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Biomedical subjects

S Giunta

Publications and source records attributed to S Giunta.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Nonpalpable lesions of breast carcinoma in elderly patients].

Breast cancer is the most frequent form of tumour in women. The only weapon at our disposal to reduce the mortality rate for breast cancer is early diagnosis. A number of studies have shown, using appropriate prevention programmes, an increasing number of minimum 20-30% lesions. The probability that a non-palpable lesion is malignant increases with age, with a positivity of 37-39% is women aged over 50. Localisation using FNAB requires studies with greater statistical value so that it can be inserted in current prevention programmes, given that the percentage of false negative is > 8%. At present, excisional biopsy with bioptic tests continues to be the standard reference method for the diagnosis of non-palpable lesions; this diagnostic procedure allows the lesion to be removed in positive cases, and avoids re-operating as in the case of suspected or inadequate cytological tests.

Aged↗
PubMed1997

[The surgical therapy of prostatic tumors].

In this paper the authors review the latest international literature regarding prostate tumour surgery, comparing surgery with the so-called "wait and see" approach. Together with hormone treatment, the latter method has been used by many researchers over the past few years given the low mortality caused by this tumour in spite of the increasing number of cases diagnosed. The wait-and-see approach is now rendered controversial by improved diagnostic methods and the widespread introduction of early diagnosis programmes. The authors report a number of studies on the use of "wait-and-see" in relation to radical prostatectomy and compare the results of the two techniques in terms of morbidity, mortality and survival. They go on to describe the various types of surgical technique used and their respective pros and cons as well as the complications typical of each technique. In conclusion, the authors discuss the indications for radical prostatectomy which, if performed in selected patients, appears to be a promising therapeutic approach in terms of disease-free survival and with a low operating mortality with complications that are not impossible to resolve using appropriate treatment.

Humans↗
PubMed1996

[Bi- and tridimensional reconstruction with spiral computerized tomography in esophageal neoplasms. Preliminary clinical applications].

Spiral CT allows rapid data acquisition in an entire anatomical region during a single breath-hold and permits to obtain 2D and 3D reconstructions with good diagnostic accuracy. We investigated the capabilities of spiral CT reconstructions in demonstrating esophageal cancers. Spiral CT was performed in 10 patients with esophageal cancers and in 3 patients who underwent endoprostheses placement with surgical or interventional procedures. Bidimensional (MPR, CPR, MIP) and three-dimensional reconstructions with Shaded Surface Display (SSD) were obtained at the end of each exam. In the analysis of the results, CT reconstructions were compared with previous barium esophagography. Some of the main semiologic patterns were considered: tumor visualization, longitudinal extent of the neoplasm and its relationships with adjacent structures. MPRs were obtained in 9 patients and allowed to visualize the esophageal lumen with a filling defect, the neoplastic mass and its longitudinal and extraluminal extent. SSD reconstructions was obtained in 7 patients and allowed a good assessment of longitudinal neoplasm extent in 6 patients. Neoplastic mass visualization and extraluminal tumor extent were difficult to assess in all cases. MIP reconstructions were obtained in all patients and demonstrated longitudinal neoplasm extent with good accuracy. Neo-plastic tissue was visualized only indirectly through the filling defect of the esophageal lumen. MIP allowed to define, in 5 patients, the relationships of the neoplasms with adjacent vascular structures after the intravenous administration of contrast agent. In conclusion, we consider that Spiral CT reconstructions can be useful for a more accurate staging of esophageal cancers.

Esophageal Neoplasms↗
PubMed1995

Chronomodulated 5-day infusion of floxuridine and L-folinic acid in patients with advanced malignancies: a feasibility and tolerability study.

