PubMed Health⌕ Search

Biomedical subjects

D Grosso

Publications and source records attributed to D Grosso.

At least 19 recordsLinked to original sources

Collapse of a new type of self-expanding metallic tracheal stent.

Alveolus TB-STS is a new self-expanding, completely polyurethane-covered, metallic stent which has been designed to be successfully used even in the treatment of non-neoplastic airway strictures as it is supposed to be removable. We recently observed the collapse of an Alveolus tracheal stent, causing dyspnea and hemopthysis, in a 63-yr-old female patient with post-intubation tracheal stenosis. Such a complication, which to our knowledge has never been previously reported with metallic stent use, forced us to remove the stent.

Bronchoscopy↗

How effective is BCNU in recurrent glioblastoma in the modern era? A phase II trial.

BACKGROUND: The initial studies on nitrosoureas were performed >30 years ago. These drugs remain the standard chemotherapy for glioblastoma. However, because the criteria used to evaluate the activity of nitrosoureas in a neuro-oncologic setting have changed, new data on their activity are needed. METHODS: The authors conducted a phase II study on 40 patients with recurrent glioblastoma following surgery and standard radiotherapy. They analyzed progression-free survival at 6 months (PFS-6), time to progression (TTP), response rate, and toxicity. Patients were treated with 80 mg/m2 carmustine on days 1 to 3, every 8 weeks for a maximum of six cycles. RESULTS: Median TTP was 13.3 weeks (95% CI, 10.26 to 16.86 weeks), and PFS-6 was 17.5% (95% CI, 8.9 to 34.3). Response to chemotherapy, age < or =40 years, and performance status > or =90 were significant prognostic factors for TTP; however, with multivariate analysis, only response to chemotherapy was significant. The major side effects were reversible hematologic and long-lasting hepatic and pulmonary toxicity. CONCLUSION: The activity of this BCNU regimen is comparable with that reported in the past and with the newest therapies, such as temozolomide. However, BCNU toxicity is high and recovery is slow, thus compromising the administration of further drugs in patients with progressive disease.

Adult↗

Amifostine and autologous hematopoietic stem cell support of escalating-dose melphalan: a phase I study.

This study was conducted to define a new maximum tolerated dose and the dose-limiting toxicity (DLT) of melphalan and autologous hematopoietic stem cell transplantation (AHSCT) when used with the cytoprotective agent amifostine. Fifty-eight patients with various types of malignancy who were ineligible for higher-priority AHSCT protocols were entered on a phase I study of escalating doses of melphalan beginning at 220 mg/m(2) and advancing by 20 mg/m(2) increments in planned cohorts of 4 to 8 patients until severe regimen-related toxicity (RRT) was encountered. In all patients, amifostine 740 mg/m(2) was given on 2 occasions before the first melphalan dose (ie, 24 hours before and again 15 minutes before). AHSCT was given 24 hours after the first melphalan dose. Melphalan was given in doses up to and including 300 mg/m(2). Hematologic depression was profound, although it was rapidly and equally reversible at all melphalan doses. Although mucosal RRT was substantial, it was not the DLT, and some patients given the highest melphalan doses (ie, 300 mg/m(2)) did not develop mucosal RRT. The DLT was not clearly defined. Cardiac toxicity in the form of atrial fibrillation occurred in 3 of 36 patients treated with melphalan doses >/=280 mg/m(2) and was deemed fatal in 1 patient given melphalan 300 mg/m(2). (Another patient with a known cardiomyopathy was given melphalan 220 mg/m(2) and died as a result of heart failure but did not have atrial fibrillation.) Another patient given melphalan 300 mg/m(2) died of hepatic necrosis. The maximum tolerated dose of melphalan in this setting was thus considered to be 280 mg/m(2), and 27 patients were given this dose without severe RRT. Moreover, 38 patients were evaluable for delayed toxicity related to RRT; none was noted. Tumor responses have been noted at all melphalan doses and in all diagnostic groups, and 21 patients are alive at median day +1121 (range, day +136 to day +1923), including 16 without evidence of disease progression at median day +1075 (range, day +509 to day +1638). Amifostine and AHSCT permit the safe use of melphalan 280 mg/m(2), an apparent increase over the dose of melphalan that can be safely administered with AHSCT but without amifostine. Further studies are needed not only to confirm these findings, but also to define the antitumor efficacy of this regimen. Finally, it may be possible to evaluate additional methods of further dose escalation of melphalan in this setting.

Adult↗

Design and post-functionalisation of ordered mesoporous zirconia thin films.

Bidimensional hexagonal or centred-rectangular mesoporous zirconia thin films have been reproducibly prepared by evaporation-induced self-assembly (EISA), which are stable up to 300 degrees C, with pore size around 35 A; the films can be post-functionalised with organic ligands presenting different functions, opening a land of opportunities for the design of new hybrid mesostructured materials, based on the synergy of a transition metal oxide network and organic groups.

