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Biomedical subjects

P Pacini

Publications and source records attributed to P Pacini.

At least 37 records · Page 2Linked to original sources
PubMed1996

Screening by ultrasonography for endometrial carcinoma in postmenopausal breast cancer patients under adjuvant tamoxifen.

Seven-hundred thirty-seven asymptomatic postmenopausal breast cancer patients under long-term adjuvant tamoxifen therapy (average, 50 months) were screened by endometrial ultrasonography. Abnormal endometrial thickness (6 mm or larger) was observed in 209 subjects and was significantly associated with patients' age and duration of tamoxifen therapy. Outpatient endometrial biopsy was recommended in presence of abnormal endometrial thickness: 25 subjects refused biopsy, whereas 76 were not biopsied because of cervical stenosis and were followed-up by repeat sonography. Of 108 biopsied subjects, one case of endometrial carcinoma (as expected in the screened cohort according to age-specific incidence rates provided by the regional cancer registry) and one case of endometrial hyperplasia were histologically confirmed, whereas endometrial atrophy was evident in the remaining cases. No other case of endometrial carcinoma has been recorded so far in the studied cohort according to the local cancer registry and no further change of the endometrium has been observed at sonographic follow-up. The cohort will be followed-up by repeat annual endometrial sonography. Thus far, we did not find evidence of increased prevalence of endometrial pathology (carcinoma or hyperplasia) which may be ascribed to tamoxifen therapy. The apparent increase in endometrial thickness observed at sonography might be explained by tamoxifen-induced changes of endometrial stroma and myometrium, misinterpreted as hyperplasia, while causing no real epithelial disease.

Aging↗
PubMed1996

In vitro effects of some differentiation inductors in metaplastic epithelium of the human nasal cavity.

The alterations in the mucociliary unit in the course of chronic inflammation of the upper respiratory tract correspond to morphologic anomalies of the respiratory epithelium and induce cuboidal and squamous metaplasia. While the squamous pattern is most probably irreversible, it is still not clear whether it is possible to restore ciliogenesis in cuboidal metaplasia. In the present study, the action of different inductors of differentiation was evaluated in vitro in isolated cells and explants from human nasal metaplastic epithelium. Polar/apolar compounds induced secretory activity, whereas retinoic acid was able to induce ciliogenesis in some cases. Therefore, the cuboidal metaplastic condition appears to be reversible, and two distinct pathways of differentiation, secretory and ciliogenetic, are identifiable.

Acetamides↗
PubMed1996

[The laryngeal mask in pediatric anesthesia].

We carried out a perspective study in order to assess the ease of insertion, the type and the incidence of perioperative complications connected with the use of the Laryngeal Mask Airway (LMA). We examined 300 consecutive patients, M/F 261/39, average age 4.2 yrs. (range 0.1-16), ASA I-II, who underwent surgical operations of short or average length not involving the pleural, the oropharyngeal or the peritoneum cavity. The choice about anesthesia was left to the discretion of the anesthesiologist. In 27 cases the position of the LM was controlled through a flexible fiberoptics. In 269 patients (89.6%) the LMA was correctly positioned during the first attempt. In 27 patients (9%), 2 or more attempts were necessary, and in 4 patients (1.4%) it was not possible to set the LMA. No differences of statistical significance were noticed between the different size of LMA, with regards to the facility of insertion. The control through fiberoptics showed a correct position, from an anatomical point of view, in 11 patients (41%), whereas in 13 patients (48%) some signs of partial obstruction were noticed (epiglottis interposing between the opening of LMA and larynx) and in 3 patients (11%) vocal cords are not visible. The following complications took place: laryngeal spasm on induction (2.3%), cough or movements on positioning (2.3%), hypoxia (4.3%), obstruction (1%), laryngeal spasm on awakening (1.7%), trauma (5%) and vomiting (0.3%). No connections were found between the size of LMA and total complications. Nevertheless, cough or movement during positioning and laryngeal spasm on awakening were significantly more frequent with LMA n. 3. In our experience, the LMA proved to be effectual and safe in the control of the airway during elective operations in pediatric surgery.

