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Biomedical subjects

G Rossi

Publications and source records attributed to G Rossi.

At least 307 records · Page 17Linked to original sources
PubMed1997

Callosotomy for drug resistant generalized seizures.

We report our series of drug resistant epileptic patients submitted to callosotomy. The 25 patients were affected by severe epilepsy with invalidating generalized seizures with fall, lacking of indication for ablative surgery. Nineteen patients, with at least 1 year of follow-up, were considered for this study. The surgical outcome was classified as: class A), seizure disappearance; class B) 80%, class C) 80-50%, class D) less than 50% seizure reduction; E) increase of seizure frequency. The follow-up analysis shows that the better results are obtained with the generalized seizures, in particular the GTA. Our surgical results are discussed considering the data of the literature: about the functional anatomy of the Corpus Callosum, the experimental studies and the clinical series published on callosotomized epileptic patients.

Adult↗
PubMed1997

[Comparison between measured and computed absorbed dose values in the tangential treatment of the breast].

The calculated absorbed dose values to the reference point of the breast tangential irradiation, obtained by 2-dimensional (2D) Treatment Planning Systems (TPS), were compared with the measured absorbed dose values obtained with a ionization chamber in an anthropomorphic phantom treated with two opposed photon beams of 60Co, 6 MV and 10 MV. This comparison was aimed at assessing the 2D algorithm dose overestimation due to the effect of missing tissue in the irradiated field. The ratio between the computed dose, Dc, and the measured dose, Dm, reached 1.08 for 60Co beams and 1.04 for X-ray beams of linacs. The Clarkson method gives an adequate correction factor for the calculated absorbed dose value in the reference point. The portal films of some patients were studied to estimate the correction factor for the treatment time or monitor units evaluated by TPS using tomographic breast central plane. The values of the correction factors reached 1.10 for 60Co photon beams and 1.04 for X-ray beams. The measurements were carried out with TLDs positioned in the central plane of the breast, covered by a special bolus, of a second anthropomorphic phantom. The dose homogeneity as well as the accuracy of the relative computed dose values in the breast phantom irradiated with 10 MV X-ray beams were assessed.

Absorption↗
PubMed1997

[Eating behavior disorders. Epidemiologic study of 434 adolescents].

METHODS: An epidemiological investigation of behavior disorders in a population of 434 students (52.3% males, 47.7% females) ranging from 16 to 19 years of age has been carried out. Possible correlations between eating disturbances, drug addiction related behaviors, suicide attempts and former sexual abuses have been discussed. An anonymous self administered questionnaire, prepared by the authors, had been used. The statistical analysis was carried out with the SPSS/PC Factor software. RESULTS: This study revealed the presence of adolescents with unstable or quantitatively not adequate eating behaviors, which are expressed by borderline symptoms and not by clear syndromes. Distorted attitudes towards weight, body and food, related to disturbances of body image, were pointed out. In particular, girl seemed to be unhappy with their own body. There was a correlation between abnormal eating behaviors (borderline bulimia) and low level of selfesteem. "Anorexic behavior" and "bulimic behavior" had a significant correlation to suicide attempts. A relationship between "bulimic behavior" and use/abuse of drugs and/or alcohol was found. In our population several kinds of violence were found (2.6% sexual abuse with physical contact; 13.5% sexual abuse without physical contact; 9.4% physical abuse) experienced inside or outside families. The adolescent victims of sexual abuse showed abnormal eating behavior, mostly a tendency to a "bulimic behavior". CONCLUSIONS: This study seems to confirm that there are significant correlations and several conduct disorders. Moreover the presence of a correlation between eating disturbances, even if borderline and traumatic events of sexual nature is confirmed.

Adolescent↗
PubMed1997

Colorectal carcinoma in different age groups: a population-based investigation.

