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Biomedical subjects

L Napolitano

Publications and source records attributed to L Napolitano.

At least 19 recordsLinked to original sources
PubMed2006

Chemotherapy of advanced NSCLC in special patient population.

The elderly and patients with Performance Status (PS) of 2, constitute the so-called special patient population. The tolerability of chemotherapy in this population is globally worse, and treatment approaches should be different. Platinum-based combination chemotherapy is currently recommended as the standard treatment for patients with advanced non-small-cell lung cancer (NSCLC), but its role in special patient population is controversial. The best treatment for elderly patients with advanced NSCLC is still debated. In the first randomized study dedicated to elderly NSCLC patients, single-agent vinorelbine showed superiority over supportive care alone, both in terms of survival and quality of life. In a large randomized trial, gemcitabine plus vinorelbine failed to show any advantage over either agent alone. Subset analyses suggest that the efficacy of platinum-based combination chemotherapy is similar in fit older and younger patients, with an acceptable increase in toxicity for elderly patients. However, the role of platin-based chemotherapy needs to be defined in prospective randomised trials. With the current evidence, single-agent chemotherapy with a third-generation drug (vinorelbine, gemcitabine, taxanes) should be the recommended option for non-selected elderly patients with advanced NSCLC. Also for PS2 patients there is no consensus on standard treatment. On the basis of current evidence, chemotherapy treatment appears justified for patients with advanced NSCLC and PS2. Single-agent chemotherapy (gemcitabine, vinorelbine, taxanes) could be the preferred option, although carboplatin-based or low-dose cisplatin-based doublets may represent alternative options. Stronger evidence is expected from new clinical research specifically focused on PS2 patients. High priority should be given to the evaluation of tolerability and efficacy of platinum-based combinations and role of new targeted therapies.

Aged↗
PubMed2005

[A case of perforated small bowel adenocarcinoma as first symptom of Crohn's disease].

A case of perforated small bowel adenocarcinoma presenting as first symptom of Crohn's disease is reported in a 53 years old male patient with abdominal pain and alteration of bowel habits. Endoscopic bioptical sampling demonstrated a Crohn's disease in active stage. The patient underwent medical therapy with resolution of the complained symptomatology; 20 days after discharge the patients is rehospitalized for acute abdomen. A narrowing perforated neoplasia in terminal ileum was discovered at laparotomy. Diffuse peritonitis and metastatic peritoneal implantations were also revealed. An ileocolic resection is performed with ileo-transverse colon anastomosis. The patient dies 4 months later for advanced disease.

Abdomen, Acute↗
PubMed2005

[Anisakiasis presenting as perforated ulcer of the cecum].

A case of cecal anisakiasis is presented. Symptoms were compatible with appendicitis. The patient was operated and a perforated ulcer of the cecum was found. Ileocolic resection was performed. The histologic result showed the presence of Anisakis simplex larva in the muscle of the cecum. The patient was discharged the fifth day without complications. At present he is asymptomatic. He had eaten uncooked anchovies some days before the onset of the disease.

Adult↗
PubMed2004

[Use of prosthetic materials in incisional hernias: our clinical experience].

Incisional hernias are fairly frequent complications of surgery. Such complications are presented by variable percentages ranging from 1% to 8% for non complicated laparotomies and from 10% to 15% in case of infection. The therapeutic possibilities are abdomino-plastic with direct suture and the use of prosthesis. The percentage of recurrency varies from 30% to 50% and from 0% to 19% respectively. From May 2000 to September 2003, the Authors operated 64 patients. In 30 cases they opted for a direct suture approach, in 34 cases a prosthesis was used. Of the 34 patients, 18 were treated using polypropylene mesh placed below the rectus muscles and above the peritoneum (Rives technique); 10 with PTFEe (Polytetrafluoroethylene expanded) prosthesis placed in intraperitoneal site and 6 were treated with SIS prosthesis (Small Intestine Submucosa), 3 placed using the Rives technique and 3 in intraperitoneal site. Nine patients had associated operations. The use of prosthesis in the management of incisional hernias has brought a considerable reduction in the percentages of recurrency, especially in cases of associated pathologies. The availability of SIS in the market has permitted the use of this prosthesis even in case of contaminated and/or infected fields. In a follow-up ranging from 3 years to 3 months (mean 18 months) the Authors observed 2 cases of recurrence in the group of direct suture. Despite the advantages offered by the use of prosthesis, we can affirm that there is no "universal" prosthesis. Their selection should be evaluated on the bases of the site and the dimensions of the incisional hernia, the possibility of infection, the surgical technique and the site of prosthetic placement in the abdominal wall.