Adolescent↗
PubMed1995

Filippo Pacini: a determined observer.

The life of Filippo Pacini (1812-1883) and his major scientific achievements are outlined. Pacini drew attention to the corpuscles named after him in 1831, when he was a medical student, and had to struggle for many years to convince the scientific community of the reliability and importance of his findings. In 1849 Pacini became professor of anatomy at the University of Florence. Creative scientist, innovative teacher, well aware that the use of the microscope represented a revolutionary approach, Pacini pursued histological studies until his death. He also first discovered in 1854 (30 years before Robert Koch) the causative agent of cholera, and firmly believed that the disease was contagious. Strong-willed, modest, and poor, Pacini received from his colleagues more recognition in the obituaries than during his life.

Eponyms↗
PubMed1995

Scanning electron microscopic evaluation of the alterations induced by polluted air in the rabbit bronchial epithelium.

With the aim of evaluating the influence of polluted air on the respiratory epithelium, ten New Zealand white rabbits, from a group of fifteen kept in the country, were transported to a site located in a metropolitan area. After 40 days, all the rabbits were killed, and the bronchial mucosa studied by scanning electron microscopy (SEM). In the animals exposed to polluted air, the ciliated cells, less numerous than in normal cases, show an evident decrease in the number and size of the cilia, exposing apical microvilli. It is therefore possible to hypothesize that a part of the non-ciliated cells is made up of cells that have lost their cilia. The number of non-ciliated elements and the amount of mucous secretion appear to have noticeably increased. The considerable response of the respiratory epithelium to inhaled agents appears to be confirmed, as is the irritant effect of polluted city air.

Air Pollutants↗
PubMed1995

The efficacy of intensive follow-up testing in breast cancer cases.

BACKGROUND: A preliminary inquiry into the follow-up practices of Italian breast cancer centers revealed a considerable diversity of policy. It is clear that accurate follow-up examinations supply important information about the development of metastases, but there is no clinical proof that they extend survival time. It is possible that the effects of early diagnosis are only negative, extending the period over which the patient is aware of her illness and leading to over-diagnosis, overtreatment and increased health-care costs. PATIENTS AND METHODS: In a study involving the national oncological centers, patients were randomized into two groups: an intensive follow-up group (6 monthly chest X-rays and bone scans) and a control group (clinical examination only). RESULTS: An excess of isolated bone and intrathoracic metastases were observed in the intensive follow-up group. The survival curves showed no difference between the two groups. CONCLUSIONS: Six monthly X-rays and bone scans provide occasion for early diagnosis of intrathoracic and bone metastases without, however, influencing overall 5-year survival. Recourse to diagnostic tests only in the presence of symptoms appears to be the most appropriate follow-up procedure. However, other studies considering long term effects of early diagnosis and the effects of considering long term effects of early diagnosis and the effects of new diagnostic tests and/or treatment modalities are clearly needed.

Bone Neoplasms↗
PubMed1994

Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council Project on Breast Cancer follow-up.

