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L Frigerio

Publications and source records attributed to L Frigerio.

At least 37 records · Page 2Linked to original sources
PubMed1997

Idiopathic sclerosing peritonitis associated with florid mesothelial hyperplasia, ovarian fibromatosis, and endometriosis: a new disorder of abdominal mass.

A 35-year-old woman underwent exploratory laparotomy for ovarian enlargement, massive ascites, and intestinal obstruction. Sclerosing peritonitis associated with florid mesothelial hyperplasia, ovarian fibromatosis, and endometriosis were diagnosed postoperatively. We add to the literature this new association of bilateral ovarian enlargement, sclerosing peritonitis, and florid mesothelial hyperplasia.

Adult↗
PubMed1997

Reliability of preoperative evaluation of prognostic factors in endometrial carcinoma.

OBJECTIVE: To define the accuracy of preoperative evaluation of prognostic factors in detecting patients with low risk of node metastasis in which different surgical approaches can be proposed. SUBJECTS: Seventy-five patients with a histologically proven endometrial carcinoma were considered in this study. METHODS: All the patients underwent a preoperative evaluation of grading (G), and myometrial invasion (M) by endometrial biopsy and transvaginal ultrasound (TVS). In 41 patients preoperative ploidy of carcinoma cells (P) was determined by flow cytometry. Pre-surgical G, M and P were then compared with surgical specimens. We considered 'low risk', patients with no or moderate myometrial invasion, well-differentiated histological grading and diploid DNA. RESULTS: We were able to identify 19/23 (82.6%) low risk cases. Correct identification of high risk patients was obtained in 49/52 (94%) patients. In three low risk patients, correctly diagnosed preoperatively, the final FIGO stage was IIIA (two for adnexal involvement and one for positive peritoneal washing). CONCLUSIONS: Our findings suggest that it is possible to detect preoperatively patients with a low risk of node metastasis. Alternative surgical approaches, i.e. vaginal surgery, can be taken into account in such patients.

Adult↗
PubMed1997

Protein quality control along the route to the plant vacuole.

To acquire information on the relationships between structural maturation of proteins in the endoplasmic reticulum (ER) and their transport along the secretory pathway, we have analyzed the destiny of an assembly-defective form of the trimeric vacuolar storage glycoprotein phaseolin. In leaves of transgenic tobacco, where assembly-competent phaseolin is correctly targeted to the vacuole, defective phaseolin remains located in the ER or a closely related compartment where it represents a major ligand of the chaperone BiP. Defective phaseolin maintained susceptibility to endoglycosidase H and was slowly degraded by a process that is not inhibited by heat shock or brefeldin A, indicating that degradation does not involve transport along the secretory pathway. These results provide evidence for the presence of a quality control mechanism in the ER of plant cells that avoids intracellular trafficking of severely defective proteins and eventually leads to their degradation.

Biological Transport↗
PubMed1997

Weekly cisplatin given for 2 months versus cisplatin plus cyclophosphamide given for 5 months after cytoreductive surgery for advanced ovarian cancer.

PURPOSE: To compare the efficacy of a treatment with cisplatin plus cyclophosphamide given for 5 months and a short treatment with cisplatin alone in advanced ovarian cancer, we conducted a multicenter randomized clinical trial. PATIENTS AND METHODS: Eligibility criteria were as follows: first diagnosis of histologically confirmed invasive epithelial ovarian cancer of International Federation of Gynecology and Obstetric (FIGO) stage III-IV, age younger than 75 years, and Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2. Within 28 days of cytoreductive surgery, eligible women were randomly assigned treatment with weekly cisplatin 50 mg/m2 for nine courses or cisplatin 75 mg/m2 plus cyclophosphamide 750 mg/m2 every 21 days for six courses. RESULTS: A total of 607 women were entered onto the study. There was no difference in the response to treatment. Pathologic complete response (CR) was documented in 63 of the weekly cisplatin cases and 70 of the cisplatin plus cyclophosphamide group (chi 1(2) = 1.43; P = .23). The median follow-up time was 3 years. There were 151 and 148 deaths in the weekly cisplatin and cyclophosphamide plus cisplatin arms, respectively. Survival curves were similar in the two groups, with a 3-year percent survival estimate of 44.1 (SE = 3.4) in the weekly cisplatin and 44.6 (SE = 3.4) in the cisplatin plus cyclophosphamide group (log-rank test chi 1(2) = 0.004; P = .96). CONCLUSION: This study found that 2-month monochemotherapy treatment with cisplatin was as effective as 5-month polychemotherapy including cisplatin at a similar doses but different dose-intensity plus cyclophosphamide.

