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Biomedical subjects

L Mastronardi

Publications and source records attributed to L Mastronardi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Tamoxifen modulation of carboplatin cytotoxicity in a human U-138 glioma cell line.

Glioma cells express high protein kinase C (PKC) activity, which may represent an important therapeutic target. Tamoxifen (TAM) has moderate PKC-inhibiting activity, blocking DNA synthesis and cellular proliferation in human glioma cells at concentrations that can be achieved therapeutically. Carboplatin (CBDCA), a second-generation platinum derivative, induces intra- and interstrand DNA-protein crosslinks producing inhibition of tumor-cell growth. In the present study, the effect of TAM, CBDCA, and the combination of both was evaluated against the human established U-138 glioma cell line during the exponential growth phase (48-72 h) by means of both the Biorad protein assay (BPA) method and Trypan blue exclusion study (TBES). Both TAM and CBDCA reduced the cellular growth rate, with a median 50%-inhibiting concentration (IC50) of 12.5 microM for TAM and 350 microM for CBDCA. The U-138 glioma cell line showed a moderate response to 100 microM of CBDCA, with < or = 10% reduction of the growth rate. The association of both chemotherapeutic agents induced a 98% reduction of the IC50 dose of TAM (0.1 microM), and a 71% reduction of the IC50 dose of CBDCA (100 microM). During the combinational TAM CBDCA exposure we observed a cytotoxic effect of TAM at concentrations lower than 0.1 microM, not recognized using it as a single drug. The differences observed among the IC50 doses (TAM, CBDCA, TAM-CBDCA) and among treated and untreated matched control cells were statistically significant (P < 0.01). Our results confirm previous observations about the efficacy in vitro of TAM against human glioma cell lines and show a marked enhancement of this activity by CBDCA.

Antineoplastic Agents↗
PubMed1998

Tamoxifen and carboplatin combinational treatment of high-grade gliomas. Results of a clinical trial on newly diagnosed patients.

Between April, 1992 and December, 1995, forty consecutive patients with a cerebral malignant glioma (WHO Grade III and IV) were enrolled in a trial consisting in surgery and post-operative administration of radiotherapy (4500-6000 cGy), carboplatin (CBDCA; dose of 450-600 mg/m2), and oral tamoxifen (TAM; at doses of 40, 80 or 120 mg/day). Two patients of the TAM group died in the postoperative period from a pulmonary embolism and myocardial infarction, respectively. The patients (all dosages combined) had a median survival time of 13 months from the time of diagnosis. The 12-month and 24-month survival rates were 52% and 32%, respectively. The median relapse-free survival time was 7 months. Patients treated with higher doses of TAM (80-120 mg/day) demonstrated a longer median survival rate (13 months both) and a longer 12-month survival result (58% and 76%, respectively). Patients who assumed TAM for a period longer than 3 months (group +3) have a higher median survival rate (16 months) and better 12-month and 24-month results (62% and 40%, respectively). Moreover, the median relapse-free survival time was 10 months (versus 6 months in group -3; p = 0.0038). However, it is not possible to exclude that patients of group +3 had a slower growing or a stable tumor and were well enough to assume TAM for a longer period. The results observed in the TAM-group have been compared with those of 40 matched controls treated with surgery, radiotherapy and CBDCA. These patients had a median survival time of 9 months (p = 0.04) and the 12-month and 24-month survival rates were 30% and 0%, respectively. The median relapse-free survival time was 4 months (p = 0.0014). These data suggest a potential role for combinational TAM-CBDCA therapy in the post-operative treatment of cerebral malignant gliomas; further clinical phase III trials, especially those with higher dosages of TAM are warranted.

Administration, Oral↗
PubMed1998

Tamoxifen as a potential treatment of glioma.

Cerebral gliomas have a poor survival time even after multimodal treatment, because of the unavoidable recurrence of tumor. Several trials with a combination of old and new chemotherapics have been performed, but survival time remains generally less than 12 months. Tamoxifen (TAM) has recently been shown to inhibit the growth rate of established and low-passage human glioma cell lines. Furthermore, this drug has enabled stabilization of the clinical and radiographic picture in selected patients with recurrent glioma. Here we review published data to discuss a potential role of TAM in the multimodal postoperative treatment of cerebral gliomas.