OBJECTIVE: To evaluate the effectiveness of early detection of intrathoracic and bone metastases in reducing mortality in breast cancer patients. DESIGN: Randomized clinical trial allocating breast cancer patients to two alternative follow-up protocols (intensive vs clinical) for at least 5 years. SETTING: Twelve breast clinics (referral centers) in different areas in Italy. PATIENTS: A total of 1243 consecutive patients (either premenopausal or postmenopausal) surgically treated for unilateral invasive breast carcinoma with no evidence of metastases. The two study groups were well balanced in terms of clinical and prognostic characteristics. INTERVENTION: Patients in both treatment groups had physical examination and mammography, while patients of the intensive follow-up group had, in addition, chest roentgenography and bone scan every 6 months. MAIN OUTCOME MEASURES: Vital status at 5 years was the main outcome; information was available for all except five patients (0.4%). Relapse-free survival was also analyzed. RESULTS: Overall, 393 recurrences (104 local and 289 distant) were observed during the study. Increased detection of isolated intrathoracic and bone metastases was evident in the intensive follow-up group compared with the clinical follow-up group (112 vs 71 cases), while no difference was observed for other sites and for local and/or regional recurrences. The 5-year relapse-free survival rate was significantly higher for the clinical follow-up group, with patients in the intensive follow-up group showing earlier detection of recurrences. No difference in 5-year overall mortality (18.6% vs 19.5%) was observed between the two follow-up groups. CONCLUSIONS: Periodic chest roentgenography and bone scan allow earlier detection of distant metastases, but anticipated diagnosis appears to be the only effect of intensive follow-up, and no impact on prognosis is evident after 5 years. Periodic intensive follow-up with chest roentgenography and bone scan should not be recommended as a routine policy.

Adult↗
PubMed1994

Combination chemotherapy with epirubicin and mitomycin C as first-line treatment in advanced breast cancer.

From December 1988 to February 1991, 112 consecutive patients were submitted to epirubicin + mitomycin C chemotherapy as first-line treatment for advanced breast cancer. Epirubicin (75 mg/m2) was given every 3 weeks and mitomycin C (10 mg/m2) every 6 weeks. Only patients with visceral involvement or with a disease-free interval of less than 12 months were considered eligible. 102 patients were evaluated for response and toxicity in the present analysis. The main sites of involvement were viscera, soft tissues, bone in 71 (69.6%), 19 (18.6%) and 12 (11.8%) patients, respectively. Multiple site involvement was present in 66 (64.7%) cases. A total of 726 courses of therapy were administered (range 2-14; mean 7.2). Follow-up ranged from 96 to 210 weeks (median follow-up 138 weeks). Response rate was complete response (CR): 21.6% [95% confidence interval (CI) +/- 0.8], partial response (PR) 49.0% (95% CI +/- 0.1), stable disease (SD) 12.7% (95% CI +/- 0.1), progressive disease (PD) 16.7% (95% CI +/- 0.1), CR + PR: 70.6% (95% CI +/- 0.1). Median values of survival and time to progression were 79.4 and 42 weeks, respectively. At 2 years, 37.2 +/- 4.7% and 12.8 +/- 3.3% of the patients, respectively, were alive or without evidence of progression. Toxicity was generally mild. One hundred and four (14.3%) cycles in 53 patients were delayed due to haematological (82) or cardiac (3) toxicity, infectious disease (11) or causes not related to the treatment (8).

Adult↗
PubMed1994

Histochemical study of human nasopharyngeal epithelium by horseradish peroxidase conjugated lectins.

This study proposes a simple method for assessing whether non-respiratory epithelia of the nasopharynx (i.e. cuboidal, squamous) represent a modified differentiation from the normal pseudo-stratified lining, or whether they possess common characteristics suggesting they are just in a different morphological stage. Peroxidase-labelled lectins were used, since they detect sugar residues of membrane glycoconjugates which play an important role in cell differentiation. Biopsies were taken from healthy controls and from patients affected by upper airway inflammation of varying degree and duration. While pseudostratified and cuboidal epithelia possess similar histochemical characteristics, squamous epithelium has a different behaviour; in particular it is the only type to show intense reactivity to Lotus tetragonolobus lectin (LTA). This would seem to indicate that squamous epithelium is in a different state of differentiation, possibly suggesting dysplasia. Lectins may be valuable both in morphological studies and in the clinical evaluation of airway epithelia.

Adolescent↗
PubMed1993

Conventional versus high-dose epidoxorubicin as single agent in advanced breast cancer.

