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C Rabitti

Publications and source records attributed to C Rabitti.

At least 37 records · Page 2Linked to original sources
PubMed1998

Cervical cancer response to neoadjuvant therapy: MR imaging assessment.

PURPOSE: To determine the accuracy of magnetic resonance (MR) imaging in evaluating the invasive cervical carcinoma response to concurrent chemotherapy and radiation therapy. MATERIALS AND METHODS: MR imaging was performed before and after concurrent chemotherapy and radiation therapy in 18 patients with locally invasive cervical carcinoma. Surgery followed neoadjuvant therapy in all patients. The presence of a lesion, signal intensity, zonal anatomy integrity, vaginal and parametrial invasion, and lymph node enlargement was determined. Posttreatment MR and histopathologic findings were correlated. RESULTS: Fourteen patients had histopathologic confirmation of MR findings: Twelve had true-negative and two had true-positive findings. (Two had microscopic neoplastic foci beyond the spatial resolution of MR images; these foci do not change surgical treatment planning and probably do not influence prognosis. Therefore, these two patients were considered to have complete response). Four patients had false-positive findings; the hyperintense lesion on posttreatment MR images was due to a tunnel cluster pattern (focal hyperplasia of the endocervical glands with inflammation) in three patients and necrosis in one patient, without any evidence of neoplastic tissue. Thirty-three of 36 parametrial halves and 67 of 72 vaginal fornices were correctly interpreted on posttreatment images. Involvement of three parametrial halves and five fornices was overestimated at MR, because edema or inflammation was not distinguishable from tumor. CONCLUSION: MR imaging is 78% accurate in evaluation of tumor response; in 22% of patients, however, benign conditions were not distinguishable from tumor.

Adult↗
PubMed1998

Management of cervical intraepithelial neoplasia of the uterine cervix: 110 cases treated by cold-knife conization.

PURPOSE OF INVESTIGATION: The purpose of this study was to evaluate treatment by cold-knife-conization in women carriers of cervical intraepithelial neoplasia (CIN). METHODS: The histologic findings of pre-clinical neoplasia of the cervix after conization were compared to the previous findings of cytology, colposcopy and punch-biopsy in 110 women examined between 1985 and 1995. The chi square test (chi2) was used for the statistical analysis. RESULTS AND CONCLUSIONS: A close correlation is clinically important where complementary roles of these three methods are used to identify lesions suitable for local ablative therapy. The Pap test alone is no longer sufficient for the screening of the pre-cancerous lesion of the cervix and colposcopy is compulsory each time the smear is inadequate or altered. Conization permitted us to single out 13 (11.8%) cases of carcinoma. After cold-knife conization we had six (5.4%) recurrences within two years and two (1.8%) within three years. Our data show that conservative therapy by conization in women with CIN reduces the risk of invasive cancer of the cervix but careful follow-up of these patients is essential.

Adult↗
PubMed1998

Role of planimetric analysis in diagnosing thyroid follicular lesions on fine needle aspiration biopsies: a study with histologic correlation.

BACKGROUND: Follicular lesions represent a gray area of interpretation in fine needle aspiration biopsy (FNAB) of the thyroid, with as much as 25% inconclusive reports. We identified "predominantly follicular lesions" (PFLs) as the cytologic category most apt to take advantage of planimetric analysis to reach a more definitive diagnosis. STUDY DESIGN: Sixty-eight cases of FNAB were diagnosed as PFL among the 1,296 FNABs submitted to our institution between January 1994 and June 1995. These cases underwent planimetric analysis with a Leica semiautomatic image analyzer. A smear from a colloid nodule was used as a reference slide. Nuclear areas, perimeters, form factors and maximum diameters were evaluated. Cases in which nuclear areas and maximum nuclear diameters values were found to be > or = 30% higher than the corresponding values found in the reference slide were reported to the clinician as suspicious for malignancy ("flagged" by the computer). These cases required closer follow-up with repeat FNAB within a month, ultrasound and nuclear imaging studies. Nineteen of these cases underwent surgical resection. RESULTS: Histologic reports diagnosed 9 cases of follicular carcinomas, 4 cases of follicular adenomas and 6 cases of nodular hyperplasia. When nuclear areas, perimeters and maximum diameters were all utilized, all the malignant lesions were reported correctly by the computer analysis as flagged, and all the benign lesions were reported as "not flagged." The sensitivity and specificity were 100%, and statistically significant correlations were proven. CONCLUSION: Although the above data provide strong evidence for the value of planimetric analysis in differentiating between follicular lesions, we cannot reach definitive conclusions on the basis of such a limited number of cases. However, the results stimulated our current efforts in applying planimetry along with the evaluation of other biologic markers to a larger set of cases.

