bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-Thoracotomy Diagnostic and Staging Conversion Rates of Clinically Staged I Lung Cancer
Authors: Valente Maurizio , Pastorino Ugo , Piva Luigi , Guzzon Adalgisio , Ravasi Gianni
Published: April 2018

The accuracy of stage I lung cancer assessment achieved by traditional clinico-diagnostic staging was retrospectively evaluated in 164 consecutive patients who underwent thoracotomy. The diagnostic conversion rate was 6.7 % (1 carcinoid and 10 innocent pulmonary lesions) and occurred only in the subset of patients lacking preoperative pathologic confirmation (15 %). The conversion rate to unresectable tumor extent was 8 % (11/153), and local spread was the main cause of unresectability (5.5 %). The staging conversion rate was 29 % (43/153): the conversion rate for nodal evaluation was double that of primary tumor evaluation (24 % versus 12 %), but conversion to anatomically unresectable nodal diffusion occurred in only one patient (0.6 %). The ability of the surgeon to convert the wrong diagnosis was scanty without extemporary biopsy, and 7 patients with innocent lesions underwent standard resection for primary cancer. Surgical staging was as precise as pathological staging in primary tumor evaluation, but was faulty in nodal evaluation (15 % error in sN0 and sN1-2 assessment). It is concluded that following stage I lung cancer assessment by traditional means, supplementary examinations are requested for a better sensitivity of pathological confirmation and a better refinement of local spread. Better nodal evaluation has less value until a biologic limit to surgery for anatomically resectable nodal diffusion is universally accepted.
Ultrastructural Aspects of the Dermatofibroma
Authors: Candiani Piero , Rainoldi Roberto , Sideri Mario , Le Grazie Cristina , De Virgiliis Giuseppe , Donati Luigi
Published: April 2018

The authors describe the ultrastructure of 2 dermatofibromas. Fibroblasts, the prevailing cellular component, showed different aspects related to a grading of their functional activity. No features of collagenogenesis were observed. Mast cells were also present, and nerve endings were found in subepidermal areas.
Unexpected Breast Cancer Detection after Outpatient Biopsy for Benign Lesion
Authors: Di Pietro Sergio , Azzarelli Alberto , Merson Mirella
Published: April 2018

At the Istituto Nazionale Tumori of Milan, in its Outpatient Department, 1302 breast surgical biopsies were carried out in 1978. Fibroadenomas occurred in 44.2% and benign dysplasias in 39.3%. Sixty-two cancers (4.8%) and 23 atypical hyperplasias (1.8%) were unexpected findings, with an increasing incidence in women over 50. Seventy-nine duct resections were performed for significant nipple discharge and revealed 5 unexpected carcinomas and 28 papillomas or papillomatosis. In our opinion and experience, this procedure of performing breast biopsy in the presence of a solid lump in women over 30 without hospitalization improves early detection of cancer, lowers costs, cuts down admission waiting lists and increases the number of women who better accept a surgical diagnosis and treatment.
Combination Chemotherapy for Metastatic Brain Tumors
Authors: Conte Pier Franco , Giaccone Giuseppe , Musella Roberto , Calciati Alessandro
Published: April 2018

Forty-four patients with central nervous system metastases were treated with combination chemotherapy (adriamycin, VM 26 and CCNU). The best results were obtained in breast adenocarcinoma and small cell lung carcinoma with multiple, small cerebral metastases and without concomitant visceral involvement at other sites. The potential effectiveness of this regimen to prevent cerebral metastases is discussed.
Modality of Lung Cancer Treatment in an Unselected Population
Authors: Pastorino Ugo , Valente Maurizio , Benino Franco , Crosignani Paolo , Ravasi Gianni
Published: April 2018

The modality of lung cancer treatment was retrospectively evaluated in an unselected population. All the lung cancer cases diagnosed among the residents in a Local Sanitary Unit of Lombardy during four years (1974–1979), were identified. The clinical records of the 235 collected patients were reviewed and on this basis the anatomical extent of disease was retrospectively classified in stages according to the TNM of UICC (1978). The relative frequency of clinical stages resulted 29 % for stage I, 17 % II, 20 % III and 32 % IV. Only 57 % of all the subjects had been treated; 11 % by resection, 22 % by radiotherapy and 24 % by chemotherapy. For the stages I and II the operability rates were 35 % and 26 % respectively, while the resectability rates were 29 % and 17 %. An objective reason of exclusion from surgery was found in no more than a quarter of stage I and II lung cancers, while the remaining (40 %) had probably been excluded from exploration owing to a subjective prognostic evaluation. If compared with similar reports from other countries, these data show a striking defect in the choice of curative treatment for a high proportion of the examined cases.
Monitoring of a Long Survival Myeloma Patient
Authors: Boccadoro Mario , Van Acker Annette , Carmagnola Anna , Conte Franco , Pileri Alessandro
Published: April 2018