Between March 1986 and December 1987, two groups of consecutive patients with advanced breast cancer underwent epidoxorubicin (Epidx) monochemotherapy. Twenty-three patients (group A) received Epidx at a dose of 60 mg/m2 and 27 (group B) at a dose of 120 mg/m2 (i.v. every 3 weeks). No patient had undergone anthracycline treatment before entering the study. Age ranged from 39 to 70 years (mean 52) in group A and from 35 to 69 (mean 50 in group B). The main sites of involvement were liver (5 patients in group A and 10 in group B), lung (4 and 5 patients, respectively), bone (7 and 8 patients, respectively), and soft tissue (6 and 5 patients, respectively). The number of courses of therapy ranged from 4 to 10 (mean 7.4) in group A and from 3 to 10 (mean 6.6) in group B. Tumor response and toxic effects were graded according to World Health Organization criteria. CR + PR were 35% in group A and 67% in group B (chi square = 3.862, p < 0.05). Results were analyzed at 130 weeks from the beginning of the therapy. At this time, survival was 9% in group A and 15% in group B, with a median survival time of 61 weeks (range 18-130) and 77 weeks (range 24-130), respectively. No patient in group A showed cardiac toxicity higher than grade 2 during or after the treatment, whereas in group B, 2 patients developed congestive heart failure after a cumulative Epidx dose of 1080 and 1200 mg/m2. Treatment delays, to allow recovery of white blood cells, were infrequent and occurred only in patients previously subjected to chemotherapy. No patient required hospitalization for sepsis, and alopecia was reversible in all patients. Our data demonstrate that there is a relationship between Epidx dose and response rate in advanced breast cancer.

Adult↗
PubMed1993

[The use of low doses of intermediate acting muscle relaxants in adenotonsillectomy].

In this study we compared the efficacy of a reduced dose of medium term neuromuscular blocking agents atracurium (0.20 mg/kg) and vecuronium (0.04 mg/kg) in short-term (8-10 min) pediatric surgery. Eighty-four children (ASA I and II) undergoing adenotonsillectomy were selected for this study. Their average age was 56 months (range 30-121 months). We compared intubation conditions and the level of neuromuscular blockade using accelerometry. The induction and maintenance of anesthesia were achieved by anaesthetic gas (halothane first followed by isoflurane). Later on 57 children received vecuronium 0.04 mg/kg (group V) and 27 atracurium 0.20 mg/kg (group A). The latency period was similar in both groups (114.5 +/- 36.1 sec gruppo V vs 100.1 +/- 32.1 sec gruppo A). Intubation was performed in the same period of time (159 +/- 17.4 sec gruppo V vs 156 +/- 20.8 sec gruppo A) and the stimulus was always less than 5% of the baseline values. Intubation was considered excellent in 93% of patients of group V, good in 3.5% and poor in 3.5%. Conversely in patients of group A intubation was considered excellent in 85%, good in 11.5% and poor in 3.5% (n.s.). The neuromuscular recovery, measured by T1 > 5%, was faster in group V (493.6 +/- 154.3 sec gruppo V) than group A (652.6 +/- 210.9 sec gruppo A) (p < 0.001). The TOF ratio during extubation was significantly lower in group A (0.556 +/- 0.177 gruppo A) than in patients of group V (0.789 +/- 0.173 gruppo V) (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoidectomy↗
PubMed1992

Intraductal breast cancer: review of 183 consecutive cases.

