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Biomedical subjects

C Motta

Publications and source records attributed to C Motta.

88 records · Page 5Linked to original sources
PubMedDate not supplied

Sentinel lymph node identification in breast cancer: feasibility study.

The aim of the study was to evaluate in our institute the technique of sentinel node (SN) identification and biopsy in the surgical treatment of early breast cancer. Between June 1998 and November 1999 54 patients (age range, 31-75 years) where studied. Inclusion criteria were age less than 75 years, indication for conservative surgery, absence of palpable axillary nodes, Karnofksy index >70. Lymphoscintigraphy was performed 16-18 hours prior to surgery, following injection of 0.1-0.2 mL of 99mTc-Nanocoll: the administered activity was 3-4 MBq in group A (44 pts) and 7-8 MBq in group B (10 pts). The colloids were administered by transdermal supralesional injection in 49 patients with palpable nodules and by intraparenchymal ultrasound-guided injection in five patients with non-palpable nodules. Planar projections were performed starting from the 5th until the 80th min (or 180th in the event of late migration). In 10 patients further projections were acquired 14-18 h following tracer administration. All nodes identified by gamma probe (MR 100 Pol.Hi.Tech) were histologically evaluated by immunohistochemistry and standard histology. Scintigraphic visualization of the SN was obtained in 49 patients: in 38 of these patients there was only one SN while in 11 patients there were two or three SNs. The delayed scan made in 10 patients did not show any further nodes. In all patients given US-guided perilesional injections migration was late (after at least 60 min). Our study confirms the validity of the scintigraphic procedure, its safety for patients and health care workers, and the feasibility of interdisciplinary collaboration.

Adult↗
PubMedDate not supplied

Radioguided surgery of breast cancer: radiation protection survey.

The aim of this study was to estimate the radioactive risk for surgical staff performing radioguided sentinel lymph node (SN) biopsy and to calculate the contamination level in the operating room for assessment of the possible need for specific radiation protection procedures. We studied 20 patients who were selected for quadrantectomy and SN biopsy. The day before surgery a volume of 0.15 mL of 99mTc-nanocoll was injected: the activity was 3.11 +/- 0.85 MBq in group A (15 pts) and 11.6 +/- 0.6 MBq in group B (5 pts). External radiation to staff was evaluated by measuring the exposure rate in air one hour after radiopharmaceutical administration. The air KERMA rate during surgery was estimated considering the physical decay of 99mTc. Contamination of disposable materials and surgical instruments in the operating room was measured using a contamination monitor, whereas the residual activity in the SN and the injection site was measured with a gamma probe. The exposure rate at 20 cm from the injection site was 0.75 microSv/h when the most radioactive patients (group B) were treated. Contamination in the operating room proved to be negligible. Considering the number of radioguided treatments carried out by a surgeon in one year, an equivalent effective dose of 0.075 mSv was estimated; the recommended dose limit according to the relevant Italian law, DL 230/95, is 1 mSv/yr. Surgical staff therefore do not require a classification of "exposed workers" and there is no need to supply the operating room with special containers for radioactive waste.

Breast Neoplasms↗
PubMedDate not supplied

[Magnetic resonance in the study of aseptic necrosis of the femur head].

Avascular necrosis (AVN) of the femoral head is a common clinical problem due to the frequent use of corticosteroids and to the high incidence of hip fractures from osteoporosis and traumas. In order to demonstrate MR diagnostic capabilities, 31 patients (62 hips) were studied with MR imaging, CT, and conventional radiology. The patients had already been diagnosed as having AVN of the femoral head, or the condition was clinically suspected. MR staging of the disease was compared with CT staging and with plain radiographs. The authors suggest new MR staging method and adapt the radiographic classification developed by Ficat, Arlet, and Lecestre. The results of this comparative study demonstrate MR imaging to be most appropriate in the patients with equivocal/negative radiological/CT findings. On the contrary, MR imaging is unnecessary when AVN has already been diagnosed by means of other imaging modalities, because in these advanced cases MR diagnostic contribution either equals or is inferior to that of CT and conventional radiology.

Adult↗
PubMedDate not supplied

[Study of the microviscosity of phospholopids in tracheal aspirates by fluorescence polarization. Its application to neonatal respiratory distress].

Microviscosity values obtained by fluorescence polarization in tracheal aspirates from 138 newborns are presented in this paper. Sixteen newborns intubated of other medical or chirurgical reasons than pulmonary affections were the control group. In the same period 122 newborns with respiratory distress were under investigation, the microviscosity values (in poises) in the control group were always less than 3 poises. This value is currently the higher found for phospholipids contained in bronchoalveolar lavages from normal adults. In the pathological group of neonates, the microviscosity values are always very high. When a favorable evolution was recorded (n = 80) the microviscosity values (pi) were less than 3.4 poises at the extubation time. In the unfavorable evolution group (n = 42) the values were always greater than 5 poises. The results the limits and validity of the method are discussed. The method appears simple and sensitive and is proposed as a tool to evaluate the functional proportion of the lung surfactant phospholipids.

Fluorescence Polarization↗
PubMedDate not supplied

[Changes in the activity of antibiotics by fatty acids in bone tissue].

The C14 to C18 fatty acid content of spongious bone was measured by gas-liquid chromatography. Palmitic acid (C16:0), oleic acid (C18:1) and linoleic acid (C18:2) represented 20 to 40% of the total free fatty acid concentration (30 mM/l). Linoleic acid was found to have the greatest bacteriostatic activity against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa strains. The effect of linoleic acid-gentamicin combination was synergistic against S. aureus. In contrast, both gentamicin and colistin activities were highly antagonized by linoleic and oleic acids against E. coli and P. aeruginosa strains. These different effects of free fatty acids on antibiotic activity could be explained, in part, by a change in permeability of bacterial cells. The clinical implications of these results in bone infections are discussed.

Anti-Bacterial Agents↗
PubMedDate not supplied

CT-guided percutaneous trochar-biopsy of the spine.

As is the case for tumor lesions of the limbs, for the spine, too, no treatment should be started without a pathological diagnosis. Open biopsy of the spine is always a major surgical procedure with all of the related risks, and the surgeon is frequently tempted to perform, during the same operation, biopsy and definitive treatment. This approach leads many patients to unnecessary major operations, when the final histology shows a disease which does not carry an indication for surgical resection. CT-guided percutaneous Trochar-Biopsy is a safe procedure used to obtain an adequate sample for full histological evaluation. Eliminating the need for biopsy, several major vertebral resections could be avoided. This technique deserves to become the standard first-choice procedure whenever a biopsy of the spine is required.

Biopsy↗
PubMedDate not supplied

Radiotherapy and spinal brace: still first-choice treatment for vertebral metastases from breast cancer.

In metastatic breast cancer the goal to reach must be the best possible palliation with minimum discomfort for the patient. We reviewed our experience with radiotherapy (20 or 30 Gy), systemic therapy and brace. Among 2200 breast cancer patients, we extracted 28 potential candidates for resection. All of them developed new metastases outside the treated field within one year. Local control was achieved in 68%, and 80% of them had stable or better performance status at 3 months. From our analysis, even patients with a so called "solitary lesion" do not seem to have a better prognosis than others. We conclude that radiotherapy (with systemic therapy and a brace) is still first-choice treatment for vertebral metastases; CT-guided percutaneous biopsy can avoid worthless major operations. The role of surgery should be limited to neurological compression, severe mechanical instability and to salvage the failures of conservative treatment.

Antibiotics, Antineoplastic↗