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G Midiri

Publications and source records attributed to G Midiri.

33 records · Page 2Linked to original sources
PubMed1983

Usefulness of preoperative CEA levels in the assessment of colorectal cancer patient stage.

In order to demonstrate a prognostic value of preoperative CEA levels, we have tried to define a correlation between CEA and histologic stage of tumor in 124 patients with colorectal carcinoma. CEA concentration has been evaluated by radioimmunologic assay and the histologic stage following Dukes' classification. The results show a 25.0% positivity rate for patients in stage A, 48.2% for stage B, 61.1% for stage C, and 85.7% for stage D. The mean CEA values are 7.8 ng/ml in the first group, 30.3 ng/ml in the second, 58.1 ng/ml in the third, and 134.3 ng/ml in the last group. Furthermore, we have tried to relate the histopathologic grade of the tumor (G) with CEA levels in 54 patients of the 124. We conclude that preoperative CEA has a prognostic value, and it is useful in the staging of colorectal cancer patients. A low concentration indicates an early stage of the tumor, while a high concentration indicates a wide spread of disease; on the other hand, there are not significant correlations with cancer grading.

Carcinoembryonic Antigen↗
PubMed1982

Reversibility by L-carnitine of immunosuppression induced by an emulsion of soya bean oil, glycerol and egg lecithin.

Experimental and clinical data appear to indicate that Intralipid--an emulsion of soya bean oil, glycerol and egg lecithin--which is usually employed to improve caloric intake of parenteral nutrition regimens, may compromise human host defence mechanisms and therefore expose patients to an increased incidence of infectious diseases. Since from a biochemical point of view it has been suggested that a possible way whereby the somewhat poor reputation of Intralipid--attributable to the liver damage and the persistent lipaemia which attend its use--might be improved is to give supplementary carnitine which acts as a rate-limiting factor in the removal of the fat emulsion from blood, we hypothesized that the addition of carnitine to Intralipid could also result in a improvement of the immune responses both "in vitro" and "in vivo". Our results lend some support to the hypothesis in favour of a metabolic basis for some of the immunosuppressive properties of Intralipid and justify the inclusion of L-carnitine in parenteral nutrition regimens which, by abrogating some co-factor limitation, improves the immune responses of the host.

Carnitine↗
PubMed1981

Correlations between serial CEA levels and surgery in patients with colorectal carcinoma.

Nowadays the evaluation of serial carcinoembryonic antigen (CEA) levels represents an important parameter for the prognosis of patients with carcinoma of the large bowel. Changes in CEA values allow the drawing of conclusions regarding the effectiveness of therapy. We have studied 63 patients with colorectal carcinoma that underwent surgical treatment. Serial CEA levels were tested in each patient before surgery and 15 days after. The 53 patients were considered surgically cured; and among these 7 did not have a significant decrease of CEA values after surgery. The percentage of recurrences among these patients has been 71.4%; meanwhile patients who showed a decrease of CEA values below cutoff values had recurrences only in 17.3% of cases. For this reason is our opinion that patients considered surgically cured who have postoperative high CEA levels cannot be considered really cured from a biological point of view.

Carcinoembryonic Antigen↗
PubMedDate not supplied

[Genetic factors and colorectal cancer: a new approach to clinical experimentation].

The Authors point out the basis for a better characterisation of colo-rectal cancer and precursory lesions. In fact the etiology of familial adenomatous polyposis (FAP), aberrant crypt foci (ACF), hereditary non polyposis colon cancer syndrome (HNPCC) seems to be correlated to molecular pathology. Therefore the Authors review colo-rectal cancer natural history which frequently appears to be not related to clinical evolution.

Colorectal Neoplasms↗
PubMedDate not supplied

Intratumoral heterogeneity in colorectal carcinoma: trucut sampling for DNA ploidy analysis.

BACKGROUND: Solid tumors, such as colorectal carcinomas, consist of cell subpopulations that differ both genetically and in their clinical behavior. Many authors have examined cell kinetics and DNA content in colorectal tumors in correlation to clinical and pathological variables with different results. The interpretation of those results present some difficulties related to tumor heterogeneity that to date are unsolved. Our study is based on a new method of colon cancer sampling for DNA content determination. The aim of this work was to reduce the risk of incorrect DNA evaluation due to tumor heterogeneity. MATERIAL AND METHODS: Our study was based on eleven selected cases of T3 colorectal carcinoma. Fresh surgical specimens from the primary tumor site were taken during surgery. For each case at least four samples were taken using a 23 gauge trucut from the outside of the serosa through the tumor to the lumen of the colon. The specimens were stained according to a modified Feulgen method and DNA content was measured by image analysis. Three parameters were evaluated: DNA index, ploidy and proliferation level (considered as the sum of elements corresponding to the S and G2 phases). RESULTS: One of the eleven (9.1%) tumors showed a diploid pattern; four out of eleven (36.4%) cases showed a tetra/polyploid pattern and six out of eleven (54.5%) cases showed an aneuploid pattern. Three tumors were monoclonal (27.3%), one diploid and two aneuploid. Eight were polyclonal (72.7%). Considering the single specimen, seven out of sixty-eight specimens (10.3%) were inadequate because of scanty material. Twenty-five out of the sixty-one adequate specimens (41%) were monoclonal and thirty-six (59%) were polyclonal. Five tumors (three monoclonal and two polyclonal) showed the same cell clones on all the examined samples. The remaining six tumors showed interregional variability. The six of the eight polyclonal cases (75%) multiple stem lines were evident, analyzing only one sample taken close to colon serosa, while in one case (25%) it was necessary to examine two samples in order to see the polyclonality of the lesion. When samples taken close to mucosa where analyzed, however, one sample was not enough to show tumor polyclonality in five of the eight polyclonal examined cases. Proliferation level varied greatly in different parts of the same carcinoma and did not correlate to the site from which the sample was taken. CONCLUSION: In the present study, we demonstrated that DNA ploidy differences may exist between the superficial and the deep part of the same neoplasia and that tumor samples show a greater variability in the deeper layers. Using trucut samplings, it was possible to point out the majority of aneuploid cell populations close to the serosa. In conclusion, trucut biopsy permits full thickness sampling of the tumoral mass and allows, from few samples, to evaluate the multiple DNA stemlines present in different parts of a colorectal tumor.

