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Biomedical subjects

G Ferrante

Publications and source records attributed to G Ferrante.

At least 19 recordsLinked to original sources
PubMed2005

The treatment by V.A.T.S. and M.A.C. of secondary neoplastic pleural effusion in the old patient (> 70 years).

A secondary malignant pleural effusion is a common event in the evolution of some tumours. It is frequent in advanced phase, above all the breast cancer in the woman and the cancer of the lung in the man, but such pathology can interest also extra-thoracic cancers (ovary, colon, prostate, etc.) and the malignant lymphoma. In the majority of cases in order to obtain a good control of the effusion entity with reduction of the respiratory symptoms and improvement of the quality of life, palliative local therapy is indispensable. Numerous methods and substances have been proposed in the time for the treatment of the N.P.E. The talc pleurodesis executed in the old patients (> 70 years) by means of the V.A.T.S. "one trough" and "Monitored Anaesthesia Care" (MAC) has shown valid procedure for the control of the secondary neoplastic pleural effusion, with little uneasiness for the patients, reduced complications and a sure effectiveness.

Aged↗
PubMed2004

Third-harmonic generation in the skin layer of a hot dense plasma.

The third-harmonic generation of a pump wave, resulting from the electron-ion collision frequency dependence on the electric field in the skin layer of a hot dense plasma is investigated. The relation of the current third harmonic with the high-frequency field in the skin layer is established for arbitrary ratios of the electron-ion collision frequency to the field frequency. For arbitrary ratios of these two frequencies, the field structure inside the skin layer is determined, and the field of the wave irradiated by the plasma at tripled frequency, too, is calculated. It has permitted us to find the explicit dependencies of the third-harmonic generation efficiency on the plasma and pump field parameters.

Journal Article↗
PubMed2003

Anomalous transmission of an ultrashort ionizing laser pulse through a thin foil.

The formation of a highly anisotropic photoelectron velocity distribution as a result of the interaction of a powerful ultrashort laser pulse with a thin foil is found to yield a large skin-layer depth and an anomalous increase of the transmission coefficient. The physical reason for the effect is the influence of the incident wave magnetic field, through the Lorenz force, on the electron kinetics in the skin layer.

Journal Article↗
PubMed2003

[So-called benign broncho-esophageal fistula].

Broncho-oesophageal fistulae are rare lesions and may be benign or malignant. The articles in medical literature generally concern one case of BEF, and rarely more cases. The term "benign" is debatable, considering the severity of this disease in view of the aetiology and the bronchopulmonary complications. The aetiology in the past was connected to tuberculosis or toxoplasmosis, now to bacterial, viral or fungal infections. The Authors report three acquired cases and one congenital. They confirm the importance of anamnesis, symptomatology and oesophagography for diagnosis and CT scan for detection of pulmonary lesions. The treatment is surgical with resection of fistula and suture of the oesophagus and bronchus, interposing pleura or pericardium or intercostal muscle.

Bronchial Fistula↗
PubMed2001

Plasma electron kinetics in a weak high-frequency field and magnetic field amplification.

We describe the linear stage of Weibel instability in a plasma heated via inverse bremsstrahlung absorption of a high-frequency, moderate intensity radiation field under conditions in which the plasma electron velocity distribution function is weakly anisotropic. We report on the possibility of a significant amplification of spontaneous magnetic fields both in the case of an electron distribution function slightly departing from a Maxwellian in the region of subthermal velocities, and in the case where the Langdon nonequilibrium distribution is formed. We show that the direct influence of collisions on the Weibel instability growth rate may be traced back to subthermal electrons, for which the effective collision frequency is large.

Journal Article↗
PubMed2001

Surgical treatment of lung cancer invading chest wall: a retrospective analysis of 110 patients.

OBJECTIVE: To retrospectively assess the results of surgical treatment in a consecutive series of 110 patients with Stage IIb and IIIa non small cell lung cancer (NSCLC) invading chest wall. METHODS: A series of 110 patients underwent surgery for Stage IIb and IIIa NSCLC with involvement of chest wall. There were 101 male and 9 female patients, mean age was 61.4 (range 32--74), 52 (47.3%) of them complaining for chest pain. Surgical procedures were pneumonectomy in seven patients (6.4%), lobectomy in 73 (66.4%), bi-lobectomy in six (5.4%) and wedge resection in 24 (21.8%). In 63 patients (57.3%) an extrapleural resection was performed while in the other 47 (42.7%) an 'en bloc' resection of tumor with chest wall was required. In 22 patients (76.3%) repair was achieved by muscle flap while in 8 (26.7%) a prosthesis was required. Five-year survival was computed using the Kaplan--Meier method; P values correspond to the log-rank test. RESULTS: There were neither intraoperative nor postoperative deaths. Postoperative staging revealed 83 T3N0M0, 17 T3N1M0 and 10 T3N2M0. Mean postoperative hospital stay was 17.7 days (range 5--40). For N0 patients 5 year survival was 47% (39/83) and no significant difference was noted when extrapleural and 'en bloc' resection groups were compared (P = 0.08). In N1/N2 patients no survival was observed (0/27) and comparison between surgical procedures was not statistically significant (P = 0.41). Moreover when N0 patients were compared with N1 patients the difference in survival was significant for both extrapleural (P = 0.02) and 'en bloc' (P = 0.04) groups. No difference was noted when the two surgical procedures were compared independently form N status (P = 0.94). Within the group of patients undergone 'en bloc' resection survival was significantly better for N0 patients as in the group of extrapleural resection. CONCLUSION: Surgical treatment of Stage IIb and IIIa NSCLC invading chest wall by extrapleural or 'en bloc' resection is widely adopted and justified by the good results in terms of morbidity and relief of pain. Survival is always depending on the N status.

