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R Molinari

Publications and source records attributed to R Molinari.

At least 109 records · Page 6Linked to original sources

Utility fo gallium-67 in determining the radicality of lymph node dissections of the neck for metastatic lymph nodes with extranodal spread in patients affected by carcinoma of the head and neck.

AIMS AND BACKGROUND: Based on the fact that scintigraphy more readily reveals uptake of a radioisotope in a superficial position owing to incomplete surgical radicality, the authors examined by 67Ga scintigraphy a group of patients who had undergone dissection of lymph nodes of the neck from carcinoma with extranodal spread. They then checked the follow-up to ascertain the efficacy of 67Ga scintigraphy in relation to the eventual recurrences in the soft tissues of the neck. METHODS: A group of 136 patients were examined by 67Ga scintigraphy and followed for a minimum of 3 years after complementary radiotherapy. A group of 20 patients with no lymph node metastases was used as control to evaluate eventual false positives or false negatives. RESULTS: Recurrences in the soft tissues of the neck occurred in 35 (42.7%) of the 82 patients positive at 67Ga scintigraphy and in 6 (11.1%) of the 54 patients negative at the examination (P = 0.0001). All the patients in the control group were negative at 67Ga scintigraphy and without recurrences. CONCLUSIONS: 67Ga scintigraphy can give reliable information on the risk of recurrences in the soft tissues of the neck. Since in spite of postoperative radiotherapy the percentage of local recurrences in cases with positive 67Ga scintigraphy was rather high (42.7%), the authors propose a scheme of radiotherapy based on administration of a higher dose per fraction on the scintigraphically positive area.

Adult↗

A statistical approach to detection of the primary cancer based on the site of neck lymph node metastases.

Preoperative differential diagnosis of a swelling in the neck is mandatory for a good therapeutic planning. Indiscriminate biopsy as first approach is to be disregarded, since it can compromise the result of a radical neck dissection in cases where a metastasis of epidermoid cancer is histologically recognized. A cervical biopsy is not to be performed until a complete HNT examination (including the thyroid and major salivary glands) has excluded the presence of a primary tumor in these regions. Since every localization of the head and neck malignancies shows rather fixed patterns in its lymphatic spreading, a correlation between site of T and particular localizations of N within the neck can be found. The knowledge of the probabilities that an adenopathy in a given region of the neck correlates with a primary tumor located in a given site of the body could strongly aid the physician in detecting the latter, following a rational statistically based approach. This study was performed applying Bayes theorem for probability calculus to the maps of distribution of metastases of tumors of different site in 3,700 patients who were taken into National Cancer Institute of Milan during 7 consecutive years. The results are gathered in tables and text-figures showing the great significance of some correlations, who become more evident when the adenopathies are multiple, but who usefully direct the physician also when the adenopathy is only one.

Adult↗

Results of 60Co-teletherapy in oral cancer.

Our study reports 282 oral cancer cases treated with 60Co-teletherapy (TCT), taken from 736 oral carcinomas treated with radiotherapy on the primary tumor from January 1959 to December 1970. They were mainly locally advanced cases which often had regional node involvement. In fact, during that period, the more advanced cases were submitted to TCT. There were only 9 (3.2%) patients with T1 lesions, while there were 134 (47.5%) T2 and 139 (49.3%) T3, T4 cases; there were respectively 106 (37.6%) and 44 (15.6%) N1 or N2 and N3 cases. Almost half of the patients were greater than or equal to 66 years old at onset of the treatment (138/282 cases, or 47.2%); the women were a small minority (18/282, or 6.4%). There were 58 (20.6%) carcinomas of the mucosal surface of the cheeks, 60 cases arising from the retromolar areas, the upper-lower alveolar processes and the hard palate (21.3%), 72 carcinomas of the mobile portion of the tongue (25.5%) and 92 arising from the floor of the mouth (32.6%). All the patients considered in the study were treated with conventional techniques by doses, field dimensions and fractionation. The overall results were objectively disappointing, even though they should be evaluated keeping in mind the nature and the gravity of oral carcinomas submitted to TCT. Actuarial survival at 5 and 10 years from the onset of treatment was respectively 11.6% and 6.4%. None of the N1, N3 cases survived beyond the fourth year from onset of the treatment. Long-term survival differs very little in relation to the site of origin in the oral cavity. Nowadays, TCT alone may have only a palliative role in the treatment of oral cancer, reserving it for those cases which, due to their extreme gravity or the various contraindications, do not permit more aggressive treatments. In a combined therapeutic approach the aim of TCT today is to control the minimum disease foci. Its association with surgery appears to be most effective.