Monitoring with anti-idiotypic sera has been applied to identify tumoral cells in a myeloma patient still alive in complete remission 9 years after diagnosis. Monoclonal plasma cells displayed a labeling index that decreased in complete remission below 1 %. The great majority of B lymphocytes belonged to the tumoral clone even in complete remission and were therefore not affected by conventional chemothrapy. Some aspects of this myeloma patient are discussed in the light of these immunologic and kinetic findings. In addition, it is suggested that the therapeutic management of the complete remission should be re-examined, by considering a lymphocytolytic therapy.
Ataxia Telangiectasia and Acute Lymphoblastic Leukemia: Report of a Case
Authors: Pastore Guido , di Montezeinolo Luca Cordero , Madon Enrico
Published: April 2018

We report a new case of ataxia-telangiectasia (AT) and acute lymphoblastic leukemia (ALL) and review all 21 known cases of AT and ALL. Leukemia in these patients is associated with a male predominance, age older than 10 years at diagnosis, a white blood cell count higher than 50,000 mm3, and a fatal course. Four patients have been reported who developed T-cell leukemia, 3 null-cell leukemia and 1 B-cell leukemia. The AT-ALL patients appear to be at risk for infections related to their immunodeficient status and ALL chemotherapy. In addition, neurologic deterioration has been noted during the early phase of therapy.
Criteri Istologici per La Valutazione Prognostica Del Neuroblastoma
Authors: Ceccamea Alberto , Bonamico Margherita , Napoleoni Marina
Published: April 2018

Gli autori espongono i risultati di uno studio statistico concernente le correlazioni tra quadro istopatologico e durata di sopravvivenza, in 41 bambini affetti da neuroblastoma. Dopo aver accennato alla significatività di alcuni elementi clinici, vengono descritti i reperti istologici che possono fornire indicazioni sul comportamento della neoplasia. Tali reperti sono rappresentati dal grado di differenziazione e dal grado di infiltrazione linfocitaria del tessuto neoplastico. Infatti dal confronto dell'incidenza di tali reperti nei soggetti deceduti ed in quelli sopravvissuti si sono rilevate differenze statisticamente significative (p < 0.001). Gli autori sottolineano, inoltre, che il grado di differenziazione cellulare si identifica con il numero degli elementi in evoluzione maturativa e non con il numero delle cellule del tutto mature.
A Comparison of the Lethal and Kinetic Effects of Doxorubicin and 4′-EPI-Doxorubicin in Vitro
Authors: Hill Bridget T. , Whelan Richard D.H.
Published: April 2018

« In vitro » lethal and kinetic effects of 4′-epi-doxorubicin (EPI-DXR) have been established and compared with those of doxorubicin (14-hydroxy-daunorubicin, adriamycin, NSC-123127, DXR). Both drugs show comparable cytotoxicity against a range of murine and human cell lines. Cytotoxicity increases exponentially with drug concentration and with duration of exposure. EPI-DXR like DXR exerts maximal lethal effects during the late S and G2 phases of the cycle in synchronised N1L8 Syrian hamster cells. Flow microfluorimetric data and measurements of mitotic indices provide evidence of population arrest in G2 with both drugs. Responses of various drug-resistant L5178Y cell lines were similar for DXR and EPI-DXR: (i) DXR-resistant cells exhibit complete cross-resistance to EPI-DXR, (ii) vincristine-resistant cells are cross-resistant to DXR and EPI-DXR, and (iii) methotrexate-resistant and 5-fluorouracil-resistant cells show collateral sensitivity to both drugs. These studies emphasise the similarities of DXR and EPI-DXR.
Effetti della Calcitonina Sintetica di Salmone Nel Trattamento delle Lesioni Ossee di Tipo Neoplastico
Authors: Adamo Vincenzo , Altavilla Giuseppe , La Torre Francesco , Palmara Domenico , Tropea Francesco
Published: April 2018