Biopsy, Needle↗
PubMed1997

Cytology, histology, and colposcopy in the diagnosis of neoplastic non-invasive epithelial lesions of the cervix.

The purpose of our study was to examine the concordance among colposcopy, cytology, and histology in the diagnoses of intraepithelial lesions of the uterine cervix. We compared the results of Pap tests, biopsies, and colposcopy in 190 patients, who had histologically proven CIN and/or HPV infection, using histology as "the gold standard". The chi 2 (chi square) test was used for the statistics analysis. The sensitivity of cytology for the detection of CIN was 70%, and was lower for LGL (low grade lesions) than for HGL (high grade lesions): 61.2% versus 88.5%, respectively (p < 0.0001). We obtained a high rate of false negative smears (30%), with a relatively high rate of inadequate samples (59.6%). The sensitivity of colposcopy was 92%. Our results suggest that the Pap test alone is no longer sufficient for the screening of precancerous lesions of the cervix, and colposcopy is compulsory each time the smear is inadequate or altered.

Adolescent↗
PubMed1996

Lymphatic spread of cervical cancer: an anatomical and pathological study based on 225 radical hysterectomies with systematic pelvic and aortic lymphadenectomy.

To assess the patterns of lymphatic spread in cervical carcinoma, radical hysterectomy with systematic lymphadenectomy was performed in 66 patients FIGO stage IB-IIA <4 cm, and 159 patients stage IB-IIA >4 cm to stage IV. The latter patients were treated with neoadjuvant chemotherapy (NACT). Parametria were evaluated by the giant section technique in 109 patients. In 40 of these, the superficial and deep layers of the vesicouterine ligament, the sacrouterine ligament, and the distal part of the cardinal ligament were separately evaluated. The median number of nodes removed was 48 pelvic (range 20-107) and 22 aortic (range 7-64). Positive nodes were found in 14 (21%) stage IB-IIA <4 cm and in 38 (23%) NACT-treated patients, all having pelvic node metastasis. Aortic nodes were involved in 2 (3%) and 5 (3%) patients, respectively. Solitary metastases were found in the superficial obturator (21% of stage IB-IIA <4 cm and 31% of NACT-treated positive node patients, respectively), external iliac (7 and 3%, respectively), and common iliac nodes (7 and 3%, respectively). Parametrial nodes were found in 59% of giant sections (8% metastatic). The superficial and deep layers of the vesicouterine ligament, the uterosacral ligament, and the distal part of the lateral parametrium revealed the presence of nodes in 33% (no metastatic nodes), 26% (3% metastatic), 5% (no metastatic nodes), and 70% (5% metastatic) of patients, respectively. Overall, parametrial nodes were positive in 12% of stage IB-IIA <4 cm and 7% of NACT-treated patients. The diameter of node metastasis was <10 mm in more than 80% of positive nodes. In conclusion, parametrial nodes were mainly located in the cardinal and vesicouterine ligaments, both being a potential site of metastasis. The superficial obturator, external iliac, common iliac, paracaval, intercavoaortic, and paraaortic nodes were the groups more frequently involved. These data may be useful for tailoring radical hysterectomy and lymphadenectomy according to the primary tumor and the surgeon's intent.

Adult↗
PubMed1996

Verrucous squamous cell carcinoma of the larynx: diagnostic and therapeutic considerations.

