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Biomedical subjects

M Greco

Publications and source records attributed to M Greco.

211 records · Page 12Linked to original sources
PubMedDate not supplied

Conservative treatment for breast cancer of limited extent. Results of a randomized trial.

From 1973 to 1980, a controlled clinical trial was carried out at the National Cancer Institute of Milan to compare the Halsted mastectomy with breast quadrantectomy and axillary dissection followed by radiotherapy in patients with breast cancer of less than 2 cm in size. Cases of breast cancer classified as T1N0 were randomized into the two treatment procedures: 349 cases were treated with the Halsted mastectomy and 352 with the quadrantectomy technique. The two series were comparable with regard to age distribution, size, site of primary tumor, menopausal status and frequency of axillary metastases. Three local recurrences occurred in the Halsted group and one in the quadrantectomy group. Actuarial curves showed no difference in the two series with regard to disease-free and overall survival. In view of these results, mastectomy appears to be an unnecessary mutilation for patients with breast carcinomas less than 2 cm in size and no palpable axillary nodes.

Breast Neoplasms↗
PubMedDate not supplied

OmniMed II: a new system for use with the emphasis erodible mask.

Clinical experience has shown the emphasis erodible mask to be an effective method for performing photorefractive keratectomy (PRK) using an eyecup placed in contact with the corneal surface. A new system (OmniMed II) which incorporates the erodible mask as an element in the optical delivery system has been developed for performing photorefractive keratectomy. With this new configuration the eyecup is no longer used. We describe in detail the advantages of the erodible mask, the associated hardware of the optical delivery system, and the mask shape transfer process.

Cornea↗
PubMedDate not supplied

Prone scintimammography in patients with non-palpable breast lesions.

Non-palpable breast lesions are a clinical problem due to the low specificity of mammography and the resulting difficulty in choosing the type and extent of surgery. Twenty-four patients with non-palpable mammographic lesions underwent prone scintimammography after the i.v. injection of 740 MBq of 99m Tc-SestaMIBI (MIBI). For this purpose, we designed a special bed which allows the widest exposure of the breast to the detector and better visualisation of deep mammary tissue without interference from intra-thoracic activity. The day after the scintigraphy, all patients underwent quadrantectomy or a more limited excision. The specimens were X-rayed to check the presence of mammographic microcalcifications or opacities. All surgical specimens were histologically evaluated. The mammographic and scintigraphic findings were compared with the histological ones. Under these conditions, we observed that the MIBI scan has a good specificity (90%) but low sensitivity (50%) for this selected population. When the MIBI scan was positive, the probability of breast cancer was very high (positive predictive value of the test = 88%) as a consequence, a wider excision would be the most accurate surgical choice. On the other hand, if the MIBI scan is normal, the high number of false negative results does not allow any final diagnosis (negative predictive value of the test = 56%). The preliminary results of this work suggest that radionuclide imaging can help the surgeon in surgical planning.

Adult↗
PubMedDate not supplied

Flow cytometric characterization of CD34+ hematopoietic progenitor cells in mobilized peripheral blood and bone marrow of cancer patients.

BACKGROUND: Hematopoietic progenitor cells (HPC), identified by expression of the CD34 surface antigen, show morphological and phenotypic heterogeneity in bone marrow (BM) and peripheral blood (PB). METHODS: CD34+ HPC subpopulations present in 18 PB leukaphereses after high-dose chemotherapy in cancer patients and in 11 BM samples from patients with stage IA lymphoma were characterized. In order to identify CD34+ HPC subsets within these two compartments, the expression of lineage- or activation-associated antigens and the c-kit gene product (CD117) was studied by flow cytometry, using a large panel of monoclonal antibodies (MoAb) in double labelling. RESULTS: We observed a higher proportion of CD34+/CD13+ and CD34+/CD33+ cells (myeloid commitment) in harvested leukapheresis products than in BM. On the contrary, a higher percentage of CD34+/CD10+ and CD34+/CD19+ cells (B-lymphoid commitment) was found in BM. The percentage of the most immature subset of CD34+ HPC (CD38- and HLA-DR-) was also higher in BM than in mobilized PB. No differences in proportions were found with respect to the expression of CD14, CD15, CD45RA (myeloid commitment), CD2, CD5, CD7 (T-lymphoid commitment), CD117, CD71 and CD45RO antigens. In terms of absolute values, however, significantly higher amounts of CD34+ HPC co-expressing CD13, CD33, CD5, CD7, CD71, CD117, CD45RA, CD45RO were detected in leukaphereses than in BM. The absolute number of immature HPC (CD34+/CD38- and CD34+/HLA-Dr-) was also significantly increased in mobilized PB. CONCLUSIONS: Our data confirm the heterogeneous phenotypic profile of HPC, thus supporting the hypothesis that different CD34+ subpopulations may have clinical relevance on the rapidity and long-term durability of engraftment in patients who undergo high-dose chemotherapy followed by rescue with HPC. We also demonstrated that mobilized PB is a particularly rich source of both primitive and committed HPC, more than BM.