The best schedule for administering floxuridine (FUDR) has not yet been established. Duration of infusion, need (and dosage) of leucovorin (folinic acid, FA), and circadian timing need to be further specified. Nevertheless, FUDR delivery according to circadian rhythms has allowed increase of dose intensity without enhancing the side effects. A 5-day infusional schedule combining FUDR and L-FA was devised as an attempt to increase dose intensity and to provide therapy every 3 weeks to patients with advanced cancer. An ambulatory programmable-in-time pump was used for this purpose. Fourteen patients entered this trial. Two dose levels (mg/kg x 5 days) were evaluated: 0.5 mg/kg/day in six patients and 0.525 mg/kg/day in eight patients. Both patient groups received a concurrent infusion of L-FA 10 mg/m2/day i.v. The delivery patterns of both FUDR and L-FA varied sinusoidally during the 24 hours with a maximum at 18.00 hours. Courses were repeated every 3 weeks. Of 35 courses, treatment produced mucosites greater than grade 2 in only two of them. No severe diarrhea, the dose-limiting toxicity of FUDR when infused over 14 days, was encountered at the dose levels tested. This 5-day chronotherapy schedule allowed delivery of a larger amount of FUDR than the flat delivery described in a previous report. A daily dose of 0.525 mg/kg FUDR, combined with 10 mg/mg2 L-FA, with intraindividual dose escalation according to tolerance, is recommended for future investigations of the activity of this chronotherapy schedule.

Adult↗
PubMed1995

Personality, inner experience and compliance in advanced cancer patients treated with external pumps.

The presence of portable pumps for protracted infusional chemotherapy in metastatic solid tumors at an advanced stage determines the need to evaluate psychologically the inner experience of the patients in relation to this therapeutic modality. The objective of the study were to analyze personality variables (coping and awareness), inner experience variables (acceptance and expectations) and the compliance of the patients during repeated courses of therapy. In addition we evaluated the influence of sex, age, level of education and response to treatment in relation to these variables. From February 1992 to March 1994 we evaluated 50 metastatic patients with a psycho-dynamic interview at the 1st, 3rd, 6th and the 9th course of therapy. The data obtained showed a positive trend for all the variables examined and in all the subgroups (age, sex, level of education, response) up to the 6th course. After the 6th course, personality variables remained stable, yet a drop in variables related to inner experience and compliance was observed in the whole group. While the personality variables remain constant in all patients, a decrease of acceptance and expectation was observed in patients non responding to therapy for their tumor, a trend which becomes significative at the 9th course regards expectation. The use of a psycho-dynamic interview allowed us to evaluate the effect of treatment on psychological variables and compliance to therapy. The length of treatment and the response to treatment seem to influence the more profound inner experiences of the patients.

Adaptation, Psychological↗
PubMed1995

111In-octreotide scintigraphy in small cell lung cancer.

Somatostatin receptors have been identified on the cellular surface of a subset of patients with small cell lung cancer (SCLC) and may be associated with a less aggressive evolution of the tumor. Moreover, medical therapy with somatostatin analogues holds promise for neoplastic growth control. We performed planar imaging in 22 patients with histologically proven SCLC at 2-4 and 24 hours after the injection of 111-185 MBq of 111In-DTPA-octreotide (Octreoscan, Byk-Gulden). Tumor uptake was observed in 19 patients in both early and late scans, while 2 patients previously treated with chemotherapy showed negative early and late scans. One patient had a positive early scan and a negative late scan. All the scintigraphic studies showed more extensive disease than expected by CT. No significant modification in tumor uptake of radiooctreotide was observed in three patients studied before and after chemotherapy. In conclusion, 111In-octreotide is a suitable radiopharmaceutical for the in vivo evaluation of the somatostatin receptors of small lung cancer. The prognostic and therapeutical implications of this nuclear technique must be further investigated, however.

Aged↗
PubMed1994

Noninvasive monitoring of ovarian cancer: improved results using CT with intraperitoneal contrast combined with immunocytology.

The purpose of this study was to evaluate whether CT with intraperitoneal contrast (ipc/CT) in combination with immunocytochemical (ICC) tests could improve the diagnostic accuracy over conventional methods in the follow-up of ovarian carcinoma. Forty-five clinically disease-free ovarian cancer patients eligible for a second-look laparotomy were given an intraperitoneal infusion of positive contrast material followed by pelvic and abdominal CT. After the radiographic examination, the contrast fluid was collected by paracentesis and processed for morphological as well as for immunocytochemical analysis employing a panel of monoclonal antibodies identifying distinct ovarian tumor-associated antigens. While ipc/CT correctly detected the presence of peritoneal recurrences in 22 of 45 (49%) patients, the immunocytochemical tests demonstrated the presence of otherwise undiagnosed microscopic disease in an additional 8 patients (18%). Our results demonstrate that the combination of radiological and immunological methods may represent a more accurate, noninvasive means of monitoring ovarian cancer, thus reducing the need for a second-look laparotomy.

