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Biomedical subjects

M Greco

Publications and source records attributed to M Greco.

At least 145 records · Page 8Linked to original sources

Prognosis of breast cancer with axillary node metastases after surgical treatment only.

Out of 753 patients with breast cancer treated with radical mastectomy from 1968 to 1970 at the National Cancer Institute of Milan, Italy, 308 had histologically proven positive nodes. The number of positive nodes was not dependent on the location of the primary tumour, its diameter and the patient's age. Extracapsular invasion was related to the number of positive nodes at a statistically significant level: P value 2 X 10(-9). Survival was influenced by the number of positive nodes and extension of metastases beyond their capsule and age. Each of these criteria had an independent impact on survival. Three subgroups with different prognosis were identified in patients older than 40: (a) with a single involved node and 69.9% 10 year survival rate, (b) patients with two or more nodes with metastatic deposit still confined within node capsule and 47.4% 10 year survival rate, (c) patients with two or more involved nodes and extracapsular invasion and 25.3% 10 year survival rate. In patients younger than 40 no subgroup was identified: this group had an intermediate 10 year survival rate (50.9%). The authors conclude that there is a need (a) of re-consideration of the prognosis of patients with positive nodes and (b) to agree on the definition of "high-risk patients".

Adult↗

A reappraisal of oophorectomy in carcinoma of the breast.

Bilateral oophorectomy was used to treat 601 patients with disseminated breast carcinoma from 1974-1984. The total response rate was 31.2%. Complete regression occurred in 10.5% of patients and partial regression occurred in 20.8%, whereas 28.3% of patients showed no change and the disease progressed in 36.9% of patients. The patients who had a total regression had good survival rates (60.8% at 5 years and 47.3% at 7 years). No significant differences were found in the various age groups or with different types of dissemination. Patients with syncronous primary carcinoma and distant metastases had a high rate of regression as did patients with slow-growing carcinomas that metastasized many years after primary treatment. Estrogen receptor (ER) rates were good indicators of response only when determined on metastatic tissue at the time of oophorectomy. The value of ER determined on the primary tumor was of limited predictivity of response. A total of 220 patients received chemotherapy before oophorectomy. In this group the response rate was 22.3%, lower than that observed in patients who did not receive chemotherapy (36.6%). No important differences in total response rates were found among patients with amenorrhea and without amenorrhea although total regressions were more frequent in the latter patients than in the former patients.

Adult↗

[Antitetanus prophylaxis: actual practice and cost benefit analysis of a hypothetical mass vaccination].

The actual practice of immunoprophylaxis in a Sanitary District of Campania (Italy) is described. As everywhere in Italy, in subjects at risk (wounded) the passive immunoprophylaxis by human specific immunoglobins is currently applied: at very high cost and with unreliable protection. The Authors suggest to implement antitetanus mass vaccination, with benefits incoming from lower expenses and higher protection.

Adolescent↗

Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long-term results.

From 1973 to 1980 we randomly assigned 701 patients with breast cancer measuring less than 2 cm in diameter and with no palpable axillary lymph nodes to Halsted radical mastectomy (n 349) or to 'quadrantectomy' with axillary dissection and radiotherapy to the ipsilateral breast tissue (n 352). The two groups were comparable in age distribution, size and site of primary tumor, menopausal status, and frequency of axillary metastases. The average follow-up time was 103 months. Actuarial curves show no difference between the two groups in the disease-free interval after surgery or in the overall survival rate. At 8 yr the disease-free survival was 77% for the patients in the Halsted group and 80% for those in the 'quadrantectomy' group, and the overall survival was 83 and 85% respectively. We conclude that small breast cancers may be safely treated with the conservative treatment described. In our opinion total ablative operations are not justified.

Axilla↗

Prognosis of breast cancer patients after mastectomy and dissection of internal mammary nodes.

The results of the analysis carried out on data on 1119 patients with operable breast cancer treated at the National Cancer Institute of Milan from 1965 to 1979 with enlarged mastectomy are reported. Metastases to internal mammary chain were found to be significantly associated with the maximum diameter of primary (16.1% for tumors less than 2 cm and 24.5% for larger tumors, p = 0.007), the age of the patients (27.6% in patients younger than 40 years, 19.7% in patients between 41-50 years, and 15.6% in patients older than 50 years, p = 0.01). The site of origin of the cancer had no impact on internal mammary node metastases. Patients with positive axillary nodes showed metastases to internal mammary nodes in 29.1% of the cases, while 9.1% of patients with axillary negative nodes had positive retrosternal nodes. Survival was significantly affected by the presence of positive internal mammary nodes: the percentage of 10-year survival varied from 80.4% in patients with axillary and internal mammary negative nodes to 30.0% in patients with both nodal basins involved. Intermediate survival rates (54.6% and 53.0%) were found when one or the other of the nodal stations (axillary and internal mammary) was separately affected. Maximum diameter of the primary significantly affected the survival of each group identified by the status of both axillary and internal mammary nodes. In conclusion, the information on the presence or absence of internal mammary node metastases would be of great importance in formulating the prognosis of breast cancer patients. To obtain this information, a biopsy at the first intercostal space may be reasonable in selected patients (age, maximum diameter, and axillary node involvement being the basis for selection) as long as noninvasive methods of diagnosis are available.

