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Biomedical subjects

L Mariani

Publications and source records attributed to L Mariani.

At least 19 recordsLinked to original sources
PubMed1995

The influence of radiotherapy on cosmetic outcome after breast conservative surgery.

PURPOSE: The influence of radiotherapy in the cosmetic outcome after conservative surgery for breast cancer was evaluated using an objective method of calculating the asymmetry between the two breasts. METHODS AND MATERIALS: One hundred and one patients treated with the same conservative surgery were evaluated for cosmetic outcome. Sixty-one of them received external radiotherapy (50 + 10 Gy) to the residual breast; the remaining 40 underwent surgery only. The aspect of the patients' breasts was objectively assessed for symmetry by means of a computerized technique. A subjective assessment of the cosmetic outcome was performed both by physician and patient. These objective and subjective assessments were compared in the two groups treated with or without radiotherapy. RESULTS: The results obtained did not show significant differences in terms of cosmetic outcome in the two groups. Skin telangectasia was noted in two radiotherapy patients, while hypertrophic breast scars were only noted in six nonirradiated patients. CONCLUSIONS: We found that standard radiotherapy does not seem to influence the symmetry and the cosmetic results in breast conservative treatment when compared to a similar group of patients with the same quadrantectomy procedure and no radiotherapy.

Adult↗
PubMed1995

Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients.

Breast conservation has become well-established in the treatment of early mammary carcinoma. However, a standardised treatment modality has not emerged. We have analysed the data from 1,973 patients treated in three consecutive randomised trials by four different radiosurgical procedures: Halsted mastectomy, quadrantectomy plus radiotherapy, lumpectomy plus radiotherapy, and quadrantectomy without radiotherapy, to compare the outcomes of these procedures in terms of local recurrence rate and overall survival. Eligibility criteria were similar in the three trials, and comparability between the four subgroups was excellent. Median follow-up for all patients was 82 months. The annual rates of local recurrence varied markedly according to the treatment. Patients treated with Halsted mastectomy and quadrantectomy plus radiotherapy had low annual rates of local recurrence (0.20 and 0.46, respectively) while both lumpectomy plus radiotherapy and quadrantectomy without radiotherapy had significantly higher rates (2.45 and 3.28, respectively). Patients under 45 years of age had a much higher incidence of local recurrences, while in women over 55 years local recurrences were much less frequent. Overall survival curves were identical in the four groups of patients, so that the three breast conserving radiosurgical procedures had the same survival rates as Halsted mastectomy. However, local recurrence rates were markedly influenced by the treatment method, patient age and specific histological features.

Adult↗
PubMed1995

Endocrinological and clinical evaluation of exemestane, a new steroidal aromatase inhibitor.

The androstenedione derivative, exemestane (FCE 24304), is a new orally active irreversible aromatase inhibitor. Fifty-six post-menopausal advanced breast cancer patients entered this study to evaluate the activity of four low exemestane doses in reducing oestrogen levels. The drug's tolerability and clinical efficacy were also assessed. Exemestane was orally administered to four consecutive groups at daily doses of 25, 12.5, 5 and 2.5 mg, and the changes in oestrogen, gonadotrophins, sex-hormone binding globulin and dehydroepiandrosterone sulphate levels were evaluated. Drug selectivity was studied by measuring 17-hydroxycorticosteroid urinary levels. After 7 days of treatment, mean oestrone and oestradiol levels had decreased by respectively 64% and 65% (a decrease which was maintained over time); in the 2.5 mg group, oestrone sulphate levels also decreased by 74%. Gonadotrophin levels were significantly higher, whereas no changes in the other serum hormone levels or any interference with adrenal synthesis were detected. Treatment tolerability was satisfactory: nausea and dyspepsia were reported in 16% of patients. The overall objective response rate was 18%. In conclusion, exemestane is effective in reducing oestrogen levels at all of the tested doses and shows interesting clinical activity.

Adult↗
PubMed1995

[The role of hysteroscopy in the follow up of post-mastectomy patients undergoing adjuvant therapy with Tamoxifen].

The authors report on up to date knowledge of the risk of endometrial carcinoma women operated on mastectomy for breast carcinoma and treated with TAM. Starting from their own clinical and scientific experience, the authors follow a group of such patients with a strict monitoring, to ascertain the eventual comparison of dysplastic and neoplastic endometrial pathologies. The group numbers 18 patients and the aim of the study is to evaluate the importance of hysteroscopy as a diagnostic approach for this iatrogenic pathology. The authors affirm the validity of this partially invasive diagnostic method that has to be integrated with clinical and laboratory parameters that are justified by the cost/benefit ratio always favourable for the diagnosis of a neoplastic pathology.

Aged↗
PubMed1995

[The audiometric evaluation of Buenos Aires schoolchildren].