Aged↗

Surgical treatment of laryngeal carcinoma with subglottis involvement.

Primary cancers arising in the subglottic region are rare and are characterized by a long asymptomatic phase. More frequently the subglottis is reached by tumors arising in the glottis or even the supraglottis through invasion of the paraglottic space. Involvement of the subglottis is associated with a relatively high frequency of stomal recurrences due to a peculiar lymphatic spread to the paratracheal nodes. We analyzed a retrospective series of 68 patients with squamous cell carcinoma of the larynx extending to the subglottis region submitted to total simple laryngectomy or total laryngectomy enlarged with hemithyroidectomy and dissection of level VI nodes (HT/SPD). Overall median follow-up is 46 months. Subglottic extension was correctly diagnosed before operation in only 13/68 patients, however the resection margins, systematically determined by the pathologist, were in every case negative. Stomal relapses in laryngectomized patients without HT/SPD have been more frequent (0.55% rate per month) than in those treated with laryngectomy and HT/SPD (0.07% rate per month). It is concluded that CT should be routinely applied in preoperative staging in order to estimate the extension of the neoplasia and surgery should always include hemithyroidectomy and dissection of the homolateral paratracheal nodes when there is even minimal involvement of the subglottis. Moreover, the high incidence of second tumors in our series is noteworthy; such patients might benefit from chemopreventive therapy.

Adult↗

Preparation and characterisation of membranes with entrapped TiO2 and preliminary photocatalytic tests.

The possibility of entrapping polycrystalline TiO2 in a polymeric support, in order to couple the two unit operations, i.e. ultrafiltration and photodegradation of organic pollutants in aqueous solutions, was investigated. To this aim, polymeric membranes for ultrafiltration with entrapped TiO2 were prepared, characterised and tested. The polymeric support chosen was commercial polysulfone (PSf). The membrane preparation was carried out with the technique referred to as phase inversion. A three-component system, with a polymer, a solvent and a non-solvent was used. The best operative conditions were determined in order to obtain the desired membrane morphology. Permeability measurements and photostability tests were also carried out by using a system under pressure. Finally, a preliminary investigation was performed in order to evaluate the photocatalytic activity of the membranes with entrapped TiO2 for the oxidation of 4-nitrophenol as a model molecule in aqueous solutions.

Catalysis↗

Supported liquid membrane stability in chiral resolution by chemically and physically modified membranes.

In the present work some stability studies on Supported Liquid Membranes (SLMs) to be used for chiral separations were realized. In particular, primary aim was to determine how a modification of the support surface influences the SLM stability. First, the procedure for support modification was optimised, making a screening of various compounds (sulphuric acid, nitric acid, chromic acid, sodium dodecyl sulphate (SDS), glycerol, oleic alcohol, propylene glycol (PPG), bovine serum albumin (BSA)) and testing their performance by means of contact angle measurements. Next, a second screening was realized by permeation tests in a stirred cell. Finally, to compare the stability of modified with unmodified support in a process of interest for chemical and/or biochemical industries, some permeation tests for resolution of DNB-DL-Leucine were realized in a re-circulation system. Results showed a better surface hydrophilization of chemically modified support and better stability of the sulphonated support. However, in operating conditions a little high stability of the unmodified support was obtained.

Filtration↗

Photocatalytic membrane processes for degradation of various types of organic pollutants and micropollutants in water.

Degradation tests in a photocatalytic membrane system have been carried out using TiO2 (Degussa P25) as catalyst and humic acid, organic dyes, 4-nitrophenol as pollutants. The influence of UV radiation and initial concentration of pollutant on the photodegradation rate were investigated in discontinuous and continuous systems. Experimental results showed that it is possible to obtain an efficient photocatalytic membrane process, but various parameters (e.g. pH) should be optimised to obtain high reaction rate and high membrane rejection of pollutants and their by-products.

Catalysis↗