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Biomedical subjects

M Ducci

Publications and source records attributed to M Ducci.

At least 19 recordsLinked to original sources
PubMed1998

Hyperfunctioning differentiated thyroid carcinoma.

A case of functioning plurifocal papillary carcinoma causing a clinical condition of hyperthyroidism is presented. Histologically, the carcinoma presented a dominant macrofocal nodule of an approximately 5 cm diameter, surrounded by chronic thyroiditis. Its occurrence in a patient under 20 years of age within a hot area in the thyroid bed and the lack of histological findings of hyperplastic tissue led the authors to consider this a rare case of hyperfunctioning differentiated thyroid carcinoma, and not a pure association of hyperthyroidism and carcinoma. Autonomously functioning thyroid nodules that are differentiated carcinomas are extremely rare with only 18 such cases reported in literature. While in the past it was commonly believed that a hot nodule is unlikely to be malignant, the possibility of an hyperfunctioning carcinoma should not be overlooked.

Adult↗
PubMed1998

[Free radial forearm flap and myocutaneous flaps in oncological reconstructive surgery of the oral cavity, Comparison of functional results].

In modern multi-disciplinary cancer treatment, rehabilitation and functional results represent utmost intent in reconstructive surgery of the oral cavity. Even in cases where the stage of disease is advanced) and the perspective of survival is limited, it is possible to achieve an acceptable quality of life. The authors report, in this study, the morpho-functional results and the morbidity observed in glossectomies in which the reconstruction was performed using three different methods. In a total of 264 reconstructive flaps of the head and neck regions, the authors considered three groups of 15 patients that had had reconstruction after the demolitive procedure. Respectively these groups were divided by the followed methods: free forearm flap, pectoralis major myocutaneous flap and nasolabial flap. The morbidity showed an extremely low rate of flap loss in all the groups, but "minor" complications, such as fistulas and leakages, were significantly more frequent in the myocutaneous flaps group. Functional evaluation for speech and deglutition showed good results in most patients. Extremely severe postoperative conditions as a permanent NG tube or incomprehensible speech had been observed in less than 15% of the cases. Particularly, the pectoralis major flap, showed its best functional performances in the total or subtotal glossectomies with a sacrifice of the muscles of the oral floor. The free forearm flap is reliable and safe with its low thickness and pliability, especially for partial glossectomies. The nasolabial flap was confirmed to be the first reconstructive choice for selected limited resections of the tongue and of the antero-lateral floor. With this experience it is possible, even in more complex free flaps, to reduce the time consumption and the complication rate. Free flaps do not substitute routinely myocutaneous and conventional flaps, but they represent the "ideal" reconstructive alternatives for specific and selected indications.

Adult↗
PubMed1997

Neck dissection for surgical treatment of lymphnode metastasis in papillary thyroid carcinoma.

In papillary thyroid carcinoma lymphnode metastases at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional tumor recurrence. The value of systematic versus selective lymphadenectomy is far less standardized, whereas the role of postoperative radioiodine in preventing either nodal recurrence or cancer death remains controversial. Clinical data of 36 N+ patients with papillary thyroid carcinoma who had undergone from 1990 to 1996 ipsilateral or bilateral neck dissection were retrospectively reviewed, to analyse the value of systematic lymphadenectomy. In our series of 50 extensive lymph node dissections (levels 2-6), the number of metastases in each specimen (mean value: 5) and the incidence of multiple level metastases (36%) were high. In 37.5% of the metastases at level 6 and in 11.1% at level 4, coexisting nodal involvement at level 2 was observed, without metastasization at intermediate levels. Multiple levels metastases and skip metastases were present in at least one third of the patients and could be excised only performing a complete dissection of the levels 2-6. Extra-capsular spread was found in 56% of the specimens. In 64.3% of these cases a functional neck dissection was performed. A modified radical or radical neck dissection was carried out in the other 35.7% of the cases. These patients received modified radical neck dissection (functional dissection with sacrifice of internal jugular vein) in 60% of the cases and radical neck dissection in the other 40%. In papillary thyroid carcinoma extensive lymphnode dissection at presentation has been stated to offer no advantage versus selective lymphadenectomy, causing increased morbidity. However, experienced surgeons report a low incidence (less than 5%) of accessory spinal nerve and cervical plexus permanent sequelae after functional neck dissection. In our opinion, patients with cervical lymph node metastases require a complete loco-regional neck dissection. Systematic lymphadenectomy, performed by lateral neck plus upper anterior mediastinal dissection, can yield a high disease-free survival. Moreover, this can limit the overall radio-iodine therapeutic dose and the risk of de-differentiation of recurrent tumor to the anaplastic type in patients with a long-term and near normal life-span.

