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Biomedical subjects

C Sacco

Publications and source records attributed to C Sacco.

At least 37 records · Page 2Linked to original sources
PubMed1996

Adjuvant immunotherapy treatment of renal carcinoma patients with autologous tumor cells and bacillus Calmette-Guèrin: five-year results of a prospective randomized study.

BACKGROUND: Active specific immunotherapy (ASI) is a strategy that attempts to boost the host's immune response specifically against its own tumor. The purpose of this study was to investigate the effect of adjuvant ASI in patients with renal carcinoma. METHODS: Of 120 consecutive patients, 60 were randomized to a control group and 60 to receive ASI comprised of 3 intradermal injections of 10(7) autologous irradiated tumor cells mixed with 10(7) Bacillus Calmette-Guèrin (in the first 2 vaccinations) or alone. At randomization and 1, 6, and 12 months after completing immunotherapy, the treated patients were evaluated for the development of delayed type cutaneous hypersensitivity (DTCH) response to autologous tumor and autologous normal renal cells. RESULTS: The baseline DTCH responses were negative in all patients. One month after completing ASI, 38 of 54 immunized patients showed a significant (P<0.01) DTCH response to autologous tumor but not to autologous normal renal cells. The response was persistent at 6 months in 25 of 44 patients and at 12 months in 16 of 28 patients. DTCH response remained negative in the nonimmunized control patients. There was no systemic toxicity but local ulcerations that healed in 2 months were observed. After a median follow-up of 61 months, the probability of 5-year disease free survival (DFS) was 63% for treated patients and 72% for control patients. The corresponding probability of 5-year overall survival (OS) was 69% and 78%, respectively. These differences were not statistically significant. CONCLUSIONS: This is the first prospective randomized study of ASI in a large population of patients with renal carcinoma after radical nephrectomy. Our data clearly indicate that ASI can increase the reactivity to autologous tumor, as measured by the DTCH test, but it appears unable to affect DFS and OS of patients.

Adjuvants, Immunologic↗
PubMed1996

Pyrazolo[1,5-a]pyrido[3,4-e]pyrimidin-6-ones. I. Synthesis and in vitro antimicrobial evaluation.

A series of pyrazolo[1,5-a]pyrido[3,4-e]pyrimidin-6-ones (9-36) was prepared by a simple synthetic procedure based on the reaction of ethyl 7-dimethylaminovinyl pyrazolo[1,5-a]pyrimidin-6-carboxylates (1-8) and reagents (a-n) containing a primary amino group. When this set of compounds was subjected to "in vitro" antimicrobial screening, it showed no significant activity.

Anti-Bacterial Agents↗
PubMed1995

Expression and release of intercellular adhesion molecule-1 in renal-cancer patients.

We examined ICAM-1 expression in 37 freshly dissociated renal-cancer cell populations. Immunoperoxidase analysis revealed that 31 of the 37 renal tumors expressed ICAM-1 to various degrees; ICAM-1 expression was significantly lower in tumor cells obtained from patients remaining tumor-free after a median follow-up of 60 months (mean value 24.4% +/- 21) than in tumor cells obtained from the relapsed patients (mean value 40.8% +/- 22), and the low expression of this molecule on the cell surface seemed to correlate with favorable clinical behavior. In 41 patients, the mean level of sICAM-I was 551 +/- 260 ng/ml, significantly higher than normal. However, sICAM-1 levels were significantly lower in the 20 tumor-free (mean 467 +/- 158 ng/ml) than in the 21 metastatic patients (mean 631 +/- 318 ng/ml). Eleven renal-cancer cell populations were cultured in order to examine the expression and release of ICAM-1. All of these cells were positive for ICAM-1 expression, which was elevated in 6 cases (> 50%) and low in the remaining 5 cases (18-35%). However, only the 5 cell populations expressing low levels of ICAM-1 released this molecule, showing an inverse correlation with cellular expression. Five of the cell populations were treated for 48 hr with rIFN-gamma, in these cells, both ICAM-1 expression and sICAM-1 levels increased, although sICAM-1 levels in the supernatants of the cell populations with constitutive high ICAM-1 expression remained very low.

Adult↗
PubMed1995

Clinical Trials in Older Patients With Intermediate and High-Grade Lymphomas.