Adult↗
PubMed2003

[Clinical study of metastasis of thyroid differentiated carcinoma].

The Authors report 5 cases of distant metastases of well-differentiated thyroid carcinoma over a number of 114 patients operated for thyroid neoplasm (4.3%). In 101 pts was total thyrodectomy performed, in 13 pts underwent istmo lobectomy. Distant metastases were verified in 3 patients with follicular and in 2 patients with papillary carcinoma. In 2 cases the metastases were in lungs, in 2 cases are the bone, and in one patient in lungs and bones. In 3 patients istmolobectomy had been performed at first operation. All the patients were treated with radioiodine. Three patients were alive after 3, 5 e 10 years from the diagnosis of metastases, 2 of them are presently disease free.

Carcinoma↗
PubMed2002

[Reoperations in thyroid surgery].

The Authors examine etiology, incidence and hazards related to reoperation in thyroid surgery either for benign either for malignant pathology. The Authors present, then, 26 secondary operations performed in the Unit of Surgical Pathology of the Department of Surgical Sciences Chieti University: 15 for benign, 11 for malignant pathology. In the cases of thyroid malignant pathology, in 2 patients (operated in different hospitals) there was a parenchimatous recurrence, in 2 patients a lymphnodal recurrence. In all the patients a total thyroidectomy was performed, in one patient associated with lymphadenectomy. In the patients with lymphadenomatous recurrence a functional laterocervical lymphadenectomy was performed.

Follow-Up Studies↗
PubMed2001

Determination of the primary structure of two lipid transfer proteins from apricot (Prunus armeniaca).

It has been recently demonstrated that the major allergen of apricot is a protein of molecular mass (Mr) 9000 belonging to the family of Lipid Transfer Protein. The aim of this study was the determination of the primary structure of apricot LTP by micro-sequencing and mass spectrometric analyses. Apricot LTP is a 91 amino acids protein like peach and almond LTPs with a sequence identity of 91% and 94%, respectively. Like for the peach LTP, out of the 25 amino acids forming the inner surface of the tunnel-like hydrophobic cavity in maize ns-LTP, 16 are identical and 7 similar in the apricot LTP, supporting the hypothesis of a similar function.

Amino Acid Sequence↗
PubMed2001

[Duodenal obstruction: unusual complication of acute pancreatitis].

The authors notice that, though the duodenal involvement in patients with acute pancreatitis is very common, the duodenal obstruction is quite exceptional and the reported cases are very few. The Authors describe; then, the case of a patient with duodenal obstruction caused by a peri-duodenal phlegmon due to an acute pancreatitis treated with a gastro-jejunostomy and a drainage of the abscess.

Acute Disease↗
PubMed2000

Treatment of the contralateral negative neck in supraglottic cancer patients with unilateral node metastases (N1-3).

BACKGROUND: Elective treatment of the contralateral N0 neck in supraglottic cancer patients with unilateral metastases is controversial. METHODS: We reviewed 127 N1-3 cases with contralateral negative necks to compare elective contralateral dissection (ED: 24 cases) with a contralateral wait-and-see policy (WS: 103 cases) and subsequent delayed therapy (SDT: 40 cases) when contralateral disease became evident. Prognostic factors were studied to identify the risk of contralateral disease. RESULTS: Nine of 24 (37.5%) ED patients had occult contralateral metastases, and 40 of 103 (38.8%) WS patients had a delayed contralateral failure. Supraglottic cancers involving or extending up to the midline had a higher risk of contralateral metastases compared with well-lateralized tumors (p =.049). The risk of contralateral neck disease was more influenced by tumor site and stage than by histopathologic characteristics of ipsilateral metastases. WS patients with contralateral neck relapse showed a higher risk of distant metastases and of level I and V neck involvement than ED cases with no difference in terms of survival. CONCLUSIONS: The risk of contralateral occult neck involvement in supraglottic laryngeal cancers with unilateral metastases is high (about 40%), particularly for more advanced lesions extending to or involving the midline larynx; thus, a bilateral neck treatment in such cases is recommended.