This cross-sectional study, which was carried out between 3 May and 30 September 1993, involved examination with a pediatric otoscope of a random sample of 100 first-grade schoolchildren in a Buenos Aires hospital, followed by tonal audiometry and tonal sweep in 90 of those children. The objectives of the study were to discover the frequency of hearing disorders and to evaluate the importance of audiometric screening in the child population. The results were classified according to the type (conduction or perception) and degree (mild, moderate, or severe) of hypoacusis, which was detected in 36 children (39%). Of those affected, 35 had mild or moderate conduction hypoacusis (loss of less than 31 decibels [dB] or less than 41 dB, respectively). No case of severe hypoacusis was found. The authors consider that audiometric screening of children entering primary school is justified by the high frequency of preventable hearing problems and by the repercussions that those problems can have on speech and learning.

Argentina↗
PubMed1993

Analysis of electroporation-induced genetic damages in V79/AP4 Chinese hamster cells.

Electroporation is a recent technique used to introduce exogenous DNA into eukaryotic cells. It is important to establish that the gene of interest is transferred into a functional, non-mutated recipient cell. V79/AP4 Chinese hamster cells were exposed to high-voltage pulsed electric fields and some biological and genetic effects were measured. The results showed that cytotoxicity was related in a dose-dependent manner to the number of applied pulses. Thioguanine-resistant colony-forming cells as well as chromosomal aberrations were also induced whereas ouabain resistants and sister-chromatid exchanges were not or slightly induced. Spontaneous and electroporation-induced clones that were phenotypically TGR/HATS were used to investigate the hprt locus. Molecular screening of the locus showed that the number of deleted exons was significantly higher in induced than in spontaneous TG-resistant clones, suggesting that the genetic damages induced by electroporation concern the loss of regions well over the size of the hprt locus.

Animals↗
PubMed1992

Chinese hamster ovary cells deficient or proficient in O6-alkylguanine-DNA alkyltransferase activity are equally sensitive to X-rays.

In mammalian cells, under aerobic conditions, ionizing radiations and radiomimetic chemical agents can induce an enzymatic activity involved in DNA repair, O6-alkylguanine-DNA alkyltransferase (O6-AT). This catalytic protein is active against alkyl-radical-induced DNA damages. This induction was proposed to be linked to the formation of hydroxyl radicals. The possible involvement of O6-AT in the defense mechanism of the cell against aerobic radiation damage was investigated by comparing the X-ray sensitivity of two Chinese hamster ovary (CHO) cell lines, the first deficient (CHO mex-) and the second proficient by transfection of O6-AT (CHO mex+). The colony-forming ability after X-irradiation was appreciably reduced in CHO mex- in comparison to CHO mex+ cells. Nevertheless, pretreatment of proficient cells with O6-methylguanine, a specific inhibitor of O6-AT, reduced the DNA repair activity but did not modify the degree of sensitivity to X-rays of the CHO mex+ cells. Since the glutathione concentrations as well as the DNA damage amounts induced by X-irradiation were comparable in the variously treated cell lines, these results suggest that the observed induction of O6-AT by ionizing radiation in aerobic conditions could be a generalized rather than a specific response to damage by radicals.

Alkylation↗
PubMed1992

The ability of liver extracts from different-aged rats to repair 'mis-instructive' and 'non-instructive' lesions of DNA.

The ability to repair 'mis-instructive', O6-methylguanine, and 'non-instructive', AP sites, DNA lesions in Fischer 344 rat livers at various ages was determined. Different behaviours were observed. While the AP-endodesoxyribonuclease enzymes displayed a high constant level throughout the animals' lifetime, the O6-methylguanine-DNA methyltransferase activity presented a stepwise modulation (DNA normalisation of results): the O6-MT activity significantly increased within the first month of animal life and enhanced again after 6 months reaching a maximum plateau in the 12-18-month-old animals. Thereafter a net significant decrease of O6-MT enzyme was detected in the 24-month-old group. While the repair of the widely formed AP sites appeared uniformly efficient like 'house keeping' functions, the removal of the rare precancerous O6-methylguanine is age-dependent indicating a decreased protection of the youngest and oldest animals against this 'mis-instructive' damage. However, any extrapolation of the age-associated cancer risk needs further assessment.

Aging↗
PubMed1992

Prevention of local relapses and new localisations of oral leukoplakias with the synthetic retinoid fenretinide (4-HPR). Preliminary results.

This paper analyses preliminary results of a randomised chemoprevention trial in patients surgically treated for oral leukoplakia started in 1988 at the Istituto Nazionale Tumori of Milan with the synthetic retinoid N-(4-hydroxyphenyl)-retinamide (4-HPR). To date 115 patients have been randomised, after surgical excision of oral leukoplakia, to receive 200 mg 4-HPR daily for 52 weeks versus no intervention. 80 patients completed the 1-year intervention, 41 in the control group and 39 in the 4-HPR group. During this period 12 local relapses or new lesions occurred in the control group and three in the 4-HPR group. Only 5 patients interrupted the intervention because of toxicity. No impaired dark adaptation was observed. It is concluded that 4-HPR is well tolerated and seems efficacious in preventing relapses and new localisations during the treatment period. This promising trend needs further confirmation.

Adult↗
PubMed1992

[Laparoscopic treatment of varicocele].