Gli autori descrivono i risultati terapeutici ottenuti in 20 pazienti colpiti da metastasi ossee secondarie a diverse affezioni neoplastiche, trattati con calcitonina sintetica di salmone. Buona è stata l'azione sul sintomo dolore e sulla ripresa della funzionalità motoria, ottima la tollerabilità. Il ruolo protettivo del farmaco è stato riscontrato inoltre in un effetto stabilizzante, cioè non progressione, della maggior parte delle lesioni trattate (riscontro radiologico) e nell'azione equilibratrice sui valori di calcemia e di altri parametri ematochimici, anche in progressione di malattia.
Malignant Peritoneal Mesothelioma
Authors: Botte Giovanna , Oriana Saro , Preda Ferdinando
Published: April 2018

Eight cases of peritoneal malignant mesothelioma observed at the Istituto Nazionale Tumori of Milan from 1972 to 1978 are reported. The clinical features of the cases clearly point out the diagnostic difficulties, the inadequacy of the treatment and the poor prognosis of this neoplasia. The authors maintain that more complete epidemiologic studies and more adequate therapeutic programs could modify the prognosis for this neoplasm.
Lithium and Granulocytopenia during Induction Treatment of Adult Acute Lymphoblastic Leukemia
Authors: Bandini Giuseppe , Ricci Paolo , Ruggero Donatella , Cantore Maurizio , Visani Giuseppe , Tura Sante
Published: April 2018

Twelve adult patients with acute lymphoblastic leukemia (ALL) received lithium carbonate, 300 mg, three times a day during induction treatment. They were compared to 12 similar patients consecutively treated with the same induction regimen; patients and controls were comparable for age, degree and presence of splenomegaly, hemoglobin level, blast cell count, polymorphonuclear (PMN) cell count and platelet count at diagnosis. All patients developed a severe neutropenia. PMN count at nadir was slightly higher in the lithium group, but not at a level of statistical significance (p = 0.100). The median number of days with PMN < 1 × 109/liter was 4 in the lithium group and 14.5 in the non-lithium group (p = 0.014), while the median number of days with PMN < 0.5 × 109/liter was 0 and 2 days, respectively (p = 0.004). Duration of thrombocytopenia was similar in the 2 groups and so was the remission rate; 2 infective episodes occurred, one in the lithium group and one in the controls.
Comparative Completeness and Correspondence of Cancer Mortality Data as Collected by Istat and Cancer Registries
Authors: Zanetti Roberto , Viganò Clotilde , De Molli Sandro , Colombo Alessandro , Cislaghi Cesare
Published: April 2018

The authors have compared individual cancer mortality records from the file of the Central Statistics Office (ISTAT) with those of the Cancer Registries of Varese and Torino for the period July-December 1976. Most diagnoses ascertained by the Cancer Registries were histologically confirmed. The results showed a high degree of reciprocal completeness (over 90 %) for both systems (Cancer Registries and mortality statistics) and a satisfactory level of concordance (75 % at Varese, 70 % at Torino). The discrepancies, concentrated in certain nosologic codes, were analyzed. The conclusions suggest that the correspondence between mortality statistics and clinical diagnoses is hight, at least in the geographical areas examined.
Age-Related Frequency of Viral Lesions and Their Association with Uterine Cervical Intraepithelial Neoplasia
Authors: de Virgiliis Giuseppe , Mauri Luisa , Masserini Marilena , Le Grazie Cristina , Beolchi Sergio , Sideri Mario , Rainoldi Roberto , Maggi Renato , Remotti Gianni
Published: April 2018

Data collection forms of 50,165 routine smears were examined, and of these 47,577 were considered for this study. Viral cytological lesions (VL) were observed in 101 cases: of these, 19 were associated with cervical intraepithelial neoplasia. The total frequency of VL was 0.21%, with the peak in the teenager group (0.49%). The frequency of CIN among VL showed an overall frequency of 18.8 %: this was null under 21 years of age and highest (50 %) between 51 and 60 years of age. The frequency of VL in relation to clinical provenance of patients and the season of the year did not attain significance.
Report of a Case of Non-Hodgkin's Lymphoma of Large Multilobated Cell Type with B-Cell Origin
Authors: Pileri Stefano , Brandi Giuseppe , Rivano Maria Teresa , Govoni Edmondo , Martinelli Giuseppe
Published: April 2018

