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Biomedical subjects

L Babilonti

Publications and source records attributed to L Babilonti.

At least 19 recordsLinked to original sources

[Autologous blood collection in gynecologic oncologic surgery].

Autologous blood transfusion, as an alternative to homologous blood, must be considered for those patients who require blood. Transfusion in gynecologic oncology surgery is often required and autologous blood transfusion has been utilized. Between January 1988 and December 1992 a total of 162 surgical procedures for gynecologic cancers were performed in the same number of patients. Of these only 102 were eligible for autologous blood transfusion as predonation. The mean age of patients was 57.8 years (range 35-81). Forty-three patients were affected with endometrial carcinoma, 31 with carcinoma of the cervix, 21 with ovarian carcinoma and 7 with vulvar cancer. Collected autologous blood units were 138 (mean 1.35 every patient). Indications for predeposited blood transfusion was given by a hemorrhage greater than 100 cc intraoperatively or hemoglobin level less than 10 g/dl until 1988 or less than 8 g/dl since 1989. Forty-eight (34.8%) of the collected units were transfused to 39 autologous donors (mean 1.2 units every patient). There was a significant difference in transfusion rate in patients: endometrium 25.8%, ovary 28%, cervix 45%, vulva 72.7%. Unused autologous blood units were discarded at the expiration date: they were 90, 65% of collected ones. In 6 patients homologous blood was necessary other than autotransfusions. Our experience demonstrates that the transfusion requirement in gynecologic cancer surgery depends on pattern of neoplasm and consequently of surgical procedure. Patients with carcinoma of the cervix and vulva are at risk for transfusion and have appropriate indications for autologous donation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The clinical value of computed tomography and lymphography in detecting lymph node metastases from epithelial ovarian cancer.

We investigated the accuracy of both lymphography and computed tomography (CT) in detecting lymph node metastases in 58 patients with primary epithelial ovarian cancer (group a) and subsequently submitted to surgery including pelvic and/or lumbo-aortic lymphadenectomy. CT accuracy was also investigated in 41 patients with clinically suspected relapse of ovarian cancer (group b). In the first group (a) overall results in the pelvis were, respectively, for lymphography and CT: 94.8 vs 89.6% accuracy, 85.7 vs 57.1% sensitivity, 97.7 vs 100% specificity, 97.7 vs 100% positive predictive value and 95.5 vs 88% negative predictive value. In the lumbo-aortic region, we had: 88.8 vs 86.1% accuracy, 71.4 vs 64.2% sensitivity, 100% specificity and positive predictive value for both techniques, and 84.6 vs 81.6% negative predictive value. In the second group (b) CT accuracy, sensitivity and specificity were 90.2, 80 and 100%, respectively. CT, thanks to its high specificity and positive predictive value, can represent the method of choice for the evaluation of pelvic and lumbo-aortic lymph node metastases in untreated and relapsing ovarian cancer. CT demonstration of lymph node metastases can affect not only lesion staging, but also chemotherapy; different indications for lymphadenectomy may also depend on CT.

Adult↗

[Computed tomography and tumor markers as diagnostic alternatives to second-look surgery in the treatment of malignant ovarian tumors].

Advanced malignant ovarian cancers are treated, after initial surgery, with first-choice mono/polychemotherapy, the response to which is evaluated by means of second-look laparotomy. The poor prognostic value of second-look results, the incidence of false negatives, the lack of valuable second-choice therapies, and the high incidence of complications after repeated interventions, lead to the testing of diagnostic imaging modalities--especially CT and tumor markers (Ca 125 and Ca 15-3). To define their actual clinical value, CT and serum assays of Ca 125 and Ca 15-3 have been performed on 32 treated patients affected with ovarian cancers (stages II-IV), who were clinically free of disease. The results have been compared with second-look pathology, but especially with patient follow-up (min. 24 months). Second-look laparotomy yielded a high number of false negatives (9/22 = 41%); moreover, many important/severe complications were observed. Thus, its value appears to be questionable. CT exhibited high positive predictive value (76.9% over the 24-month follow-up); high for both Ca 125 and Ca 15-3 (100% respectively, at 24-month follow-up) thus, few false positives were observed. Moreover CT, having higher sensitivity (55.5%) than Ca 125 (11.5%) and Ca 15-3 (27.7%), has greater diagnostic capabilities, especially when the lesion is in extraperitoneal location.

Aged↗

[Computerized tomography versus lymphography in the assessment of lymph node metastasis in epithelial carcinoma of the ovary].

