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Biomedical subjects

B Zani

Publications and source records attributed to B Zani.

At least 19 recordsLinked to original sources
PubMed2002

[Multifactorial prognostic analysis in the surgical treatment of well differentiated thyroid neoplasms].

BACKGROUND: Although in recent years our knowledge of pathogenesis and natural history of thyroid cancer has widely increased, there is not accordance among authors in the field of surgical treatment of well-differentiated tumours. In fact the extension of the tumour resection and modality of cervical lymph-nodes dissection show questions not easy to answer. METHODS: From 1985 to 1994, in our Surgical Institute, 128 cases of well-differentiated thyroid cancer, out of 1346 nodular thyreopathies, were operated on. We have considered some factors as anamnestic thyreopathy, familiarity, symptoms, US and scyntigraphic factors, fine-needle aspiration cytology and surgical option. The surgical treatment consisted of 99 total thyroidectomies (with or without cervical lymph-nodes dissection) and 18 lobus-isthmectomies. Surgical morbidity was 0.7% for permanent vocal cords palsy, 9.3% for transient hypoparathyroidism and 1.4% for permanent hypoparathyroidism. RESULTS: The 5.8-year survival rate was 92.9%. Fifty-four patients were in Stage I, 35 patients in Stage II, 27 in stage III and 4 in Stage IV. Histological patterns showed the prevalence of papillary type (63.3%) over follicular type (36.7%). CONCLUSIONS: The aggressive surgical approach in well-differentiated thyroid tumours, supported by complementary postoperative therapies, leads to a good control of the disease

Adenocarcinoma, Follicular↗
PubMed2000

Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer.

BACKGROUND: Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expander after mastectomy for breast cancer and the acute cumulative toxicity of the treatments. METHODS: We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity. RESULTS: The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0-19, median 5 days) and IBR groups (range 0-40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p = 0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group. CONCLUSIONS: Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation.

Adult↗
PubMed1999

Statewide replication of predictive validation for the Multnomah Community Ability Scale.

The Multnomah Community Ability Scale is a 17 item instrument that case managers can use to rate levels of functioning for clients with severe mental illness. Prior work in a large urban community mental health center showed that the instrument predicted subsequent involuntary hospitalization. The current project involved some 2,487 clients of community mental health programs throughout Oregon. This replication study again showed that low scores on the instrument predicted subsequent psychiatric hospitalization.

Adolescent↗
PubMed1998

Psychosocial integration of adolescents and young adults with thalassemia major.

UNLABELLED: The aim of this study was to explore the effect of thalassemia major on the psychosocial adjustment of adolescents and young adults. DESIGN: unmarried adolescent and young adult patients were asked to fill in an ad hoc questionnaire; a semi-structured interview exploring marriage and family life was done with married patients. SAMPLE: group A: 90 unmarried patients, 50% females and 50% males, aged 14-22 years. The control group was formed by 100 matched subjects; group B: 19 thalassemic married subjects, 6 males and 13 females, aged 28-45 years, 7 patients had children and 12 did not. RESULTS: group A: subjects with thalassemia had normal psychological and social development and scored better than their normal peers in tests investigating social adjustment, self-esteem and self-description. Moreover the family relationships of adolescents with thalassemia appeared to be stronger than those reported by normal controls; group B: the behavior of thalassemic couples did not differ from the one observed in non-thalassemic couples in the course of previous investigations. CONCLUSIONS: Our data shows that neither thalassemic adolescents nor thalassemic married, well-treated, young adults differ significantly from the healthy young people in their ability to cope with life's difficulties both in adolescence and marital life.

Adaptation, Psychological↗
PubMed1996

Who has the final say? Decisions on adolescent behaviour within the family

The transition to adolescence involves significant changes for the family. To date, research on these changes and how they occur has been restricted by lack of suitable measures. An instrument-the Perspectives on Adolescent Decision-Making Questionnaire-was designed for such research. It examines 21 issues which can lead to conflict. The instrument was completed by 500 Italian adolescents aged 13 and 15. Sensitivity to age and sex differences was examined, and perceptions of personal choice, parental feelings, conflict and normal patterns for adolescents were analysed. The instrument offers promising possibilities for more effective study of parent/offspring relationships during the adolescent period.

Journal Article↗
PubMed1992

The role of spontaneous portosystemic shunts in the course of orthotopic liver transplantation.

