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Biomedical subjects

M Greco

Publications and source records attributed to M Greco.

At least 127 records · Page 7Linked to original sources

Quantitative and qualitative cosmetic evaluation after conservative treatment for breast cancer.

148 consecutive patients treated by two different types of conservative surgery were objectively and subjectively evaluated for cosmetic outcome. In 73 patients, tumorectomy, axillary dissection, external radiotherapy (45 Gy) plus iridium implant (15 Gy) were performed, while in the other group of 73 patients a more extensive surgical approach was carried out: quadrantectomy, axillary dissection plus external radiotherapy (50 + 10 Gy). The appearance of the patients' breasts was analysed for symmetry by computer, and differences in symmetry were correlated with tumour location and breast size. A subjective assessment was given by a 3-member panel and the results were correlated with objective measurements. In addition, patients were asked to fill out a self-assessment questionnaire on the aesthetic result of the operated breast. Better results were generally noted in the group of patients treated by more conservative surgery. Substantial differences in the aesthetic outcome were noted between the patient's own evaluation, the computer's measurement of symmetry and the assessment of the panel of observers.

Adult↗

Helium-neon laser irradiation of rat liver mitochondria gives rise to a new subpopulation of mitochondria: isolation and first biochemical characterization.

An experiment was performed to isolate the small atypical mitochondria produced during the irradiation of normal mitochondria with an He-Ne laser. Rat liver mitochondria were irradiated with a low-power continuous-wave He-Ne laser (energy dose, 5 J cm-2), followed by isolation using a sucrose gradient. In the irradiated sample, two bands were observed, one corresponding to normal mitochondria and the other to atypical mitochondria. Certain biochemical features of the mitochondria were investigated: mitochondrial enzyme activity and the presence of DNA and RNA were demonstrated. Hybridization experiments carried out with labelled mitochondrial probes, containing the genes for cytochrome oxidase subunit I and 12S rRNA, confirmed the mitochondrial nature of the isolated RNA.

Adenylate Kinase↗

[Blocking antibodies during specific hyposensitization immunotherapy in respiratory allergies in children].

A group of 35 children affected by bronchial asthma, rhinitis and/or allergic conjunctivitis was examined; the children selected for the study had never undergone ITS before; all patients had received preventive drug and nondrug therapy for several months but none had succeeded in significantly reducing allergic clinical symptoms. Subcutaneous ITS Lofarma was prescribed for all patients (for various allergens) and blocking antibodies (IgG1 + IgG4) were assayed using a RAST system (Kit-Pharmacia) before the start of the study, and after 3, 9 and 12 months of therapy; 25 nonatopic children represented the control group. Although a certain number of allergen-specific blocking antibodies were present in all patients before the start of ITS, a significant increase in IgG1 + IgG4 specific allergens was observed after 9 months (especially for pollenosis). Compatible results were also obtained for blocking antibodies for children affected by dermatophagoides following 12 months of ITS. The aim of the present study was to evaluate the extent of the appearance of blocking antibodies in the circulation following ITS and to discover whether or not there was a correlation between their increased titre and improvement of the disease assessed by the use of clinical scores.

Adolescent↗

Evaluation of resection margins after breast conservative surgery with monoclonal antibodies.

An immunocytochemical method for the detection of cancer cells, in the cell suspension obtained by scraping the surface of the surgical resection margins is described and its sensitivity compared to the conventional histology performed on random biopsies from the same margins. The reactivity of the cells with a pool of monoclonal antibodies (Mab) directed against epithelial markers indicated that in 80% of the 42 cases tested, the scraping method was adequate for the gathering of cells from the margins. The analysis of the samples using B72.3 Mab specific for tumor cells revealed that, among B72.3-positive tumor cases, 31% of breast margins contained tumor cells, whereas only 12% were histologically positive. Our results indicate that the immunocytological methodology is therefore more sensitive and should be used alongside histological examination to detect the tumor contamination in the surgical resection margins.

Antibodies, Monoclonal↗

Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more.

