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Biomedical subjects

C Dominici

Publications and source records attributed to C Dominici.

At least 37 records · Page 2Linked to original sources

Immunohistochemical detection of high-affinity nerve growth factor receptor in neuroblastoma.

High levels of mRNA (as assessed by northern blot) for the high-affinity nerve growth factor receptor (p140TRK) are predictive of favourable outcome in neuroblastoma. The feasibility of determining p140trk on frozen sections using a recently developed monoclonal antibody was evaluated, and immunohistochemical findings were compared to those obtained from northern blot analysis. Primary tumour samples from 28 untreated patients were quick frozen and an indirect immunofluorescence assay was performed on 4-microns acetone-fixed cryostat sections. 9 cases were positive with immunohistochemistry, and these were among the 15 cases also positive by northern blot. None of the cases negative by northern blot were positive with immunohistochemistry. The concordance rate was 79% (P < 0.03), with a sensitivity of 60% and a specificity of 100%. Immunohistochemistry can thus be rather reliable for assessing p140trk expression, even when only very small amounts of tissue are available, such as with needle biopsy.

Biomarkers, Tumor↗

Preoperative and postoperative evaluation of latissimus dorsi myocutaneous flap vascularization by color flow duplex scanning.

At the Plastic and Reconstructive Surgery Department of the University of Perugia, 104 patients have been examined by color flow duplex scanning in order to study latissimus dorsi vascular supply before and after surgical procedures. This noninvasive ultrasound technique provides a precise and accurate measurement of blood flow velocity (15 cm/s) and volume (27 ml/min) within the thoracodorsal artery, which represents the vascular pedicle of the flap, and it allows us to detect the exact location of the perforating branches with their cutaneous distribution. This preoperative evaluation, pointing out vascular pathologies that contraindicate use of the latissimus dorsi flap, can be considered a great help for the reconstructive surgeon in the choice of the most suitable operation, and it can surely lead to a significant decrease in postoperative graft failure rates.

Adolescent↗

Colour flow duplex scanning: an accurate, non-invasive technique for preoperative evaluation of the vascular supply of the rectus abdominis myocutaneous flap.

Forty patients were examined with colour Doppler to study the vascularization of rectus abdominis myocutaneous flaps before operations. The accuracy of this non-invasive ultrasound technique allowed us to describe the characteristics of the blood flow, including volume and velocity, diameter of vessels and their transverse section area within the epigastric arteries which supply the superior and inferior vascular pedicles of the flap. Vessels are drawn on the skin surface so that the flap can be more precisely and rapidly dissected. We are now using colour Doppler to assess variations in the diameter of vessels and in other variables of blood flow within the vascular pedicle of the transferred flap. These evaluations before and after operation are a great help to the reconstructive surgeon in the choice of operation and will lead to an appreciable reduction in postoperative morbidity.

Abdominal Muscles↗

[Platinum-based antineoplastic agents: biomedical applications and therapeutic aspects].

A survey of investigations performed over the last decade concerning analytical, clinical and pharmacological data on cancer chemotherapy with Pt-based drugs is reported. From this standpoint discussion focuses on clinical studies aimed at evaluating therapeutic response and toxicity during regional and systemic treatment of cisplatin against solid tumors in adults as well as in children. Concurrent treatments with locoregional hyperthermia in the case of limb tumors or with radiotherapy in the case of lung carcinoma are also dealt with.

Adult↗

Lack of correlation between N-myc and MAX expression in neuroblastoma tumors and in cell lines: implication for N-myc-MAX complex formation.

Detectable levels of MAX messenger RNA were found in a set of human neuroblastoma tumors and established cell lines. MAX mRNA levels were independent of tumor stage and N-myc genomic amplification. By contrast, N-myc mRNA transcripts were detectable only in tumors with amplification of N-myc gene and in cell lines. Analysis by reverse transcriptase polymerase chain reaction and hybridization to specific oligodeoxynucleotide probes revealed approximately equal amounts of two MAX transcripts in all cases analyzed. Immunoprecipitations with a specific antibody to MAX detected two proteins of M(r) 21,000 and 22,000 in approximately equal amounts in all neuroblastoma lines regardless of N-myc amplification and/or expression. On the other hand, protein binding to the myc DNA consensus sequence correlated with N-myc expression in neuroblastoma cells. Thus, N-myc expression might be a limiting factor in the formation of the N-myc-MAX heterodimer in neuroblastomas.

Amino Acid Sequence↗

Coexpression of messenger RNA for TRK protooncogene and low affinity nerve growth factor receptor in neuroblastoma with favorable prognosis.

