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Biomedical subjects

G Papa

Publications and source records attributed to G Papa.

At least 19 recordsLinked to original sources
PubMed1992

Simultaneous occurrence of monoclonal gammopathy and acute secondary leukemia with overexpression of P-glycoprotein.

A 52-year-old woman, previously treated with chemo- and radiotherapy for Hodgkin's disease, developed an acute non-lymphoid leukemia and, contemporarily, an IgG-kappa paraproteinemia. Cytogenetic analysis showed a major clone, representing 90% of observed metaphases, with monosomy of chromosomes 5 and 14. In addition, leukemic cells exhibited a high expression of the P-glycoprotein, a transmembrane glycoprotein involved in the multidrug-resistance mechanism. Possible explanations for this cluster of findings are provided.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1992

Modification of the volumetric growth responses and steady-state hypoxic fractions of xenografted DLD-2 human colon carcinomas by administration of basic fibroblast growth factor or suramin.

We studied the growth characteristics and hypoxic fractions of DLD-2 human colon tumours xenografted into male nude mice either in the unperturbed state or after i.p. injection (q.i.d. x 7) of basic fibroblast growth factor (0.25 mg kg-1) or suramin (50 mg kg-1). Hypoxic fractions were measured by clonogenic excision assay 1 day after administration b FGF or suramin was stopped. As compared to controls, the growth of tumours in b FGF treated mice was increased by a factor of 1.5 as indicated by the relative volumes of tumours on the day of excision. Similarly, suramin decreased the growth of DLD-2 tumours by a factor of 1.6. The percentage of hypoxic cells in control neoplasms was 42.9% (95% confidence limits 34.2-52.1%). In mice that received basic fibroblast growth factor injections, hypoxic fractions decreased to 19.1% (95% confidence limits 13.5-26.9%). In contrast, in mice treated with suramin, the percentage of hypoxic cells increased to 74.0% (95% confidence limits 65.3-83.9%). These data indicate that the biology of solid tumours can be significantly modified by alteration of growth factor status.

Adenocarcinoma↗
PubMed1992

Anaphylactic shock after skin test with phytohaemoagglutinin.

A young woman (26 years old), with gastrointestinal candidosis of 8 months duration, was hospitalized in our department to study her cell immunity. Five minutes after an id injection of PHA (bactophytohaemoagglutinin M, Difco, 1 mg), mix monilieae, mix tricophyton and PPD Berna, she showed an extensive wheal and flare reaction in the PHA injection area, eyelid oedema and respiratory distress. In spite of adrenaline, corticosteroid and antihistamine drug administration, the patient collapsed and was admitted to the resuscitation department, where she quickly recovered. In the following days, the patient underwent immune and allergy testing: 1) total Ige immuno-enzymatic assay: 72 KU/1; 2) specific IgE and IgE immuno-enzymatic assay for Candida: negative; 3) in vitro lymphocyte transformation test (thymidine 2-C14) with PHA Difco was positive. This finding and the positivity of the id injection with PHA could indicate an allergic type I immunoreaction, the description of which we have not found in the international literature (the presence of IgG STS cannot be totally excluded).

Adult↗
PubMed1992

Extended-field radiotherapy is superior to MOPP chemotherapy for the treatment of pathologic stage I-IIA Hodgkin's disease: eight-year update of an Italian prospective randomized study.