Large multilobated nuclei lymphoma is a rare entity that is characterized morphologically by large neoplastic elements with prominent nuclear lobations and clinically by a predilection for extranodal sites and a favorable prognosis. According to the data collected to date, the neoplasia is thought to be of T-cell origin. The authors describe the clinical, morphologic and immunohistochemical findings of a case of non-Hodgkin's lymphoma with large multilobated nuclei that showed a definite B-lymphocyte origin.
Bladder Cancer and Cigarette Smoking in Males: A Case-Control Study
Authors: Vineis Paolo , Frea Bruno , Uberti Eugenio , Ghisetti Valeria , Terracini Benedetto
Published: April 2018

Cigarette consumption was compared between 355 males with cancer of the lower urinary tract and 276 male hospital controls. Both duration of smoking and average daily consumption of cigarettes showed a dose-response relationship with risks of developing bladder cancer. Quitting smoking seems to have a protective role, whereas higher relative risks are associated with an early age at start of smoking. The use of a filter seems to have a weak protective effect.
Carcinoembryonic Antigen in Gynecologic Cancers. Immunohistochemical Localization and Serum Levels
Authors: Kula Józef , Harlozinska Antonina , Richter Roman , Albert Zygmunt , Sward Józef , Gawlikowski Wojciech
Published: April 2018

The presence of carcinoembryonic antigen (CEA)-dependent fluorescence was observed in almost 89% of female genital tract cancers irrespective of their histologic type. Anti-CEA serum was free of antibody to normal cross-reacting antigen. The high percentage of positive fluorescence tests did not correlate with the preoperative serum CEA levels. Double immunodiffusion tests showed different content of CEA and normal cross-reacting antigen in individual specimens of genital tract cancers.
Does the Antitumoral Activity of Platinum(IV) Derivatives Result from their in Vivo Reduction?
Authors: Rotondo Enrico , Fimiani Vincenzo , Cavallaro Antonia , Ainis Tommaso
Published: April 2018

The antitumoral activity of some octahedral platinum(IV) and square-planar platinum(Ii) derivatives against Yoshida ascites tumor in the rat is reported. It is shown that only those octahedral platinum(IV) complexes which give active reduction products are active. These results support the hypothesis that the antitumor activity of octahedral complexes involves activation by in vivo reduction. Anticancer drugs functioning by this mechanism may be preferentially toxic to or may localize in hypoxic areas of tumors.
Influence on Response to Therapy and Overall Survival of Mediastinal Involvement by Hodgkin's Disease
Authors: Cornelia Pasquale , De Rosa Vincenzo , Frezza Pasquale , Bevilacqua Annamaria , Scoppa Gianfranco , Abate Giuseppe , Comella Giuseppe , Pergola Mario , Zarrilli Donato
Published: April 2018

To assess the prognostic significance of mediastinal involvement of Hodgkin's disease, 91 patients with stage I to III disease treated at our Institute were reclassified according to size of mediastinal disease and other clinical and therapeutic characteristics. Complete remission (CR) was achieved in 46 of 67 (81%) patients without mediastinal involvement, and in 16 of 17 (94%) patients with small mediastinal masses, but only in 10 of 17 (59%) patients with large masses (P < 0.05). Twenty-seven of 32 (84%) patients treated with irradiation alone and 26 of 28 (93%) patients treated with combined modality therapy reached a CR, whereas such a result was obtained only in 19 of 31 (61%) patients who received MOPP chemotherapy alone (P < 0.01). In particular, none of the patients with large masses had a CR when treated with chemotherapy alone, whereas no differences in response to therapy were found between patients with large vs. small or no masses when irradiation or combined treatments were utilized. Since combined treatment seems to reach a high proportion of CR and to prevent extranodal relapse, further randomized clinical trials are needed to decide its routine utilization in patients with poor prognostic factors such as large mediastinal adenopathies.
Impact on Survival of the Extent of Resection in Unrelapsed Lung Cancer
Authors: Bedini Amedeo Vittorio , Pastorino Ugo , Valente Maurizio , Ravasi Gianni
Published: April 2018