Nerve growth factor (NGF), essential for differentiation and survival of sympathetic neurons is suggested to play a role in differentiation or regression of neuroblastoma. Expression of mRNA for the trk protooncogene, encoding a tyrosine kinase receptor essential for functional NGF signal transduction, and mRNA for the low affinity NGF receptor (LNGFR) was examined in 45 neuroblastomas and 3 benign ganglioneuromas using Northern blot analysis. Expression of trk mRNA and LNGFR mRNA correlated with young age, favorable clinical stages, and absence of N-myc amplification. All children (n = 19) with neuroblastomas coexpressing mRNA for trk and LNGFR are alive 8-84 months from diagnosis, regardless of age and stage. In contrast, no child (n = 15) with tumor lacking trk mRNA is alive without disease. Three subsets of patients were distinguished, one favorable (trk+, LNGFR+, n = 19, 100% survival probability), one intermediate (trk+, LNGFR-, n = 11, 62.3% survival probability), and one unfavorable (trk-, LNGFR +/-, n = 15, 0% survival probability, P < 0.001). In widespread neuroblastoma stage IVS prone to spontaneous regression, three tumors coexpressing trk and LNGFR mRNAs regressed after no or minimal therapy while the remaining tumor expressing trk but not LNGFR mRNA progressed to a fatal outcome. It is concluded that neuroblastomas coexpressing mRNA for both NGF receptor subtypes are favorable tumors likely to differentiate or regress spontaneously or respond to conventional therapy. It is further hypothesized that loss of functional NGF receptors is an important step in tumorigenesis of undifferentiated malignant childhood neuroblastoma. For these unfavorable tumors current therapy remains futile and first-line innovative therapy is justified.

Child, Preschool↗

Phonetic rehabilitation after laryngectomy.

This work deals with the phonetic rehabilitation of patients after laryngectomy, describing the various types of alaryngeal voice. The rehabilitation was monitored with a computer by means of a specific voice programme which permits the registration, visualization and reproduction of each sound emitted in conjunction with the classification of the principal parameters, thus allowing the patient to check his acoustic feedback.

Humans↗

Deferoxamine, cyclophosphamide, etoposide, carboplatin, and thiotepa (D-CECaT): a new cytoreductive chelation-chemotherapy regimen in patients with advanced neuroblastoma.

Thirteen patients with Stage III (3 patients) or Stage IV (10 patients) neuroblastoma were treated with a new iron chelation-cytotoxic therapy regimen. Deferoxamine given for five consecutive days followed by 3 days of cyclophosphamide, etoposide, carboplatin, and thiotepa (D-CECaT) caused moderate to severe myelotoxicity. In 39 courses there were four episodes of sepsis; platelet and packed red blood cell transfusions were required in 72% and 82% of courses, respectively. Mild nausea and vomiting occurred in 52% of courses. Objective responses after two courses were observed in 12 of 13 patients. Three of four partial responses were achieved in previously treated relapsed patients, and seven of eight complete responses (four of which were surgically documented) were achieved in previously untreated patients. This cytoreduction regimen appears to be an improvement over other initial induction regimens and may be worth testing in larger populations.

Antineoplastic Combined Chemotherapy Protocols↗

[Cryosurgery in the treatment of condylomatosis].

The authors report their personal experience of the treatment of condylomas in both male and female patients using cryosurgery. The temperature of -80 degrees C which can be obtained using hyperdry nitrogen monoxide equipment allow radical treatment to be performed without pain in an outpatient setting without general or loco-regional anesthesia. The characteristics of this treatment allow patients to be regularly monitored, thus eliminating all signs of recidivation of those lesions which were too small to be seen at the start of treatment. The patient is considered cured after an interval of approximately 30-40 days after the disappearance of all condylomas.

Anus Neoplasms↗

[Cryosurgery in the treatment of verrucae].

The paper reports the A. experience of 1460 cases of verrucae treated with cryosurgery. A hyperdry nitrogen monoxide method was used which enables a temperature of approximately -80 degrees C to be obtained. The large number of cases treated allowed the A. to present a statistical picture which was highly significant with regard to the mean number of applications, mean freezing time and, lastly, the mean healing time for different types of verrucae. The study confirms that cryosurgery is the elective treatment for this type of pathology.

Cryosurgery↗

[Use of superior musculus rectus abdominis flap in the reconstruction of the thoracic wall].

The paper reports the Author's experience of the use of the muscle-skin flap of the upper rectum homolateral to the abdomen in the reconstruction of defects of the anterior thoracic wall following cancer surgery or radionecrosis, and compares it to that using other flaps (lower T.R.A.M., Latissimus dorsi, etc.). The well known anatomy of the flap, which is fed by the upper epigastric artery, also requires a precise surgical technique to isolate the muscular fibres without damaging vascularisation, a fundamental requisite for the vitality of the flap itself. Equally important for the vitality of the operation is a detailed study of the skin above the flap in patients treated with radiotherapy. The common and specific (epigastric hernia) complications of this operation are also examined, together with the precautions used by the Authors to prevent their occurrence.