The number of studies concerning non-Hodgkin's lymphoma (NHL) in elderly patients has increased in the last few years. However, the effectiveness of treatments specifically devised for elderly patients with aggressive lymphoma must be determined despite a trend towards reduction of treatment-related death. Direct comparison of trial results is difficult since different age limits were set for the inclusion of patients on study, but we can confirm that the complete response rate decreases with increasing age. Comparison of results even among trials conducted on patients of the same age remains difficult due to the lack of homogeneity in prognostic factors related to the NHL as well as to associated comorbidity, mental status, physical activity and family and social status.

Journal Article↗
PubMed1995

The effects of doxofylline versus theophylline on sleep architecture in COPD patients.

Theophylline is known to alter sleep architecture because of its affinity to adenosine receptors. One of the consequences of disrupted sleep is impaired cognitive performance. A single-blind, randomized cross-over study of eight male chronic obstructive pulmonary disease (COPD) patients was undertaken to evaluate the effects of theophylline versus doxofylline on sleep architecture. The patients, who were all ex-smokers, had been treated with theophylline. Mean age was 53 +/- 12 yrs, forced expiratory volume in one second (FEV1) 50 +/- 22% predicted and forced vital capacity (FVC) 70 +/- 18% predicted. Following a wash-out period, four patients were given oral slow-release theophylline (T) (300 mg b.i.d.) for one week, followed by a cross-over to doxofylline (D) (400 mg t.i.d.) for a second week. The other four patients were given the drugs in the reverse order. All patients underwent polysomnography at baseline and at the end of each week of treatment. The number of arousals per hour was 5.5 +/- 2.9 at baseline, 9.4 +/- 5.2 during T treatment and 5.4 +/- 4.4 during D treatment. During T treatment, sleep efficiency was 60 +/- 19% vs 75 +/- 13% recorded at baseline trial and 68 +/- 25 recorded during D treatment. Sleep quality, during T treatment, was poorer than at baseline, with a greater increase in the percentage of wakefulness and more stage 2 sleep than at baseline. Slow wave sleep was reduced with both treatments, particularly D. Neither drug affected the arterial oxygen saturation (Sao2) or respiratory rate during sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Selective inhibition of gastrointestinal beta-glucuronidase by poly(vinylbenzyl D-glucaro(1,4)lactonate). Part 2. Poly(vinylbenzyl D-glucaro(1,4) lactonate) in vitro inhibition studies.

In vitro inhibition studies with beta-glucuronidase from purified E. coli and mouse intestinal contents indicated that the polymer, poly(vinylbenzyl D-glucaro(1,4)lactonate, is an effective beta-glucuronidase inhibitor. Purified E. coli beta-glucuronidase was inhibited by 99.6% with 177 mM D-glucaro(1,4)lactone using the polymer-inhibitor. Similarly, 95% inhibition of beta-glucuronidase activity of mouse intestinal contents was obtained with 177 mM and 50% inhibition was obtained with 31.5 mM D-glucaro(1,4)lactone based on the modified polymer. The structural requirements of an effective beta-glucuronidase inhibitor based on the structure of the polymer-inhibitor are also discussed.

Animals↗
PubMed1994

[Hypertrophic cardiomyopathy with two episodes of recuperated sudden death. Report of the first implantable defibrillator cardioverter inserted in Chile].

We report a 29 years old male with a non obstructive hypertrophic cardiomyopathy that survived two episodes of cardiac arrest and with a familiar history of the disease and sudden death. He had an implant of an automatic implantable cardioverter defibrillator by a left anterior thoracotomy with intraoperative electrophysiology. The postoperative outcome was uneventful. After one year of follow up, the patient is in good functional capacity and the implanted device has not performed defibrillations.

Adult↗
PubMed1994

Correlates of well-being among caregivers of cognitively impaired relatives.

The characteristics and use of respite services of 64 caregivers of severely cognitively impaired clients were correlated with the caregivers' purposes-in-life and burden outcome scores. Caregiver well-being was similar across users of a variety of respite service packages. Correlates of caregiver well-being, in spite of their burdens, were caregiver hardiness and favourable meaning given illness. Both of these cognitive variables exceeded the importance of perceived social support in explaining the variation in caregiver purpose-in-life.

Caregivers↗
PubMed1993

Overnight urinary uric acid: creatinine ratio for detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure.