PURPOSE: To compare the effectiveness of chemotherapy (CHT) with extended-field radiotherapy (RT) in the treatment of early-stage Hodgkin's disease (ESHD), we report an 8-year updated analysis of a study in which treatment with six cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) CHT was randomly compared with extended-field RT. PATIENTS AND METHODS: From August 1979 to December 1982, 89 adult patients with pathologic stage I-IIA Hodgkin's disease (HD) were randomly allocated to receive either RT with mantle field followed by periaortic irradiation (n = 45) or six monthly courses of MOPP CHT (n = 44). RESULTS: All patients in the RT arm and 40 of 44 in the CHT arm achieved complete remission. Twelve relapses occurred in each group. Eight patients treated with MOPP and two of the RT arm died of HD. Three other patients of the CHT group died because of a second cancer. With a median follow-up greater than 8 years, the overall survival rate is significantly higher in the RT than in the CHT group (93% v 56%; P less than .001), whereas the rates of freedom from progression and relapse-free survival (RFS) were similar in the two groups (76% v 64% and 70% v 71%, respectively). Of the 12 patients relapsing after RT, 11 (92%) achieved a second CR, compared with only six of the 12 (50%) in the MOPP group. Analysis of the response rate to salvage treatments showed that the type of relapse in the MOPP group was a prognostic indicator for the achievement of a second CR, whereas in the RT group, a second CR was obtained regardless of the characteristics of the relapses. At 80 months, the probability of survival of relapsing patients calculated from time of relapse was 85% and 15% in the RT and CHT groups, respectively (P = .02). CONCLUSION: We conclude that RT alone is the treatment of choice for adult patients with ESHD with favorable prognostic factors.

Actuarial Analysis↗
PubMed1992

[Recent biological and therapeutic advances in multiple myeloma].

Multiple myeloma still remains a fatal disease. However, in the last months new biological and clinical informations have been provided about this disease. In particular, the immunophenotype of myeloma cells seems indicate, in some patients, a clonal involvement of a stem cell in the pathogenesis of mieloma. Moreover, new biological insights concerning the cytokine network, have revealed a probable effect of some cytokines, such as IL6, IL3, IL4. Finally, new insights in the biology of multiple myeloma have been provided by studies of molecular biology and flow cytometry. As for therapy, the best conventional induction treatment still remains to be defined. In the last years, the increased use of alpha Interferon and new therapeutic modalities, such as transplantation procedures in multiple myeloma, open new hopes toward a cure of this disease. Therefore, in the future a better knowledge of the multiple myeloma biology, associated with a wider use of new effective therapeutic approaches will certainly improve the natural course of this disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

F-MACHOP in advanced aggressive lymphoma.

The results of our ten years experience indicate that F-MACHOP, conceptually designed to exploit cell kinetic and synergistic principles, is an effective regimen with acceptable toxicity in a large proportion of adults with advanced stages of diffuse large cell or small non-cleaved cell lymphoma. More than 60% of all treated patients all expected to achieve long-term EFS. Patients achieving CR within 3 courses have a very high chance of being cured of their disease and do not require, in our opinion, intensification with other regimens. On the other hand the identification of a group of patients with poorer outcome (i.e. those failing to achieve an early CR) enabled testing of the potential efficacy of superintensive salvage regimens. Together with other 6 Italian hematologic institutions, we have recently participated in a prospective comparative randomized trial in which F-MACHOP was compared to MACOP-B in adults with advanced stages of diffuse large cell or small non-cleaved cell lymphoma. The preliminary results of this trial appear to confirm that F-MACHOP is an effective and tolerable regimen in such patients and there is a suggestion that its efficacy is superior to that of MACOP-B. This trial was closed to accrual in September 1991 and we look forward to the first complete analysis in March 1992.

Actuarial Analysis↗
PubMed1992

[Efficacy and safety of amrinone in the treatment of heart insufficiency in intensive care].

The authors describe the results obtained treating with amrinone for 48 hours 11 patients with acute heart failure. The patients (4 males and 7 females), age range between 50 and 82 years) received an initial bolus of 0.75 mg/kg followed by and infusion which on average was of 5.82 +/- 1.06 (SD) micrograms/kg/min. Besides a subjective and objective clinical improvement they could observe a quick and remarkable improvement of the main hemodynamic parameters (cardiac index, cardiac output, pulmonary capillary wedge pressure, mean pulmonary pressure). The tolerability of the drug was good, except for a decrease in platelet, already described in literature. In conclusion, the Authors consider amrinone a very interesting drug for its positive inotropic and vasodilating activity and because it does not cause an increase of the myocardial oxygen consumption.

