Biomedical subjects
Publications and source records attributed to M Marchetti.
The authors have studied 152 patients aged between 15 and 20 year old who underwent colposcopy and colpocytology. They have compared the incidence of white colposcopic lesions with the results of the cytology. According to literature the results have pointed out that the very young patients are "at risk-patients" for serious cervical lesions and that depistage of gynecologic tumors must be done in all the other women.
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The problem of hormonal treatment of benign disease and mastodynia is still dividing Clinicians and Researchers. The Authors, in order to select the patients suitable to be treated, propose the assay of Estradiol and Progesterone Receptors in the most accessible hormone-dependent tissue: the Endometrium. Author's data point out a quite different behaviour of Estradiol and Progesterone cytoplasmic receptors in the Endometrium of women with B.B.D. and controls. The knowledge of this information in the single patients will release from subjectivity when deciding about B.B.D. therapy or when trying to correct unsatisfactory treatment.
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The uptake of an injected dose of [3H]PteGlu and its incorporation into folate forms in the liver of control and phenobarbitone-treated rats were investigated at a number of time intervals from 1 to 24 h. At 1 h the hepatic uptake of the label was quite similar in both groups of animals and radioactivity was incorporated only in pteroylmonoglutamates. At 6 h label was present also in pteroylpolyglutamate forms and radioactivity values were similar in the two groups. At longer time periods the radioactivity was lower in treated animals than in control ones. The whole data show that phenobarbitone on the one hand does not modify the transport of the vitamin; on the other, it does interfere with "pteroylpolyglutamate synthetase activity".
Therapeutical program in cervical cancer usually include surgical or radiotherapeutical interventions or a combination of the two, variously integrated with techniques and sequences of application. Treatment planning and evaluation of results are normally based on the classification into clinical stages codified by the FIGO. But this classification, though providing useful prognostic standards of judgement, has proved to be inadequate to identify specific therapeutical guidance. Within a single clinical stage different risk factors have been identified which influence prognosis thus determining the therapeutical treatment more than staging itself. Furthermore clinical staging has failed to predict the surgical stage correctly in a significant number of cases. The index of correction after surgical staging shows discrepancy in about 1/3 of cases. In these cases a therapeutical program based on clinical examination exclusively may prove to be inadequate. The results reported by Authors warrant a rational resort to operative staging in cervical cancer in order to establish the real topography of the original focus more correctly. This indication is further strengthened by the need to identify lymphatic involvement, notably of para-aortic nodes, in locally advanced cases since such an occurrence bears a significant influence on the patient's prognosis and possibility of treatment. On the bases of these considerations the Authors suggest surgery as primary treatment in the management of cervical cancer.
The metabolism of injected [3H] PteGlu in hepatectomized rats was studied. Significantly higher radioactivity was found in all folate derivatives of regenerating liver. The results confirm the hypothesis according to which the decrease of endogenous polyglutamate content of regenerating liver might be ascribed to greater utilization rather than to lower synthesis of these coenzymes.
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Anticonvulsant drugs have well-known relationships with folic acid, often leading, in epileptic patients on long term treatment to signs of folic acid deficiency and to haematological complications. The findings of this work, carried out on rats, show strong interference of phenobarbitone with folic acid metabolism, particularly with pteroylpolyglutamate synthesis in liver. This is proved by lower polyglutamate content, lower 3H folate incorporation in polyglutamate forms and in protein-bound folates, and also by lower blood radioactivity, higher urinary excretion of 3H folate metabolites and by higher 3H folate concentration in kidneys.
The effect of cimetidine on abnormally elevated serum levels of parathyroid hormone was studied in 21 patients with secondary hyperparathyroidism due to chronic renal failure, receiving regular dialysis treatment. The concentrations of carboxyl (-COOH) and aminoterminal (-NH2) fragments of circulating immunoreactive parathyroid hormone (iPTH) were determined before and after 2 months af treatment with cimetidine 400 mg/day. All patients had, on admission, raised levels of either hormonal fragment. The mean pre-treatment value was 17.2 mU/ml for -COOH terminus (upper normal limit 6.5 mU/ml) and 5.7 mU/ml for -NH2 terminus (upper normal limit 1.9 mU/ml). At the end of cimetidine treatment the mean values were 19.9 and 5.7 mU/ml respectively for the two forms of circulating iPTH. No changes in total serum calcium, phosphate or alkaline phosphatase activity were recorded during the study. These results do not indicate any lowering effect of cimetidine on serum iPTH in chronic uraemic patients with secondary hyperparathyroidism.