Although colorectal cancer is a disease of the older population, these tumors are not infrequent before the age of 55. Through the data of a population-based registry, we proposed giving a description of the clinical features of three groups of patients in whom the disease occurred at a relatively early age of onset (group I: < 40 yr; group II: 41-50 yr; group III: 51-55 yr). There were only 14 patients under the age of 40 yr (1.1% of total registered patients, n = 1298 in the period 1984-1992). Group II and III represented 5.9% and 6.0%, respectively (n = 76 and 78), with minor fluctuations throughout the 9-yr period of registration. Inherited colorectal tumors [hereditary nonpolyposis colorectal cancer (HNPCC), adenomatosis coli, and suspected HNPCC] accounted for 38.4% of group I patients (5 of 14), 17.1% of group II, 10.2% of group III, and only 3.5% of individuals older than 55 (p, for trend, < 0.001). Thus, hereditary colorectal tumors were detected significantly more often in younger individuals. The majority of colorectal malignancies were localized in the left colon or rectum in all three groups, with a tendency (not significant) to a preferential localization in the right colon for tumors developed in group I (37% vs 18% and 14% in groups II and III, respectively). Pathological stage and main histological types did not differ among the three groups. Finally, life-table analysis did not show significant differences in 5-yr survival among the three groups; however, when considered together, early onset cases showed a more favorable prognosis than older individuals (log-rank 11.6; p < 0.001). In conclusion, colorectal cancer is diagnosed very rarely before the age of 40 yr, whereas about 12% of all cases belong to the age group 41 to 55 yr of age. Hereditary tumors were found more frequently in younger patients, with a well-defined inverse relationship between age of onset and frequency of genetically determined tumors. Finally, the clinical outcome was more favorable in the whole series of early onset cases than in older registered patients.

Adenocarcinoma↗
PubMed1997

Pregnancy in a patient with essential thrombocytosis.

An insurgent case of pregnancy in a patient in whom essential thrombocytosis was diagnosed five years earlier is described. Pregnancy was confirmed and therapy with platelet aggregation inhibitor was introduced. The pregnancy reached full term notwithstanding a positive result of the "Triple Test" during the 15th week of gestation. A histology exam of the placenta revealed an ischemic lesion. We retain that platelet aggregation inhibitor therapy remains an important aid in eliminating the risk of thrombosis determined by the presence of two conditions that are predisposed to these risks, such as pregnancy and essential thrombocytosis.

Aspirin↗
PubMed1997

[Twenty-six consecutive patients with acute superior mesenteric infarction. Comparison of conventional radiology, ultrasonography, and computerized tomography].

Ischemic bowel disease is a rare disorder whose incidence is increasing as the mean age of the population increases. Diagnosis by clinical, laboratory and radiologic means is often difficult, and delay in definitive therapy results in substantial morbidity and mortality. A series of 26 consecutive patients, with proved acute superior mesenteric ischemia, was retrospectively reviewed: the authors report the diagnostic methods performed preoperatively, the site and the cause of infarction and the time passed between the first radiograph ans surgery. Plain abdominal radiographs were performed in 25 of 26 patients, screening abdominal US in 23 cases and CT in 19 cases. All radiological examinations were retrospectively reviewed by three authors, independently, to recognize the different signs of infarction. On plain abdominal films, the findings warranting a presumptive diagnosis of bowel infarction were air-fluid levels (84% of cases), dilated bowel loops (48%), thickened and unchanging loops (20%), gastric distension and gasless abdomen (12%), small bowel pseudo-obstruction (8%). Screening abdominal US demonstrated intraperitoneal free fluid (26%) and dilated bowel loops (22%). Abdominal CT showed air-fluid levels (79%), dilated loops and free intraperitoneal fluid (47%), intramural gas and thickened bowel loops (36.8%), engorgement of the mesenteric vessels (31%), mesenteric-portal gas, mesenteric thrombus and marked reduction in the volume of gas in the small bowel (10.5%) and paper-thin bowel loops (5%). The authors conclude that air-fluid levels, dilated loops and intraperitoneal free fluid are the most frequent findings, even though they are not specific. While abdominal plain film and screening ultrasonography can be negative, CT detects at least one abnormal finding and at least three abnormal findings in 73% of cases.

Acute Disease↗
PubMed1997

[Results of flow-controlled antiblastic perfusions (stop-flow technique) carried out with percutaneous technique: 30-month experience].

PURPOSE: We report the morphological and clinical results in a series of patients with advanced thoracopulmonary, abdominal, pelvic and lower limb tumors treated with stop-flow perfusion (SFP). MATERIAL AND METHODS: We performed 77 SFPs with the percutaneous angiographic technique in 55 patients (25 women and 30 men; mean age: 53 years). Eighteen thoracic perfusions with aortocaval block (ASI) were performed in 11 patients, 33 abdominal hypoxic perfusions (HAP) in 26 patients, 17 hypoxic pelvic perfusion (HPP) in 11 patients and 9 hypoxic lower limb perfusions (HILP) in 7 patients. 42/77 procedures were followed by hemofiltration. RESULTS: No technical complications were observed. Twenty-eight patients in our series are still alive (mean follow-up: 14 months) and 23 have died (mean survival: 8 months), 20/23 of them (87%) for disease progression. Three of 77 patients (3.8%) died within 7 days of the procedure (2 AS, 1 HAP). At CT or MR follow-up, responses > 50% were observed in 56% of the procedures and clinical CR was achieved in 53/77 patients (69%). In the subgroups classified by procedure, positive responses were observed in 56, 48, 59 and 78%, respectively for ASI, HAP, HPP and HLP. Clinical CR was observed in 67, 67, 71 and 78%, respectively. The death rate for disease progression relative to the overall death rate was 100, 86, 75 and 100%. Hematologic toxicity according to WHO criteria (mean: 2) was observed in 77% of the whole of procedures (59/77). Statistical analysis showed no relationship between morphological responses and type of antiblastic drug or previous antiblastic treatments. CONCLUSIONS: SF procedures permit the effective control of many advanced tumors which cannot be treated otherwise, with a high rate of positive morphological and of complete clinical responses. The best results were obtained in hypoxic perfusion of the lower limb. The results were not correlated with previous antiblastic treatments. However, the high rate of sequels and the low hematologic tolerance of those procedures must be emphasized.