Journal Article↗

Nonmyeloablative conditioning allows for more rapid T-cell repertoire reconstitution following allogeneic matched unrelated bone marrow transplantation compared to myeloablative approaches.

Nonmyeloablative pretransplantation conditioning regimens have resulted in durable engraftment of allogeneic hematopoietic stem cells. In contrast to conventional fully myeloablative approaches, nonmyeloablative regimens are associated with a marked reduction of morbidity and mortality in the early posttransplantation period. Consequently, such reduced-intensity transplantation approaches can be used in older and frailer patients who would not tolerate fully ablative regimens. However, it is currently unclear how this radically different transplantation strategy affects immunological reconstitution. To address this important issue, we used T-cell receptor Vbeta spectratype analysis to examine the distribution of complementarity-determining region 3 (CDR3)-size bands as a measure of the complexity of the redeveloping T-cell repertoire. For this study, we evaluated the T-cell repertoire of 9 patients receiving T-cell replete, matched unrelated donor transplants following fully ablative or nonmyeloablative conditioning regimens. All 4 of the myeloablative and 2 of the nonmyeloablative patients received bone marrow, whereas 3 other nonmyeloablative patients received peripheral blood stem cells. The results of the spectratype analysis demonstrated that the patients who received nonmyeloablative conditioning together with either bone marrow or peripheral blood stem cells exhibited more rapid reconstitution of T-cell repertoire complexity.

Adult↗

The maternal immune response in coccidioidomycosis. Is pregnancy a risk factor for serious infection?

Seven subjects with prior coccidioidal disease and three with active Coccidioides immitis infection during their first trimester were studied during pregnancy and postpartum to determine their general and antigen-specific cell-mediated immune status. All ten were white and carried their pregnancies to term without incident. Decreases in total lymphocytes and T-helper and T-suppressor subsets were noted during the third trimester, presumably secondary to an increase in plasma volume. Lymphocyte responses to the mitogens phytohemagglutinin, concanavalin A, and pokeweed were mildly decreased late in pregnancy, with significant intrasubject and intersubject variation. Responses to tetanus antigen were consistently and significantly lower as pregnancy progressed, rising above first trimester levels by 12 weeks postpartum. A similar pattern of response was noted with spherulin antigen for the seven subjects with previously demonstrated coccidioidal immunity. The three subjects with active coccidioidomycosis either failed to mount a significant spherulin immune response or demonstrated an early response that fell as pregnancy progressed. This antigen-specific immune suppression continued for up to 16 months postpartum despite the fact that there was no clinical evidence of coccidioidal activity beyond the first trimester. Thus, while all three completed pregnancy without complication, the data suggest that significantly increased maternal risk may be present when active coccidioidomycosis and pregnancy occur together. This risk may be greatest among darker-skinned individuals who become infected during the latter half of pregnancy.

Coccidioidin↗

Tamoxifen therapy in recurrent epithelial ovarian carcinoma.

Thirty-seven patients with recurrent epithelial ovarian carcinoma were entered into a trial of tamoxifen therapy (10 mg BID) to determine the effect on long-term survival. Thirty-one patients were evaluable with follow-up ranging from 6 to 42 months since initiation of hormonal therapy. All patients were heavily pretreated with multiple chemotherapeutic regimens (median 3). There was 1 complete responder (3.2%), 2/31 (6.4%) had a partial response, 6/31 (19.3%) had stable disease, and 22/31 (71%) had progressive disease. Twenty-four patients are dead (23 from advanced carcinoma, 1 from cardiac causes); 5 patients are alive with disease; 2 patients are lost to follow-up. Median survival of nonresponders was 7 months versus 16 months for responders (CR + PR + stable disease) (P = 0.001 life table analysis). Of the 9 responders, 7 had poorly differentiated tumors (grades 3 or 4), and 2 had moderately differentiated tumors (grade 2). Eleven patients had estrogen and progesterone receptor studies (ER, PR). No correlation between response rate and receptor status was evident. We conclude that although significant disease regression is unlikely to result from tamoxifen therapy, there may be a subset of patients who can benefit from the cytostatic properties of hormonal manipulation.

Carcinoma↗

Epidermal growth factor inhibits the proliferation of a human endometrial carcinoma cell line.