Five-year survival of resected stage la non-oat cell lung cancer was evaluated in 69 consecutive patients without recurrence. The impact of the extent of resection on perioperative and long-term mortality was studied after an evaluation of confounding factors, such as age and associated cardiopulmonary diseases, which further stratified our series. Our patients were subdivided into 2 groups: the first included lobectomies and was further subdivided into 2 subsets according to whether the operation had caused the resection of less than 4 (30 cases) or more than 3 segments (18 cases). The second one included pneumonectomies (21 cases). Thirty-two patients were 60 years or older; pulmonary and/or cardiovascular diseases were assessed in 38 patients. There were 6 perioperative deaths, 3 among major lobectomies (more than 3 segments resected) and 3 among pneumonectomies. Survival rate of lobectomies was 75% (86% for minor, 55% for major lobectomies), and 57% for pneumonectomies. Major lobectomies included the highest percentage of elderly patients with cardiopulmonary diseases who had significantly poorer survival probabilities than young subjects without cardiopneumopathies. Lobectomy cases, after standardization by age, had a significantly higher probability of surviving than pneumonectomy cases. Standardization by cardiopulmonary disease showed a better chance for lobectomy cases, although it was not significant. Major lobectomy cases had poorer cumulative survival rate than minor lobectomy cases. Such a difference was revealed in patients 60 years or older and in those with pneumocardiopathies.
Toxic, DNA-Damaging and Mutagenic Activity of Epichlorohydrin on Human Cells Cultured in Vitro
Authors: Perocco Paolo , Rocchi Paola , Ferreri Anna Maria , Capucci Antonella
Published: April 2018

Epichlorohydrin (ECHH) highly inhibited the tritiated thymidine uptake by human lymphocytes cultured in vitro, although the corresponding cell viability was unaffected. Furthermore, it elicited unscheduled DNA synthesis, acting as a DNA-damaging agent after its metabolic activation. ECHH also showed a clear toxic and mutagenic activity toward a human epithelial-like cell line, causing a decrease in cell viability and an increase in mutants resistant to 0.05 Lf/ml of diphtheria toxin.
Red Blood Cell Hexokinase in Tumor Bearing Mice
Authors: Magnani Mauro , Bonfigli Sabina , Canestrari Franco , Stocchi Vilberto , Dachà Marina , Fornaini Giorgio
Published: April 2018

Red blood cell hexokinase of tumor-bearing BALB/c mice was found to be 35% higher than in the normal controls, whereas glucose 6-phosphate-dehydrogenase and other red blood cell glycolytic enzymes were in the normal range. This hexokinase increase cannot be explained by a mean younger red cell population because normal hematological data and normal red cell enzymes, known as red cell age-markers, have been found in tumor-bearing mice. The isozymic pattern of red cell hexokinase is not modified in the tumor-bearing mice.
Humoral Nonparathyroid Hypercalcemia without Evidence of Bone Involvement
Authors: Liberati Anna Marina , Di Costanzo Francesco , Anasetti Claudio , Buzzi Franco , Falchi Raffaello , Grignani Fausto
Published: April 2018

A case of humoral non-parathyroid hypercalcemia in a breast cancer patient is discussed. Bone metastases developed 23 months after the first clinical evidence of increased serum calcium levels and did not appear to be etiologically involved in this case of hypercalcemia. Serum levels of I-PTH and PGE2 were normal, as were urinary c-AMP levels. Furthermore, no significant response to corticosteroid therapy was observed. However, the correlation between the activity of metastatic disease and calcemia suggests that this cancer produced humoral factor(s) with calcium-mobilizing activity.
Strumal Carcinoid of the Ovary: An Immunohistochemical and Electron Microscopic Study
Authors: De Maurizi Maurizio , Bondi Arrigo , Betts Christine M. , Eusebi Vincenzo
Published: April 2018

A case of strumal carcinoid of the ovary is reported. The follicles contained T4-immunoreactive substance, whereas the carcinoid component of the tumor had a trabecular structure and showed argyrophilic elements. Pancreatic-polypeptide and enteroglucagon were localized in these cells by an immunocytochemical method. The same cells displayed small electrondense endocrine-like granules. A common precursor for the thyroid and carcinoid components is postulated.
Abnormal Serum Hormone Levels in Lung Cancer
Authors: Recchione Camilla , Galante Emanuele , Secreto Giorgio , Cavalleri Adalberto , Dati Veronica
Published: April 2018