Acute Disease↗
PubMed1992

[Role of oxygen venous saturation monitoring and CAVH in the multiple organ failure syndrome. Description of a clinical case].

A 42 year old man was admitted to the intensive Care Unit with signs and symptoms of septic shock, associated with adult respiratory distress syndrome (ARDS), jaundice and acute renal failure. In order to support different organs failures mechanical ventilation (IPPV, PSV, CPAP), continuous arteriovenous hemofiltration were affected, and continuous intravenous infusion of dopamine and dobutamine was started. After and during application of these therapeutic measures, continuous monitoring of mixed venous blood oxygen saturation (SvO2) was applied by Swan-Ganz fiber optic catheter in the pulmonary artery. Monitoring of SvO2 represented a useful means to guide inotropic therapy and to assess the hemodynamic effects of CAVH and mechanical ventilation. The case reported emphasized the role of continuous venous oximetry in multiple organ failure syndrome.

Adult↗
PubMed1991

A metastatic breast carcinoma presenting as autoimmune hemolytic anemia.

The authors describe the case of a 75-year-old female who was hospitalized for anemia of unknown origin. Physical examination revealed a swelling in the right mammary region, where a mastectomy scar was present from surgery for a breast carcinoma. On admission, laboratory tests disclosed anemia (Hb, 8.5 g/dl), with a reticulocyte count of 65,000/mm3 and slightly increased bilirubin. Immunohematologic study revealed the presence of a red cell autoantibody with anti-D specificity in the serum and in the eluate from the patient's erythrocytes. A biopsy of the swelling was performed and histologic examination showed the presence of metastatic cells of breast carcinoma. The patient was given chemotherapy and radiotherapy. At this writing the anemia was absent, the immunohematologic study was negative, the swelling was greatly reduced, and no other metastatic lesions of breast carcinoma were present.

Aged↗
PubMed1991

Non-Hodgkin lymphomas of the central nervous system.

Non-Hodgkin lymphomas (NHL) of the Central Nervous System (CNS) are rare but they nonetheless constitute a clinical, biological and therapeutic problem of great interest. Primary lymphomas of the CNS account for 2% of all malignant lymphomas and for 0.3-1.5% of all intracranial tumors. Surgery and radiotherapy afford only poor control of the disease. The most satisfactory results have been achieved with combination therapy, surgery + radiotherapy + chemotherapy, but the optimal combination has still to be devised. Secondary neuromeningeal involvement affects a fair number of patients with systemic NHL. The symptoms are broadly the same as in CNS NHL and the treatment as problematic. There have recently been suggestions that the onset of CNS NHL may be exacerbated by immunodeficiency states such as occur in patients who have undergone organ transplantation, in autoimmune disease and, still more recently, in the acquired immunodeficiency syndrome (AIDS). The frequency of these tumors is anyway on the increase and a better insight into the disease in essential.

Acquired Immunodeficiency Syndrome↗
PubMed1991

In vitro radiation survival parameters of human colon tumor cells.

As part of an ongoing research program in the biology of human colon cancer cells, a database is being generated on the radiation responses of established lines in vitro. In this report, data are summarized on the graded single dose clonogenic survival responses to graded single doses of 250 kVp X rays of 16 exponentially growing lines. These data were analyzed using the linear quadratic (LQ) formalism for X ray inactivation; the 95% confidence limits on the colony forming efficiencies (CFEs), the alpha and beta parameters from the LQ equation, the surviving percentage at 2 Gy, and the mean inactivation dose (D, Gy) are listed herein. The average D from these 16 colon tumor lines was 2.35 Gy (95% confidence limits 2.10-2.60 Gy), which indicates that these tumor cells are of equal radioresistance to melanoma or head and neck cells, with only glioblastoma cells being of greater radioresistance.

Carcinoembryonic Antigen↗