Adult↗
PubMed2000

Identification of the human beta-casein C-terminal fragments that specifically bind to purified antibodies to bovine beta-lactoglobulin.

The presence of foreign proteins in human milk after the ingestion of bovine dairy products is thought to be one of the possible causes of allergic sensitization in exclusively breast-fed predisposed infants. The immunologic determination of bovine beta-lactoglobulin (LG) concentration in human milk has been reported by several researchers, but the results are conflicting. Moreover, a strong cross-reactivity between antibodies to bovine beta-LG and human milk proteins and peptides was reported, throwing doubt on the reliability of radioimmunoassay and enzyme-linked immunosorbent assay detection and quantification assays for bovine beta-LG in human milk. Thus, the goal of this study was to isolate human milk peptides with a molecular mass >or= 1,000 Da cross-reactive with antibodies to bovine beta-LG in order to identify possible common epitopes between human and bovine milk proteins. The proteins were first isolated by affinity chromatography with purified polyclonal antibodies to bovine beta-LG, followed by gel filtration fast phase liquid chromatography and reverse phase-high performance liquid chromatography purification of the components specifically bound in the affinity separation step. Affinity-bound peptides were identified by determining their amino acid sequence. All the sequenced peptides belonged to the C-terminal part of human beta-casein, which confirms the cross-reactivity of human milk proteins and peptides with antibodies to bovine beta-LG and allows the identification of possible common epitopes between the two proteins. No bovine beta-LG peptides with a molecular mass >or= 1,000 Da were found in our milk samples from healthy mothers on a diet rich in bovine milk and dairy products.

Journal Article↗
PubMed1999

Complete amino acid sequence determination of the major allergen of peach (Prunus persica) Pru p 1.

The major protein allergen of peach (Prunus persica), Pru p 1, has recently been identified as a lipid transfer protein (LTP). The complete primary structure of Pru p 1, obtained by direct amino acid sequence and liquid chromatography-mass spectrometry (LC-MS) analyses with the purified protein, is described here. The protein consists of 91 amino acids with a calculated molecular mass of 9178 Da. The amino acid sequence contains eight strictly conserved cysteines, as do all known LTPs, but secondary structure predictions failed to classify the peach 9 kDa protein as an 'all-alpha type', due to the high frequency of amino acids (nine prolines) disrupting alpha helices. Although the sequence similarity with maize LTP is only 63%, out of the 25 amino acids forming the inner surface of the tunnel-like hydrophobic cavity in maize ns-LTP 16 are identical and 7 similar in the peach homolog, supporting the hypothesis of a similar function.

Allergens↗
PubMed1998

[Acute thrombosis of the infrarenal aorta].

The Authors report three cases of patients operated for acute thrombotic aortic occlusion. All the three patients were treated with an aortic transabdominal approach, thromboendarteriectomy and aorto-femoral by-pass. In two patients the result was satisfying, one with a late and partial recovery of the motility of the inferior limbs. One patient died for heart failure in eighth postoperative day. The Authors believe that this unsatisfying result was caused by delay in the surgical treatment (almost 30 hours).

Acute Disease↗
PubMed1998

Evidence for a common epitope between bovine alpha-lactalbumin and beta-lactoglobulin.