Specific epidermal growth factor (EGF) receptors were measured in RL95-2 human endometrial carcinoma cells. At 37 C, binding of 125I-labeled EGF was associated with marked ligand internalization. Maximal cell surface binding occurred within 10 min. Bound [125I]EGF was partially degraded to low mol wt products, and this degradation was blocked by the lysosomotropic compound ammonium chloride. At 4 C, maximal cell surface binding occurred at 3 h. Scatchard analysis of data obtained after 3 h at 4 C revealed a single order of binding sites with a Kd of 1.8 nM and approximately 150,000 surface receptors/cell. EGF, at a concentration of 0.83 nM, inhibited the proliferation of RL95-2 cells. Inhibition was reversible and was associated with morphological changes leading to a fusiform appearance of the growth-arrested cells. These findings indicate that RL95-2 human endometrial carcinoma cells bind, internalize, and degrade EGF in a manner similar to that described for other target cells for EGF action. The ability of EGF to inhibit the growth of RL95-2 cells supports the hypothesis that this type of inhibition is dependent on postreceptor events, rather than on the presence of an overabundance of EGF receptors.

Adenocarcinoma↗

Bilomas: a new approach to the diagnosis and treatment.

Biloma, a newly described entity, appears to have gained a heightened clinical interest recently. During the past 18 months we have diagnosed 9 abnormal biliary collections. We discuss here the role of sonography and radionuclide cholescintigraphy in the evaluation of bilomas. The diagnosis of all cases was confirmed by ultrasound-guided percutaneous needle aspiration. Subsequently 7 patients were treated with catheter drainage, obviating the need for any surgery.

Adult↗

Prolactin responses, menstrual cycles, and body composition of women runners.

Fourteen young women with normal menses participated in an endurance running program to investigate the effects of physical training on menstrual function, plasma PRL, and body composition. Body composition, measured by hydrostatic weighing, and PRL (basal and TRH-stimulated ) were determined initially and after each subject had increased her weekly mileage by 30 miles (delta 30) and 50 miles (delta 50). Mean (+/- SEM) total body weight did not change, but the subjects became significantly leaner (relative fat, 25.5 +/- 1.3% at baseline vs. 22.4 +/- 0.9% at delta 50; P less than 0.02). Thirteen women developed menstrual changes (mainly oligomenorrhea), but not amenorrhea. Mean (+/- SEM) unstimulated PRL levels were 16.8 +/- 3.1%, 16.9 +/- 2.4, and 11.5 +/- 2.1 ng/ml at baseline, delta 30, and delta 50, respectively (P less than 0.03 at delta 50 compared to baseline and delta 30). Mean ( +/- SEM) integrated TRH-stimulated PRL responses increased from 5002 +/- 462 ng/ml.min at baseline to 5748 +/- 609 mg/ml.min at delta 30 and 6535 +/- 552 ng/ml.min at delta 50, and were significantly different from one another (F = 4.01; P less than 0.04). Endurance training, without total body weight loss or extreme leanness, results in frequent menstrual dysfunction. Other authors have shown that young female athletes have an increased PRL response to acute exercise compared to nonathletes. One mechanism responsible for menstrual dysfunction in endurance-trained women may be frequent and exaggerated PRL responses to exercise and other stimuli.

Adult↗

[Occupational ophthalmology and ergoophthalmology: a developing field].

In 1979 it was decided to activate, within the Institute of Occupational Health of the Milan "Università degli Studi", a new Unit of Ergophthalmology. This decision was taken owing to the progressive diffusion of "optical instruments", particularly computer-based equipment, in the world of work and to the relevance that this topic assumed among Italian occupational physicians. Since its beginning, one of the main characteristics of the Ergophthalmology Unit was an interdisciplinary approach, where occupational physicians, ophthalmologists, occupational hygienists and lighting engineers were collaborating on a daily basis. Research activities, which developed over many years and in several phases, were concerned with four main topics: 1. analysis and quantification of "near work load"; initially the investigations were mainly aimed at the evaluation of the observation distance in different tasks, followed by the development of a method which, by means of specifically designed electronic equipment, allows quantification of the accommodation and convergence required by the task; 2. development of a new method aimed at evaluating, by a photometric procedure, the luminance ratios in the "occupational visual field"; this research was carried out, both in the laboratory and during on-site investigations, in collaboration with the Dept. of Electrotechnics of Milan Polytechnic; 3. studies on the relationships between indoor microbial pollution and Computer Assisted Design work, considering that ocular conjunctiva and cornea, due to their external position, can be easily inoculated by micro-organisms present on periocular tissue and hands; this research showed that bacteria and fungi pathogenic for the eye (Staphylococcus aureus, Candida sp., Aspergillus sp.) are present on desk, keyboard and mouse, as well as in the conjunctival sac of the exposed operators; 4. studies on "blue light" and its effects on the Pigmented Retinal Epithelium (PRE) in workers exposed to halide lamps, like electricians, installers, maintenance staff, polymerization operators, etc.; the laboratory and on-site investigation that was carried out in cooperation with the Health Physics Dept. of the Milan ICP Hospital, showed that long-term exposure to low levels of irradiation could constitute an eye risk for these working populations.

Computer Terminals↗