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Biomedical subjects

G Ardito

Publications and source records attributed to G Ardito.

At least 19 recordsLinked to original sources

A less invasive, selective, functional neck dissection for papillary thyroid carcinoma.

HYPOTHESIS: To describe an alternative lateral neck access in order to perform neck dissection in papillary thyroid carcinoma (PTC) with lymph node involvement. DESIGN: Prospective (January 2000 to December 2003), 36-month study. SETTING: Catholic University of Rome and University of "Tor Vergata", Rome, Italy. PATIENTS AND METHODS: Twenty-four consecutive patients with PTC and cervical lymph node metastases were included. Functional neck dissection (FND), unilateral or bilateral, was performed acceding via a lateral dissection through a traditional Kocher incision, running along the superficial fascia of the neck and posteriorly to the sternocleidomastoideus muscle. RESULTS: Mean age was 39.04+/-13.69 years. Twenty patients were women and four were men. Mean tumour size was 2.5+/-1 cm, while the greatest metastatic lymph node size was 4.5 cm. Minimally invasive, selective FND was performed in all patients associated to total thyroidectomy and central compartment lymph node clearance. Metastatic lymph nodes were found in 142 out of 340 of the lymph nodes dissected. CONCLUSIONS: Minimally invasive neck dissection seems to carry a lower risk in terms of specific morbidity and allows a quicker recovery and a better aesthetic result. This access has to be considered as a less invasive procedure compared to the other surgical accesses for the radical or modified lateral neck dissection.

Adult↗

Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism.

The association of a functional parathyroid cyst with a parathyroid adenoma is an uncommon finding. In this report we describe the clinical history of a 60-yr-old man, presenting with the following findings: hypercalcemia (18.9 mg/dl), elevated serum parathormone levels (1320 pg/dl), hypercalciuria (228 mg/dl), and hyperphosphaturia (155 mg/dl). Neck ultrasound, magnetic resonance imaging (MRI) and 99Tc Sestamibi scintigraphy led to the identification of a left parathyroid adenoma, located at the lower pole of the left thyroid gland lobe, associated with a parathyroid cyst, located at the upper extremity of the same thyroid lobe. Parathyroidectomy was performed and the histological examination confirmed the diagnosis of a parathyroid adenoma with aspects of cystic degeneration and an upper parathyroid cyst. Analysis of the crystal clear intracystic fluid showed elevated parathyroid hormone (PTH) levels (137.000 pg/ml). The patient is normocalcemic at 2 yr after surgery without signs of recurrent parathyroid enlargements. Aetiology, diagnosis and management of parathyroid cyst will be discussed.

Adenoma↗

Modified radical neck dissection via extra-thyroideal space (MRND vets) in papillary thyroid carcinoma.

The purpose of this study was to describe an alternative lateral neck access to perform lymph nodes sampling and/or neck dissection via extra-thyroideal space (MRND vets) in papillary thyroid carcinoma with lymph nodes involvment. Twenty-four consecutive patients with papillary thyroid carcinoma were included. Lymph nodes sampling and modified radical neck dissection, unilateral or bilateral, were performed acceding via a lateral dissection through a traditional Kocher incision, running along the medial fascia of the neck, posteriorly to the sterno-cleido-mastoideus muscle (SCM). Mean age was 39.04 +/- 13.69 years. Twenty patients were women, and 4 were men. Mean tumor size was 2.5 +/- 1 cm.. Total thyroidectomy with lymph nodes dissection of the central compartment associated to modified radical neck dissection was performed in 17 patients: among these, nine patients had a preoperative diagnosis of the latero-cervical lymph nodes metastases, and eight had a perioperative diagnosis of metastases of the extensive sampling of the lower third of the jugular chain. Metastatic lymph nodes were found in 107 out of 615 lymph nodes dissected. The MNRD vets access for modified lateral neck dissection seems to carry a lower risk in terms of specific morbility and allows a quicker recovery and a better cosmetic result. This access has to be considered as a less invasive procedure compared to other surgical accesses for the radical modified lateral neck dissection.

Adult↗

Thyroid tumors in children and adolescents: preoperative study.

