A singular association of neurinoma of the abdominal vagus with relapsing peptic ulcer is reported. The singularity lies in the exceptional finding of a neurinoma of the left abdominal vagus -- not previously recorded in the literature -- and in the concomitant severe relapsing peptic ulcer, for which the nerve lesion may have been partly responsible.

Gastrectomy↗

PubMedDate not supplied

[Immediate and long-term results of anterior resection in tumors of the rectum and sigmoid (author's transl)].

127 anterior resections for adenocarcinoma of the rectum and sigmoid were performed at the Istituto Nazionale Tumori from 1950 to 1972. In 48% of cases the site of tumor was upper rectum and recto-sigmoid. The surgical mortality rate was 4,7%. Complications were observed in about 40%, fecal fistula being the most frequent. It seems correlable with the anastomotic technique and is significantly reduced by colostomy. Local failure occurred in 8,3% of patients with maximum rate (28,5%) for tumors located under 12 cm from the anus. The 5-year over-all survival rate was 73,3% with substantial differences according to the extent in initial disease.

Adenocarcinoma↗

PubMedDate not supplied

[Reliability and value of diagnostic lymphography in carcinoma of the sigmoid, rectum and anus (author's transl)].

From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the intial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95%. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28%) to the clinical inspection (6%) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.

Anus Neoplasms↗

PubMedDate not supplied

Adenocarcinoma of the large intestine in young adults.

Twenty-eight cases of adenocarcinoma of the large intestine in patients under 30 years of age, admitted to the National Cancer Institute of Milan from 1955 to 1975, are reported. Fourteen patients underwent radical surgery: of these, 8 are alive, and the survival times range from 8 months to 17 years. The 14 patients who received pallative therapy only all died within 15 months. The degree of infiltration of the intestinal wall seemed to be the most significant prognostic factor. The worse prognosis for the neoplasia in young adults with respect to older people, already reported in the literature and confirmed by our data, seems to be correlated, more than with the histologic type or biologic behavior of the tumor, with the diagnostic delay, which results in more advanced forms, with respect to those seen in older patients, being observed at clinical examination.

Adenocarcinoma↗

PubMedDate not supplied

The value of the CEA test in the diagnosis of metastases of adenocarcinoma of the gastroenteric tract.

Of 174 patients previously resected for gastric, colon or rectal adenocarcinoma, 75 had distant metastases at the time of the first examination and provided information on the specific characters of different types of tumors as regards CEA sensitivity. The remaining 99 cases, all without clinical evidence of disease, showed positive CEA levels in 26 and negative CEA levels in 73. Of the 26 CEA-positive cases, 24 showed clinical signs of metastases in a period of times varying from 1 to 11 months. The remaining 2 cases, although CEA positive at subsequent tests, did not develop clinical metastases and have been disease-free for 5 years after the first test. Of 73 CEA-negative patients, 30 developed metastases: in 17 the clinical appearance of recurrences was preceded by a positive CEA test, while in 13 the CEA test remained negative even with the presence of disease. The remaining 43 cases are still CEA negative and without metastases from 44 to 51 months from the first examination. Altogether, in 22 cases CEA was negative, but the clinical evidence of recurrences was positive, and in these cases 63.6% were undifferentiated carcinomas; 2 patients were CEA positive but without signs of evident metastases.

Adenocarcinoma↗

PubMedDate not supplied

Feasibility of intraportal chemotherapy with fluorouracil and folinic acid immediately after hepatic resection for colorectal metastases.