Adolescent↗
PubMed1997

[Locoregional therapy with hypoxic liver perfusion in malignant neoplasms of the gallbladder. Preliminary experience].

PURPOSE: We report four cases of advanced malignant cancer of the gallbladder treated with hypoxic hepatic perfusion. MATERIAL AND METHODS: Hypoxic hepatic perfusion is currently used to treat diffuse hepatic metastases: the common hepatic artery is occluded with a balloon catheter and then a large amount of antiblastic solution is infused into the liver. Hypoxia and slow flow increase the effect of the drug on neoplastic tissue. Two sessions were performed in three patients with an interval ranging 2-4 months, while one patient underwent a single session. The drug was Mitomycin C, whose dose ranged 20-40 mg (mean: 30 mg). Blood filtration was performed after one of the six procedures only and can be considered unnecessary. RESULTS: Acute gastric bleeding appeared in a patient after the embolization of the right gastric artery with bucrylate during the first session performed to avoid drug reflux into gastric wall arteries. No other technical or clinical complications occurred. An objective morphological response (tumor necrosis or reduction in size > 50%) was observed in all patients after the first session. CT findings were stable in two of three patients submitted to a second session, while local progression was observed in the other patient. Complete clinical response was achieved in all symptomatic patients. No WHO toxicity was observed. DISCUSSION AND CONCLUSIONS: The rate of positive morphological and/or clinical responses after hypoxic perfusion was very high in our experience, even though our series was small. Recurrences were found in two patients some months later, which suggests the need of long-term follow-up. Hypoxic perfusion can be nevertheless considered as a new and interesting therapeutic approach for advanced malignant gallbladder cancer, with a strong short-term effect on the lesion and good results on clinical symptoms.

Adenocarcinoma↗
PubMed1997

[Computed tomography in the diagnosis of posttraumatic pancreatic lesions].

CT is currently the most accurate technique to study pancreatic parenchyma traumas. We examined six patients with pancreatic injuries due to a car crash in five cases and to a gunshot in one using a 3rd generation CT unit with 8- and 4-mm slices in the upper abdomen and pancreas, respectively; a contrast agent was administered i.v. US was performed with a 3.5 MHz sectorial probe. The correct diagnosis was made by CT alone in five cases, while US had already suspected isthmus trauma in one case and CT confirmed it. One critical patient was submitted to emergency laparotomy without preoperative CT or US, but CT was used for postoperative follow-up. CT showed partial isthmus laceration in one of three patients submitted to conservative treatment and a body-tail laceration in the others. CT showed complete isthmus laceration in three surgical patients and a tail injury in the gunshot patient; the third patient had already undergone duodenocephalopancreatectomy and was therefore only followed-up. In our experience, CT is the most valuable tool to study pancreatic traumas because it is a fast and noninvasive method and shows pancreatic parenchyma better than US. Moreover, CT is useful also to monitor the possible complications of pancreatic trauma and to follow-up surgical patients.

Female↗
PubMed1996

Urokinase-type plasminogen-activator receptor associates to a cell surface molecule in monocytic cells.

The monocyte-like THP-1 cells express on their surface the urokinase-type plasminogen activator receptor (uPA-R). This receptor, chemically cross-linked to its possible ligands, migrates, in SDS PAGE, slower than the uPA-R expressed on the epithelial thyroid cell line TAD-2, cross-linked to the same ligands. The different migration corresponds to a difference in molecular weight of 15 kDa. Similar results were obtained with peripheral monocytes and primary cultures of thyroid cells. The molecular weight of the native receptor is about 50 kDa and appears to be identical in these two cell types. Such results suggest that, in monocytic cells, uPA-R associates to a 15 kDa molecule. This molecule is probably linked to the cell surface by a glyco-phospho-inositol anchor since, by phospholipase-C treatment, it is co-eluted with the urokinase-type plasminogen activator receptor from THP-1 cells.

