Biomedical subjects

A Curcio

Publications and source records attributed to A Curcio.

6 recordsLinked to original sources

PubMed1990

Supersensitivity to vasoconstrictor action of serotonin precedes the development of atheroma-like lesions in the rabbit.

We have studied the relationship between the early morphological changes and arterial responsiveness to vasoactive agents in a new animal model that is proposed to mimic the events of early human atherosclerosis. Atheroma-like lesions were produced by positioning a hollow Silastic collar (referred to as a cuff) around the common carotid arteries of rabbits. Following a period of either 48 h or 1, 2, or 4 weeks after surgery, vessels from both cuffed and sham-operated animals were removed, and vascular reactivity to cumulative concentrations of agonists were studied in isolated rings in organ baths. The contralateral arteries were perfused and fixed, studied by light microscopy, and the degree of intimal thickening was quantified by computer-assisted morphometric analysis and expressed as changes in the ratios of the cross-sectional areas of the intima and media in each artery. At 48 h, rings prepared from cuffed arteries were sixfold more sensitive to the contractile effects of serotonin (5-HT) than the corresponding controls. Histologically, such vessels showed some perivascular inflammation but no other morphological abnormality. At 7 days, cuffed vessels were again sixfold more sensitive to 5-HT than controls, and showed a thickened intima with marked smooth muscle proliferation and some infiltration by monocytes. Intimal/medial cross-sectional area ratios remained elevated at 2 and 4 weeks, but the supersensitivity to 5-HT diminished by 2 weeks to threefold and was absent at 4 weeks. The augmented reactivity to 5-HT at 48 h was specific, in that it did not occur for the alpha-adrenoceptor agonist, phenylephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1989

Yield of total body GA-67 scintigraphy in the staging of non-small cell lung cancer.

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.

Adult↗

PubMed1989

Continuation of chemotherapy versus supportive care alone in patients with inoperable non-small cell lung cancer and stable disease after two or three cycles of MACC. Results of a randomized prospective study.

Recommendations concerning the continuation of chemotherapy in nonresponding patients with non-small cell lung cancer (NSCLC) and stable disease after the first chemotherapy test are empirical and often conflicting. Between 1984 and 1987, 116 inoperable NSCLC patients were treated with methotrexate, doxorubicin, cyclophosphamide, and lomustine (MACC regimen). After two or three cycles of therapy, 74 patients were judged to have stable disease and assigned at random either to chemotherapy maintenance with the same regimen (38 subjects) or to chemotherapy discontinuation (36 subjects). The two study groups were comparable for all the major prognostic factors. Median time to progression was 26 weeks for the chemotherapy group compared to 24 weeks for the nonchemotherapy group (P = NS). Median survival was prolonged in the treatment arm (47 weeks) compared to nontreatment arm (30 weeks), which was statistically nonsignificant. A patient self-assessment of the quality of life revealed a significantly worse tolerance to therapy and a better physical condition in the chemotherapy group. Objective MACC toxicity was significant with two treatment-related deaths. This study failed to demonstrate sufficient therapeutic benefits to justify the increased cost and toxicity of continuing treatment in nonresponding NSCLC patients.

Adult↗

PubMed1989

Combination chemotherapy with methotrexate, adriamycin, cyclophosphamide and CCNU (MACC) for nonsmall cell lung cancer. 4-year experience with 92 patients.

Ninety-two nonsmall cell lung cancer (NSCLC) patients were treated with a combination chemotherapy containing methotrexate, adriamycin, cyclophosphamide and CCNU (MACC). The regimen was administered in the dose and schedule originally reported. Median survival for all patients was 32 weeks. Only 6 patients demonstrated an objective response with a median survival rate of 51 weeks. The remaining 70 evaluable patients were nonresponders. These latter patients had a survival probability reduced to 29 weeks. Median time to progression for the whole group was 17 weeks. Partial responses were seen in 3 squamous, 1 large cell carcinoma and 1 adenocarcinoma. One patient with bronchiolo-alveolar carcinoma had complete disease regression and is still alive 136 weeks after starting treatment. Toxicity was significant with 2 treatment-related deaths. The major toxic effects consisted of myelosuppression, nausea, vomiting, and stomatitis. Alopecia was nearly universal; a mild cardiac, renal, or hepatic toxicity was relatively infrequent. Polychemotherapy with MACC regimen may benefit a few selected patients with NSCLC, but its overall antitumor efficacy appears to be very limited.

Adult↗

PubMed1987

Lack of clinical significance of gallium-67 uptake in non-small cell lung cancer.

To evaluate the clinical significance of tumor Ga-67 uptake, we studied 89 consecutive patients with a potentially resectable non-small cell lung cancer (NSCLC) by performing a whole body Ga-67 scan. For each scintigraphy, an overall Ga-67 accumulation index (T-N) and a volume independent index (T/Nr) were calculated. Both parameters were related to disease extent, response to subsequent treatment and host survival. With the exception of the significant correlations of T-N to both stage of disease and survival-the higher the T-N, the more advanced the disease and the worse the prognosis-no other relationship was found. Based on these findings, we conclude that, in NSCLC at least, gallium uptake is mainly dependent on tumor size and, therefore, of limited practical value.

Adult↗

PubMed1978

Normal cardiac function with a hybrid heart.

A left ventricular bypass procedure using a cardiac allograft was performed in a patient with a long history of rheumatic heart disease and two aortic valve replacements. Normal cardiac function was reestablished, and the only problem following transplantation was that of serious arrhythmias involving the recipient heart. Eighteen months after left ventricular bypass bacterial endocarditis which was resistant to medical treatment developed on the aortic prosthesis. The patient underwent operation, the prosthesis was removed, and the recipient left ventricle was partially resected and excluded from the circulation. Since then the patient has been asymptomatic and, at the time of writing three years after cardiac allograft, he is our longest survivor.

Arrhythmias, Cardiac↗