Sister chromatid exchanges in bone marrow cells from a patient with Fanconi's anemia.
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Biomedical subjects
Publications and source records attributed to P Carbone.
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In a randomized multi-institutional trial of the Eastern Cooperative Oncology Group, 316 patients with advanced measurable colorectal adenocarcinoma were treated with a weekly schedule of 5-fluorouracil given orally and intravenously with oral-5-fluorouracil in combination with cyclophosphamide or 6-thioguanine, or with oral Methyl CCNU administered once every eight weeks. On failure or progression, 133 protocol patients crossed-over to a secondary therapy, while 116 other patients previously treated with 5-fluorouracil off protocol were randomized to treatment with Methyl CCNU or B-2'-deoxythioguanosine. Response rates among patients who had received no prior chemotherapy were 18% to oral 5-FU, 15% to intravenous 5-FU and to MeCCNU, 12% to 5-FU and 6-thioguanine and 5% to cyclophosphamide and 5-FU, with little activity (3% response rate) in crossover or previously treated patients. Treatment with 5-FU, particularly oral 5-FU was associated with the least drug-related toxicity. Hematologic toxicity was greatest with Methyl CCNU, but was no more frequent in previously treated than in untreated patients. A tendency toward cumulative bone marrow depression was noted. 5-FU was effective only in ambulatory patients, whereas responses among non-ambulatory patients were seen only in the group treated with Methyl-CCNU.
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In an Easter Cooperative Oncology Group trial, Cytoxan-prednisone (CP) Induction was compared to BCNU-prednisone (BP) in 273 patients with lymphocytic lymphoma. Response rates were comparable, with 21% achieving complete response and 40%, partial response. Patients with a nodular pattern responded better. Maintenance phase comparing cyclic intensive therapy (BCVP) with intermittent chlorambucil revealed the superiority of BCVP as demonstrated by improvement of the quality of response and somewhat longer remissions. The value of the Rappaport classification in the evaluation of lymphoma chemotherapy results is discussed. It is suggested tha NHL be separated into "favorable" and "unfavorable" groups, based on the presence or absence of nodularity and treatment schedules devised accordingly.
Other approaches to determine whether patients have a high probability of metastases (and therefore no need for axillary dissection) have been the measurements of several circulating substances (e.g., polyamines, nucleosides, CEA and HCG). None of these are by themselves useful. There is a high percentage positive in those patients with metastatic disease (with up to 97% positive for either HCG, CEA, or guanosine (nucleoside). What we need is a correlation or a parameter of what the tumor cell number is, who to treat, and how long. Today's therapy is larger empiric. The ultimate goal is to individualize therapy. Figure 1 summarizes a planned treatment for a woman with a breast cancer in 1974.
Prolonged l-phenylalanine mustard (L-PAM) administration as an adjuvant to mastectomy in the management of patients with primary breast cancer and pathologically positive axillary nodes was evaluated by a prospective, randomized, clinical trial. Treatment failures occurred in 22 per cent of 108 patients receiving placebo and 9.7 per cent of 103 women given L-PAM (p = 0.01). A statistically significant difference (p = 0.02) existed in favor of L-PAM relative to disease-free interval. In premenopausal women, the difference with respect to disease-free interval of treated and control groups was highly significant (p = 0.008). A treatment failure occurred in 30 per cent of premenopausal patients receiving placebo and 3 per cent of those treated with L-PAM (p = 0.008). Whereas a similar trend was observed in postmenopausal patients, the difference is not statistically significant. Thus, L-PAM has been demonstrated to be effective in the treatment of women with primary breast cancer, particularly those who are premenopausal. Results were achieved with minimal undesirable side effects.
The urinary activities for bone marrow colony formation were measured on consecutive 24-hour urine samples from two gray collie dogs with cyclic neutropenia and from two normal collies. The activity varied cyclically in the gray collies with a peak activity developing during the neutropenic phase, which antecedes the return of blood neutrophils. The activity fell to undetectable levels after the blood neutrophil counts returned to the normal range. The urine of normal dogs showed no activity. Since the dogs with cyclic neutropenia have been shown to have periodic hematopoiesis, these data suggest a regulatory hormonal role for the substance measured by this assay.
