Biomedical subjects
Publications and source records attributed to S Parisi.
The paper reports the historical origins of remote afterloading systems in intracavitary radiotherapy, together with the results and complications of high dose rate brachytherapy in gynecological tumours. High dose rate therapy achieves the same results as low dose rate therapy but has the advantage of making treatment more comfortable for patients.
A case of early cutaneous involvement by an acute myeloid leukemia in a Caucasian man, previously affected by a "classical" Kaposi's sarcoma is reported. The diagnoses were based upon histologic examinations and appropriate hematologic investigations. After reviewing extensively the literature about the association of lymphoreticular system malignancies and Kaposi's sarcoma, possible implications and hypothetical etiopathogenetic mechanisms are discussed.
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480 cases of advanced gastric carcinoma are classified according to Laurén or WHO and correlated to age and sex of the patients. The modal value of the incidence for age of the mucinous histologic type is 61-65 years for the men and 71-75 years for the women, while in the signet ring cell histologic type is 50 years in both sexes. These relationship, obtained only by the WHO classification, suggest that mucinous and signet ring cell type constitute distinct histoepidemiological entities.
The authors examine primary small bowel tumours, dealing at some length with problems of a diagnostic and clinical nature. The difficulties often encountered in reaching an early diagnosis and the feasibility of radical surgery frequently prove to be factors conditioning prognosis. The importance is then stressed of thorough evaluation of those vague symptoms which may be the only manifestation of this disease.
The Authors, while presenting a case of endoscopic extraction of a foreign body fixed in the duodenum, underline the value of operative endoscopy, which, going beyond the limits of a exclusively diagnostic technique, is intended as a first choice therapeutic procedure to be always carried out, leaving to surgery the treatment of the most complicated cases and those where the endoscopic attempt fails.
The authors report a case of vascular leiomyosarcoma of the superficial soft tissues, and point out its epidemiologic (rareness of the report), biologic (high degree of malignancy, trend to local relapse and remote conversion into metastases), histopathologic aspects. They consider significant as to prognostic value the appraisal of the "mitotic index" and the opportunity of a radical intervention, followed by radiotherapy. They, moreover, think it useful, in consideration of the frequency of the relapses, to perform a periodic checking of the patient.
Results of a multicentric controlled trial on the efficacy of somatostatin in the treatment of severe gastrointestinal bleeding from peptic origin is reported. The trial was carried out on 90 patients presenting with severe bleeding from hemorrhagic gastric disease in 20 cases, from gastric ulcer in 31 and from duodenal ulcer in 39. Diagnosis was ascertained by endoscopy. Fifty-three patients were treated with somatostatin; in 95% of cases the bleeding was controlled in an average time of 7h 37'. Thirty-seven patients were treated with H2 receptors antagonists and the bleeding was controlled in 76.3% of cases in an average time of 21h. Cases treated with somatostatin required a lower amount of blood transfusion (1 Unit/patient, against 2.7 Units). The better efficacy of somatostatin, at least on a temporary basis, in the control of severe upper gastrointestinal bleeding is underlined while keeping in mind that prevention of recurrence is still an open question.
Uterine cervical carcinoma is a locoregional disease. However, particularly in advanced stages, in the presence of N+ and pelvic relapse, it may produce secondary lesions located far from it. In our case series, consisting of 473 portio carcinomas treated at the Institute of Radiology of the U.C.S.C., we found distant metastases in 6.76% of the cases. This study examines the cases of metastasis in relation to stage, histology, risk-factors, treatment of the primary tumour and survival after the treatment of the secondary lesions.
Radical surgical intervention is not always possible in vulvar tumours, particularly in infiltrating forms of paraurethral locations. In our case-series, the supplementary performance of Curietherapy, particularly with Radium substitutes (Iridium 192) and following the afterloading method, has enabled us not only to obtain long disease-free periods but also, coupled with the "large volume" of External Radiotherapy, to master forms exceeding the surgical action scope.
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The validity of the assessment of the fetal age and pulmonary maturity was evaluated on 369 patients at various stages of normal pregnancy and complicated by diabetes, toxemia and fetal anencephaly. Gestational maturity was assessed by ultrasonic measurement of the fetal biparietal diameter and by analysing constituents of amniotic fluid (creatinine, bilirubin, fat cells) while pulmonary maturity was assessed from the L/S ratio in the amniotic fluid. Each individual method has a wide margin of error, however, ultrasound cephalometry gave the best prediction for determination of fetal age. In 135 selected cases lung maturity was assessed by using two techniques, a thin layer chromatographic determination of the lecithin/sphingomyelin ratio in the amniotic fluid and a rapid semiquantitative test to determine the titre of surfactant which generates stable foam in presence of ethanol. The results obtained by the two methods correlated well and were reliable in predicting the respiratory distress syndrome. It appears that these methods make it possible to obtain greater margins of reliability. The role of fetal and maternal factors in the maturation of fetal lungs was also studied in several pathological conditions and it was noted that in many cases of maternal diabetes mellitus lung maturity was reached at a later age than in normal pregnancies. It is condluded that if termination of pregnancy is indicated, the physician should rely more on the assessment of lung maturity than on indicators of gestational age.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.