BACKGROUND: About 50% of recurrence after resection of hepatic metastases from colorectal cancer remain confined to the liver. Adjuvant locoregional treatments could reduce the failure rate, but these treatments have been scantily investigated. Experimental models have shown that both intra-arterial chemotherapy (IAC) and intraportal chemotherapy (IPC) in adjuvant setting were able to reduce metastatic growth, but IPC should be initiated in the immediate postoperative period. AIMS: To evaluate the feasibility of immediate postoperative IPC of fluorouracil (5-FU) plus folinic acid (FA) in a consecutive series of patients undergoing hepatic resection for metastatic colorectal cancer. METHODS: Forty-three consecutive patients underwent hepatic resection. The first 25 (Control Group = CG) received only surgery; the latter 18 (Treated Group = TG) were candidate to postoperative IPC of 5-FU 750 mg/m2 plus FA 20 mg/m2/day continuous infusion for 8 days. One patient was not treated owing to bleeding, thus only 17 received the treatment. RESULTS: Postoperative morbidity was 14%, equally distributed in both groups. Biochemical hepatic parameters of TG were not statistically different from those of CG. Five patients (29%) developed systemic toxicity: one hematologic grade 4; 3 mucositis grade 3 and one allergic erythema. Three of these patients had been treated by systemic chemotherapy less than one year before. DISCUSSION: IPC of 5-FU plus FA in the immediate postoperative period has not yet been tested. The schedule we have investigated neither affected the postoperative outcome, nor influenced hepatic function and regeneration. Systemic toxicity was evident and severe mainly in patients already pretreated by systemic chemotherapy. In these patients, however, toxicity did not affect further outcome. This study confirms the feasibility of immediate intraportal chemotherapy after hepatic resection.

Adult↗

PubMedDate not supplied

Immunocytochemical detection and characterization of intrahepatic human pancreatic islets after combined liver-islet allotransplantation.

The unique availability of an explanted liver-islet allograft, removed for primary nonfunction of the liver, led us to evaluate distribution and phenotype of exocrine and endocrine components of the pancreatic graft. Immunocytochemistry was used to map patterns of gene products for islet hormones, proprotein processing enzymes, panneuroendocrine markers, and pancreatic exocrine markers. When compared with age-matched control pancreases, insulin-, glucagon-, somatostatin-, and pancreatic polypeptide-producing cells were similarly represented and distributed within the grafted islet. We also demonstrate that the intrahepatic transplanted islets retained the enzyme machinery able to process the hormone precursors into bioactive fragments. In the clinical setting, this resulted in an immediate functioning of the graft and insulin-independence of the patient one month after transplantation. The purity in islets, as assessed by immunocytochemistry with antibodies to tissue constituents of endocrine and exocrine lineages, was around 40%. Despite the massive intraportal presence of pancreatic acinar tissue, no signs or symptoms attributable to ectopic hypersecretion of exocrine enzymes occurred. In fact, when tested with antibodies to such enzymes, low levels of immunoreactivity were observed in the grafted acinar cells.

Biomarkers↗

PubMedDate not supplied

Rectal cancer.

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Colorectal Neoplasms↗

PubMedDate not supplied

Prognostic factors in colorectal cancer.

Prognostic factors should always be taken into consideration before planning treatment. As reported in the literature, and also in our experience, the extent of intestinal wall invasion and the lymph node status must be considered the most important prognostic factors. In the present paper the data from literature are reported and the impact of biologic factors is analyzed. We are convinced that in the future the biological factors of the tumor as well as of the patient should be considered in planning treatment.

Biomarkers, Tumor↗

PubMedDate not supplied

New perspectives in the treatment of gastrointestinal tumors. Introduction.

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Combined Modality Therapy↗

PubMedDate not supplied

[Stomach cancer: old and new problems].

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Gastrectomy↗

PubMedDate not supplied

[Evaluation of early biomarkers of cartilage degeneration in the diagnosis and clinico-therapeutic monitoring of primary osteoarthrosis].

It is known that in the course of osteoarthritis (OA), articular cartilage develops biochemical and structural changes. In the last years, serum and urinary markers of both the synthesis and destruction of cartilage have been dosed, above all in order to carry out an early diagnosis of OA. Among them, the urinary excretion of pyridinoline seems to correlate with the entity of the degradation of cartilage. The aim of the present study is to evaluate the above mentioned markers in OA patients compared to control subjects. Moreover, the possible influence on cartilage of two different non steroidal antiinflammatory drugs (NSAIDs), in particular Nabumetone and Piroxicam, has been verified. The study shows that the urinary excretion of pyridinoline is able to express the severity of OA. At last, the study shows that the tested drugs do not interfere with the metabolism of cartilage.

Aged↗