Spontaneous portosystemic shunts are commonly found in cirrhotic patients. Not yet established is their role after orthotopic liver transplantation (OLTx), especially when an increase in portal pressure develops, as during early acute rejection. In this study, 34 cirrhotic patients in a series of 70 OLTx are considered. Each patient had preoperative angiographic assessment, and, in 21 (62%), large spontaneous portosystemic shunts were evident. In 12 cases the shunts were not affected by the surgical procedure and were present during the postoperative period; in 9 the hepatectomy itself involved interruption of the shunts. The patient population was divided into two groups: patients with postoperative shunts (n = 12) and those without (n = 22). The two groups were similar in age, sex, Child's stage, transplantation variables, and number and grade of rejection episodes. However, mean transaminases (AST) values in the first 2 weeks were significantly higher levels in shunt versus nonshunt patients (421 +/- 335 vs 183 +/- 126; P less than 0.025), and this was even more evident when rejection occurred (626 +/- 375 vs 195 +/- 129; P less than 0.001). Furthermore, during an acute rejection reaction, three cases showed a true "steal phenomenon" through the large reopened shunts with ischemic damage to the grafts. The data indicate a possible detrimental effect of the spontaneous shunts on graft perfusion and suggest the prophylactic surgical interruption of the residual shunts during the transplantation.

Adult↗
PubMed1991

Biliary complications in orthotopic liver transplantation: experience with a modified technique of duct-to-duct reconstruction.

Biliary complications are described as frequent causes of morbidity during the postoperative course of orthotopic liver transplantation (OLTx), even in recent papers. The authors report here on their experience with duct-to-duct anastomosis as their method of choice for biliary reconstruction in a consecutive series of 100 OLTx in adult patients. The original technique, as described by Starzl, was modified by the authors by performing a wide, longitudinal plasty of both the donor and recipient bile ducts, joined together with two polidioxanone running sutures, producing the effect of a side-to-side anastomosis. This technique was used in all procedures, even when a significant discrepancy was evident between the ducts (n = 10). Follow-up was completed in 100% of the patients for a period of 2-40 months (mean 13.1 months). Four major complications (4%) occurred including hepatic abscesses due to ascending cholangitis, T-tube dislocation, partial occlusion by a branch of the T-tube at the anastomotic site, and disruption of the bile duct after T-tube removal. In four other patients, transient abdominal pain followed removal of the stent. Neither strictures nor fistulas were observed. Choledochocholedochostomy on a T-tube stent represents, in our experience, the technique of choice for biliary reconstruction in OLTx. The procedure, as described in the present study, proved to be safe in preventing strictures and leakages and appears to be feasible in nearly 100% of all adult patients undergoing OLTx.

Adult↗
PubMed1991

Male and female patterns in the discovery of sexuality during adolescence.

The present paper attempts to analyse the various factors which influence adolescents strategies in their efforts to cope with the problems related to pubertal and sexual development: the physiological changes, the social pressures engendered by family and cultural environment, and the personal meanings young boys and girls attribute thereto. The data came from 603 questionnaires and 60 interviews performed on Italian adolescents (both males and females, students and non-students) on the following issues: the awareness of physical maturation in the same and opposite sex; the significance of heterosexual relationships; the motivation for early sexual experiences; and their effects on personal identity. Significant differences concerning sex and level of schooling emerged with regard to the elaboration of the subject's psychosexual identity, motivation in the choice of partner and the precocity in the onset of sex life.

Adolescent↗
PubMed1983

[Minor anal pathology. Suggestions for ambulatory and hospital treatment].

A series of cases of anorectal pathology treated at the out-patient level or after hospitalisation in the course of the last five years is reviewed. Deference is made to subjects with haemorrhoids operated according to Milligan-Morgan or Parks in accordance with varying indications, or treated cryosurgically as out-patients, patients with upper or lower transsphincteric perianal fistula treated by means of the lay-open technique or elastic tourniquet under general or local anaesthesia, patients with acute anal fissures treated by means of internal lateral sphincterotomy under local anaesthesia, and those with inveterate forms subjected to Arnous posterior leiomyotomy. From a critical assessment of the hospital and out-patient activities carried out suggestions and indications are drawn with regard to cases that must be treated in hospital and those for which outpatient management is correct.

Ambulatory Care↗
PubMed1983

The glycoproteins of the complex surface coat of Trypanosoma lewisi.