During hypoxia ATP degradation to uric acid is increased in animal models and humans. To assess the reliability of an overnight increase in uric acid excretion as a marker of nocturnal hypoxemia, we selected 10 normal volunteers (7 males and 3 females), 29 COPD patients (26 males and 3 females), and 49 subjects with obstructive sleep apnea (OSA) (43 males and 6 females). The patients underwent standard polysomnography, which was repeated in 14 subjects with nasal continuous positive airway pressure (CPAP), and were subdivided into two groups: Group D included desaturating subjects who spent at least 1 h at SaO2 < 90% and 15 min below 85%, and Group ND were nondesaturating subjects. The overnight change in the uric acid:creatinine ratio (delta UA:Cr) was negative in normal subjects (-27.5 +/- 9.1 [mean +/- SD]) and ND groups: -19.7 +/- 14.3 in COPD, -16.1 +/- 13.0 in OSA. In both COPD and OSA Group D, the ratio was usually positive: delta UA:Cr was 17.9 +/- 31.4 in Group D COPD (p < 0.001 versus ND) and 10.1 +/- 30.7 in Group D OSA (p < 0.001 versus ND and versus normal subjects) despite 4 of 15 false negative results in COPD and 8 of 20 in OSA. CPAP effective treatment induced a marked reduction ((p = 0.0024) in delta UA:Cr, leading to a negative value. We conclude that delta UA:Cr seems to be a promising index of significant nocturnal tissue hypoxia, with good specificity but poor sensitivity (about 30% false negative), which might be useful for the long-term follow-up of outpatients on nasal CPAP with a positive ratio at baseline.

Adult↗
PubMed1993

Selective inhibition of gastrointestinal beta-glucuronidase by polyvinylbenzyl D-glucaro(1,4)lactonate: attachment of D-glucaro(1,4)lactone to polyvinylbenzyl chloride.

D-Glucaro(1,4)lactone, a potent beta-glucuronidase inhibitor was attached via the carboxylic acid moiety to polyvinylbenzyl chloride (PVBC) using a bimolecular nucleophilic displacement reaction. First, the caesium salt of D-glucaro(1,4)lactone was prepared by titrating the carboxylic acid to neutrality with aqueous caesium bicarbonate. The polyvinylbenzyl D-glucaro(1,4)lactonate was obtained in maximum yields of between 50 and 60% when caesium D-glucaro(1,4)lactonate was incubated with PVBC in DMF at 50 degrees C for 7 d in the presence of a catalyst, caesium iodide.

Cesium↗
PubMed1992

Does chronic lung failure lead to cognitive failure?

This study seeks to find out whether impaired cognition is associated with Chronic Obstructive Pulmonary Disease (COPD). Two experiments have been carried out to address two aspects of selective attention: a focused attention paradigm with a random and a facilitated condition and a divided attention paradigm with and without interference. Twenty-eight COPD patients and 28 matched healthy controls took part in both experiments. Reaction time (RT) was the variable considered. COPD patients had slower RTs than controls, however facilitation and interference had the same effect on both groups. No correlation was found between neuropsychological measures and lung failure indices. A threshold model in the lung-failure/brain-failure trade-off is envisaged.

Adult↗
PubMed1992

[Radiologic characteristics of the thorax during therapy with interleukin-2].

Interleukin-2 is a glycoprotein physiologically produced by human lymphocytes which is capable of mediating some still unknown immunologic reactions. In vitro, interleukin-2 was seen to induce a lytic reaction against tumor cells through the activation of a cytolytic system of natural killer cells. If administered to man in heavy doses, it causes a clinical response in the treatment of metastases from melanoma and renal cell carcinoma in 20-40% of cases. However, the clinical use of the drug, in therapeutic doses, is prevented by the occurrence of several side-effects, the major one being increased permeability of alveolar vessels with capillary leak and interstitial pulmonary edema (Vascular Leak Syndrome in the English literature). Thus, this work was aimed at evaluating chest radiographs during interleukin-2 treatment to detect, in the pulmonary district, the early stages of the vascular leak syndrome--i.e., pulmonary edema, pleural and pericardial effusions. Forty-three patients had been treated for metastases from renal cell carcinoma and melanoma November 1989 through September 1991: standard chest radiographs demonstrated 26 cases (60%) of pulmonary edema, 14 cases (32%) of bilateral pleural effusions and 12 cases (27%) of pericardial effusions. Daily chest films of the patients undergoing interleukin-2 therapy allowed the early stage of the vascular leak syndrome to be depicted, thus enabling the physician to use the highest tolerated doses and eventually to stop infusion before marked respiratory distress develops.

Humans↗