110 cases of conisation carried out in the Obstetric and Gynecological Clinic of the University of Padua between 1.1.74 and 31.12.82 have been considered. The operations were always performed on completion of diagnostic assertions comprising colpocytology, colposcopy and biopsy, this last undertaken upon indications from both colposcopic and colpo-cytological examinations. The comparison of the histological sample with the serial on the cone, with the cytological, colposcopical and bioptic ones, correspond in the importance of the lesion in almost 90% of cases. The reliability of the diagnosis by the three methods associated and then integrated by the conisation therefore approaches 100%. Prophylaxis carried out in this way allows a personalisation in the operation which, though respecting radicality, must be as non-demolitary as possible.
The rate of [3H] PteGlu uptake and of its incorporation into pteroylpolyglutamate derivatives at different times after label administration, was studied in the regenerating liver of rats 36 hr after partial hepatectomy. While 1 hr after administration of labelled PteGlu the radioactivity levels in regenerating livers are quite similar to controls, they are markedly higher 6, 12, 24 hr after label injection, which is mostly due to the high polyglutamate content. If the regenerating process, on the one hand does not modify the folate uptake rate, it does, on the other, increase the capacity for retaining folates, thanks to a more powerful ability to convert them into pteroylpolyglutamates.
The problem of progestin treatment for benign breast disease and mastodynia is still dividing Clinicians and Searchers: the traditional methods of clinical investigation and follow-up do not allow any further step in the debate. In this work we evaluated the role of E2/Progesterone R.I.A. and thermography in monitoring the effect of progestin on BBD and found that only the latter can give useful informations, insufficient, however, to direct the treatment. If we want to be able to select the patients suitable to be treated by progesterone, we must know the tissutal hormone receptivity and be able to reexamine it during the treatment to verify the effectiveness of the administered drug. These informations can be obtained through the assay of Estradiol and Progesterone Receptors in the most accessible hormone-dependent tissue: the endometrium. Our data point out a quite different behaviour of Estradiol and Progesterone cytoplasmic Receptors in the endometrium of women with mastodynia and controls. The knowledge of these informations in the single patient will let us come out from subjectivity when deciding about BBD therapy or when trying to correct unsatisfactory treatments.
The Authors report the preliminary results of a study performed on patients submitted to radical hysterectomy according to Wertheim-Meigs for cervical-carcinoma, in order to evidence possible changes of the intestinal functionality, by means of a manometric investigation of the anal sphyncteres and measurement of the intestinal transit times. The manometric survey showed that no essential parameter was uniformly altered whereas the transit time measurement proved in some cases the slowing-down of the intestinal progression at the level of the ascending and transverse colon, and a normal transit in the descending colon as well as in the rectum in all examined cases.
We use from some years the doppler method for noninvasive measurements of venous pressure and about seven years ago we communicated the early results. We have confirmed the reliability and sensitivity of the method carrying on our clinical work. Now we report the results of a more extensive observation.
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Chick embryos at 9 and 12 days of development were injected into the air space with [3', 5', 7, 9 -3H]pteroylglutamic acid. After various time periods the incorporation of radioactivity into folate derivatives was measured. In the 9-day embryo the label incorporation into longer chain polyglutamates, expressed per gram, was higher than in the 12-day embryo. Since the endogenous content of these compounds was lower at 9 days, the results suggest that, at this stage of development, the turnover of longer pteroylpolyglutamates is more rapid.
The effects of "acute" phenobarbitone treatment on some aspects of folate metabolism in rat liver, that is total folate activity, protein bound and free folate, and various-length pteroylpolyglutamate amounts, were studied. The administration of two doses of the anticonvulsant drug (8 mg/100 g of body weight), caused a severe depletion in folate pool, free folate and in the percentage of longer-chain polyglutamates, while the amount of protein bound folates was unchanged. Such modifications are more evident in the animals killed at 24 h after the last drug injection rather than in those killed 12 h later. The possible mechanisms by which phenobarbitone might interfere with the synthesis of pteroylpolyglutamates, the actual coenzymic forms of folic acid, are discussed.