Blood stream forms of Trypanosoma lewisi from rats previously infected were labelled in vitro by galactose-oxidase oxidation followed by NaB3H4 reduction and subjected to 7.5% SDS-polyacrylamide gel analysis, by this procedure 8 bands were detected on SDS polyacrylamide gel electrophoresis. We conclude that surface composition of Trypanosoma lewisi resulted more complex than that of Trypanosoma so far studied, suggesting a possible relation with induced immunity and reduced ability of the parasite to survive in its host.

Animals↗
PubMed1980

In vitro differentiation of satellite cells isolated from normal and dystrophic mammalian muscles. A comparison with embryonic myogenic cells.

Satellite cells were isolated from skeletal muscles of adult normal and dystrophic mice (C57/6J/dy strain) by sequential digestion of tissue fragments with collagenase, hyaluronidase and trypsin. These cells exhibit in culture similar behaviour to that of embryonic myoblasts, undergoing an initial duplicative period lasting about 2--3 days, followed by a shorter phase (1--2 days) of rapid cell fusion. During the duplicative phase most of the satellite cells appear round-shaped, whereas embryonic myoblasts appear typically spindle-shaped: both cell types actively incorporate [3H]thymidine. During the subsequent days of culture an increasing number of satellite cells becomes spindle-shaped; afterwards the cells contact each other and fuse into multinucleated myotubes. The majority of spindle-shaped satellite cells is unable to incorporate [3H]thymidine, thus behaving as post-mitotic cells. Concomitantly with satellite cell fusion, an increase of about 80-fold of creatine phosphokinase (CPK) specific activity is observed. Satellite cells are able to recognize co-cultured embryonic myoblasts ([3H]thymidine-labelled): hybrid myotubes containing labelled and unlabelled nuclei are formed in these experimental conditions. Satellite cells from dystrophic animals are able to differentiate in culture and do not show appreciable differences as compared to their normal counterparts. In dystrophic myotubes, however, CPK specific activity is almost twice that observed in normal myotubes. Human dystrophic satellite cells from biopsies of adult muscle cultured in similar conditions grow and fuse into multinucleated myotubes showing a behaviour identical to normal controls.

Animals↗
PubMed1978

Biosynthetic changes in myosin heavy subunit during myogenesis in culture.

In primary culture of chick embryo muscle cells myosin synthesis is detected in mononucleated cells and increased at the onset of fusion with a maximal increment of 20-fold per plate in differentiated myotube. The possibility that the myosin synthetized by duplicating myoblast could be different from that present in post-mitotic myoblast and myotube was evaluated by investigating the regulation of its synthesis and the turnover of the molecule. Following Actinomycin D treatment (0.05 microgram/ml, 8 h), myosin synthesis is partially affected (about 50% inhibition) in pre-fusion myoblast while the synthesis is more sensitive to the drug at the onset of fusion (80% inhibition). With the progress of the differentiative stage the half-life of the molecule increases from 30 h in duplicating myoblasts to 200 h in fibers. The half-life of myosin synthetized by duplicating myoblasts in the explanted embryonic muscle, is 12 h. These data show different features of myosin heavy chains related to specific stages of differentiation and suggest the possibility that modulative changes of the molecule could induce its functional maturation during myogenesis.

Animals↗
PubMed1976

Expression of differentiative traits in the absence of cell fusion during myogenesis in culture.

Fusion of myoblasts is inhibited in cultures at low Ca++ concentration (0.44 mM); yet creatine phosphokinase and myokinase activities as well as myosin synthesis and the appearance of post-mitotic myoblasts do not significantly differ from those of control cultures (grown at 1.04 mM Ca++) which undergo cell fusion. When Ca++ concentration is increased to the control value after the second day of culture, fusion occurs very rapidly and it is not inhibited by actinomycin D or cycloheximide. Treatment with 0.06 mM bromodeoxyuridine strongly inhibits creatine phosphokinase activity and myotubes formation. The study of the kinetics of reversal of cell fusion and of creatine phosphokinase activity after removal of the analog, shows that this process is slower than the decrease of the relative content of bromodeoxyuridine incorporated into DNA. The result obtained support the following conclusions: a) the expression of the differentiative characters examined does not require cell fusion; b) the process of myotube formation seems to imply two subsequent stages consisting first of a slow maturative process, which is followed by the actual fusion of cell membranes; the former is Ca++ independent, the latter is Ca++ dependent and does not require RNA or protein synthesis.

Adenylate Kinase↗