Varicocele is frequently a contributing factor in male infertility. We performed laparoscopic treatment of varicocele in 6 patients. This procedure can be carried out through three ports and allows not only ligation and excision of the dilated testicular veins, but those veins branching through the back of the inguinal canal lower down. It is a quick operative procedure and we completed it within 30 minutes. All the patients have gone home on the 2 days and, to date, there have been no complications. During a follow-up period of 3-6 months it was possible to observe the disappearance of varicocele. It is possible to conclude that the laparoscopic procedure is simple and effective as more traditional methods.

Adult↗
PubMed1992

The effectiveness of danazol therapy in postmenopausal women affected by endometrial hyperplasia.

Forty eight patients in postmenopause affected by histologically confirmed endometrial hyperplasia (34 with simplex and 14 with complex forms) were administered Danazol therapy, 400 mg/day for 3 consecutive months. At the end of treatment, regression of the endometrial hyperplasia was histologically ascertained in 46 patients (95.9%) with disappearance of the metrorrhagia. Endometrial atrophy was obtained in 75% of the cases, while secretive (14.7%) or proliferative (6.2%) aspects resulted in the others. Only 2 patients (4.1%) showed persistence of the hyperplastic endometrium. On the basis of this experience, treatment with Danazol appears to be effective and safe with only scarce and transient side effects. This therapy is therefore proposed as a valid alternative to progestogen therapy in cases of postmenopausal endometrial hyperplasia.

Aged↗
PubMed1991

Spontaneous trigemino-pontine pneumocephalus.

A case of a spontaneous trigemino-pontine pneumocephalus in a 25-year-old man without any known risk factors is described. Other cases of spontaneous pneumocephalus in the literature are briefly reviewed.

Adult↗
PubMed1991

[Cytological history of 101 patients with invasive cancer of the uterine cervix].

The cytological history of 101 patients affected by cervical cancer was examined. Three different groups of patients were identified: Group I included 73 women (72.3%) who had never submitted to a cytological cervical sampling, Group II included 17 (16.9%) with an unsatisfactory cytological history and Group III included 11 (10.8%) with a satisfactory cytological history. The disease stage at the time of hospitalization was evaluated in all three groups. In group I, the diagnosis of Stage I was made in 43% of the cases while in the second and third groups, this same stage was diagnosed in 75% and 80% of the cases respectively. Three of the patients from group III presented a normal cytological history, while the other 8 had an abnormal cytological response. Sixty five percent of these 8 had not been submitted to further cytological testing briefly thereafter. From an analysis of these data, the authors attempted to identify the reasons for unsuccess which are still today related to a screening program such at that for cervical cancer. Various international proposals on the organization of a screening program are considered with particular attention given to the minimum and maximum age limits of the women selected for the screening with reference to the authors' personal experience.

Adult↗
PubMed1991

[Psychologic reactions of patients undergoing magnetic resonance imaging. Preliminary study].

MR imaging, like other imaging techniques, can cause emotional and psychological reactions in the patients. Although reversible, these reactions sometimes lead the patient to absolutely refuse the examination or to make it impossible to carry it through. To investigate the patients' emotional distress, a study group of 28 subjects was examined. They were heterogeneous in sex, age, and pathologic condition. The main psychological reactions were analyzed, and anxiety--both of state and of trait. The anxiety parameter was evaluated as a specific index in the psycho-behavioral modifications induced by MR examination. The influence was also considered of the "fantasies" related to examination results on the patients' psyche. Talks and STAI X1 and STAI X2 were employed to this purpose, to identify possible disturbing elements related to both patients' character and examination situations. Our results point to anxiety as the major reaction observed in the subjects undergoing MR examination; it seems to be related to different parameters, which are difficult to identify. Claustrophobia, pathofobia, and the fear of an unknown examination play a major role. Talking to the patients and informing them of the characteristics of the examination proved useful to significantly reduce their emotional distress.

Adolescent↗
PubMed1990

[Manual and mechanic anastomosis. Comparison in oncologic surgery of the colon and rectum].

Personal experience in the treatment of 60 cases of cancer of the large bowel with left hemicolon and rectal localisation is reported. 20 manual double layer anastomoses (group I), 20 single layer (group II) and with mechanical stapler (EEA stapler) (group III) were carried out in consecutive series. The results are reported in terms of early local and general complications: specifically 13 cases of anastomotic dehiscence of which 69.2% were observed in group I, 15.4% in group II and 15.4% in group III. Total postoperative mortality was 5%, average hospitalisation was as follows: 19 days group I, 14 days group II, 17 days group III. The value of single layer anastomoses, which is comparable to results with the stapler whose use is essential in cases of real manual technical difficulty, is stressed.

Adult↗
PubMed1990

Clinically useful measures to assess the effectiveness of treatments: hints for a proper choice with special emphasis on cancer research.

Several absolute and relative measures useful to assess the consequences of treatments in cancer research are presented together with statistical methods suitable for computing the pertinent confidence intervals. The relationship of these measures with the parameters of the regression models commonly used in the analysis of survival data is elaborated upon. Three examples are elaborated, and conditions of interchangeability of the measures are discussed in detail. Finally, suggestions for the choice of the measure most appropriate for a specified data set are given.

Clinical Trials as Topic↗