Antineoplastic Agents, Hormonal↗
PubMed1997

Intraneural capillary hemangioma of the cauda equina.

A case of intraneural capillary hemangioma involving the dorsal root of a spinal nerve of the cauda equina is reported. The patient was a 41-year-old man with a 3-month history of intermittent left lumbosciatalgia. MRI and CT myelography showed a space-occupying mass at the level of the cauda equina. Laminectomy of L5 and complete removal of the lesion were performed without neurological problems. The clinical, diagnostic, and therapeutic aspects of hemangiomas of the cauda equina are analyzed.

Adult↗
PubMed1997

Metastatic involvement of the Meckel's cave and trigeminal nerve. A case report.

The case of a patient with a right atypical trigeminal neuralgia caused by a metastatic tumor involving the Meckel's cave is reported. His medical history was significant for colon-rectal adenocarcinoma. The preoperative diagnosis of Meckel's cave neoplasm was made by MR. The patient underwent surgery, consisting of total removal of tumor and peeling of the ganglion and of the branches of the nerve, obtaining a histological diagnosis and a resolution of pain. The clinical, radiological findings and the treatment of this rare entity are discussed.

Adenocarcinoma↗
PubMed1996

Cervical spontaneous epidural hematoma as a complication of non-Hodgkin's lymphoma.

Epidural hematoma is a rare cause of spinal cord compression, which usually provokes severe neurological deficits. It is presumed to originate from venous or, more probably, arterial bleeding. Thrombocytopenia and other disorders of coagulation may precipitate the onset of epidural hematoma and facilitate the evolution of the disease. We report the case of a patient suffering from a non-Hodgkin's lymphoma with severe thrombocytopenia during a MACOP-B schedule, who presented with a spontaneous cervical epidural hematoma. We discuss the etiopathological aspects, diagnosis, and treatment of this rare cause of acute cervical spinal cord compression.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Spinal accessory nerve palsy due to neurovascular compression. Report of a case diagnosed by magnetic resonance imaging and magnetic resonance angiography.

The case of a young patient with left accessory nerve paralysis is reported. He had slight tilting of the head to the right side, developed over a period of about 6 months. On neurological examination hypotrophy of the left sternocleidomastoid and trapezius muscles was observed. MRI and MR-angiography imaged the presence of a neurovascular compression between the medulla oblungata, at the level of the nerve entry zone, and a vessel loop of an elongated left vertebral artery. In spite of the absence of a surgical demonstration it is our opinion that the neurovascular conflict is the cause of the accessory nerve palsy.

Accessory Nerve↗
PubMed1996

Intravenous administration of high doses of carboplatin in multimodal treatment of high grade gliomas: a phase II study.

The object of this study is to evaluate the efficacy of a high dose of carboplatin in 20 patients operated on for high grade glioma (Group A) compared with a matched control (Group B) treated with BCNU administered after radiotherapy. The toxicity profile has been evaluated during the therapy. The survival of patients entering this study was measured in terms of months: the mean survival time was 10.45 months and the median 11.0 months in the group treated with carboplatin (8 patients are still alive); the 18-month survival rate was 10%. The mean survival time of the control group was 9.85 months and the median 10.5 months; no patients are still alive and the 18-month survival rate was 0%. On the basis of our phase II clinical study, we could conclude that i.v. administration of high-doses of carboplatin in high grade gliomas is generally well tolerated and the results are better than those of a matched control treated with 1-2 courses of BCNU (low-dose). The adjuvant treatment and the role of carboplatin in the therapy of high grade gliomas is discussed.

Adult↗
PubMed1996

Utility of early postoperative MRI in hindbrain-related syringomyelia. A preliminary prospective study on five patients.

