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Biomedical subjects

L Leo

Publications and source records attributed to L Leo.

At least 19 recordsLinked to original sources
PubMed2003

Sentinel Lymph Node (SLN) laparoscopic assessment early stage in endometrial cancer.

BACKGROUND: The aim of the study was to demonstrate the validity of sentinel lymph node (SLN) detection after injection of radioactive isotope and patent blue dye in patients affected by early stage endometrial cancer. The second purpose was to compare radioactive isotope and patent blue dye migration. METHODS: Between September 2000 and May 2001, 11 patients with endometrial cancer FIGO stage Ib (n=10) and IIa (n=1) underwent laparoscopic SLN detection during laparoscopic assisted vaginal hysterectomy with bilateral salpingo-oophorectomy and pelvic bilateral systematic lymphadenectomy. Radioactive isotope injection was performed 24 ours before surgery and blue dye injection was performed just before surgery in the cervix at 3, 6, 9 and 12 hours. A 350 mm laparoscopic gamma-scintiprobe MR 100 type 11, (99m)Tc setted (Pol.Hi.Tech.), was used intraoperatively for detecting SLN. RESULTS: Seventeen SLN were detected at lymphoscintigraphy (6 bilateral and 5 monolateral). At laparoscopic surgery the same locations were found belonging at internal iliac lymph nodes (the so called "Leveuf-Godard" area, lateral to the inferior vescical artery, ventral to the origin of uterine artery and medial or caudal to the external iliac vein). Fourteen SLN were negative at histological analysis and only 3 positive for micrometastasis (mean SLN sections = 60. All the other pelvic lymph nodes were negative at histological analysis. The same SLN locations detected with g-scintiprobe were observed during laparoscopy after patent blue dye injection. CONCLUSIONS: If the sensitivity of the assessment of SLN is confirmed to be 100%, this laparoscopic approach could change the management of early stage endometrial cancer. The clinical validity of this technique must be evaluated prospectively.

Adenocarcinoma↗
PubMed2001

HELLP syndrome and factor V Leiden.

The association of thrombophilia and obstetrical complications is documented and well consistent with the hypothesis of an insufficient placental perfusion due to fibrin deposition as a major underlying pathophysiological mechanism. Factor V Leiden is one of the most frequent thrombophilic mutations. A high prevalence of this mutation has recently been reported in a group of 21 German women with haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. In this respect, we studied the prevalence of factor V Leiden in 18 women who were consecutively diagnosed at our Department of Obstetrics and Gynaecology as having HELLP syndrome, between 1995 and 1999. Women were tested either at the time of diagnosis or months or years after delivery for coagulation parameters, protein C (PC), protein S (PS), antithrombin III, lupus-like anticoagulant, anticardiolipin antibodies (ACA), activated protein C (APC) resistance and detection of the G1691A mutation (factor V Leiden). In all women, the parameters studied were normal and in none of the investigated cases was the G1691A mutation found. HELLP being a severe form of preeclampsia, we think that the reported association between factor V Leiden and HELLP may reflect the well-known association with preeclampsia.

Adult↗
PubMed2000

Laparoscopic uterine suspension using three-stitch technique.

We conducted a prospective, longitudinal study to assess the efficacy of a new laparoscopic hysteropexy technique in alleviating pelvic pain. Subjects were 50 women of reproductive age with chronic pelvic pain or dyspareunia in whom the only clinical finding was uterine retroversion who underwent laparoscopic uterine suspension using three-stitch technique. There were no intraoperative complications. The only postoperative complication was abdominal pain in one woman. The technique was effective in relieving symptoms in these patients. Of the 22 women who had associated infertility for longer than 3 years, 10 became pregnant within 1 year after surgery. This benefit, however, is likely due to couples' improved sex life rather than change in surgical axis of the uterus.

Adult↗
PubMed2000

Vinorelbine + mitomycin C as second-line treatment of metastatic breast cancer: a two-stage phase 2 study.