Several studies indicate that in young patients (less than 21 years of age at the time of diagnosis), the prognosis of thyroid carcinoma (TC) is more favorable than in older patients. However, a more radical treatment approach is recommended in children and adolescents due to the higher prevalence of local lymph-node involvement in these cases. Since the extent of primary surgical treatment is closely related to the overall prognosis, preoperative diagnosis becomes essential in the management of thyroid neoplasms in young patients. In this retrospective study (1987-1998), we analyzed a surgical series of 50 children and adolescents with thyroid nodules in an attempt to establish the role of diagnostic studies in detecting malignant lesions prior to surgery. Our diagnostic protocol for evaluating thyroid nodules was based on clinical evaluation, measurement of thyroid-hormone and thyroglobulin (TG) levels, anti-TG and anti-TPO antibody titers, calcitonin, CEA, and TPA levels, sonography, scintigraphy, and fine-needle aspiration cytology (FNAC) of the thyroid nodules and any enlarged lymph nodes. Eleven of the 15 cases of histologically confirmed carcinoma were preoperatively identified as malignant lesions with the aid of FNAC. The authors conclude that the preoperative work-up of children and adolescents with thyroid nodules requires the collaboration of an experienced team of professionals, and recommend FNAC as the initial test.

Adolescent↗

Follicular adenoma of the thyroid gland with extensive bone metaplasia.

Follicular adenomas of the thyroid account for over 90% of benign neoplasms of the gland. They exhibit a wide range of morphological structures, from the classical follicular pattern to the peculiar hyalinizing trabecular pattern. Although follicular adenomas grow slowly, they are nonetheless subject to degenerative, most often hemorrhagic changes in their central portion. These hemorrhagic areas undergo further regressive changes such as sclerosis and calcification. However, the detection of a true bone formation with a trabecular structure and the presence of marrow is a very rare occurrence. A follicular adenoma with central cartilaginous metaplasia has been reported in literature but, to our knowledge, a follicular adenoma with bone metaplasia has never been described.

Adenoma↗

Chromosomal aberrations, sister chromatid exchanges and high frequency cells in young patients with neurofibromatosis 1 (NF1).

Chromosomal aberrations (CAs), sister chromatid exchanges (SCEs) and high frequency cells (HFCs) have been assessed in peripheral blood lymphocytes of 10 neurofibromatosis (NF1) patients and 10 healthy controls. In both groups, the spontaneous rates and the induced (bleomycin for CA and MMC for SCE) frequencies were analyzed. No differences between cells from NF1 patients and controls were observed with respect to spontaneous or bleomycin induced CA. Spontaneous or MMC induced SCE frequencies were also similar in NF1 patients and controls. HFCs, on the contrary, were statistically lower in NF1 patients.

Adolescent↗

MFASAT: a new alphoid DNA sequence isolated from Macaca fascicularis (Cercopithecidae, Primates).

A new highly repeated DNA fragment isolated from Macaca fascicularis (MFASAT) is described. Our findings obtained by sequencing, Southern blot analysis, and fluorescent in situ hybridization (FISH) on metaphasic chromosomes strongly suggest that MFASAT can be considered as a member of the alphoid DNA family characteristic of Old World monkeys. The chromosomal localization of MFASAT, obtained by FISH, showed that this alphoid DNA is present in the peri-centromeric area of all the chromosomes. MFASAT showed a high degree of conservation when compared, by sequence alignment, to other Macaca species and Papio papio as expected for species with considerable genome conservation. A low degree of homology has been found comparing M. fascicularis alphoid DNA with a more distantly related Cercopithecidae species such as Cercopithecus aethiops.

Animals↗

Baseline and mitomycin C (MMC)-induced sister-chromatid exchanges in XX and XY cells of Callithrix jacchus chimeric twins.

Lymphocytes from chimeric individuals of the species Callithrix jacchus (Primates) were examined to evaluate differences in the frequency of sister chromatid exchanges (SCE) between XX and XY cells. The aim was to discover whether SCE differ according to genetic sex and whether XX and XY cells show a different sensitivity to SCE inducing agents. This experimental model has enabled us to eliminate the possible differences caused by environmental factors. The results obtained do not reveal significant differences between male and female cells, in either the baseline SCE frequency or that induced by mitomycin C at concentrations of 0.01 and 0.03 microgram/ml. No significant differences were observed in the distribution of high SCE frequency cells (HFC), even if it is possible to observe a higher level of exchanges in XX cells in each trial. With regard to the phenotypic sex, there appears to be a trend towards slightly higher SCE rates in females, even if results are not statistically significant.

Animals↗

Sister-chromatid exchange rates in XX and XY cells of ten chimeric Callithrix jacchus individuals.

In order to ascertain whether or not sister-chromatid exchange (SCE) differs in relation to sex, SCE rates in XX and XY cells from 10 specimens of marmoset (Callithrix jacchus) were examined. The choice of this primate is particularly suitable for three reasons: most individuals have a chimeric constitution, the X chromosome is quite large and the Y chromosome is particularly small. Therefore, the influence of possible differences in their exposure to the external environment can be eliminated. The results obtained did not reveal any significant difference between SCE rates in male and female cells in any of the examined individuals.