Adult↗
PubMed1997

[Multiple stage cervical laryngotracheal reconstruction after trauma with extensive tissue loss].

Laryngotracheal reconstruction after trauma with extensive tissue loss is one of the most controversial issues in head and neck surgery today. The main goal is to provide a durable supportive framework over which endolaryngeal mucosa can regenerate. Although a variety of single-stage and multiple-stage reconstructive techniques are available, all have limitations. As there is no single universally applicable technique, it is necessary to know most of them and to realize the advantages and limitations of each procedure. On the basis of 18 years' experience we show the results from a series of 18 patients who underwent multiple-stage laryngotracheal reconstruction done with almost all available procedures (Laser surgery, Aubry technique, laryngotracheoplasty with cartilage grafting, subtotal laryngectomy, tracheal and laryngo-tracheal anastomosis, sternocleidomastoid myoperiosteal flap, composite hyoid sternohyoid muscle flap). Fourteen of the 18 patients were successfully decannulated. All of the mentioned procedures have been previously reported to be successful by their proponents, with variable complication rates. Subsequently, every case requires individual evaluation to determine which reconstructive technique is most appropriate for the patient's particular disease process.

Anastomosis, Surgical↗
PubMed1996

[Differentiated carcinoma in autonomously functioning thyroid nodule: case report].

This paper report a case of autonomously functioning thyroid nodule, firstly occurred in a 13 years old women, complicated 9 years later by hyperthyroidism, with no response to thyreostatic treatment, hystologically diagnosed as papillary carcinoma, in a thyroid gland affected by Hashimoto's thyroiditis, with cervical bilateral lymph node metastasis. In literature the rate of coexisting hyperthyroidism, chronic thyroiditis and differentiated carcinoma is low; thus thyroid malignancies are very rare in young people. In this patient the large autonomously functioning nodule was entirely made of neoplastic tissue, while in the remaining thyroid there was no evidence of adenomatous tissue. Moreover, thyreostatic treatment failed in controlling hyperthyroidism. The Authors consider these facts as indirect evidences that this is a rare case of hyperfunctioning differentiated thyroid carcinoma.

Adult↗
PubMed1995

Pressor, renal and endocrine effects of L-arginine in essential hypertensives.

The pressor, renal and endocrine effect of the physiological precursor of endothelial derived nitric oxide, L-arginine was compared, with a substrate inactive on nitric oxide, hypertonic D-glucose, in hypertensive patients. Ten mild-moderate essential hypertensives were assigned to either L-arginine (n = 5) or D-glucose (n = 5). Substances were infused over 25 min at equiosmolal rates preceded and followed by saline infusion for 25 min. Blood pressure and heart rate were monitored at 3-min intervals, while hormonal and humoral variables, inulin and paraaminohippurate clearance and electrolyte excretion were measured at the end of each period under conditions of maximal diuresis. L-arginine and D-glucose increased serum osmolality comparably and caused similar haemodilution to that with control saline. During L-arginine infusion, systolic and diastolic blood pressure decreased by 16.6% and 11%, respectively, and recovered in the postinfusion period. Heart rate, plasma renin activity, and plasma noradrenaline did not change significantly. The percent blood pressure decrement induced by L-arginine was significantly greater than that by D-glucose. Glomerular filtration rate was stable and renal plasma flow was increased by both substances. However, natriuresis, kaliuresis and chloruresis were markedly stimulated only by L-arginine, which also promoted the development of systemic acidosis, possibly as a consequence of hydrochloridric acid generated during its metabolism. Circulating insulin, atrial natriuretic peptide, growth hormone and glucagon levels were increased and plasma aldosterone was unchanged during infusion of L-arginine. Insulin was stimulated and the other hormones inhibited during infusion of D-glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

Arginine↗
PubMed1995

[The rectus abdominis free flap in reconstructive surgery of the head and neck].

The Authors describe their preliminary experience with rectus abdominis free flap in reconstructive surgery of the head and neck. Out of the 29 cases of microsurgery in treating head and neck tumours, four inferior rectus abdominis free tissue transfers were used: two for complex intraoral reconstruction and two for composite facial defects. There was one flap loss due to late infection in the region of anastomosis, while there were two complications in the remaining three cases. The morphological and functional results have proved to be highly satisfactory. The flap, based on the deep inferior epigastric vessels, appears to be versatile in terms of skin island design, thickness and length of the pedicle. As with the forearm free flap, the inferior rectus abdominis has the advantage of offering the possibility of simultaneous demolition and reconstruction in one surgical session. The Authors conclude that the low morbidity concerned with this microvascular flap, also reported in international literature, confirm its validity as a soft tissue transfer in the in the treatment of advanced head and neck cancer.

