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Biomedical subjects

D Franceschi

Publications and source records attributed to D Franceschi.

86 records · Page 5Linked to original sources
PubMed1986

[Value of piracetam in the treatment of sudden idiopathic deafness. Preliminary report].

The authors report ten cases of sudden deafness treated by piracetam. In eight cases there was a complete recovery, in one case there was a partial recovery and in one it was a failure. There was observed in two cases a rise in the compound action potential of the electrocochleography measured after 30 minutes of the infusion in comparison with that performed 30 minutes before the infusion. They were impressed by the rapidity of the recovery and they did not encounter side effects.

Drug Evaluation↗
PubMed1986

[ORL manifestations of AIDS].

The authors report their ENT observations in 20 patients suffering from AIDS. They point out the frequency of finding Kaposi sarcoma, cervical lymph nodes, oral mycosis in these cases, and they compare their results with those of other recent publications.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Microcomputer image processing for burn patients.

A computer-based system was developed to handle information and images in a clinical setting. The system is based on an 80286 AT computer, the topology of which includes a 16-bit color image capture/display graphics adapter and a 256 gray scale 8-bit digital image analysis processor. Using its color capabilities, we have created a picture database of patients' injuries, radiographs, and other relevant clinical data. The computer-based imaging system allows instant access to this information and minimizes subjective evaluation, making comparison of and follow-up of treatments more objective. The image analysis components permit digital characterization of the burn wound, enhancing our ability to quantitatively evaluate wound size, contracture, graft take, and re-epithelialization. This is a cost-effective method of handling information and images in the clinical setting as well as an effective research and teaching tool that facilitates management and follow-up care of the patient with burns.

Burns↗
PubMedDate not supplied

Peripheral lymphocyte membrane fluidity after thermal injury.

Serum cortisol levels are increased in patients after thermal injury. Lymphocyte function is altered in these patients, which renders them susceptible to infections. Elevated cortisol levels may contribute to this compromised state. In this study, we have demonstrated that cortisol directly affects lymphocyte membrane fluidity as measured by the polarization of fluorescence from the membrane-associated probe diphenylhexatriene in peripheral blood lymphocytes. Membrane fluidity increased in vitro with short- or long-term cortisol exposure. However, membranes of control peripheral blood lymphocytes that were previously exposed to cortisol became resistant to the fluidizing effect of cortisol, which implies membrane adaptation to long-term cortisol exposure. Cortisol effects were similar to those associated with ethanol, a known membrane-fluidizing agent, in peripheral blood lymphocytes and cytotoxic T lymphocytes. Membrane fluidity was compared in peripheral blood lymphocytes from thermally injured patients and peripheral blood lymphocytes from normal (control) subjects. Peripheral blood lymphocyte membrane fluidity increased in major thermal injury. Our data suggest that cortisol affects lymphocyte membrane fluidity in vitro in a manner similar to the membrane fluidity alterations that are observed in vivo after thermal injury. These observations reflect a direct membrane effect of cortisol, which may explain, in part, the cellular dysfunction and immunologic suppression that is observed after thermal injury.

Adult↗
PubMedDate not supplied

Increased thymidylate synthase gene expression in liver metastases from colorectal carcinoma: implications for chemotherapeutic options and survival.

OBJECTIVES: To determine the association of intratumoral thymidylate synthase (TS) gene expression with resistance to fluoropyrimidines and to study the association of TS gene expression with outcome in patients with liver metastases from colorectal cancer. METHODS: Intratumoral TS gene expression was measured by reverse transcriptase and polymerase chain reaction in 33 patients with liver metastases from colorectal carcinoma. Fifteen patients underwent resection, and 18 were treated with chemotherapy only. Patients with high levels of TS gene expression were compared to those with low levels of TS gene expression. RESULTS: All patients with a high level of TS gene expression were nonresponders to fluoropyrimidine chemotherapy. Median survival in patients with unresectable disease was shorter in those who had high levels of TS gene expression (7 months vs 15 months, P = 0.02). After hepatic resection, median disease-free interval was shorter in patients with high levels of TS gene expression (5 months vs 18 months; P = 0.004). Similarly, survival was shorter after resection in those with high TS gene expression (17 months vs 43 months, P = 0.0002). DISCUSSION: Increased TS gene expression is associated with a poor outcome in patients with liver metastases from colorectal carcinoma, whether resected or treated by chemotherapy only. This is related in part to reduced responsiveness to chemotherapeutic agents, but it also reflects inherently more aggressive behavior of metastases.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Management of hilar bile duct carcinoma.