BACKGROUND AND METHODS: Karyotype in ANLL is referred as an independent prognostic factor. The prognosis of diploid ANLL subjects has been defined as "good" by some authors, or, more recently, "intermediate" by others. This is a retrospective study on 30 consecutive heavy treated ANLL diploid patients with the aim to make a correlation among age, normal karyotype and response. Chromosomal banding studies were performed at presentation with GTG technique. Diploid patients were divided into two age groups < 60 years (17 cases) and > or = 60 (13 cases). Data were analyzed by NCSS software. RESULTS AND CONCLUSIONS: CR rate for the two diploid age groups was 94% and 38% respectively (p = 0.002). Median DFS and overall survival were 14.4 and 23.3 months, 4 and 5 months for the two subgroups respectively: these data were not statistically significative. The probability of achieving CR was not affected by blood counts and Karnofsky performance status on admission, but only by age. Though ANLL patients with the same karyotype have the same course regardless of other prognostic factors, this does not occur in our series of diploid patients. We suggest that a normal karyotype, at least as defined with the GTG technique, does not characterize a homogeneous group of patient. Heterogeneity in this group might be due to submicroscopic or molecular genetic changes; it can enhance the age as prognostic factor.
INTRODUCTION: The incidence of Congenital Malformations may represent an early biological indicator for human toxicity to environmental and occupational contaminants. SCIENTIFIC OBJECTIVE: We are in the process of exploring the relation between various potential sources of parental periconceptional pregnancy exposures to Endocrine Disrupting Chemicals (EDCs) and selected Congenital Malformations in offspring. MATERIALS AND METHODS: The low incidence of Congenital Malformations leads to an epidemiological "Case-Control" study. The areas of the study are the Ragusa Municipalities and the south-east Siracusa Municipalities. We are conducting personal interviews with parents of about 100 cases with orafacial clefts or male genital malformations and 200 nonmalformed controls. The infants for the study were selected from those born during 1998-2002 in these areas. The more important variables considered are: 1--parental occupation and workplace exposures. 2--relevant confounders and recall bias. The analysis of the data will use the classical approach of case-control study (matching procedure), comparing risk factor frequency between cases and controls. CONCLUSIONS: The results of the study will allow to clarify the relationship between parental exposure to EDCs compounds and human reproduction.
After a wide-ranging review of the literature on the topic, the case of a 33-year-old woman is reported who, after an emergency right nephrectomy performed six years earlier due to renal angiomyolipoma with Wunderlich's syndrome, was admitted with anemia and acute shock following left renal hemorrhage. Having overcome the acute stage, a number of tests were carried out (echography, urography, abdominal CT, aortography) before the patient underwent conservative surgery in the form of lower heminephrectomy. The postoperative urography is presented showing satisfactory residual renal function which enabled the patient to live normally. The Authors discuss the criteria which lead them to select conservative surgical treatment.
The incidence of echinococcal cysts and their percentage occurrence in different human organs is reported. A case of hydatid cyst localisation in the pelvic cavity is reported and the pathogenesis of this infrequent localisation discussed. The various hypotheses: haematogenous and fall into the peritoneal cavity are examined; then the diagnostic approach and conservative surgical therapy employed.
A case of left pyeloureteral duplication with half a kidney functionally excluded is reported. After some mention of embryology to evidence the pathogenetic moments of the malformation, the clinical case is described, particular reference being made to the problems encountered in reaching diagnosis, in spite of the patient having undergone varied and repeated investigations. Superior heminephrectomy and total ureterectomy led to the clinical wellbeing of the patient.
The authors present clinical and instrumental results of N. 543 operations executed by CHIVA system. These cases are the result of trial performed in seven SIOC (Italian Society of CHIVA Operators) centers executed from November '87 to July '89. Functional and aesthetic results had been very good on over 85% of all cases; superficial thrombosis were verified on 10% of all cases but almost completely asymptomatic. The aa. propose to start a deeper trial on 500 patients choose by rigorous criteria of inclusion.
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