The clinical findings, histopathology, management and outcome of 31 patients with verrucous squamous cell carcinoma of the larynx (VSCC) are discussed. Laryngeal VSCC is a rare, highly differentiated variant of SCC and has specific morphological features and clinical behavior. A close liaison between the laryngologist and pathologist is needed to formulate a correct diagnosis, because this tumor appears to be malignant clinically and histologically benign. A low-power magnification of multiple large specimens, including the deep margins of the lesion, is required in order to differentiate VSCC from keratosis, verruca vulgaris or SCC with verrucous appearance, and to detect underlying microscopic foci of invasive SCC within or adjacent to a verrucous carcinoma. Long-lasting hoarseness was the most common symptom as the glottic region was the most common site of VSCC. Presumed clinically positive N1 lymph nodes were observed in the necks of 7 patients, but none had metastatic disease on histopathological study. Surgery alone was the most effective form of treatment, as it allowed a good outcome of all treated patients. Surgery plus radiotherapy was associated with an early recurrence and a poor outcome in 2 of 7 patients treated. The generally "benign" behavior of VSCC allows for conservative surgery, with complete endoscopic resection using the carbon dioxide laser representing a more conservative surgical approach. Neck dissection is not indicated due to the non-metastatic behavior of this tumor.

Adult↗
PubMed1995

Morphologic and planimetric diagnosis of follicular thyroid lesions on fine needle aspiration cytology.

During 1989-1992, 2,729 fine needle aspiration biopsies were performed; 585 with histologic controls were reviewed. The aim of the study was to demonstrate the incidence of carcinoma in follicular-structured smears without nuclear enlargement, evaluated with planimetric techniques, and to suggest a new cytodiagnostic classification. Of 398 follicular-structured smears, 188 were colloid nodules, 38 were thyreocytic hyperplasias without nuclear atypia, 146 were predominantly follicular lesions (PFL) and 26 were follicular lesions with nuclear pleomorphism. The last showed a high incidence of neoplasia (69.2%) and carcinoma (46.1%) and the largest planimetric values for nuclear area, perimeter and maximum diameter. The second and third categories showed only a difference in the incidence of benign neoplasms (32.9 vs. 15.8%). These results suggest that six months of expectant management might be useful in simple follicular lesions, whereas a follicular pattern with nuclear enlargement requires surgical treatment for the strong possibility of carcinoma.

Adenoma↗
PubMed1994

[Preoperative cytodiagnosis by needle aspiration of follicular thyroid lesions].

In the period 1989-92, 2729 F.N.A.B. were performed: 585 with an histological control were reviewed. The aim of the study was to evaluate the risk of carcinomatous occurrence in the follicular-structured smears and to suggest a new cytodiagnostic classification. Out of 398 follicular-structured smears, 188 were colloid nodules (CN), 38 thyreocytic hyperplasias without nuclear atypia (THWNA), 146 predominantly follicular lesions (PFL), 26 follicular lesions with nuclear pleomorphism (FLWNP). The last one showed a high incidence of neoplasia (69.2%) and carcinoma (46.1%); the second and the third only a difference in the incidence of benign neoplasms (32.9 vs. 15.8%), with almost the same percentage of occurrence of malignancies (2.6 vs. 2.1%). Such results suggest that a six-months dilatory strategy might be useful in simple follicular lesions (THWNA and PFL) whereas a cytological follicular pattern with nuclear pleomorphism requires a surgical treatment for the high risk of carcinomatous occurrence.

Biomarkers, Tumor↗
PubMed1993

Anatomical and pathological study of retroperitoneal nodes in epithelial ovarian cancer.

The pattern of lymphatic spread was evaluated in 81 previously untreated ovarian cancer patients (Stage I, 35; Stage II, 2; Stage III, 44) undergoing systematic aortic and pelvic lymphadenectomy. Positive nodes were found in 14% Stage I and 68% Stage III patients. Either pre- and paraaortic, or pre- and paracaval nodes were the only aortic node metastasis in 14% of patients. Common iliac nodes were the sole metastasis in pelvic area in 11%, external iliac in 14%, and obturator in 6% of patients. Therefore, the above node groups, which overall were the most frequently involved, may be considered those primarily invaded by the tumor. When data were analyzed according to stage, aortic nodes were the site of metastasis in 6% Stage I and 14% Stage III patients and pelvic nodes in 8% Stage I and 11% Stage III patients. Both aortic and pelvic areas were positive in 43% Stage III patients. The median number of positive nodes/patient was 2 (range, 1-3) and 4 (range 2-46) in Stages I and III, respectively. Lymphatic spread was ipsilateral to the tumor in all Stage I and in 40% Stage III patients. In Stage III metastases were also observed in intercavoaortic, retrocaval, retroaortic, internal iliac, and presacral nodes. In apparent Stage I, lymphatic metastasis seemed to be limited to one ipsilateral group, and the removal of the primary nodes ipsilateral to the tumor may be considered an adequate procedure. In Stage III, the presence of metastasis beyond the primary nodes and the frequent bilateral involvement suggest that all lymphatic tissue surround the aorta, the cava, and the pelvic vessels should be removed if a cytoreductive intent is pursued.