Adult↗
PubMed1993

The role of medical counseling in secondary prevention of cancer in the elderly.

In western countries the elderly are those who experience the major impact of cancer, as epidemiologic data clearly show. Thus, secondary prevention of cancer (SPC) in older persons deserves more attention than it has received until now. Target subjects, however, are often reluctant to enter SPC plans. The reasons range from the lack of knowledge about the importance of SPC to the underevaluation of the risk of cancer, or, even more often, to the anxiety and fear that may stem from such a clinical investigation. In this context, the intervention known as counseling finds its natural and essential role. In the paper some general considerations on the significance of medical counseling is given, with particular emphasis on its role in SPC in the elderly. The analysis herein reported points out the specific skills and methods that physicians can adopt to cope with the eventually adverse influences that may affect the participation of the elderly in SPC initiatives. However, such action should avoid any paternalistic approach and respect the patient's will and autonomy.

Age Factors↗
PubMed1993

Somatostatin receptor imaging in small cell lung cancer using 111In-DTPA-octreotide: a preliminary study.

Small cell lung cancer is a common and aggressive disease. Combined multiagent chemotherapy and radiotherapy can improve short-term prognosis, but long-term prognosis remains dim. Somatostatin receptors have been identified on the cellular surface of subsets of this cancer and may be associated with less aggressive evolution. Moreover, medical therapy with somatostatin analogues holds promise for neoplastic growth control. Planar scintigraphy has been performed in 15 patients with histologically proven small cell lung cancer at 4 and 24 h after the intravenous (i.v.) injection of 185 MBq 111In-octreotide (Octreoscan, BYK-Gulden). No short-term adverse effects were recorded; tumour uptake of the radiopharmaceutical was observed in 13 patients at 4 h and in 12 patients at 24 h suggesting more extensive disease than apparent by computed tomography (CT). It is highly likely that the 24 h uptake reflects the presence of somatostatin receptors on the tumour. Previous chemotherapy does not seem to play a key role in tumour visualization. 111In-octreotide is a suitable radiopharmaceutical for in vivo evaluation of somatostatin receptor status of small cell lung cancer. Quantitative scintigraphic methods are needed to investigate nonspecific binding and receptor kinetics.

Aged↗
PubMed1993

Dilation of venous vessels at the splenic hilum in normal sized spleens as an indication of pathologic splenic involvement: preliminary results.

Twelve hundred patients without liver or heart disease, having a normal sized spleen without focal lesions, were examined by ultrasonography to measure the inner diameter of the splenic vein in relation to possible current or recent recovery from pathologic processes. SVD was measured at the hilum of the spleen with the patients supine. Ten of the patients in whom dilation of the SVD was found, together with a group of healthy controls (25), were subsequently studied with a duplex Doppler analysis to measure the venous outflow from the spleen. The results showed 1,175 spleens (98%) with SVD at the hilum of < 8 mm and 25 spleens (2%) with SVD of > 8 mm. Twenty-three of 25 patients (92%) with enlarged SVD had recent histories of hematopoietic or infectious diseases. Ten of 23 patients with enlarged SVD were studied further with a Doppler analysis. They demonstrated a rapid splenic blood flow with maximum flow velocities ranging from 14 to 27 cm/sec and high outflow volumes (from 430 to 1,227 ml/min, averaging 786 ml/min +/- 266), both significantly increased in comparison with controls (outflow volume from 200 to 355 ml/min, averaging 274 +/- 40; P < 0.0001). We conclude that dilation of the SVD accompanied by an increased intrasplenic blood flow volume without splenic enlargement would indicate a state of increased perfusion of splenic tissue associated with an immune response, reflecting reaction of the spleen to disease.

Adolescent↗
PubMed1992

New in vitro findings on the "free" form of apolipoprotein A-1.