Aged↗
PubMed1991

[Experience in staging malignant tumors of the orofacial area].

The paper reports the authors experience at the Regina Elena Institute for the Study and Treatment of Tumours in Rome during the period 1987-1989 concerning the setting up of a register for primary malignant tumours of the head and neck. This experience has allowed various parameters to be assessed from the initial diagnosis through the subsequent diagnostic and therapeutic procedures [correction of iter]. The stage of disease was assessed in 134 patients using a TNM system proposed by UICC for tumours located in the oral cavity, oro- and hypo-pharynx and maxillary sinuses. At the end of the period a complete definition was made of some typical aspects of the disease in question: firstly, the high incidence of patients with advanced stages of disease found at the first diagnosis, and secondly, the significant delay in confirming the diagnosis of the tumour in spite of the ease with which the area may be explored. In conclusion, the authors comment on current systems of TNM classification, underlining the need for a more correct interpretation and assessment of findings related to neoplastic orofacial pathologies.

Facial Neoplasms↗
PubMed1990

The penetration of roxithromycin into human skin.

The skin penetration of roxithromycin was studied in 27 surgical patients treated with 300 mg orally followed by three oral doses of 150 mg 12-hourly. Peak plasma and skin concentrations of 7.9 +/- 1.2 mg/l and 31.3 +/- 3.7 mg/kg occurred 2.5 and 4 h after last dosing respectively. The plasma and skin half-lives were 7.7 and 6.0 h, and the mean plasma and skin area under the curve values were 64.3 mg/l.h and 155.3 mg/kg.h. Skin/plasma concentration ratios were 4.9 +/- 0.5, 9.7 +/- 1.2, 7.6 +/- 0.8 and 5.9 +/- 1.1, at 3, 4, 5 and 6 h after last dosing respectively. These results demonstrate that roxithromycin achieves high levels in human skin.

Female↗
PubMed1990

Roxithromycin penetration into gingiva and alveolar bone of odontoiatric patients.

The concentrations of the new macrolide antibiotic roxithromycin in plasma, saliva, gingiva, and alveolar bone were studied in 24 odontoiatric patients treated with a first dose of 300 mg p.o. followed by three maintenance doses of 150 mg p.o., 12-hourly. Samples of blood, saliva, gingiva, and bone were collected at various time points up to 24 h after the last dosing, and the roxithromycin concentration was measured microbiologically, using Bacillus subtilis ATCC 6633 as the reference organism. Pharmacokinetic analysis was performed according to a two-compartment open model with first-order absorption. The plasma, gingiva, and alveolar bone peak concentrations were 6.12 +/- 1.94 mg/l, 6.55 +/- 2.54 mg/kg, and 5.09 +/- 1.60 mg/kg, respectively. Low levels of roxithromycin were detected in saliva (0.67 +/- 0.12 mg/l at the 3rd h). The values of the area under the concentration-time curve for plasma, gingiva, and bone were 59.47 mg/l.h, 51.88 mg/kg.h and 46.80 mg/kg.h, respectively; the half-life values were 7.52 h for plasma and 6.36 and 5.20 h for gingiva and bone, respectively. These results indicate that roxithromycin reaches high levels in periodontal tissues.

Adult↗
PubMed1988

Unilateral sensorineural hearing loss in children.

The authors present a report of 280 cases of unilateral sensorineural hearing loss (U.H.L.) in children, observed from 1979 to 1986 in the Bambino Gesu' Hospital in Rome. Only 23.2% of these hearing impairments were due to a known etiology (mainly mumps infection). In the majority of the cases (79.3%) the hearing loss was profound. The authors discuss the methods for the etiological diagnosis and the possibility of prophylaxis both of U.H.L. and of communication difficulties.

Child↗
PubMed1988

Plasma pharmacokinetics of cinmetacin following oral administration in healthy volunteers.

The pharmacokinetics of a single 600 mg oral dose of 1-cinnamoyl-2-methyl-5-methoxy-3-indolylacetic acid (cinmetacin, Cindomet) was studied in 8 healthy volunteers of both sexes. Plasma levels of the drug were assayed by using an HPLC technique ad hoc devised. Following administration, the Cmax was reached at the 2nd h in 7 out of 8 subjects with an average value of 18.19 micrograms/ml; 12 h after the dose (last sampling time) appreciable plasma levels of cinmetacin were measured, corresponding to 17.2% of the maximum average concentration. The mean values +/- S.E. concerning the elimination half-life, the total volume of distribution, the total plasma clearance and the total area under the curve were 3.80 +/- 0.21 h, 0.28 +/- 0.03 l/kg, 0.051 +/- 0.005 l/kg/h, and 125.64 +/- 15.97 micrograms.h/ml, respectively. The plasma decay of cinmetacin was monophasic and the data were interpreted according to a one-compartment open model. Overall results indicate that cinmetacin is well and rapidly absorbed orally and widely distributed in body fluids.