Serum levels of chorionic gonadotropin (HCG), testosterone, luteinizing hormone (LH) and prolactin were evaluated with the radioimmunoassay in 59 patients with lung cancer, 10 patients with benign lung disease, and 37 normal controls. HCG was present in 6.8% of the lung cancer patients but in none of the subjects of the other two groups. Prolactin and LH levels were significantly higher than normal in lung cancer patients (respectively p < 0.001 and p < 0.01) as well as in patients with benign lung disease (p < 0.01 for both the hormones). Testosterone levels were significantly lower than normal in patients with lung cancer (p < 0.05) but not in those with benign lung disease. When the patients were analyzed according to histologic type and clinical stage of disease, significantly lower than normal values of testosterone were found in patients with small cell carcinoma or squamous cell carcinoma. In the squamous cell carcinoma group, the patients with lymph node metastases had significantly lower testosterone levels than those without lymph node metastases. From these results, we may hypothesize that the raised levels of prolactin and LH are related to a pulmonary pathology, not necessarily neoplastic, whereas the low levels of testosterone are related to the presence of the tumor.
Alteration in Natural Resistance of Sarcoma 180 Tumor to Bouvardin (NSC 259968) following Hyperthermia
Authors: Adwankar Manohar K. , Chitnis Manik P.
Published: April 2018

Sarcoma-180 (S-180) tumor cells grown in Swiss mice displayed natural resistance to Bouvardin (NSC 259968) when administered alone in a single dose or in multiple doses. Hyperthermia treatment (43 °C for 1 hr) alone did not show any tumor growth reduction. However, the drug combined with hyperthermia markedly reduced tumor growth suggesting that hyperthermia alters the natural resistance of S-180 cells to Bouvardin.
Morphologic and Classificatory Considerations about 140 Cases of Carcinoma of the Nasopharynx
Authors: Resta Leonardo , Ricco Rosalia , Santangelo Antonio
Published: April 2018

The morphologic aspects are reported for 140 cases of nasopharyngeal carcinoma collected from a retrospective review of malignant tumors of this region. Of 97 cases of undifferentiated carcinomas of nasopharyngeal type, 63 were composed of solid cords of epithelial cells (Régaud type), 22 showed isolated cells in a lymphoid stroma (Schmincke type), and in 12 the neoplastic cells were aligned with a fibrosarcoma-like aspect (spindle-cell type). The 36 cases of squamous cell carcinoma showed various degrees of differentiation. Of the remaining 7 cases, 3 were transitional cell carcinomas, 1 was an adenoid cystic carcinoma, and 3 were unclassifiable carcinomas. The undifferentiated carcinoma was present in all ages, with a male: female rate of 1.27:1. The squamous cell carcinomas were prevalent in males (3.5:1) and older patients. The 10-year survival rate was 30% in the group of patients with undifferentiated carcinoma, whereas patients with squamous cell carcinoma died within 4 years of the diagnosis.
Low-Grade Malignancy Non-Hodgkin's Lymphomas: Prognostic Relevance of their Clinicopathologic Heterogeneity
Authors: Brusamolino Ercole , Magrini Umberto , Canevari Angelo , Castelli Guglielmo , Morra Enrica , Pagnucco Guido , Isernia Paola , Bernasconi Carlo
Published: April 2018

We reviewed 182 consecutive adult patients with low-grade malignancy, non-Hodgkin's lymphomas classified according to the Kiel classification, followed at the Division of Hematology, Policlinico S. Matteo, Pavia, from January 1975 to December 1981, to recognize, in each histopathologic type, important subgroups from the prognostic standpoint. Median follow-up was 36 months. No significant differences were observed in the response rate to conventional therapy (radiotherapy for localized disease, CVP for advanced stages) between the 4 cytologic types. The centrocytic-centroblastic lymphoma with diffuse nodal architecture showed an intermediate-grade malignancy (median survival, 50 months) and underwent cytologic progression to the high-grade malignancy centroblastic type in 10% of the cases. Large-cell centrocytic and polymorphic lymphoplasmacytoid lymphomas had a poor prognosis (median survival less than 30 months) when treated with conventional therapy for favorable histologies, and 6% of the cases transformed into the high-malignancy immunoblastic type. Patients with lymphocytic lymphoma with bulky mediastinum had a median survival of 20 months. The identification of these subgroups with a worse prognosis may have therapeutic implications.
Comments on a Series of 88 Invasive Microcarcinomas of the Breast
Authors: Salvadori Bruno , Luini Alberto , Muscolino Giuseppe , Greco Marco
Published: April 2018