BACKGROUND/AIMS: Hilar cholangiocarcinoma is a rare tumor with a dismal prognosis. Because proximal bile duct cancers are uncommon, outcomes related to various therapeutic interventions are not well defined. METHODOLOGY: Between 1985 and 1997, 55 patients with bile duct cancers involving the proximal third of the extrahepatic bile ducts were seen. The management of patients with resectable and unresectable disease was retrospectively reviewed. All but four patients were followed until the time of death. RESULTS: Forty patients underwent laparotomy following preoperative assessment of extent of disease and 19 patients (35%) ultimately underwent resection with curative intent. Survival was significantly longer in patients who underwent resection (2-year survival 47% vs. 18%; P = 0.027). Of those patients whose disease was resected, 11 patients received adjuvant radiotherapy. Survival for this group was not significantly different from that seen in patients who did not receive adjuvant radiotherapy. Similarly, in patients with unresectable disease, administration of radiotherapy was not associated with an improved outcome. CONCLUSIONS: Locoregional extent of disease is the greatest problem in cases of proximal bile duct cancers. Resection provides the best hope for long-term survival, but new adjuvant strategies are needed.

Adult↗
PubMedDate not supplied

Intralymphatic antibiotic delivery for reducing acute prosthetic graft infection.

The lymphatic system has been implicated as a source of synthetic graft contamination when grafts are implanted in the presence of a distal septic focus. In previous studies, radical lymphatic excision and ligation were shown to reduce acute graft sepsis. However significant lymphedema precluded its clinical application. The present study was undertaken to evaluate methods for reducing acute graft sepsis while avoiding lymphatic obstructive complications. Twenty dogs were divided into one control and two experimental cohorts. Femoral interposition grafts were placed in each dog. A hind paw septic focus was introduced and therapy included a control (Group I--no therapy), intravenous antibiotics in Group II and intralymphatic antibiotics in Group III. Graft, blood and tissue cultures from each dog were taken at 48 hours. Lymphatic antibiotic therapy resulted in significantly improved graft culture results when compared to the control (p = 0.0003) and intravenously treated animals (p = 0.007). Blood cultures in the intralymphatically treated group were also significantly better (p = 0.003) than the control group.

Animals↗
PubMedDate not supplied

Implantable venous access device.

Procedures for long-term angio access have for many years made up a major component of vascular surgical practice. A totally implantable vascular device for chronic venous access developed in the early '80s compares favorably with other methods of angio access. We implanted 76 of these devices in 73 patients on the oncology service of Fairview General Hospital between May 1984 and May 1986. The infusion ports were in place for a total of 14,509 patient days with a 3.9% rate of catheter related sepsis and 6.5% rate of catheter occlusion. Three occlusions resolved with streptokinase. Pocket infection occurred as a late complication in 3 patients. Emphasis is placed on a modified technique for device implantation. Strict adherence to a simplified percutaneous technique for the silastic catheter placement via the subclavian vein, with creation of the reservoir pocket after adequate vascular access is secure, has led to no serious complications during placement. Routine use of fluoroscopy during this procedure helped avoid potential technical complications. The advantages and disadvantages of the implantable systems compared to the dacron cuffed silastic catheters are discussed. Patient acceptance is excellent and improved cost/benefit ratio has been observed when compared to other forms of chronic venous access. Implantable vascular devices can be safely inserted with little morbidity or risk to the patient. They provide a convenient route for drawing blood, administering chemotherapy, hyperalimentation, and intravenous therapy in oncology patients and may represent an advantage over Hickman-Broviac catheters and the attendant catheter related sepsis associated with their use.

Adolescent↗