Second-line treatment of patients with metastatic breast cancer resistant to anthracyclines is an important clinical issue. The aim of the present two-stage phase II study was to evaluate activity and toxicity of vinorelbine + mitomycin C (VM) in such patients. Fifty-five patients were entered and received vinorelbine 30 mg/m(2) on days 1 and 8 + mitomycin C 10 mg/m(2) on day 1, every 4 weeks, up to 9 cycles. Two complete and 23 partial responses were observed for an overall response rate of 45.4% (95% CI 32.0-59.4). Median survival was 13 months and probability of surviving after a 1-year follow-up was 58%. Toxicity was never life-threatening, but G-CSF was used in 45% of cycles to contrast neutropenia that was the most frequent side effect. These results are consistent with previous studies and strongly support VM being considered among the optimal polychemotherapy regimens for second-line treatment of metastatic breast cancer in clinical practice; for clinical research aims, VM should be used as control arm for randomized trials evaluating the activity of new drugs against breast cancer.

Adult↗
PubMed1997

Grand multiparity: a study of 168 cases.

The aim of this retrospective study was to consider the problem of grand multiparity in our female population to evaluate if grand multiparity represents a real risk factor for pregnancy, delivery and fetal well-being. From 1981 to 1989 the Gynaecology and Obstetrics Institute of Turin University together with St. Anna Hospital of Turin carried out a retrospective study on pregnancy course, delivery and fetal status in 168 women who had had four or more pregnancies and in 5320 multiparous women who had parity < 4. We analyzed the parity distribution in the different ages with the aid of the registry office and by consulting patient's obstetric clinical history. We evaluated the incidence of gestational complications in the multiparous group. Finally we studied the delivery modality and perinatal mortality in 72,907 births from 1981 to 1989.

Adult↗
PubMed1997

Complications of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer.

The International Federation of Gynecology and Obstetrics (FIGO) changed the staging criteria for endometrial cancer in 1988 and adopted a surgical-pathological staging involving also pelvic and/or para-aortic lymphadenectomy. A total of 236 patients were treated for endometrial adenocarcinoma at Department B of the Gynecologic and Obstetrics Institute, University of Turin, between January 1976 and December 1995. Our protocol for surgical staging always entails pelvic and para-aortic lymphadenectomy and a simple total hysterectomy and bilateral adnexectomy with removal of the upper third of the vagina. The aim of this study was to carry out a retrospective evaluation of the morbidity in patients with endometrial cancer after surgical treatment, either TAH-BSO alone or TAH-BSO with pelvic and para-aortic lymphadenectomy.

Adenocarcinoma↗
PubMed1997

Surgical management of leiomyomata in pregnancy.

A review was made of the medical records of 26 patients with uterine myomas during pregnancy between 1983 and 1992 among 12,965 deliveries. Thirteen patients underwent myomectomies before pregnancy. In three patients myomectomy was performed during pregnancy between the 12th and the 19th week of pregnancy. In ten patients myomectomy was performed during cesarean section delivery to prevent necrobiosis. Myomectomy should remain exceptional during pregnancy and it must be performed only in selected cases but is frequently used towards the end of a cesarean section. Indications for hysterectomy, on the other hand, remain limited.

Cesarean Section↗
PubMed1997

Cervical cerclage for malformed uterus.

The role of cervical cerclage was evaluated in six pregnant women with anomalous uterus. Early prophylactic cerclage according to the Shirodkar and McDonald technique was done on all cases of uterine malformation (except septate uterus) with or without cervical incompetence in association with progesterone and antispastic therapy. Improvement in obstetrical outcome was noted after cerclage. Even if no doubt exists as to the need for cerclage in cases of cervical incompetence, the concept of routine prophylactic cerclage in all cases of uterine anomalies should be considered.

Abortion, Habitual↗
PubMed1997

Tamoxifen and endometrial cancer: new data for an old problem. Review.

Tamoxifen, a nonsteroidal antiestrogen, is used for pre- and postmenopausal patients with breast cancer. Data on a possible association of endometrial pathologies with Tamoxifen treatment have been accumulating. The current literature and our experience are presented.