Adult↗
PubMed1993

Thyroid cancer in suppressed contralateral lobe of patients with hot thyroid nodule.

We studied 60 patients with thyrotoxicosis due to single toxic nodule. At surgery in 3 patients (5%) a papillary carcinoma has been detected in the contralateral suppressed lobe. Thyroid function tests and thyroid scan confirmed thyrotoxicosis. Thyroid stimulating hormone (TSH) was undetectable in all patients. It is common opinion that differentiated thyroid tumour growth is TSH dependent. On the basis of our study two hypotheses are possible: (1) the development of thyroid carcinoma precedes the adenoma and suppressed TSH levels inhibit tumour growth; (2) suppressed TSH levels do not protect patients from the occurrence of cancer. In the evaluation of hot thyroid nodule we suggest careful ultrasonographic control in order to look for nodules outside the adenoma. A complete surgical examination of the whole thyroid gland is required and intraoperative biopsies are advocated in abnormal areas.

Adenoma↗
PubMed1993

Collection of 'normal' blood repopulating cells during early hemopoietic recovery after intensive conventional chemotherapy in chronic myelogenous leukemia.

Twenty-five patients with CML (chronic phase (CP): 15 patients; accelerated phase (AP): 10 patients) at a median of 40 months after diagnosis and ineligible for allogeneic BMT, received an intensive chemotherapy regimen consisting of idarubicin, intermediate-dose ara-C and etoposide (ICE protocol). All patients had previously received alpha-interferon and only two patients had had partial cytogenetic response. During recovery from chemotherapy-induced aplasia, blood progenitors cells (BPC) were harvested by leukapheresis. All metaphases were found to be Ph-negative in the collection of 12 of 25 (48%) patients (CP: 9 of 15 (60%), AP: 3 of 10 (30%)) and a decrease of < 50% Ph-positive metaphases was seen in an additional five (CP: 4 patients; AP: 1 patient). The percentage of complete Ph-disappearance was 66% in patients receiving this procedure within the first 2 years of diagnosis and 30% in those treated after the second year of diagnosis. So far, the Ph-negative collections have been used in 9 patients (CP: 8 patients; AP: 1 patient) as autograft after conditioning with total body irradiation/etoposide/CY. Seven of 9 patients engrafted and 5 are alive and well, Ph-negative at 2+, 3+, 6+, 10+ and 18+ months.

Adult↗
PubMed1993

[Lymphocytic infiltration in thyroid neoplasms. Preliminary prognostic assessments].