We report a series of five patients operated on for hindbrain-related syringomyelia with posterior fossa decompression and duraplasty. In all cases an early postoperative MRI was performed (24-36 h after surgery). These images have been compared with the preoperative ones and with those obtained, 1, 3 and 6 months after operation. Both before and after surgery there was not always a tight correlation between clinical and MRI pictures. In all but one patient the early postoperative MR images showed a reduction of syrinx size and were as to those obtained later. We discuss the results observed in our small series and analyze the role of early postoperative MRI studies in patients with hindbrain-related syringomyelia.

Adult↗
PubMed1996

Clinical and radiographic stabilization of intracranial glioblastoma. Report of a case treated after surgery with tamoxifen.

We report the case of a patient with a left temporal-parietal glioblastoma treated with subtotal surgical excision, radiotherapy and chemotherapy, with a single intravenous administration of carboplatin and continuous oral administration of tamoxifen (40 mg/daily). Two years after the patient presents a stabilization of clinical and CT picture. We discute the possible role of tamoxifen in prolonging the survival of selected patients with intracranial high-grade glioma.

Brain Neoplasms↗
PubMed1995

Chronic spontaneous spinal epidural hematoma simulating a lumbar stenosis.

A case of a patient with a clinical picture of lumbar spine stenosis actually caused by a chronic, spontaneous, spinal epidural hematoma is reported. There was no history of major or minor trauma to the lumbar spine. The correct preoperative diagnosis was made by magnetic resonance imaging. The possible etiology and clinical and radiological findings and treatment of this rare entity are discussed.

Diagnosis, Differential↗
PubMed1995

Cavernous angioma associated with oligo-astrocytoma-like proliferation. Report of two cases and review of the literature with a reappraisal of the term "angioglioma".

Reporting two cases of cavernous angioma closely associated with oligo-astrocytoma we were stimulated to revise the proper use of the term "angioglioma", introduced by Councilman 80 years ago7. In the past this term was often used in a merely descriptive sense i.e. either to give a name to an exceptional coincidence of AVM and glioma or simply to describe a hypervascularized glioma. Today, according to the majority of authors, such a use of this term has to be rejected as inappropriate. Occasionally however the term angioglioma has been used to designate a true mixed composite neoplasm developed after the transformation of both glial and angiogenic elements determined by simultaneously or consecutively acting (even possibly intermingled) oncogenic factors. Among reported cases claimed to be examples of "true" angioglioma, the association cavernomaoligodendroglioma/astrocytoma seems the most intriguing besides being also the most frequent one. Opinions about this topic however did continue to be unequivocal. While some authors regarded the oligodendroglial proliferation associated with AVM as merely reactive or malformative, others considered it as truly neoplastic putting forward the hypothesis of a common viral or genetic aetiology for both AVM and glioma.

Adult↗
PubMed1995

Intracranial meningiomas in the 9th decade of life: a retrospective study of 17 surgical cases.

The general availability of cerebral computed tomographic and magnetic resonance imaging scans makes the observation of symptomatic intracranial meningiomas in very elderly patients (aged 80 yr or more) relatively frequent. A few authors have reported on patients who have undergone surgery for intracranial meningiomas in their 9th decade of life, without providing indications regarding the surgical criteria and the prognostic factors. We report on a series of 17 patients who have received surgery for intracranial meningiomas in their 9th decade of life, with the goal of determining some surgical criteria for general physicians and neurosurgeons. Patients with severe systemic disease and definite functional limitations (American Society of Anesthesiology Class III) had a major postoperative morbidity (P = 0.020) and mortality (P = 0.005), especially if they scored low (< 70) on the preoperative Karnofsky Rating Scale (P = 0.010). The risk of postoperative morbidity was higher when the maximum diameter of the tumor was > 5 cm (P = 0.031).

Aged↗
PubMed1994

Crossed aphasia. An update.

The aim of this article is to present an update of a rare but interesting problem: "crossed aphasia". This term indicates the presence of aphasia after unilateral cerebral lesion of the hemisphere ipsilateral to the patient's dominant hand. We report two cases, review the most relevant literature, and analyze clinical, neuroanatomical, and neurophysiological aspects, taking in consideration the various interpretations proposed to explain this unusual language disorder.

Aged↗