Evaluation Studies as Topic↗

Transcription of N-myc and proliferation-related genes is linked in human neuroblastoma.

A definite association between the transcription of N-myc oncogene and proliferation-related genes, histone H3, c-myc and p53, was found in a set of 12 primary untreated neuroblastomas and a metastasis of one of these at relapse. Molecular analysis allowed us to discriminate between actually proliferating and non-proliferating tumors, and suggested a link between N-myc and proliferation. Flow cytometric analysis of DNA distribution was less reliable for assessing tumor proliferative activity. Our data also seem to indicate a down-regulation of c-myc by N-myc in human neuroblastoma.

Blotting, Northern↗

N-myc genomic content and DNA ploidy in stage IVS neuroblastoma.

DNA ploidy and N-myc genomic content were analyzed in a series of stage IVS neuroblastomas by flow cytometry and Southern blot hybridization, respectively. Of the 12 stage IVS neuroblastomas studied, nine were aneuploid (DNA index [DI] greater than 1), two were diploid (DI = 1), and one was not assessable for DNA content due to insufficient tumor material. N-myc gene amplification was present in two of 12 tumors. None of the aneuploid tumors exhibited N-myc amplification. Among the aneuploid neuroblastomas, the DIs were between 1.27 and 1.60, ie, in the near-triploid range. The follow-up from diagnosis ranged from 1 to 41 months (mean, 20 months). The nine neuroblastomas with near-triploid DNA content were free of disease at the end of the follow-up period. In contrast, a rapid and fatal tumor progression was observed for the three neuroblastomas with N-myc amplification and/or diploidy. Although involving only a limited series, these results strongly suggest that the combined analysis of DNA ploidy and N-myc genomic content could predict clinical outcome in stage IVS neuroblastoma and should help to identify patients for whom a more aggressive therapy is required.

Aneuploidy↗

[Prognostic factors in neoplasms of the upper 2/3 of the stomach compared to the lower 1/3. Our experience].

The choice of the type of surgical treatment used in gastric cancer, in cases where it is possible to operate in relation to the extent of cancer, raises the question of whether the surgeon should perform a total exeresis of the organ, even in cases where the tumour is located in the 3rd distal of the stomach. A retrospective study was carried out on patients admitted to the Surgical Department of the University of Perugia between January 1963 and December 1988. Having rejected 123 cases because of incomplete data or insufficient follow-up, 1.140 cases were selected from a total of 1.263 patients. The sites of neoplasia were as follows: terminal esophagus: 1.76% of cases; cardia: 6.67%; fornix of the stomach: 9.37%; the body of the stomach and lesser curvature: 23.65%; body of the stomach (other portions): 10.07%; angulus: 3.63%; gastric antrum: 37.82%, pylorus: 4.45%; the remaining 2.58% showed a diffuse form involving two or more the above parts. The subdivision of the cases into stages, using the TNM classification, revealed the following groupings: 7.04% of patients were first observed at stage I, 20.70% at stage II, 42.04% at stage III and 30.20% at stage IV. From the above figures it is evident that radical surgical was indicated only in some of the patients observed. The prognostic factors examined in the comparative study of different tumour sites were: age, sex, macroscopic and histological tumour type, size, infiltration of neoplasia through gastric wall coat, lymph node and/or systemic diffusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

[Our experience with early gastric cancer].

Gastric cancer has always required surgical therapy since in the majority of cases at the moment of treatment symptoms are already at an advances stage. Over the past years many advances have been made in the early diagnosis of many forms of neoplasia, but the rate of progress has been much slower with regard to gastric cancer. Only the preventive and regular use of gastroscopy will allow the disease to be diagnosed at a non-advanced stage. The term early gastric cancer is used to describe a carcinoma which only infiltrates the mucosa, or the mucosa and submucosa, irrespective of lymph node or other metastases. The present study was based on a retrospective analysis of cases of stomach cancer observed in the Surgical Department of the University of Perugia from January 1963 to December 1988. A total of 1,263 patients were affected by cancer of the stomach during the above period. One hundred and twenty-three cases were not included because of incomplete data or insufficient follow-up. A total of 1,140 patients were therefore included in the study; of these only 99 cases were affected by early gastric cancer. Age, sex, earlier gastric diseases, life styles, familial occurrence of disease, and symptomatology were among the different parameters evaluated. In addition, the site of disease, diagnostic methods, pre- and post-operative staging, intramural diffusion of the disease and surgical treatment were taken into account. In older cases the 5-year survival rate was calculated, whereas in more recent cases statistical methods, based on accumulated data, were used to estimate survival rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