In 165 women with breast cancer who were candidates for mastectomy because the largest diameter of the tumor was 3 cm or more, we administered primary chemotherapy in the attempt to substitute conservative for mutilating surgery. We then systematically quantitated tumor reduction by clinical, radiologic, and histopathologic evaluations. Five consecutive groups of 33 patients received cyclophosphamide, methotrexate, and fluorouracil (CMF); fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide (FAC); or fluorouracil, epirubicin, and cyclophosphamide (FEC). The regimens for the five groups were as follows: group 1, three cycles of CMF; group 2, four cycles of CMF; group 3, three cycles of FAC; group 4, four cycles of FAC; and group 5, three cycles of FEC. In response to primary chemotherapy, 157 of the 161 assessable patients showed measurable tumor shrinkage; progressive disease was documented in four. Tumor shrinkage to less than 3 cm was documented in 127 (81%) of the 157 women subjected to surgery, thus allowing a breast-saving procedure, rather than modified radical mastectomy, in these 127 women. Histopathologic complete remission was documented in seven patients. Tumor response was unrelated to age, menopausal status, DNA content (ploidy), [3H]thymidine-labeling index, drug combination used, or number of treatment cycles in excess of three. The degree of response was inversely proportional to the initial tumor size, and the frequency of response was greater in receptor-negative tumors. Severe vomiting and hair loss were less frequent with CMF than with anthracycline-containing regimens, and the frequency of severe leukopenia and thrombocytopenia was minimal. Our results challenge the classical indication for primary mastectomy by showing that use of full-dose primary chemotherapy, sequentially combined with conservative surgery and radiation, can offer an effective and safe alternative to women concerned about the preservation of body integrity.

Antineoplastic Combined Chemotherapy Protocols↗

[Surgical treatment of blepharoptosis in patients with mitochondrial myopathies. Apropos of 4 cases].

The authors briefly describe the commonest forms of mitochondrial myopathies particularly those associated with disorders of ocular motility. They report their series of four patients suffering from ptosis of the eyelid caused by mitochondrial myopathies. The ptosis was corrected surgically in all cases by means of Müller's muscle adaptation technique. The authors discuss their results and the indication for this technique.

Adult↗

Increase in RNA and protein synthesis by mitochondria irradiated with helium-neon laser.

To gain further insight into the mechanism of cell photostimulation by laser light, both RNA and protein synthesis were measured in mitochondria irradiated with the low power continuous wave He-Ne laser (Energy dose: 5 Joules/cm2). Following mitochondrial irradiation, both the rate and amount of incorporation of alpha-[32P]UTP and L-[35S]methionine, used to monitor RNA and protein synthesis respectively, proved to increase. Electrophoretic analysis made of the synthesis products clearly shows that He-Ne laser irradiation stimulates the synthesis of all mitochondrial transcription and translation products.

Animals↗

Long-term survival and prognostic factors for 2170 breast cancer patients treated at two cancer centers (Milan and Houston).

Data on 2170 consecutive patients with breast cancer submitted to curative surgery with or without combined radiotherapy in the period 1968-1972 at the National Cancer Institute of Milan (Italy) and at the University of Texas M.D. Anderson Cancer Center of Houston (Texas, USA) were analyzed to evaluate the prognosis of breast cancer patients after loco-regional treatment only and to verify if different prognostic factors have the same relevance. Forty-four percent of patients were alive without evidence of disease at the end of the follow-up in both centers: 14% of patients treated in Milan died without evidence of breast cancer with an intercurrent disease, whereas the death rate for intercurrent disease was 27% in Houston. Thirty-seven percent of the patients in Milan and 26% of the patients in Houston died from breast cancer. A considerable percentage of patients (23.4% in Milano, 38.2% in Houston) had one or more of the required items not specified in the clinical chart. Since the lack of information was considered a possible source of bias, the series were divided into two groups: the first collecting patients with all information available, the second gathering patients with at least one of the required items missing. The latter group was defined "unknown". Multivariate analysis of survival, carried out by means of Cox's regression model, showed that mortality of these patients for all causes was significantly affected by the following criteria: status of regional nodes (P = 2 X 10(-13)), unknown (P = 10(-9)), maximum diameter of primary tumor (P = 7 X 10(-10)), age of the patients (P = 10(-4)), site of primary (P = 0.01), and Center (P = 0.04). A significant interaction was found between center and a) age of the patients, b) menopausal status and c) unknown. The relative P values were 6 X 10(-7) for age and center, 8 X 10(-3) for menopausal and center, 3 X 10(-2) for unknown and center. Multivariate analysis of breast cancer mortality was significantly affected by: status of regional nodes (P = 10(-18)), diameter of primary (P = 5 X 10(-14)), unknown (P = 2 X 10(-13)), center (P = 2 X 10(-6)), site of primary (P = 0.002), and age of the patients (P = 0.03). The same significant interaction as for mortality from all causes was found. It is concluded that comparability of results obtained in different institutions may be dependent on the standardization and availability of patients data.(ABSTRACT TRUNCATED AT 400 WORDS)