INTRODUCTION: It is known that the immune system is involved in several thyroid diseases and in the reaction against cancer progression. We have therefore evaluated lymphocytic infiltration in the slices of surgically removed thyroids in patients affected by thyroid carcinomas, to further clarify the anatomic and clinical characteristics of this pathology and the possible prognostic correlations. MATERIALS AND METHODS: Thirty-eight patients, 7 men and 31 women, aged 23-73 years, were studied. They underwent total or subtotal thyroidectomy for thyroid carcinoma. The histopathological findings were: papillary carcinomas (P): 22 cases; follicular carcinomas (F): 10 cases; undifferentiated carcinomas (U): 3 cases; other types (e.g., medullary carcinoma, M): 3 cases. RESULTS: The lymphocytic infiltration was evaluated in 4 different grades. The following results, regarding the different histological types, were found: grade 0 (no lymphocytic infiltration) in 10 cases (6 P, 2 F, 1 U, 1 mixed); grade 1 (poor lymphocytic infiltration, equivalent to a non specific inflammatory reaction) in 21 cases (11 P, 6 F, 2 U, 1 M); grade 2 (moderate lymphocytic infiltration) in 4 cases (2 P, 2 F); grade 3 (plentiful lymphocytic infiltration) in 3 cases (2 P, 1 trabecular carcinoma). In 3 patients a lymphocytic (Hashimoto's) thyroiditis was also present. The follow-up, 2 years after surgery, showed, among 17 patients examined, local recurrence and/or lymph node localization in 8 cases (the lymphocytic infiltrations was: grade 1: n = 6; grade 0: n = 2; no one exhibited a higher grade) and apparent remission in 9 (grade 3: n = 2; grade 2: n = 1; grade 1: n = 6; no one exhibited a grade 0 lymphocytic infiltration). DISCUSSION: In most patients a poor or absent infiltration was found. In 7 cases, however, the infiltration was moderate or high. In our experience, no correlation between the histologic type and the infiltration grade was observed. However, in no patient with recurrence of neoplasia a relevant (grade 2-3) infiltration could be observed; patients without recurrence often showed a grade 2-3 infiltration, and no one of them showed a grade 0. The significance of lymphocytic infiltration in thyroid carcinoma is not well clarified. In fact, a few studies underline a possible unfavourable role, since a relevant infiltration seems to be associated with a weak cell-mediated immunity, mostly in follicular and anaplastic carcinomas. However, most data support the hypothesis that the lymphocytic infiltration is a good prognostic feature: in fact, it can be often found in papillary carcinomas and in juvenile thyroid carcinomas, both characterized by a good long-term prognosis. CONCLUSIONS: Our preliminary data underline the opportunity of comparing the clinical course of the disease, the histologic grading and the tumour staging with the lymphocytic infiltration grade, an easily available pathologic datum, for a better prognostic evaluation of patients.

Adult↗
PubMed1993

[Gastroenterologic pathology and replacement organotherapy in thyroidectomized patients].

Thyroid replacement therapy in patients treated by near-total or total thyroidectomy, as well as spontaneous hypothyroidism , can be difficult in patients with alterations in absorption functions or specific gastroenteric diseases. We have studied 25 patients, 22 women and 3 men, 18-72 years old (mean 47 years), affected by spontaneous or post-surgical hypothyroidism, who presented, during the usual replacement therapy, persistently elevated or high-normal TSH levels, and therefore required repeated variations in the prescribed dose of thyroxine. In these patients we evaluated hormone pattern, the presence of autoantibodies (anti-tyroglobulin, anti-Sm, anti-DNA, anti-microsomal antigens, anti-gliadin and anti-parietal cell), and performed an esophagogastroduodenoscopy (EGD) with histological examination. In all patients, plasma TSH ranged from 2.5 to 20 microU/ml. Only 17% of patients exhibited the presence of antibodies against thyroglobulin, 17% of patients had antibodies against microsomal antigens, 6% of patients presented antibodies against nuclear antigens; 4% had against gliadin. Histological examination revealed chronic gastritis (98%) with atrophic aspects (20%) and intestinal metaplasia (28%); and chronic duodenitis (86%) with villus abnormalities (23%) and total villus atrophy (4%). We underline the case of a patient, treated by total thyroidectomy for papillary carcinoma, who presented, two months after starting L-thyroxine therapy, a recurrence of celiac disease, that had been silent after childhood. The EGD showed, at the level of the second duodenal segment, a reduction of number and thickness of mucosal folds; the histological examination showed total villus atrophy, elongated crypts and a dense infiltration of chronic inflammatory cells in the lamina propria. Our experience underlines the frequent association of gastroenteric disease and hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Oral condyloma lesions in patients with extensive genital human papillomavirus infection.

OBJECTIVES: The incidence, location, and morphologic appearances of human papillomavirus oral lesions in patients with genital condylomatosis were investigated with clinical, colposcopic, and histologic examination as diagnostic procedures. The human papillomavirus types were also evaluated with filter in situ hybridization. STUDY DESIGN: One hundred one patients, 66 female and 35 male, with genital condyloma underwent an oral cavity examination. Ninety-nine (99%) practiced orogenital sex, and all were asymptomatic for oral lesions. RESULTS: Ninety-one underwent biopsy; histologic studies gave a diagnosis of condyloma in 48% of 101 specimens collected. In 8 of 91 (9%) oral lesions were suspected by naked-eye examination; they were confirmed histologically in all eight. Of 83 patients suspected of having oral condyloma on colposcopic examination, 38 (46%) were confirmed histologically. Thus 38 of 46 patients (83%) had oral condyloma not visible to the naked eye. Colposcopically, oral lesions appeared filiform (50%), moruloid (26%), and mixed (24%). Twenty cytologic oral samples were also collected for deoxyribonucleic filter in situ hybridization analysis. Human papillomavirus deoxyribonucleic genital types were observed in 45% (9/20) of all oral scrapings collected, and all were histologically confirmed. CONCLUSION: Our data indicate that genital human papillomavirus types are capable of establishing a local infection in the oral cavity and demonstrate a high incidence of human papillomavirus oral lesions in patients with genital condyloma.