The aim of this work was to check and quantify any cross-reactivities among the main bovine whey proteins, utilizing purified polyclonal antibodies against bovine beta-lactoglobulin, alpha-lactalbumin and serum albumin, and to identify possible common epitope(s). Purified polyclonal anti-bovine beta-lactoglobulin antibodies show 10% cross-reactivity with bovine alpha-lactalbumin, both in its native and its denatured form. A continuous stretch of four amino acids common to alpha-lactalbumin and beta-lactoglobulin that might be responsible for this cross-reactivity has been identified. Cross-reactivity between this antibody and bovine serum albumin is, on the contrary, negligible. Purified polyclonal anti-bovine alpha-lactalbumin and anti-serum albumin antibodies do not cross-react.

Amino Acid Sequence↗
PubMed1997

The unusual amino acid triplet Asn-Ile-Cys is a glycosylation consensus site in human alpha-lactalbumin.

Human alpha-lactalbumin has not been described as a glycoprotein, despite the fact that several alpha-lactalbumins of both ruminant and nonruminant species are known to be glycosylated. In all these species the glycosylation site is the 45Asn in the usual triplet 45Asn-Gly/Gln-47Ser. We have found that human alpha-lactalbumin is glycosylated and the glycosylation site has been determined by protein sequencing and mass spectrometry. We report an unusual glycosylation site at 71Asn in the triplet 71Asn-Ile-73Cys, which is conserved in all known alpha-lactalbumins except red-necked wallaby. That a relatively small proportion of the protein is glycosylated (about 1%) may reflect the importance of this region of the protein sequence to the molten globule state of alpha-lactalbumin.

Amino Acid Sequence↗
PubMed1997

[Unusual pathology of the spleen].

The Authors report 7 cases of unusual spleen pathology represented by 2 real cysts, 1 pseudocyst, 1 hydatid cyst, 2 abscesses, 1 splenic artery aneurysm. Pathophysiological hypotheses are examined, and clinical and diagnostic considerations are stressed, evaluating particularly anatomo-histologic characteristics and the differential diagnosis through non invasive imaging techniques. All patients were subjected to splenectomy via laparotomy, except for the case of real cyst where an inferior hemisplenectomy was performed. In the case of splenic artery aneurysm, an urgent aneurysmectomy was required together with splenectomy, considering the young age of the patient (29 years old), and the type of aneurysm presenting in a double rupture phase. Reoperation was necessary in only one patient to drain an hematic abscess. After a 9 year follow up all the patients are well.

Abscess↗
PubMed1997

[Personal experience in the treatment of carcinoma of the head of the pancreas].

The Authors report 195 cases of carcinoma of the head of the pancreas observed in the period 1983-1995. Only 94 (48%) of these patients were operated: in 32 cases an exploratory laparotomy was performed, while in 36 a bilio-digestive bypass, associated in 2 patients with a gastro-jejunal bypass was assured. In 26 patients a resection was performed: in 12 a Whipple procedure, in 6 a total duodenopancreatectomy, in 8 a pylorus preserving procedure (Traverso-Longmire). The mean survival was 2 months after laparotomy, 6 months after bilio-digestive bypass, 20 months after Whipple procedure, 20 months after total duodenopancreatectomy, 23 months after a pylorus preserving procedure (Traverso-Longmire). The Authors believe that the Whipple procedure is the treatment of choice for the carcinoma of the head of the pancreas. Only in cases of suspected multifocality or when there is a severe nodal involvement it is advisable to perform a total duodenopancreatectomy.

Biliopancreatic Diversion↗
PubMed1996

Amino acid sequence and crystal structure of buffalo alpha-lactalbumin.

Isolation, purification, amino acid sequence determination and X-ray crystal structure of buffalo alpha-lactalbumin were performed in order to gain further knowledge of the molecular basis of alpha-lactalbumin in the lactose synthase complex. The deduced amino acid sequence differs at one position from the bovine alpha-lactalbumin sequence (at position 17). The refined crystal structure at 2.3 A is very similar to those previously reported for human and baboon alpha-lactalbumins. However, a portion of the molecule (residues 105-109) exhibits different conformation. It forms a 'flexible loop', and appears to be a functionally important region in forming the lactose synthase complex.

Amino Acid Sequence↗