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Biomedical subjects

A Tarquini

Publications and source records attributed to A Tarquini.

At least 19 recordsLinked to original sources
PubMed1996

Double phase parathyroid technetium-99m-MIBI scintigraphy to identify functional autonomy in secondary hyperparathyroidism.

UNLABELLED: Double-phase 99mTc-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy has been proposed to detect hyperplastic parathyroid tissue, but the clinical usefulness of this technique in secondary hyperparathyroidism is still debated. METHODS: Technetium-99m-MIBI parathyroid scintigraphy associated with parathyroid echography and [99mTc]pertechnetate thyroid scans were performed on 38 patients with chronic renal failure (CRF) and secondary hyperparathyroidism. In all patients, serum calcium, phosphorus, FT3, FT4, TSH, calcitonin and intact PTH (iPTH) were determined. Nine patients eventually underwent neck exploration and 28 parathyroid glands were removed. RESULTS: Thyroid diseases were excluded in all patients. Echography revealed parathyroid enlargement in 22/38 (58%) patients, while MIBI scintigraphy was positive in 28/38 (74%), including 5 ectopic glands. Mean serum iPTH concentration was significantly higher in MIBI-positive glands compared to MIBI-negative glands, but several discrepancies were observed in single patients. A significant positive correlation between serum iPTH and gland size was observed when MIBI-positive, but not MIBI-negative, parathyroids were considered. A paradoxical positive correlation between serum calcium and iPTH concentrations was found in MIBI-positive patients. CONCLUSION: Double-phase 99mTc-MIBI scintigraphy is positive in the majority of patients with uremic hyperparathyroidism. Comparison of scintigraphic data with morphological and functional data strongly suggests that 99mTc-MIBI scans do not reveal simple parathyroid enlargement but rather, identify the presence of hyperfunctioning (autonomous) parathyroid tissue suggestive of tertiary hyperparathyroidism.

Adult↗
PubMed1994

[Hyperthyroidism and cancer of the thyroid].

The relationship between hyperthyroidism due to Graves' disease or toxic nodular goiters and carcinoma of the thyroid remains uncertain. The incidence of thyroid carcinoma varies considerably from as low as 0.3% to as high as 16.6% with a higher rate in toxic nodular goiters than in diffuse goiters and in endemic goiter areas or after external radiation to head and neck. Occult thyroid carcinoma ( < 1.5 cm or microscopic foci) is the rule and only a few tumors are suspected preoperatively with ultrasonography or fine needle aspiration or 131I scan. Authors studied 11 patients found to have thyroid cancer concomitant with Graves' disease (2 patients) or toxic nodular goiter (9 patients) between 1979 and 1991 at University of Cagliari, Department of Surgical Oncology. Eight of the 11 cancers were papillary while three were follicular. A carcinoma was diagnosed intraoperatively on frozen section in only two patients, while on permanent section in nine patients. Two patients received subtotal thyroidectomy, because resection edges were safe and tumors were small. Nine patients received total thyroidectomy and three also lymphoadenectomy. All patients were alive and well with a mean follow-up of 91.8 months. The authors conclude that the incidence of coexisting thyroid malignancy and hyperthyroidism is rare, does not affect prognosis and is unimportant for therapeutic purposes because, currently, toxic nodular goiter, Graves' disease and carcinoma are treated by total thyroidectomy.

Adult↗
PubMed1993

[Intraoperative ultrasonography in the diagnosis of liver metastasis from gastrointestinal neoplasms].