Animals↗

Comparative analysis of the fragments of highly repeated DNA of Homo, Pan, Macaca and Cercopithecus.

In the present paper the restriction patterns of Homo, Pan troglodytes, Macaca fascicularis and Cercopithecus aethiops, obtained by digestion with Eco RI endonuclease, were compared. All these species showed two common bands at 0.3 and 0.6 Kb. In this region another band at 0.5 Kb was present in Macaca fascicularis and Cercopithecus aethiops. Furthermore Macaca fascicularis, Cercopithecus aethiops and Pan troglodytes showed a series of bands not present in humans. The distance matrix shows a strong similarity between Homo and Pan and a decreasing similarity with Macaca fascicularis and Cercopithecus aethiops. No intraspecific variability was observed.

Animals↗

[Therapeutic and prognostic possibilities in primary lymphoma of the thyroid].

Personal experience with small cell thyroid tumours is reviewed in the light of recent developments in diagnosis and treatment. All cases were examined by means of immunohistochemical investigation of the lymphocytic and epithelial antigens. In 7 cases in which the production of lymphocytic antigens was confirmed, a primary lymphoma of the thyroid was diagnosed. Immunohistochemical studies of the lymphocytic and epithelial antigens are essential in all small cell thyroid tumours, in order to differentiate between small cell anaplastic carcinomas and thyroid lymphomas. This differentiation is indispensable for the correct choice of treatment and an accurate prognostic assessment. In the case of lymphomas, combined surgical and radiation treatment adjusted to the clinical stage of the tumour is recommended.

Aged↗

[Advanced age and clinical staging in the prognostic evaluation of differentiated carcinoma of the thyroid gland].

The prognostic significance of age in differentiated thyroid tumours is assessed via the analysis of 156 cases of differentiated thyroid carcinoma surgically treated in 1967-85. A statistical analysis was performed on a sample of 120 patients under observation since their operation. The results indicate that the negative influence of old age is due more to the higher incidence of advanced tumours among the elderly than to more aggressive behaviour by the tumour.

Adenocarcinoma↗

Chromosome analysis in operating room personnel.

Cytogenetic tests were performed on operating room personnel working in a Turin hospital. The aim of our study was to determine if any chromosome damage was caused by the use of anaesthetic gases. Blood samples were collected from 45 hospital workers: 15 exposed to anaesthetic gases, 15 exposed to both anaesthetic gases and ionizing radiations and 15 controls. An examination of sister-chromatid exchanges did not highlight significant differences when exposed subjects were compared to controls. Chromosomal aberrations were significantly higher (P = 0.029) in all the exposed personnel, while no statistically significant increase was observed in staff exclusively in contact with anaesthetic gases. Moreover there was a positive correlation for chromosome aberrations with the years of employment, when the entire exposed population was considered and when personnel from the different operating rooms were considered separately. Both sister-chromatid exchange and chromosomal aberrations were higher among smokers though differences were not statistically significant.

Adult↗

Cytogenetic monitoring of hospital workers exposed to low-level ionizing radiation.

In the present study the cytogenetic effects in hospital workers exposed to low-level radiation were evaluated. Samples of peripheral blood were collected from 63 subjects working in radiodiagnostics and from 30 subjects, working in the same hospitals, who were used as controls. A higher number of cells with chromosome-type aberrations (CA) was observed in the exposed workers vs. the controls and the difference was statistically significant (p less than 0.05). No correlation was, on the contrary, found between CA and years of exposure. A significant difference was observed in the incidence of cells with CA between smokers and non-smokers, but in the control group only. In contrast, in the workers exposed to ionizing radiation, the frequency of cells with CA was very similar in smokers and non-smokers.

Chromosome Aberrations↗

Comparison of chromosome aberration frequency before and after administration of 131I in two groups of thyroid cancer patients.

The chromosome aberration frequencies of 10 thyroid cancer patients, before and after their first radioiodine treatment (group A), were compared to the frequencies found in another 10 subjects previously treated with two or more radioiodine administrations (group B). Our data show that the relative increase in chromosome-type aberrations was similar in the two groups: from 2.0% to 3.7% (group A) and from 4.7% to 9.0% (group B). However, the increase in the number of cells with aberrations was greater in group A. Moreover, the higher frequency of aberrations in group B, even before the radioiodine treatment, points out the effect of previous treatments and demonstrates the persistence of this type of lesion. The sister chromatid exchange frequency in the two groups was also analysed, but no effect bound to the radioiodine treatment could be demonstrated.

Adult↗