Carcinoma, Papillary↗
PubMed1996

Consolidation biochemotherapy for patients with advanced nonsmall cell lung carcinoma responding to induction PVM (cisplatin, vinblastine, mitomycin-C) regimen. A phase II study.

BACKGROUND: The authors investigated a consolidation biochemotherapy program with subcutaneous recombinant interleukin-2 (rIL-2) and recombinant interferon-alpha (rIFN alpha) biologic response modifiers (BRM) in patients with advanced nonsmall cell lung carcinoma (NSCLC) with responsive or stable disease to induction chemotherapy. METHODS: Patients with proven, advanced, previously untreated NSCLC were entered into the study. Induction chemotherapy consisted of cisplatin, 120 mg/m2 intravenously (i.v.), on Day 1; vinblastine, 6 mg/m2 i.v., on Day 1; and mitomycin-C, 6 mg/m2 i.v., on Day 1 (PVM), every 3 weeks. Subsequently, patients with complete response (CR), partial response (PR), and stable disease (SD) received consolidation biochemotherapy with subcutaneous rIL-2, 3 MU/m2 twice/day, and rIFN alpha, 3 MU once/day, 5 days a week, starting 2 weeks after the second PVM course. After 3 and 6 weeks of BRM treatment, patients had a 14-day rest period to intercalate consolidating PVM courses. RESULTS: Seventy-seven patients were enrolled in the trial. After 2 PVM induction courses, 16 patients progressed and went off the study, whereas 61 patients were eligible for consolidation biochemotherapy. Among the 61 patients, 9 were not treated with BRM for several reasons, whereas 52 patients began biochemotherapy and were evaluable for toxicity. Furthermore, a few days after starting BRM, 9 patients discontinued therapy due to side effects; the remaining 43 patients received adequate treatment and were fully evaluable. In the 52 evaluable patients, the following BRM related toxicities were observed: World Health Organization (WHO) grade 2-3 fever in 85% of patients, asthenia in 71%, anorexia in 63%, and flu-like syndrome in 18.5%. PVM-related vomiting was present in 19% of patients. WHO Grade 3-4 myelosuppression, from both BRM and PVM (overlapping toxicity), was anemia in 16% of patients, leukopenia in 12%, and thrombocytopenia in 19%. There were three toxic deaths: two due to BRM-induced hypotension and one from pneumonia. In the 43 fully evaluable patients (23 PR and 20 SD after induction chemotherapy), after a median of 6 weeks of biochemotherapy (range, 3-16 weeks), we observed 5 of 20 patients achieving PR from SD, and 6 of 23 with confirmed PR. In these 11 patients, the median duration of response was 21 weeks (range, 7-80 weeks). Overall response improvement was 11.6% in the 43 patients and 6.4% in the 77 total enrolled patients. Median survival was 41 weeks (range, 15-173 weeks) in the 43 patients and 38 weeks (range, 1.4-173 weeks) in the 77 patients. CONCLUSIONS: In this study, biochemotherapy, when administered by this dose and schedule, did not offer substantial benefit although it caused significant toxicity.

Adult↗
PubMed1996

Somatostatin inhibits PC Cl3 thyroid cell proliferation through the modulation of phosphotyrosine activity. Impairment of the somatostatinergic effects by stable expression of E1A viral oncogene.

In this study, we report the effects of somatostatin on the proliferation of PC C13 thyroid cell line and the intracellular mechanisms involved. We also evaluated the possible alterations, induced by E1A oncogene transformation on the intracellular pathways mediating somatostatin inhibition of cell proliferation. We showed that somatostatin was able to powerfully inhibit insulin- and insulin + TSH-dependent cell proliferation by inducing a block in the G1/S progression in the cell cycle. These cytostatic effects were completely reverted by vanadate, suggesting that somatostatin may induce antiproliferative effects through the modulation of phosphotyrosine phosphatases. In the E1A-transformed cell line, somatostatin was completely ineffective. The lack of somatostatin inhibitory effects on cell proliferation were not due to alterations in the expression of somatostatin receptors, which were regularly expressed and coupled to adenylyl cyclase activity, but were dependent on an alteration in their coupling with the phosphotyrosine phosphatase. In fact, although in PC C13 cells somatostatin increased by 100% phosphotyrosine phosphatase activity, it was completely ineffective in E1A-expressing cells. In conclusion we demonstrated that somatostatin activates phosphotyrosine phosphatases in PC C13 thyroid cells to inhibit cell proliferation and that the stable expression of E1A oncogene in these cells completely abolishes this antiproliferative effect.

Adenovirus E1A Proteins↗