The aim was to review a series of 183 intraductal breast cancer to define the diagnostic features and therapeutic outcome. Patients' average age was 54 years. Diagnostic procedures employed were clinical examination, mammography in 173 cases and fine-needle aspiration cytology in 98 cases. The sensitivity of clinical examination was 0.61, of mammography 0.74, of fine needle aspiration cytology 0.70. The sensitivity of clinical examination and mammography associated was 0.93. The surgical options adopted were: conservative surgery 80 cases, mastectomy 103 cases. Conservative surgery was followed by breast irradiation in 34 cases. Axillary dissection was performed in 122. 97 cases have been reviewed histologically. 60% of ductal carcinoma in situ (DCIS) were multifocal and 22% multicentric. Local recurrence, all infiltrating, occurred in the same breast after conservative surgery in 8 cases, 3 of which had received postoperative radiotherapy, and in 3 patients after mastectomy. Contralateral breast cancer was recorded in 13 cases, being synchronous in 4 (infiltrating in 3, DCIS in 1) and metachronous in 8 (all infiltrating). 3 patients died of breast cancer. The present series confirms the risk of ipsilateral cancer recurrence after conservative surgery but there are no significant differences relating to mammographic pattern, size, histological type, margin involvement and radiotherapy.

Adult↗
PubMed1992

Subjective and metabolic effects of clodronate in patients with advanced breast cancer and symptomatic bone metastases.

Twenty postmenopausal women (aged between 46 and 67 years old) with skeletal metastases from breast carcinoma were treated with clodronate 450 mg i.v. daily for 5 days and thereafter with 100 mg i.m. daily for 10 days. All patients received standard hormonal therapy (tamoxifen). Symptomatic pain (evaluated according to a linear analog scale), performance status (according to Karnofsky), serum alkaline phosphatase, serum creatinine and osteocalcin were measured before and after treatment on days 5, 15, 30 and 45. Scanning by radiology were performed pre- and post-therapy. Bone pain was significantly reduced in 15 out of 20 patients. After clodronate treatment the base line value of circulating osteocalcin (3.2 +/- 1.6 ng/ml) showed a significant increase on days 30 and 45 (p less than 0.001). Radiological assessment of bone lesions showed stable disease in 18 patients and progression in two patients. No adverse side effects were observed. These data show that clodronate provided pain relief in 75% of treated patients and the increase in circulating osteocalcin levels can be considered a marker of the stabilization of skeletal metastatic lesions.

Aged↗
PubMed1992

Morphological study of fetal nasopharyngeal epithelium in man.

In 30 human fetuses between 8 and 13 weeks of intrauterine life the lateral wall of the nasopharynx was examined by light microscopy and transmission and scanning electron microscopy. In the subjects between 8 and 9 weeks in utero the mucosa displays still an immature appearance, being mono- or bistratified and lacking the characteristic structures of the respiratory epithelium. Nevertheless, signs of differentiation are to be noticed, with the presence of two distinct cellular types that, in the later periods, will give rise to ciliated cells and microvillus-provided cells. An almost complete differentiation will be reached at 12-13 weeks in utero, even if goblet cells are still lacking in the examined zone during the considered period. Nonrespiratory types of epithelium, such as transitional or squamous, were never found in the studied subjects.

Embryonic and Fetal Development↗
PubMed1992

[Teleradiography for diagnosis in emergency care. A clinical experience].

This work was aimed at evaluating the role of teleradiology in a diagnostic emergency room. Over a 6-month period (September 1991-February 1992), 2,000 films made in the emergency room were transmitted to a resident radiologist 1 kilometer away: each examination included patient's data (sex, age, site of trauma, etc.) which were sent by the admitting physician. A teleradiology system (Lumiscan 100 AT&T and Philips) was used. Films were digitized on a 1024 x 1024 x 8-bit image matrix and then transmitted over a dedicated standard phone line to the Department of Radiology. The autograph report was sent by fax to the emergency room. Four radiologists, of varying experience, independently reviewed a sample of 179 digitized radiographs and, 30 days later, the original films on a conventional light-box. The results appear to be encouraging because no significant differences were observed in the performance of any of the radiologists. Good video/films agreement was obtained, together with high sensitivity and specificity. A good result was the relatively small number (0.4% of all examined cases) of false negatives diagnosed on faxed films relative to the actual clinical diagnosis.

Computer Peripherals↗