The authors illustrate their experience in the systematic use of intraoperative ultrasonography of the liver in patients undergoing surgery due to gastrointestinal cancer. The liver is the organ in which metastases from colorectal, stomach, pancreatic, and biliary cancer are most often localised. Between January 1991 and April 1992 95 patients underwent intraoperative ultrasonographic controls of the liver. In all cases the liver was studied using traditional image diagnosis: standard ultrasonography and CAT. On the basis of their experience the authors observed 12 cases negative for metastases using CAT and traditional ultrasonography which were positive using intraoperative ultrasonography, 2 cases which were positive for secondary hepatic lesions using traditional diagnostic tools but negative following histological tests guided by intraoperative ultrasonography. In the case of false negatives using traditional methods, those metastases revealed by intraoperative ultrasonography were above all located deep down and in segments which are difficult to explore, or were so small that they were not visible or palpable during intraoperative controls of the viscera. Intraoperative ultrasonography of the liver has been found to be a more sensitive test (97% of the best series) than standard ultrasonography (65%) or CAT (43%). Higher resolution due to the characteristics of the method is coupled with the possibility that intraoperative ultrasonography may be used to guide biopsies of the metastases revealed, thus allowing histological confirmation to be obtained: for this reason the risk of false positives is virtually zero.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[The role of node-picking lymphadenectomy in the treatment of differentiated carcinoma of the thyroid].

A retrospective analysis of the treatment of spreading of differentiated thyroid carcinoma to regional lymph nodes was performed in 201 patients observed in 1973-1991. In 183 patients with no clinical metastatic involvement (A group), no lymph node excision was performed. In 36 patients with limited metastatic lymph node involvement (B group), a node-picking lymphadenectomy was performed. After 1977, all patients were treated also with metabolic radiotherapy postoperatively. Actuarial 15-year survival was 98.28% in A group and 87.50% in B group (n.s. difference). In 15 patients with lymph nodal relapse, actuarial 10-year survival was 83.4%. The survival figures are not different from those obtained after more radical operations. So, in limited metastatic involvement of neck lymph nodes by differentiated thyroid carcinoma, in the opinion of the Authors, node-picking lymphadenectomy is equally effective as more radical surgical procedures.

Adenocarcinoma↗
PubMed1993

[Hyperparathyroidism resulting from chronic renal insufficiency. Diagnosis and therapy].

Twenty-seven patients, eighteen females and nine males, with chronic renal failure and secondary hyperparathyroidism, were treated by subtotal parathyroidectomy. Bone pain, in 24 patients, hypercalcemia in 2 and severe pruritus in 1 were the main indications to surgery. Result evaluation was possible in twenty four patients. Bone pain disappeared or was reduced in 20/22 patients. Serum alkaline phosphatase and PTH returned to normal in 21/24 patients. There patients had persistent hyperparathyroidism because of inadequate surgical exploration. Another group of seven patients with secondary hyperparathyroidism recalcitant to medical therapy or relapsing after subtotal parathyroidectomy was treated with calcitriol ev. After nine months of follow-up PTH and alkaline phosphatase serum levels were reduced to normal value in all patients.

Adult↗
PubMed1991

[Secondary hyperparathyroidism in chronic renal failure. Role of subtotal parathyroidectomy].

Fourteen patients with chronic renal failure and secondary hyperparathyroidism were treated by subtotal parathyroidectomy. Bone pain and hypercalcemia were the main indications to surgery respectively in 13 and 1 patients. Bone pain disappeared or was significantly reduced in 12/14 patients. Two patients had a persistent hyperparathyroidism. Serum alkaline phosphatase returned to normal in 12 patients and PTH in 11 of 12 patients with pretreatment high levels.

Adult↗
PubMed1990

[Progress in the diagnosis of unknown primary neoplasms].

About 5% of tumours clinically begin as unknown origin metastases involving some difficult diagnostic and therapeutic problems. In these cases the main goal is the formulation of the diagnosis as rapidly as possible because only about 10-15% of diagnosed patients are susceptible of treatment. Between 1973-1989 we observed 59 patients with unknown origin metastases. The diagnosis has been expressed in 5 patients by means of histochemical and immunohistochemical analysis, in 6 patients by means of radiologic and instrumental tests and in 3 patients spontaneously after 2-3 months.

Adenocarcinoma↗
PubMed1990

[Acute abdomen in patients with hematologic neoplasms].