Aged↗
PubMedDate not supplied

[Differential diagnostic problems between nodular fasciitis and soft-tissue sarcomas. A review of the literature and a case report].

After a review of literature and the report of a case with intrathoracic location, the authors consider present criteria for a correct diagnosis of low grade soft tissue sarcoma, when the possibility of nodular fasciitis is under evaluation. Nodular fasciitis is a benign pathology up to day not well characterised from the clinical and pathological point of view. The authors conclude that differential diagnosis between low grade soft tissue sarcoma and nodular fasciitis is frequently possible only on the basis of clinical course evaluation; otherwise the management may be inadequate.

Adult↗
PubMedDate not supplied

Altered expression of hMSH2 in sporadic colorectal cancer, surrounding mucosa and at distant colonic mucosa.

BACKGROUND: Mismatch repair gene hMSH2 is involved in correction of mispairing during replication and its mutation is associated both with microsatellite instability and with hereditary colorectal cancer. We evaluated its involvement in sporadic colorectal cancer tumorigenesis too. MATERIALS AND METHODS: The protein expression pattern of hMSH2 was evaluated on 29 cases of resected sporadic adenocarcinoma using an immunohistochemical approach. RESULTS: In 14 cases, lack of hMSH2 protein expression was observed in adenocarcinoma and in peritumoral mucosa. In 12 patients, hMSH2 resulted in strong expression in the tumour as well as in the surrounding mucosa and at distant mucosa. In three cases, hMSH2 protein expression in tumoral, adjacent and at distance normal mucosa resulted negative. CONCLUSION: Repair genes could play an important role in tumour progression and in sporadic colorectal cancer. Detection of protein expression by immunohistochemistry may be a method to select tumours for successive genetic investigations.

Adenocarcinoma↗
PubMedDate not supplied

[Remote teaching in surgery: problem-based learning, telementoring, and evaluation tests].

The authors propose the use of distant learning in the surgical knowledge teaching. The problem based learning methodology can support this new didactic approach. Telementoring is an interactive experimental methodology that allows young surgeons education by distant learning tutoring of an expert surgeon. The problem about assessment of efficacy and quality of computer-assisted instruction is to day under evaluation.

Education, Distance↗
PubMedDate not supplied

[Is the Lauren classification an independent parameter for the prognostic evaluation of surgically treated gastric cancer patients? Analysis of a case series].

The Authors highlight the efficacy of the Lauren's classification in 28 surgically treated gastric cancer patients. Lauren's classification allows a prognostic evaluation corresponding to the effective gastric cancer natural history. Present histo-morphological classification criteria appear not to coincide with the clinical evolution; as a matter of fact over- or understaging is possible in gastric cancer patients. 64,28% of the Lauren's classification intestinal type patients survive after a four year follow up vs. 42,85% of the diffuse type patients. The Authors discuss about new biomolecular knowledge in gastric cancer oncogenesis.

Aged↗
PubMedDate not supplied

[Clinical-experimental models for the identification of immunologic parameters to be integrated in traditional staging systems of colorectal neoplasms].

The Authors evaluate new possible models for the staging of colorectal cancer based on clinico-morphological, histo-pathological and bio-immunological parameters. Particularly, they evaluate the possibility of studying host's immunological response against tumor spread by the examination of the "in situ" cellular responses. This study was performed by cytotoxic test and immunohistochemical evaluation of the lymphocytes. The latter seems to give better results compared to the first in the evaluation of the host's immunological response.

Colorectal Neoplasms↗
PubMedDate not supplied

[Gastric xanthomatosis in a patient with severe lipid metabolic disorder].

Gastric xanthomas are rare in routine endoscopy, generally ranging from to 2 to 5 mm in diameter, mostly isolated, but in some cases multiple. Their nature has not yet been cleared. In fact, even if they have histochemical characteristics similar to cutaneous xanthelasmas, they are not generally considered closely related to lipid metabolism disorders. The Authors report a case with some peculiarities regarding number, location and dimension of the gastric xanthomas, and point out the possibility of a metabolic disorder in their aetiopathogenesis.

Esophageal Diseases↗
PubMedDate not supplied

[A case of multiple intestinal perforations due to TBC in a female patient with HIV-1 infection].

The authors report a case of HIV-1 infection, primary miliary tuberculosis of the lung and secondary intestinal tuberculosis complicated with multiple intestinal perforations. The surgical emergency therapy, supported by specific antitubercular drugs, antibiotics, and total parenteral nutrition, consisted in suturing seven perforative sites of the small and large intestine. The Authors stress the possibility that in the future tubercular complications up till now considered atypical may become more and more frequent because of the HIV-1 infection association.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Is it possible to consider intranuclear DNA imaging analysis as a new parameter in the staging of colorectal cancer?].

Intranuclear DNA imaging may be considered as a marker of the biological behaviour of neoplasias. However, some questions fundamentally related to the interpretation of cytometric data, to the correlation with other histomorphological parameters and to tissue sampling concerning staging and prognostic evaluation of colon cancer patients are still unsolved. A way to solve this problem may be to perform multiple full thickness samplings.

Cell Nucleus↗