We investigated the accuracy of both lymphangiography and CT in detecting lymph node metastases in 59 patients evaluated preoperatively and subsequently submitted to surgery with selective/systemic pelvic and paraaortic lymphadenectomy. CT accuracy was also investigated in 46 patients with a clinically suspected relapse of ovarian cancer (verified by means of clinical and/or CT follow-up in 36 patients, by laparotomy in 7, by fine-needle biopsy in 1 and by necroscopy in the last 2). In the first group (previously untreated patients) the overall results in the pelvis were, respectively, for lymphangiography and CT: 94.9% vs 89.8% accuracy, 86.6% vs 60% sensitivity, 97.7% vs 100% specificity, and 92.8% vs 100%, 95.5% vs 88% positive and negative predictive values. In the paraaortic region the results were: 89.1% vs 86.5% accuracy, 73.3% vs 66.6% sensitivity, 100% specificity for both techniques, 100% positive predictive value, and 84.6% vs 81.5% negative predictive value. In the second group (clinically suspected relapse), CT accuracy, sensitivity, and specificity were, respectively: 91.3%, 81.8%, and 100%. Our experience demonstrated a high incidence of lymph node metastases in ovarian cancer, both in pelvic (15/49; 25.5%) and especially in aortic (15/37; 40.5%) locations in untreated patients, and an even higher incidence in relapses (22/42; 52.5%). The high specificity and positive predictive value of CT depended on the fact that there were no false positives. We arbitrarily considered as metastatic a lymph node with phi greater than 2 cm, and this threshold seemed to be of clinical value since it made a good predictor of metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Serous carcinoma of the ovary: value of computed tomography in detection of calcified pleural and pulmonary metastatic implants.

Reported are three cases of serous papillary cystoadenocarcinoma of the ovary with pleural and pulmonary calcified metastatic implants detected by computed tomography (CT), but not by chest X-ray. CT patterns of metastatic calcifications were considered because of the unexpected frequency of this finding (15.7%) and in view of a possible clinical use of CT in monitoring extraabdominal disease.

Adult↗

Clinical value of computerized tomography (CT) in assessment of recurrent uterine cancers.

Fifty-one patients with a clinically suspected relapse of uterine cancer were evaluated with computerized tomography (CT) in the Departments of Obstetrics/Gynecology and Radiology of the University of Pavia. The accuracy of these scans was always compared with biopsy results (31 cases) or clinical outcome (20 cases). To evaluate the role CT played in the treatment of each patient we divided the results of these examinations into "Confirmative" (when there was clinical evidence of a tumor) and "Diagnostic" (when physical examination and conventional radiologic techniques were inconclusive). Overall diagnostic accuracy was 92%, specificity 80%, and sensitivity 92%. The authors found that CT provides information that is useful for planning treatment and for avoiding unnecessary surgical exploration when a tumor is clinically evident; furthermore, CT was found to be better than conventional diagnostic means in doubtful cases, especially those in which post-therapeutic pelvic fibrosis was not extensive (correct diagnosis is 15 of 19 cases).

Adult↗

Cytology of malignant mixed mesodermal tumour of the uterus: experience of 10 cases.

The value of cytology as a diagnostic tool in uterine MMMT has been tested in order to reach an earlier diagnosis. From 10 endocervical scrapings we were able to obtain 7 positive smears, two of them diagnostic for mixed tumour at first examination, 1 detected upon revision. In one case the positive smear was obtained from a direct scraping of the neoplasia protruding through the cervical os.

Aged↗

Complications of pelvic lymphadenectomy in patients with endometrial adenocarcinoma.

The complications of surgical treatment in 193 cases of endometrial adenocarcinoma, subdivided into two groups, were analyzed: 58 without lymphadenectomy and 135 with systematic pelvic lymphadenectomy before total abdominal hysterectomy and bilateral salpingo-oophorectomy with vaginal cuff. The only significant differences concern the number of patients requiring transfusions and the length of the postoperative stay. It is suggested that lymphadenectomy should always be performed when an abdominal approach is chosen.

Adenocarcinoma↗

Dedifferentiating endometrial adenocarcinoma. Report of a case.

A case of well differentiated endometrial adenocarcinoma in a 70 year-old patient is reported, which evolved to undifferentiated small cell after being treated with chemotherapy for six months. The possible mechanisms of dedifferentiation are briefly discussed.

Adenocarcinoma↗

[Serous-papillary carcinoma of the endometrium. Usefulness and limitations of computerized tomography].

The staging of endometrial carcinoma and the evaluation of tumor recurrences take advantage from Computerized Tomography (CT). The CT appearances are described of six new cases and two recurrences of uterine papillary serous carcinoma (UPSC), which is a particularly aggressive and rare form of endometrial carcinoma. CT has been scarcely useful in first clinical stages, while in advanced stage and when the tumor appears as a pelvic mass CT has allowed to recognize the uterine origin, to define the involvement of surrounding tissue and to depict the extrauterine spread patterns. CT has been extremely useful in the evaluation and in the search for tumor recurrences.

Carcinoma, Papillary↗

T-lymphocyte subsets in normal menstrual cycle.

OKT3, OKT4, OKT8 positive cells levels were evaluated in 27 healthy volunteers, during preovulatory phase, luteal phase and menstrual period. OKT3, OKT4 positive cells showed no statistical difference over the three periods, while OKT8 positive cells decrease in preovulatory phase compared to both luteal phase (p less than 0.05) and menstrual period (p less than 0.02). A possible immunoregulatory function of oestrogens is discussed.

Adult↗

Primitive mucinous cystadenocarcinoma of the retroperitoneum. Case report and diagnostic considerations.

The combination of ultrasonography (US) and computed tomography (CT) proved useful in recognizing and defining the characteristics of a primitive mucinous cystadenocarcinoma of the retroperitoneum, a rare anatomopathological finding which consistently presents certain macroscopic features that help in the formulation of a diagnosis with imaging techniques.

Cystadenocarcinoma, Mucinous↗