Age Factors↗

The role of magnetic resonance imaging in the evaluation of neoplastic lesions of the breast.

Thirty-seven patients were evaluated for suspected breast cancer by magnetic resonance imaging (MRI) using 0.5- and 1.5-Tesla. We examined the patterns in breast images and the use of MRI in evaluating neoplasms. At the moment the cost/benefit ratio is unfavorable, mainly because of the availability of alternative methods of high accuracy and low cost, like mammography and ultrasonography. Furthermore fine needle aspiration biopsy is not possible with MRI. The widespread use of MRI for breast pathology seems not to be justified by the results obtained.

Breast Neoplasms↗

Epidural spinal electrostimulatory system (ESES) in the management of diabetic foot and peripheral arteriopathies.

Epidural spinal electrostimulatory system (ESES) or dorsal column stimulation (DCS) may be used for the treatment of peripheral vascular diseases of the lower extremities. ESES has been used in our metabolic and surgical department as a way to ameliorate inadequate blood supply in patients suffering from diabetic foot (seven patients), painful chronic arterial narrowing, or inoperable occlusions (25 patients). The continuous stimulation by an implantable apparatus (Medtronic model Itrel, Medtronic, Inc., Minneapolis, MN, USA) led to a reduction or disappearance of pain, an improvement in plethysmographic curves, functional performance, and trophic lesions in about 75% of the patients. The system is safe and well-tolerated by patients.

Aged↗

[Role of plastic surgery in male sterility].

The Authors discuss the problems related to male infertility, pointing out their different clinical and therapeutical features. They stress the importance of plastic surgery in the treatment of disorders such as penile chordee, hypospadias as well as nervous and vascular lesions.

Humans↗

Norfloxacin prophylaxis for neutropenic patients undergoing bone marrow transplantation.

To prevent bacterial infections in the neutropenic post-transplant period, norfloxacin 400mg twice daily was administered as oral prophylaxis to 44 marrow recipients isolated in laminar airflow rooms (LAFRs). Patients had a mean age of 30 years (8-50) and a male/female ratio of 29/15. The mean duration of prophylaxis was of 41 days (20-80), that of neutropenia (PMN less than 1000 x 10(6)/l) of 31 days (6-76) and that of severe neutropenia (PMN less than 100 x 10(6)/l) of 19 days (10-55). All but two patients developed one or more febrile episodes (total episodes: 71), 33 of which were documented infections. Eighteen bacteraemias occurred and all were caused by Gram-positive cocci: five by coagulase-negative staphylococci (three methicillin resistant), four by coagulase-positive (one methicillin resistant), seven by streptococci (four S. sanguis, one S. milleri, one group B, one group C), and two by enterococci. All streptococcal and enterococcal strains, but only one MR coagulase-positive staphylococcus, proved to be resistant to norfloxacin. Norfloxacin was well tolerated and no prophylactic course had to be interrupted because of side effects. In conclusion, norfloxacin adequately prevents infections caused by Gram-negative bacilli in bone marrow recipients isolated in LAFRs, but Gram-positive infections still remain a problem in these patients indicating the need for improving this prophylactic regimen.

Adolescent↗