Adult↗
PubMed1996

Early involvement of 6q in surface epithelial ovarian tumors.

Complex karyotypes are often seen in primary surface epithelial ovarian tumors (SEOTs). Conventional cytogenetic as well as fluorescence in situ hybridization analyses coupled with loss of heterozygosity studies identified abnormalities of chromosome 6 as one of the most frequent lesions in these types of tumors. We performed cytogenetic analysis of direct preparations from 40 SEOTs, including borderline tumors and low-, intermediate-, and high-grade carcinomas to verify the frequency of chromosome 6 alterations. We also carried out fluorescence in situ hybridization analysis with a chromosome 6 library and yeast artificial chromosome clones from a region of the same chromosome (6q27). Chromosome 6 abnormalities were identified in 30 of 32 analyzable SEOTs. Twenty-five of 32 cases showed a deletion of 6q irrespective of their histological grade. We wish to underline that this is the first report proving that del(6q) was the most frequent chromosome anomaly in near-diploid SEOTs and that it was the sole anomaly observed in four SEOTs with diploid complement. Our findings suggest that abnormalities of the telomeric region of chromosome 6 (6q27) may be considered one of the earliest lesions in the pathogenesis of ovarian carcinomas.

Aneuploidy↗
PubMed1996

Management of low-risk gestational trophoblastic tumors with etoposide (VP16) in patients resistant to methotrexate.

Careful selection and treatment monitoring of patients with gestational trophoblastic tumors (GTT) is critical because 20 - 50% of patients may develop a resistance and consequently require alternative chemotherapeutic agents. In our study we propose and demonstrate the efficacy of etoposide (VP16) as a second-line drug. An average of 5 courses with VP16 were used to achieve a remission in 12 patients resistant to MTX with low-risk GTT. Toxicity was mild and no resistance to VP16 was observed. A follow-up of 66 months (range, 22-109) has been performed for the patients and all of them are now disease free. Two patients had a pregnancy, respectively, 3 and 4 years after treatment. The others did not desire any pregnancy.

Adolescent↗
PubMed1996

Octreotide in the management of bowel obstruction in terminal ovarian cancer.

Intestinal obstruction is a common and distressing clinical complication in ovarian cancer. The aim of our study was to assess vomit control in terminal ovarian cancer patients with inoperable gastrointestinal obstruction, using a symptomatic pharmacological treatment with octreotide which obviates the need for nasogastric tube placement. We studied 13 patients, all of whom had advanced ovarian cancer FIGO stage IIIc. Seven patients were treated in the Gynecology Department of S. Raffaele Hospital, at the University of Milan, and 6 were managed in the University of Varese Hospital. Octreotide was administered at doses starting with 0.3 up to 0.6 mg (mean 0.44 mg) a day by subcutaneous bolus or continuous infusion. Octreotide controlled vomiting in all cases to grade 0 on the WHO emesis scale. Complete relief of symptoms was achieved within 3.07 days (range 1-6 days). Vomiting stopped within 2-3 days of starting treatment in most patients. In 8 patients with a nasogastric tube, drainage decreased from 2000 to under 100 ml/day after the start of octreotide treatment. No side effects were reported. All patients died with minimal distress or pain.

Adolescent↗
PubMed1994

Risk factors for placenta praevia.

Risk factors for placenta praevia have been analysed in a case control study conducted in Milan, Italy. A total of 140 cases of placenta praevia and the two women who delivered healthy babies consecutively after each index case (280 controls) were identified reviewing clinical records of 49,765 registered deliveries at the Clinica Mangiagalli in Milan from 1979 to 1991. An increased relative risk (RR) of per cent confidence interval, CI, 2.3-6.7) and among those with previous abortions (RR = 1.8, 95 per cent CI, 1.2-2.8) or with more than one previous pregnancy (RR = 1.9, 95 per cent CI, 1.1-3.3). A non-significant trend in risk was observed with parity (RR = 1.2 for one and 1.5 for two previous deliveries versus nulliparas) and for caesarean section (RR = 1.2 for one and 2.1 for two previous caesarean deliveries versus no previous caesarean section). No relation emerged with sex of the newborn and multiple pregnancy and risk of placenta praevia. Our study shows that older age and previous abortions are associated with an increased frequency of placenta praevia.