Adult↗
PubMed1991

Neoadjuvant chemotherapy and radical surgery in locally advanced cervical cancer. Prognostic factors for response and survival.

Between January 1986 and September 1988, 75 patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stages IB-III) received three courses of neoadjuvant chemotherapy (NAC), including cisplatin, bleomycin, and methotrexate (PBM). Fifteen percent of patients achieved a complete response (CR) and 68% a partial response (PR). Pretreatment characteristics were analyzed for response to NAC. Significantly lower response rates were found in patients with tumor size more than 5 cm in diameter and bilateral parametrial involvement to the pelvic side wall. None of the biological parameters studied was related to chemoresponsiveness. Patients achieving CR or PR had a significantly improved 3-year survival rate compared with those who did not respond. After NAC, radical surgery was possible in all responding patients. The median number of lymph nodes removed was 60. A lower than expected incidence of lymph node metastases was detected. None of the clinical and pathologic features considered was significantly correlated with the lymph node status. Twelve of the 62 operated patients had disease recurrence. Pathologic parametrial involvement and cervical infiltration equal to or deeper than 5 mm were found to be significant prognostic factors for recurrence. A 3-year, disease-free survival of 89%, 73%, and 43% for Stage IB-IIA, IIB, and III, respectively, was found. Among the operated patients these rates increased to 100%, 81%, and 66% for Stage IB-IIA, IIB, and III, respectively. A prospective randomized trial comparing NAC and surgery with radiotherapy alone is in progress.

Adenocarcinoma↗
PubMed1991

Ovarian fibrothecoma: sonographic and histologic findings.

The sonographic and histologic findings observed in 11 cases of ovarian fibrothecoma were compared, and an attempt was made to find a correlation between each histologic type of the tumor (pure thecoma, predominantly fibrous fibrothecoma, mixed fibrothecoma) and its sonographic appearance. The presence of a homogeneous echogenic pattern, with marked posterior acoustic shadowing, in the absence of any calcification, was highly suggestive of a predominantly fibrous ovarian fibrothecoma; the presence of a diffusely hypoechoic ovarian mass, with no posterior echo enhancement, was strikingly correlated with pure thecomas; mixed fibrothecomas were characterized by the presence of an echogenic pattern with no posterior acoustic shadowing. Sonographic findings, even though nonspecific, can provide the clinician with useful information which permits to detect these rare neoplasms preoperatively.

Adult↗
PubMed1991

Lack of gastric adverse effects of erdosteine in rats and men.

Erdosteine is a thiol derivative endowed with mucolytic, mucomodulator and free radical scavenging properties. Studies were performed in rats and men with the aim to assess its safety on gastric mucous barrier. Two experiments were performed in rats by comparing the effects of erdosteine, homocysteine thiolactone (HTL), carbocysteine, tiopronin and placebo on a) macroscopic appearance of G. I. ulcer, total HCl, pH and volume of gastric juice 4 and 6 hours after, respectively, pylorus ligation in Shay rats and drug oral treatment, and on b) macroscopic appearance of G. I. ulcer in fasting rats for 50 hours, during which the animals received 4 oral doses of each compound. In both conditions erdosteine was completely inactive in the dose-range of 500-1000 mg/kg p.o. while HTL, carbocysteine and tiopronin were ulcerogenic already at the dose of 500 mg/kg p.o. Accordingly, 15 human beings, undergoing gastroscopy, well tolerated erdosteine at the oral dose of 300 mg TID for 9-13 days. In this open study the patients neither revealed worsening of their pre-existing gastric complains, nor indicated new subjective symptoms, nor manifested macroscopic and histological alterations concerning the parietal tonus, the status of epithelial mucosa and of gastric content (including: volume, total acidity and total, bound and free sialic acid).

Administration, Oral↗