Clinical and experimental gerontologists are extremely interested in lipoproteins as well as in new methods for investigating and probing the apolipoprotein pattern. Using immunofixation electrophoresis, we separated free apolipoprotein A-1 from the apo A-1 associated with high-density lipoproteins. Free apolipoprotein A-1 is a low-molecular-mass form of apo A-1 that seems to contain an extremely low quantity of lipids. The use of IFE as a tool for probing free apo A-1 has revealed new and interesting findings, such as its "artificial" increase during serum conservation at temperatures between 0-4 degrees C. From the clinical point of view, we demonstrated a decrease to the point of disappearance of free apo A-1 in some patients with liver cirrhosis. Moreover, one of the main findings here reported is the failure of anti-human apo A-1 murine monoclonal antibody and monoclonal antibody mixture to precipitate free apo A-1 in agarose systems. This discovery has important implications both for basic knowledge on apolipoproteins and for practical reasons concerning variability in those immunoassays (radial immunodiffusion) utilizing monoclonal antibody mixtures.

Antibodies, Monoclonal↗
PubMed1991

An in vitro bacterial model of cytotoxicity to living cells caused by dopamine and 6-hydroxydopamine oxidation at physiological pH.

The cytotoxicity of dopamine (DA) and 6-hydroxydopamine (6-OHDA) on living cells, in vitro, has been previously deeply investigated in neuroblastoma cells. This study was designed to explore the possibility to use bacteria as targets for studying DA and 6-HODA cytotoxicity. Both DA and 6-HODA oxidize when added to bacteriological media. The rate of autoxidation of 6-HODA was greater than DA within the first hours. The oxidation-dependent cytotoxicity caused bacterial growth-inhibition and killing at concentration of 10(-4)M. All the bacterial strains tested were slightly more susceptible to DA than to 6-HODA. Antioxidants (sodium metabisulfite, cysteine) prevented the oxidation and abolished the growth-inhibitory activity. The addition of exogenous catalase protected the cells against the effect of the oxidation of both the catecholamines up to the concentration of 5 mM, while the addition of exogenous superoxide dismutase protected the cells only at the minimal inhibitory concentrations. Taking into account that some of the results obtained are similar to those previously reported using neuroblastoma cells as targets, the use of bacteria for studying oxygen toxicity from these catecholamines seems to be a potentially useful model system.

Bacteria↗
PubMed1990

CT demonstration of peritoneal metastases after intraperitoneal injection of contrast media.

Thirty-three patients with ovarian carcinoma who had no evidence of metastases or ascites demonstrated on computed tomography (CT) with and without contrast agent were examined with CT after injection of approximately 3000 cc of a 2.4% solution of nonionic contrast media into the peritoneum. After intraperitoneal injection with CT (IPC CT), 22 were diagnosed as having intraperitoneal metastases. Of these, 19 were found to be true positives and 3 false negatives. Three other patients diagnosed as normal were found to have metastases. In all patients the peritoneum was well outlined and generally any metastases smaller than 1 cm were demonstrated. It was possible to identify compartmentalization of the peritoneum and to determine the location of the lesion to be in the peritoneum or the extraperitoneal space. This information is necessary in the planning of chemotherapy, particularly endoperitoneal chemotherapy. Tiny metastases to the omentum or adherent loops of small bowel could not be seen well.

Female↗
PubMed1990

Mueller-Hinton broth undergoes visible oxidative color changes in the presence of peroxidase and hydrogen peroxide.

In the presence of peroxidase and hydrogen peroxide, Mueller-Hinton broth undergoes a slow but clearly detectable color change from pale yellow to dark yellow or brown. An investigation of this phenomenon led to the conclusion that it is the result of the oxidation of tyrosine, a major component of the broth. Indeed, tyrosine has long been known to oxidize upon treatment with peroxidase and hydrogen peroxide. The observations reported here, besides being curious for the clinical microbiologist, might deserve attention for the possible implications in the medium color darkening which sometimes happens during microbial growth.

Bacteriological Techniques↗
PubMed1988

Streptococcus faecalis susceptibility to amiloride depends on medium pH.

Amiloride is one of the major molecular probes in basic and applied investigations on the physiology of cation transport in animal cells. In these cells the drug also exerts growth inhibitory activity. Recently, we discovered that amiloride causes growth inhibition also on bacterial cells. In this paper we report that medium pH influences amiloride activity on Streptococcus faecalis. The lowering of external pH causes a drop in the susceptibility of this bacterium to amiloride up to an almost complete resistance. This finding, constitutes a novel aspect of the in vitro experimental pharmacology of this diuretic potentially useful also in clinical pharmacology and in animal cell investigations.

Amiloride↗