Adult↗
PubMed1994

Adjunctive radiotherapy after radical hysterectomy in high risk early stage cervical carcinoma. Assessment of morbidity and recurrences.

Morbidity and prognostic factors were reviewed in 145 patients who underwent radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer between January 1976 and December 1986. Ninety five patients received adjuvant postoperative external radiotherapy (average 4800 cGY). One hundred twenty patients were F.I.G.O. stage IB, and 25 were clinical stage IIA. Indications for adjuvant radiotherapy included 3 categories of patients with high risk factors: 1) pelvic lymph node metastases, 2) parametrial invasion and/or surgical margins involvement, 3) large volume, deep stromal penetration or uterine extension. Four percent of the patients suffered major gastrointestinal complications, 8.9% had major genito-urinary complications, 19 patients had lymphocytes and 2 patients complained of thromboembolic episodes. Of the 19 patients with major gastrointestinal or genito-urinary morbidity, 7 (38.8%) were related to radiotherapy. Thirty-nine patients had node involvement, 38 of these patients received radiotherapy and 5-year survival rate was 43.5% versus 87.7% in other cases (p < 0.001). Of the 14 patients with parametrial invasion and/or surgical margins involvement, 10 received radiotherapy and overall 5-yrs survival was 85.8%. Of the 37 patients related to third category of risk, 18 received adjuvant radiotherapy with 83.3% 5-yrs survival versus 94.7% of other 19 cases (n.s.). Patients treated with surgery alone had a better 5-yrs survival (96%) than those who received combination therapy (66.3%) (p < 0.001). Adjuvant radiotherapy increases the morbidity of radical hysterectomy, while it has a relative value in preventing local and distant recurrences. In view of reduced survival in high risk patients with node involvement, consideration should be given to adjuvant systemic chemotherapy in high risk cases.

Adult↗
PubMed1993

Color-Doppler ultrasound in ovarian masses: anatomo-pathologic correlation.

BACKGROUND AND AIMS: In the radiologic assessment of ovarian masses, the major difficulty consists in the late recognition and lack of parameters for a differential diagnosis between benign and malignant lesions, especially in the post-menopause when the incidence of cancer is higher. The use of a transvaginal probe and the color-Doppler examination have recently improved the study of the female pelvis. This study is aimed to verify the possibility of the color-Doppler imaging to differentiate between malignant and benign ovarian lesions during transvaginal echographies, on the basis of the qualitative and quantitative characteristics of the vascular pattern of the ovarian lesions. RESULTS: Twenty-six expansive ovarian lesions were studied: 8/26 showed no vascular signals and were considered benign as confirmed at histology. In the remaining lesions with some vascularization, the resistance index (RI) was evaluated: those with RI > 0.40 were considered benign, those with RI < 0.40 malignant. In 8/9 benign lesions and 7/9 malignant neoplasms, the results of color-Doppler were coherent with histology. The results showed a sensibility of 87.5% and a specificity of 88.8% for the transvaginal examination. CONCLUSIONS: The main advantages of the color-Doppler transvaginal examination are: the high frequency of visualization of the ovaries, even in postmenopausal patients; the definition of small lesions; the visualization of small parenchymal vessels, both physiologic and pathologic, and their quantitative analysis. The importance of the RI cutoff was critical for the differential diagnosis between benign and malignant lesions; we think that a cutoff of 0.50, instead of 0.40 proposed by other authors, would be far more appropriate.

Adult↗
PubMed1993

Primary carcinoma of the fallopian tube.

BACKGROUND: Because of the rarity of fallopian tube cancer, clinical approaches have changed during the last 18 years. METHODS: Twenty-nine patients with fallopian tube cancer were treated at the Gynecologic Oncology Department of Milan University from 1970 to 1988. The mean patient age was 59 years. Parity, symptomatology and histology were considered. Distribution by stage was as follows: I, 11 (37%); II, 10 (34%); III, 8 (27%) according to the Dodson classification. Twenty patients (69%) underwent surgery followed by pelvic irradiation. Adjuvant chemotherapy was performed in the treatment of 5 women with stage I disease, 6 with stage II, and all 8 with stage III. RESULTS: Five-year overall survival was 41.38%: 47.6% at stages I and II, 25% at stage III. Radiotherapy has not been replaced by cisplatin-based multiagent chemotherapy. Optimal surgical debulking combined with accurate lymph node sampling are not followed by systematic use of repeat laparotomy. CONCLUSIONS: The procedures described in this work improve the clinical assessment and patient survival, and make different series comparable.