Adult↗
PubMed1999

Phase I-II study of gemcitabine and carboplatin in stage IIIB-IV non-small-cell lung cancer.

PURPOSE: Platinum-based chemotherapy currently represents standard treatment for advanced non-small-cell lung cancer. Gemcitabine is one of the most interesting agents currently in use in advanced non-small-cell lung cancer, and high response rates have been reported when it is administered in combination with cisplatin. The aim of the present study was to evaluate the combination of gemcitabine and carboplatin in a phase I-II study. PATIENTS AND METHODS: Chemotherapy-naive patients with stage IIIB-IV non-small-cell lung cancer received carboplatin at area under the concentration-time curve (AUC) 5 mg/mL/min and gemcitabine at an initial dose of 800 mg/m2, subsequently escalated by 100 mg/m2 per step. Gemcitabine was administered on days 1 and 8 and carboplatin on day 8 of the 28-day cycle. Dose escalation proceeded up to dose-limiting toxicity (DLT), which was defined as grade 4 neutropenia or thrombocytopenia or grade 3 nonhematologic toxicity. RESULTS: Neutropenia was DLT, inasmuch as it occurred in three of five patients receiving gemcitabine 1,200 mg/m2. Nonhematologic toxicities were mild. Gemcitabine 1,100 mg/m2 plus carboplatin AUC 5 was recommended for phase II studies. An objective response was observed in 13 (50%) of 26 patients, including four complete responses (15%) and nine partial responses (35%). Median duration of response was 13 months (range, 3 to 23 months). Median overall survival was 16 months (range, 3 to 26 months). CONCLUSION: The combination of gemcitabine and carboplatin is well tolerated and active. Neutropenia was DLT. The observed activity matches that observable in cisplatin-gemcitabine studies, whereas duration of response and survival are even higher. A phase II trial is under way.

Adult↗
PubMed1999

[Palliative surgical treatment of thoracic esophageal cancer].

BACKGROUND: Esophageal carcinoma is frequently diagnosed at an advanced stage, therefore most patients may only benefit from surgical or endoscopic palliation. METHODS: From 1982 to 1998, out of 247 patients who underwent palliation for thoracic esophageal carcinoma, 29 (11.7%) underwent surgical palliation. Eight received a palliative resection, 10 a bypass, 5 a jejunostomy and 6 a gastrostomy. A retrosternal transposition of the stomach (17 patients) and colon (1 patient) was performed. In 15 out of 29 patients palliation was decided during surgical exploration. All resected patients underwent postoperative radiotherapy (400 Gy) while 3 received also preoperative chemotherapy (PDD and % FU). RESULTS: Seven temporary neck fistulas and 9 cardiorespiratory complications were recorded. Two patients (11%) died of severe cardiac and respiratory insufficiency. Mean survival for resected patients was 12.5 months (range 3-21), higher than for bypass (11.5 months; range 3-18) and for jejunostomy or gastrostomy (5 months; range 2-12). CONCLUSIONS: Palliative resection, when technically feasible, is the treatment of choice in advanced thoracic esophageal carcinoma in selected patients. The type of procedure to be performed depends on site, extent of the disease and surgeon's experience together with the quality of life expected by the patient.

Aged↗
PubMed1999

Endoscopic and surgical palliation of esophageal cancer.

BACKGROUND: Esophageal carcinoma is frequently diagnosed at an advanced stage. Therefore for most patients either surgical or endoscopic palliation with or without radiochemotherapy may be taken into consideration. This retrospective study analyzes immediate and long term results of perendoscopic treatment in patients with unresectable esophageal cancer. Moreover a comparative analysis has been made with a group of patients who underwent palliation surgery. METHODS: From 1982 to 1998 458 patients with esophageal cancer underwent palliation perendoscopic disobstructive treatment (427 patients), palliation surgery (29 patients) and dis-obstruction followed by perendoscopic gastrostomy (2 patients). Among patients treated by perendoscopic procedures, 18 underwent dilation, 53 dilation and radiotherapy, 236 stent implantation, respectively of the plastic (102) and self-expandable metallic (134) type. 120 patients underwent NdYAG laser treatment. RESULTS: The results for patients who underwent perendoscopic procedures are referred to as regards the first 30 days after treatment and on the long run in terms of grade of dysphagia according to Visick's scale. For the group of patients undergoing simple dilation we had an improvement (from Visick III-IV to I-II) in 33% of cases and in 54.7% when radiotherapy was added. Far better results were achieved in all groups undergoing stent implantation, with or without brachytherapy, and NdYAG laser treatment with or without previous chemical necrolysis (range 90.3-100%). Most frequent complications were obstruction and stent displacement. Mean survival was better for patients undergoing laser recanalisation (7.2 months) while among stents the metallic type has given better results than plastic ones both for survival (6.2 vs 5.9 months) and mortality (2.4 vs 4.9%). Comparison with the group undergoing palliation surgery has shown that mean survival is the same for patients undergoing jejunostomy or gastrostomy while it is significantly better for patients undergoing palliation resection or by-pass surgery compared with those treated by stent implantation or laser recanalisation. CONCLUSIONS: The palliation treatment of patients with esophageal and cardial carcinoma is still a complex problem as far as therapeutic strategy is concerned. The best palliation is surgery even though characterized by a greater morbidity and mortality compared with perendoscopic techniques that may represent, in selected cases, a suitable alternative.