Sixteen onco-haematological patients with acute abdomen are presented. The diagnosis of acute abdominal conditions was: neutropenic enterocolitis, gastrointestinal perforation, bowel neoplastic obstruction hepatic abscess and strangulated tumoral hernia. The operative death was 31.2%; 62.5% died 2-24 months after surgery and 6.3% is alive at 72 months. The Authors conclude that in these patients the extended surgery should be performed only in prognostic all favourable cases.

Abdomen, Acute↗
PubMed1989

[Bilateral carcinoma of the breast].

Authors, in the light of literature and personal experience of 27 patients observed, discuss risk factors, treatment and prognosis of bilateral breast cancer. Finally, Authors stress the utility of carefully planned follow-up with mammography and random biopsy to obtain an early diagnosis.

Breast Neoplasms↗
PubMed1986

Elevated plasma levels of beta-thromboglobulin in breast cancer.

Beta-thromboglobulin, a platelet-specific protein secreted into the plasma during the release reaction, was measured in 73 women with breast cancer, 10 women with dysplastic disease and 30 healthy female control subjects. 73% of patients with primary operable breast cancer and 65% with metastatic disease had levels above 40 ng/ml (control range 11-38 ng/ml). Among 2-6 months' postoperative patients without evidence of disease at the time of sampling, beta-thromboglobulin was raised in 75% of patients with nodal involvement and in 28% of patients without nodal involvement. Only 1 of 10 patients with benign disease showed abnormal beta-thromboglobulin concentration. Our results show that in a high percentage of breast cancer patients a state of ongoing in vivo platelet activation may be present. Furthermore, beta-thromboglobulin can be regarded as a potential tumor marker in breast cancer.

Adult↗
PubMed1985

[Prognosis of breast cancer (T1-4 No Mo) with reference to anatomo-pathological and clinical factors].

Using methods of multivariate statistical analysis, the Authors analyse the prognosis of 135 patients affected by No Mo breast cancer treated with radical mastectomy alone. Among eight risk factors examined, "vascular invasion" and "peritumoral infiltration" seemed to have the greatest influence on prognosis. Therefore, more aggressive treatment may be considered for the patients affected by breast cancer with the two factors former quoted.

Adult↗
PubMed1982

Effects of opiates and naloxone on certain enzymes of carbohydrate metabolism in human breast carcinomas.

The effects of administration of opiates and naloxone on the activities of PFK, 6PGDH and alpha-GPDH and alpha-GPDH/6PGDH ratios in human breast carcinomas were investigated in patients awaiting mastectomy. Injection of naloxone or fentanyl into an antecubital vein resulted in a statistically significant reduction in the activity of alpha-GPDH. Fentanyl was also effective in reducing the activity of 6PGDH. Injection of morphine into a branch of the internal mammary artery during mastectomy failed to induce changes in the activities of any of the enzymes but injection of naloxone resulted in a significant rise in the activity of 6PGDH. It is postulated that these alterations in the activities might not be associated with the binding of these drugs to opiate receptor proteins in the carcinoma. Furthermore opiate agonists or antagonists might not produce the required changes in the activities of any of the enzymes.

Breast Neoplasms↗
PubMed1980

Hormone synthesis by primary breast carcinomas and prognosis in human breast cancer.

The ability of human breast carcinomas to convert pregnenolone to progesterone and dehydroepiandrosterone to delta 4-androstene-3,17-dione (delta 4) was investigated as a potential aid for prognosis, and the following observations were recorded. 1. Neither the amounts of progesterone or delta 4 synthesized nor delta 4/progesterone ratios correlated with tumour size or lymph node involvement. 2. delta 4 synthesis was lower in carcinomas from patients who had recurrences within 2 years of mastectomy than in carcinomas from those who remained free of metastases. 3. Life table analysis of the results indicated that these parameters appeared unlikely to be useful aids for prognosis.

Androgens↗