Adult↗
PubMed1989

Down patients: extracellular preamyloid deposits precede neuritic degeneration and senile plaques.

Using anti-SP28 (a polyclonal antibody to a 28 residue synthetic peptide homologous to the NH2-terminal region of the Alzheimer amyloid beta-protein) to investigate the cerebral cortex of 6 Down patients aged 6-55 y, we found that, besides senile plaques and congophilic vessels, extracellular deposits unrelated to degenerating neurites, tangle-bearing neurons or congophilic vessels were labelled. These deposits were similar to the extracellular deposits previously observed in the cerebral cortex of Alzheimer patients and non-demented individuals. The material accumulated in the deposits did not react with Congo red, thioflavine S or, on some occasions, silver salts and therefore might have been constituted by beta-protein precursors lacking the molecular conformation of amyloid fibrils. Age-related analysis of the cortical lesions in Down patients suggested that such extracellular deposits precede degenerating neurites and evolve into senile plaques.

Adult↗
PubMed1989

[Prevention of acute neonatal respiratory insufficiency. A method of conditioning the baboon lung during cesarean section].

Preterm baboons at 140 +/- 3 day gestation (term 182 +/- 7 days) have been subjected to lung conditioning, consisting of a series of prolonged inflations of the lungs at 35 cm H2O, followed by approximately 10 min of application of continuous positive airway pressure (CPAP) equal to 15-20 cm H2O, before umbilical cord interruption. The aim of this study was to evaluate, in a primate experimental model, the safety and efficacy in the prevention of neonatal RDS of a technique so far experimented on only in ovine models. Thoraco-pulmonary compliance exceeded the value of 0.2 ml (cm H2O)-1.kg-1 in only 1 animal out of 5 (20%), which didn't develop illness, versus 69% of positive results achieved with the same technique in lambs at 128-130 day gestation, an experimental model considered in the literature as equivalent to a 140 +/- 3 day gestation baboon as far as it concerns incidence and severity of RDS. The application of lung conditioning was easy and safe (as previously reported), but its effectiveness in a primate model is still to be defined.

Animals↗
PubMed1989

[Outlook for the use of the colpocystoproctogram in the pre- and postoperative diagnosis of patients with urinary stress incontinence].

Colpocystoproctography is an X-ray investigation that uses radio-opaque material to highlight the bladder and urethra, vaginal canal and rectum. Twenty-five patients (7 suffering from SUI, 7 operated on for SUI and cured, 7 operated on for SUI with relapse, 4 suffering from prolapse without SUI) were submitted to this X-ray examination so as to determine mutual space relations within the pelvic viscera and the efficiency of their support mechanisms. The following parameters were examined: the anterior angle, the urethro-pelvic angle, the vagino-pelvic angle, the ano-rectal angle, the pubo-vesical distance and the position of the vesical neck with respect to the subpubic margin, in three different pictures recorded at rest, during voluntary contraction of the pelvic floor and in the contrary condition of increase in abdominal pressure. The purpose of the study is to see which data provide useful clinical indications in the pre- and post-operative stages in patients with SUI. The extreme variability of the data under dynamic conditions limits the usefulness of the X-rays taken with the pelvic floor at rest. It can be stated that the anterior angle (a.v. 30 degrees) expresses the anatomic condition of the vesical neck supports; the vagino-pelvic angle (a.v. 106 degrees) is an indicator of the support function of the vaginal walls with respect to the cervico-trigonal region, while good elevation on the neck of the bladder and its closeness to the posterior side of the pubic bone are necessary for complete cure. Colpocystoproctography may therefore represent an important diagnostic tool for assessing what operation is available today as the most suitable for correcting the anatomic defect.

Female↗
PubMed1987

A new set for transhepatic insertion of large caliber catheters for biliary drainage: technical and clinical report.

An original set for percutaneous insertion of large caliber (12-16 French) biliary drainages is described. The results obtained in the 70 patients submitted to biliary drainage with late complications due to malfunction of the standard 8.3 or 10 F catheters show the advantage of the set described. The correction of unsatisfactory levels of bilirubinemia was obtained in 100% of cases, the resolution of recurrent cholangitis in 84.2% and of bile leakage on the skin in 46.7%. The large caliber and the large side holes of the catheter, together with its length and its easy handling, allow resolution of many different problems of insufficient drainage present in patients with neoplastic involvement of bile ducts.

Bile↗