Journal Article↗
PubMed1998

Infection with Mycobacterium tuberculosis complicating a pulmonary sequestration.

Pulmonary sequestration is a relatively rare malformation. Infection with common pyogenes is a frequent feature in the evolution of this disease. We report a case of intralobar sequestration infected with Mycobacterium tuberculosis in the absence of any other site of tuberculous infection. The patient underwent surgical removal of the affected lobe and subsequent antituberculous chemotherapy. At 1-year follow-up his clinical status is excellent.

Bronchopulmonary Sequestration↗
PubMed1998

Preoperative antimicrobial prophylaxis with a long-acting cephalosporin for thoracic surgery in 192 non small cell lung cancer patients.

The efficacy of preoperative antibiotic prophylaxis in thoracic surgery with a single dose of ceftriaxone was investigated. Here we report the results of a prospective study including 192 patients undergoing thoracic surgery for non small cell lung cancer. Overall, the postoperative infection rate, as measured by wound, respiratory tract, and urinary tract infections, was 8.3% (16/192). Ceftriaxone was well tolerated, and no allergic or other adverse reactions were reported. A single preoperative dose of ceftriaxone was cost-effective and allowed considerable saving of time, material, labor costs and money. This study, even though open and non-comparative, suggests that the routine use of a single preoperative dose of ceftriaxone provides a cost-effective prophylaxis for patients undergoing major thoracic operations.

Adult↗
PubMed1994

Tetraether lipids of Methanospirillum hungatei with head groups consisting of phospho-N,N-dimethylaminopentanetetrol, phospho-N,N,N-trimethylaminopentanetetrol, and carbohydrates.

Acyclic, standard tetraether and diether lipids each account for about 50% of the total ether lipids found in Methanospirillum hungatei. Sixteen ether lipids were purified and defined according to relative weight percentage and staining reactions on thin-layer plates. Structures were elucidated for six previously uncharacterized tetraether lipids. Four of these lipids had as one head group either alpha-glcp-(1-2)-beta-gal(f)-, or beta-gal(f)-(1-6)-beta-gal(f)-, in glycosidic linkage to the first glycerol of the lipid backbone, and either a N,N-dimethyl-aminopentanetetrol or a N,N,N-trimethylaminopentanetetrol moiety in phosphodiester linkage to the second glycerol of the backbone. A fifth lipid was a tetraether structure novel in having carbohydrate moieties at both head group positions; namely alpha-glcp-(1-2)-gal(f)- and beta-gal(f)-. Two other lipids, a diether and a tetraether, had a single head group consisting of alpha-glcp-(1-2)-beta-gal(f)- modified by O-acetylation of the gal(f) residue at C-6. In addition to the seven new lipids described above, diether and tetraether analogs of phosphatidylglycerol were found.

Carbohydrate Sequence↗
PubMed1994

Carboplatin plus epirubicin plus VP-16, concurrent 'split course' radiotherapy and adjuvant surgery for limited small cell lung cancer. Gruppo Oncologico Centro-Sud-Isole (GOCSI).

Thirty-three patients with limited small cell lung cancer (SCLC) received carboplatin, epirubicin and VP-16 chemotherapy, concurrent 'split course' thoracic radiotherapy, followed by surgery for patients achieving an objective response (OR). High-risk patients and those staged T4-N3 (IIIB) at diagnosis, were excluded from surgery. After induction chemoradiotherapy we obtained 90.9% OR, with 63.3% obtaining complete response (CR). Ten patients (30.3%) were eligible for surgery after induction therapy. Five patients (15.1%) were subjected to surgery and five additional patients refused. Of the five patients who were subjected to surgery, four had a complete response (CR), (three pathological confirmations), and one had a partial response (PR), (unresectable). The median survival time for all patients was 16 months with 12.1% of the long-term survivors still living after 2 years and 9% still living after 3 and 4 years. Toxicity consisted mainly of myelosuppression. This study shows a high activity of the chemotherapy and the chemoradiotherapeutic regimen employed but a low feasibility for adjuvant surgery in SCLC.

Adult↗