Antineoplastic Agents, Hormonal↗
PubMed1996

Cervical cerclage for the treatment of patients with placenta previa.

Over a ten year period, placenta previa occurred in 103 instances among 12,965 deliveries. In six of these, cervical cerclage was undertaken to prevent severe bleeding while prolonging pregnancy between the 24th and the 30th weeks of gestation, according to the McDonald technique. We performed cesarean section delivery in all cases. The medium prolongation of the pregnancy was of 8.2 weeks and the foetus weighed from 1,820 to 3,360 g. No complications due to fetal respiratory distress were observed. No patients needed transfusions. Postpartum and the puerperium were regular. These results support the use of cervical cerclage for the treatment of patients with symptomatic placenta previa early in gestation.

Cervix Uteri↗
PubMed1996

Endometrial carcinoma in women 45 years of age or younger.

Adenocarcinoma of the endometrium in patients 45 years or age of younger accounts for 21% of all endometrial neoplasms diagnosed. The clinical and pathological findings in 17 cases of endometrial adenocarcinoma patients aged 45 years or younger treated between January 1976 and December 1992 in Department B of the Gynecologic and Obstetric Institute, University of Torino, Italy are reported. The patients age ranged from 31 to 45 years, with a median age of 39.3 years. Thirteen of the 17 neoplasms (76.4%) were stage IB (FIGO 1988), two (11.7%) stage IIB, one (5.8%) IIIC and one IVA. Histologically all patients had endometrial adenocarcinoma, eight were well-differentiated tumors (G1), six were moderately-differentiated tumors (G2) and three poorly-differentiated tumors (G3). Three of the patients treated from 1976 to 1979 received post-operative administration of 17-hydroxiprogesterone-19-norcapronate (500 mg i.m. weekly for one year) and 14 of the patients treated from 1980 to 1992 received, according to neoadjuvant hormonal protocols, Medroxiprogesterone acetate (MPA) 1,000 mg daily per os for 90 days and 500 mg per os for one year. The aim of this paper is to draw attention to the existence of this neoplasm in an unexpected age range.

17-alpha-Hydroxyprogesterone↗
PubMed1996

Reduced IL-2 level concentration in patients with breast cancer as a possible risk factor for relapse.

Reduced interleukin 2 (IL-2) production has been described as one of the most frequent immune dysfunctions observed at relapse in patients with disseminated solid neoplasms. It was seen that patients treated for breast cancer (NED-no evidence of disease- at check-up) have a relapse percentage of 4.7% if the IL-2 plasmatic level is normal while the relapse percentage increased to 33.3% if it is low after a 10-12 month follow-up. This link between low IL-2 and the host immune response is a new prognostic indicator and one not strictly related to the tumour itself.

Adult↗
PubMed1996

Management of patients with intrauterine fetal death.

Fetal death incidence is 5-10 per 1,000 births. About 25% of the women who carry a dead fetus for more than 4 weeks will show significant alterations in their coagulation system. The treatment for a patient with endouterine fetal death depends on when the pregnancy is terminated, based on the ecographic fetus age. There were 15,070 births from January 1983 to December 1994 in Department B of the Institute of Obstetrics and Gynecology, University of Torino. We took into consideration the cases ofintrauterine fetal death between the 26th and 40th week before labour. This study is based on a cohort of 57 cases of intrauterine fetal demise from the 24th to the 40th week of pregnancy before spontaneous labour.

Abortion, Therapeutic↗
PubMed1994

Microinvasive carcinoma of the uterine cervix. Diagnostic and therapeutic dilemma.

Squamous microcarcinomas of the uterine cervix represent a focus of controversy regarding a useful clinical definition. The confusion of terminology and numerous pathological definitions have led to a great variety of surgical treatments from the cone to the radical hysterectomy, with pelvic adenectomy. This report analyses retrospectively 133 cases of Stage IA cervical cancers which have been followed up for 10-240 months. The purpose of this work is to seek a uniform therapeutical approach to cervical microcarcinoma with the review of International Literature.

Carcinoma, Squamous Cell↗