Antigens, CD34↗
PubMedDate not supplied

Use of a threshold serum level of anti-gliadin antibodies improves diagnostic efficiency of the test in adult coeliac disease but is unreliable as a screening test.

Measurement of anti-gliadin antibodies is considered a highly sensitive test for coeliac disease in children. Specificity, however, appears to vary due to the presence of anti-gliadin antibodies in other diseases. Sensitivity and specificity of anti-gliadin antibody measurement for coeliac disease in adults has, thus, been assessed using the ratio of the densitometric unit test/the mean +3SD of densitometric unit values of a pool of sera of healthy biopsy-proven controls. Anti-gliadin antibodies-A and G were measured separately with an enzyme-linked immunosorbent assay in 64 coeliacs (20 males; 44 females; age range 14-71 years) with diagnosis confirmed at jejunal biopsy; and in 60 controls (25 males; 35 females; age range 16-69 years) with normal jejunal biopsy. Detection of anti-gliadin antibodies-A and G had a sensitivity of 58% and 61%, respectively, and a specificity of 85% and 94%. For the procedure a Receiver Operating Characteristic analysis was used. Considering anti-gliadin antibodies-A and G values of at least 0.9 densitometric unit, sensitivity was 50% and 60%, respectively, whereas specificity was 100% for both. These findings confirm the low sensitivity of these measurements in adult coeliacs and thus the unreliability for screening. The high specificity, when using a threshold value of 0.9 densitometric unit, may be useful in the evaluation of adults with suspected coeliac disease.

Adult↗
PubMedDate not supplied

Axillary dissection can be avoided in selected breast cancer patients: analysis of 401 cases.

The role of axillary dissection in early breast cancer remains controversial because of its uncertain value with respect to disease free and overall survival. 401 breast cancer patients underwent breast surgery without axillary dissection from January 1986 to June 1994. 323 (81%) patients were postmenopausal whereas 78 (19%) were premenopausal status, the mean age was 62.9 years. 216 out of 401 patients (53.6%) had a pathological tumour < or = 1 cm, 133 (33.6%) were between 1 and 2 cm, whereas 38 (9.5%) had a tumour size > 2 cm. Breast conservative surgery was performed in 383 patients (95.6%), 257 patients (64.1%) received radiotherapy to the operated breast. In elderly patients adjuvant hormonotherapy was preferred considering the hormonal receptorial status. Accurate follow-up showed that 25 patients underwent delayed full axillary dissection, and pathological metastases were determined in 19 cases, so that the total rate of axillary relapses, histologically confirmed, was 4.7%. We conclude that axillary surgery can be avoided in selected breast cancer patients.

Adult↗
PubMedDate not supplied

Evaluation on serum 2'-5'oligoadenylate synthetase (2'-5'oligoAS) and beta 2 microglobulin (B2M) in patients with nodal metastases from cutaneous malignant melanoma treated with rIFN-alpha 2A.

UNLABELLED: IFN-alpha is a promising adjuvant agent in patients with regional melanomatous metastases (stage IIIB). The aim of this study was to verify whether serum evaluation of the interferon induced proteins 2'-5'oligoAS and B2M can predict the clinical response to rIFN-alpha 2A therapy. PATIENTS AND METHODS: Forty-two patients who had undergone radical dissection of nodal metastases were evaluated. All patients received adjuvant rIFN-alpha 2A (3 million units s.c. three times weekly) for 3 years or until progression. The patients were followed for a medium period of 43 months (range 19-46). During follow-up 22 of the 42 patients had disease progression. In all patients blood samples were obtained before starting adjuvant therapy and after 1 and 6 months of therapy with rIFN-alpha 2A. 2'-5' oligoAS and B2M were measured by radioimmunoassay. RESULT: During the first month of adjuvant therapy with rIFN-alpha 2A the serum levels of 2'- 5' oligoAS increased 10-fold, and this trend was maintained in the following 6 months. Similar results were obtained for B2M serum levels. However, we did not find any significant difference in AS and B2M serum levels between responders and non-responders. CONCLUSION: Our results, therefore, indicate that AS and B2M are markers of the biological activity of administered IFN but that they have little efficacy in predicting the clinical outcome of the treated patients.

2',5'-Oligoadenylate Synthetase↗