Adenocarcinoma↗

[Medical docimology in radiology].

The authors report the experience of computerized integrated didactics on trial at the Institute of Radiology of the University of Catania. Students majoring in Medicine undergo a propaedeutic written test, consisting in a number of multiple choice questions, before proceeding to the oral examination in radiology. The procedures preceding the test and those following it are accomplished with the aid of a computer. The authors discuss the docimological motivations, the specifications of the system and the results obtained after a trial period.

Education, Medical, Graduate↗

[Antigenic characteristics of various strains of Campylobacter jejuni. Preliminary note: technic of extraction of soluble thermostable antigens].

Immune serum from rabbit has been obtained against Campylobacter jejuni ATCC no 29428 from the same strain an antigen of the outer Envelope was prepared by EDTA extraction. The specificity of antibodies against the outer antigen has been observed by direct agglutination, C.F., passive haemoagglutination and houcherlony test in agar. In eight other strains of Campylobacter isolated from patients, cross reactions with the ATCC no 29428 strain have been stored, by direct agglutination: only one strain (H) cross-reacted with the immune serum in use.

Animals↗

Rat liver mitochondrial aspartate aminotransferase mRNA: synthesis of an higher molecular weight precursor by free polysomes.

The site of synthesis of the higher molecular weight precursor of mAAT has been determined by separation of free and membrane-bound polysomes. Free and bound polysomes were isolated from rat liver and the polyA+RNA was extracted. Protein synthesis was carried out for two hours by using a reticulocyte lysate system in the presence of 35S-methionine. The samples were subjected to immunoprecipitation with specific antiserum. The precipitates were analyzed by Na-DodSO4/polyacrylamide gel electrophoresis and fluorography. The results clearly demonstrate that the enzyme is synthesized by free polysomes.

Animals↗

Rat liver mitochondrial aspartate aminotransferase mRNA: isolation of mRNA by polyacrylamide gel electrophoresis.

In order to obtain an enriched fraction of mRNA for mAAT we applied the following method: preparation of cytoplasmic polysomes; isolation of total RNA; isolation of mRNA by chromatography on oligo(dT)-cellulose column; polyacrylamide gel electrophoresis; extraction of mRNA from the gel. The procedure seems to allow isolation of mRNA enriched fraction for mAAT. An enriched fraction of mRNAs can be useful for the preparation of corresponding cDNAs.

Animals↗

Prognostic factors in operable breast cancer.

A series of 743 consecutive cases of operable breast cancer, admitted and treated at the Istituto Nazionale Tumori of Milan from 1969 to 1970, was analyzed by a multivariate statistical method to evaluate a) the variables of the host and the primary tumor associated with the frequency of nodal metastases, b) the variables that significantly affect survival, and c) the identification of homogeneous risk groups. As regards the frequency of regional node metastases, they were more frequently observed in young than in old patients with large tumors (P values 10(-5) and 3 X 10(-5), respectively). Tumors that originated in the axillary tail, upper, outer and central quadrants were significantly associated with a higher rate of node metastases (P = 0.002). Each of these variables maintained its significant value when adjusted by the other two. Survival was affected at a statistically significant level by the age of the patients (P = 2 X 10(-4) ), the pathologic diameter of the primary tumor (P less than 10(-6) ), and the number of metastatic regional nodes (P less than 10(-6) ). The number of involved nodes appears to be the most relevant factor in the assessment of prognosis of patients with positive nodes, Age of the patients, size of the primary tumor, and number of involved nodes maintain their own statistical significance when each is adjusted by the remaining two. The site of origin of the primary tumor, even if associated with the frequency of regional node metastases, did not affect survival. Three groups with a significantly different risk of death were identified in patients with negative lymph nodes and three groups in patients with positive nodes. It is concluded that age, size of the primary, and number of involved lymph nodes are important pieces of information that clinicians should have at hand following radical surgery, not only to make a prognosis, but also to identify groups of patients with high risk of death on which the role of adjuvant treatment should be evaluated.

Adult↗