been submitted to curative gastric resection for gastric cancer (647 males and 427 females, mean age, 65 +/- 12, min 22, max 92). The surgical procedure consisted of 289 (27%) total and 785 (63%) subtotal gastrectomies. The extent of lymph node dissection was limited D1 (n = 376, 35%) or extended D2 (n = 578, 54%) and D3 (n = 12, 1%); no lymphadenectomy was performed in 108 (10%) cases. The pathological nodal status has been defined based on the number of involved lymph nodes (N1: 1 to 6 positive nodes; N2: 7 to 15 positive nodes; N3: more than 15 positive nodes). The distribution of N stage was: N0 = 278 (26%), N1 = 344 (32%); N2 = 215 (20%); N3 = 129 (12%). Univariate analyses were performed for gender, age, pT stage, pN stage, tumor site, tumor size, and extent of lymphadenectomy. Significant factors were then entered into a Cox regression analysis. RESULTS: The median number of examined lymph nodes was 17 (mean, 18). Overall, 688 (64%) of patients had lymph node metastases. Of these patients, the median number of involved nodes was 2 (mean, 6). In the univariate analysis age, pT stage, pN stage, tumor size, and extent of lymphadenectomy were found to be significant factors. In the multivariate analysis T stage, N stage, and extent of lymphadenectomy were all independent predictors of survival. The median and mean survival time were 69 and 87 months, respectively. Overall survival was 80%, 51% and 40% at 1, 5, and 10 years, respectively. CONCLUSIONS: T stage, N stage, and extent of lymphadenectomy were all independent predictors of survival in patients submitted to curative gastric resections.

Adenocarcinoma↗
PubMedDate not supplied

[Colorectal laparoscopic surgery. Single center experience with 599 cancer patients].

PURPOSE: To analyze the results of laparoscopic colectomy for cancer of colon and rectum on early outcome. METHODS: Fifty hundred and ninety-nine consecutive unselected patients who underwent laparoscopic colectomy for cancer of the colon or rectum between January 1998 and December 2004 in a single Institution were prospectively evaluated. Tumor classification was by TNM stage. Patients were monitored for postoperative complications for 30 days after surgery. Follow-up was done by direct patient contact. RESULTS: Mean (SD) age was 65.8 (11.7) years. Mean (SD) ASA score was 2.0 (0.5). The following operations were performed: 248 left colectomies, 131 right colectomies, 26 sigmoid resections, 164 rectal resections, 21 abdominoperineal resections (Miles operation) and 9 total colectomies. Conversion rate was 7.2% (43/599 pts). The overall morbidity rate was 23.3% (143/599 pts). The mortality rate was 0.3% (2/599 pts). Anastomotic leak occurred in 45/599 (7.3%) patients. Re-operation rate was 4.6% (26/599 pts). Mean (SD) length of stay was 9.9 (5.8) days. The mean number (SD) of lymphnodes intraoperatively collected was 16.7 (9.8). Median (range) time of follow-up period was 20.2 months (6-68). One port-site metastasis was found at 18 months after surgery. Overall 5-years survival was 81%. Local recurrence rate in patients who underwent TME of the rectum was 4.4%. CONCLUSION: Laparoscopic colectomies is safe and effective in the treatment of colon and rectal cancer.

Aged↗
PubMedDate not supplied

[Gastrectomy and laparoscopic lymphadenectomy for carcinoma: preliminary experience with 59 cases].

BACKGROUND: Laparoscopic surgery has been used in the treatment of gastric cancer with low mortality and morbidity and improvement in patient's quality of life. AIM: To evaluate the results of laparoscopic gastric resection. METHODS: A retrospective review of 59 patients after laparoscopic surgery for gastric cancer was performed. The patients were 31 males and 28 females with a mean age of 67 (+/- 11) years (min 39, max 90). RESULTS: Tumor stage was IA in 15 patients, IB in 10, II in 9, IIIA in 6, IIIB in 9, and IV in 10. In 15 cases the tumor was an early gastric cancer. The mean number of dissected lymph nodes was 29 +/-10. Conversion rate was 16%. Morbidity rate was 37%. The median length of hospital stay was 10 days. Operative mortality was 3%. The mean time of follow-up was 23 months. Two-year survival was 75%. CONCLUSIONS: Laparoscopic radical total or subtotal gastrectomy with extended lymphadenectomy for gastric cancer is a feasible, safe, and oncologically effective procedure.

Adult↗
PubMedDate not supplied

[The identification of minimal residual disease in the bone marrow and peripheral blood in neuroblastoma. The prognostic and therapeutic implications].

A highly sensitive and specific methodology to detect neuroblastoma cells in the bone marrow and peripheral blood of children with neuroblastoma is of critical importance for proper staging and treatment of these patients. In addition, patients with bone marrow infiltration at diagnosis need to undergo regular investigation to measure the effectiveness of chemotherapy (so called "in vivo" purging). Finally, the evaluation of autologous stem cells taken from bone marrow or peripheral blood is necessary to rule out or minimise the possibility of reinfusing tumor cells to the patient following myeloablative therapy. The authors provide a "state of the art" data on this complicated issue and give their preliminary results of their own experience, mainly concerning the immunocytological methods.

Biomarkers, Tumor↗