Adult↗
PubMed1987

Postsynaptic effects of alpha agonists on adrenoceptors of the reserpinized rat vas deferens.

The activities of the alpha-1 antagonist prazosin and alpha-2 antagonist yohimbine were evaluated against noradrenaline (NA), methoxamine (Me) and clonidine (Clo) on the reserpinized rat vas deferens. Prazosin antagonized competitively Me but not NA and Clo. On the other hand yohimbine showed a low and not competitive antagonism towards all the three agonists. Similar results were obtained when the antagonistic activities were tested in the presence of the alternative antagonist, in the attempt to isolate a single receptor population. We can conclude that the smooth musculature of the rat vas deferens contains prevalently alpha-1 adrenoceptors and a small population of NA activated receptors resistant to alpha-2 antagonists.

Adrenergic alpha-Agonists↗
PubMed1987

Role of the (acyloxy)methyl moiety in eliciting the adrenergic beta-blocking activity of 3-(acyloxy)propanolamines.

Some totally aliphatic 3-(acyloxy)propanolamines were synthesized with the aim of testing whether beta-blocking activity could be obtained from this class of drugs, even in the absence of an aromatic group. The significant and, in most cases, competitive beta-blocking activity shown by the compounds under examination, together with the results of a theoretical study in which their reactivity was compared with that of other adrenergic beta-blocking drugs, seems to confirm a hypothesis previously advanced on the basis of knowledge about the action mechanism of adrenergic beta-blocking drugs and of the results of structural studies. It was also possible to suggest some considerations about the role played by the (acyloxy)methyl portion of 3-(acyloxy)propanolamines in eliciting their adrenergic beta-blocking activity.

Adrenergic beta-Agonists↗
PubMed1986

The pharmacokinetic profile of clofoctol in rat plasma and tissues after oral and rectal administration.

The pharmacokinetics of clofoctol was investigated in rat plasma and tissues after both oral and rectal treatment at a single dose of 300 mg/kg. After oral administration the plasmatic peak was 2.12 +/- 0.92 microgram/ml, occurring at the 90th min, with T/2 of 121.45 +/- 23.41 min. After rectal administration a plasmatic peak of 1.97 +/- 0.61 microgram/ml was reached at the 20th min with T/2 of 41.07 +/- 12.30 min. The kinetic profile of the drug in tissues exhibited a pattern similar to that in the plasma, since the maximal peak of clofoctol in tissues following rectal administration occurred before that obtained after oral administration. Tissue concentrations significantly higher than plasmatic ones were obtained through both administration routes. The present results indicate that clofoctol is well absorbed after both oral and rectal administration; however rectal treatment produces more rapid absorption and elimination compared with oral treatment.

Animals↗
PubMed1985

Might adriamycinol contribute to adriamycin-induced cardiotoxicity?

The pharmacokinetics of adriamycin (ADR) and its 13-hydroxylated-metabolite adriamycinol (ADR-ol) was investigated during treatment with ADR in rats at a dose of 2 mg/kg i.v., once a week for 3 weeks. At various times, samples of blood and cardiac and pulmonary tissues were collected to measure the amount of ADR and ADR-ol by an HPLC procedure. Periodical ECG monitoring was performed during the study; the severity of cardiac lesions was histologically evaluated at the end of treatment. During the first 180 min after ADR administration, plasma levels of ADR and ADR-ol rapidly decreased; ADR levels in cardiac and in pulmonary tissues increased between the 15th and 30th min and than decreased between the 60th and 180th min; on the contrary, ADR-ol was undetectable in either cardiac or pulmonary tissues during the first 3 hours following ADR administration. Between the 1st and 3rd weeks of treatment, plasmatic levels of ADR and ADR-ol were unchanged; in a similar way, both cardiac and pulmonary tissue levels of ADR were constant during the period of treatment. By contrast, the cardiac tissue level of ADR-ol significantly increased between the 2nd and 3rd weeks. ECG tracings showed maximal enlargement of both QRS and S alpha T at the end of the 3rd week. The histological examination of cardiac tissue indicated the occurrence of degenerative changes in 20% of rats at the end of the experiment. Overall results seem to indicate that ADR-ol is produced and stored in cardiac tissue during repeated ADR administration; as a consequence the cytotoxic metabolite might contribute to the cardiotoxic effect of ADR.

Animals↗