Eightly-eight women with minimal invasive breast cancer were treated at the Istituto Nazionale Tumori of Milan, in the decade 1970–1980. Their tumors were smaller than 0.5 cm in diameter and were clinically assessed as T1N0M0; surgery, consisting of radical or limited procedures, was performed, always with complete axillary dissection. Pathologic assessment showed that axillary lymph nodes presented with metastases in 21.5% of cases. In 1 of N-positive cases, more than 3 nodes were affected, and in 5 cases extracapsular invasion was observed. Five-year actuarial survival, calculated by the life table method, was as high as 90%, demonstrating that these have a favorable prognosis, even when they are treated by limited surgery followed by radiotherapy on the residual breast, provided that the axilla is completely dissected. Minimal invasive breast cancer should consequently be clearly distinguished from other pathologic entities termed as « minimal », such as lobular carcinoma in situ and intraductal carcinoma, for which complete axillary dissection is not worthwhile.
Gastric Epithelial Dysplasia and Sulphomucin-Type Intestinal Metaplasia
Authors: Pagnini Carla Arslan , Farini Roberto , Cardin Fabrizio , Di Mario Francesco , Rugge Massimo , Naccarato Remo
Published: April 2018

The HID-AB histologic staining technique, which distinguishes sulphomucin from sialomucin types of intestinal metaplasia, was employed in endoscopic gastric mucosal biopsies to evaluate their frequency of association with epithelial dysplasia. Sulphomucin-type intestinal metaplasia was found in 33% of the cases under observation; moderate or severe dysplasia was only associated with this type of intestinal metaplasia. Its precancerous significance can be ascertained only by means of prospective studies.
Familial Occurrence of Kaposi's Sarcoma. Report of Two Brothers
Authors: Friedman-Birnbaum R. , Abraham Z.
Published: April 2018

The racial and geographical distribution of Kaposi's sarcoma is well recognized. Therefore, a hereditary factor is suspected to play a role in it's etiology. Inspite of this, only about 15 instances of familial cases with the disease have been as yet reported in the literature. We describe here an additional instance of Kaposi's sarcoma occuring in two Jewish brothers born in Rumania and we resume the literature on previous reports of familial occurence of Kaposi's sarcoma.
Characterization and Treatment of the Non-Lymphoblastic Crisis of Chronic Myelogenous Leukemia
Authors: Mariani Guglielmo , Annino Luciana , Solinas Stefano , Mandelli Franco
Published: April 2018

Fifty-six consecutive patients affected by the non-lymphoblastic-like crisis of chronic myelogenous leukemia were the subjects of this study. The cytologic and cytochemical features, together with the extension of clinical involvement, were investigated in all the patients. The most frequent cytologic variant was the « myeloid » one (60% of the patients). All the patients received a standard treatment (hydroxyurea, 6-mercaptopurine ± prednisone). The overall median survival was 5.1 months; however, 22% of the patients survived for one year or more. The length of survival was independent of the cytologic variety and clinical conditions (previous splenectomy, organomegalies, etc.). There was no correlation between drug dosage and length of survival, whereas the disappearance of blast cells from the peripheral blood appeared to be directly correlated with a longer survival. The treatment was well tolerated (slight hematologic and hepatic toxicity) and allowed a reasonably good quality of life: most of the patients were treated on an out-patient basis.
Reasons for Failure of Physical Examination in Breast Cancer Detection (Analysis of 232 False-Negative Cases)
Authors: Cardona Gaetano , Cataliotti Luigi , Ciatto Stefano , Del Turco Marco Rosselli
Published: April 2018

The diagnostic role of physical examination (PE) is evaluated in 1450 cases of breast cancer detected in 34,677 women controlled at the Centro per lo Studio e la Prevenzione Oncologica in the period 1974–1981. In 47 cancer cases, PE findings were normal since the neoplasm was not clinically palpable because of its size and site, and in another 185 cases the clinical diagnosis was benignancy without evidence of suspect signs. Therefore, the overall sensitivity of PE was 84%. PE errors did not involve a therapeutic delay for the patient in 75% of cases in which a biopsy was recommended for clinical benignancy or for suspicion on the basis of other diagnostic methods. The present study confirms that PE has a good diagnostic sensitivity when the examined population is represented by self-referred women, who for the most part are symptomatic, whereas it cannot be considered as the only diagnostic test for early diagnosis in mass screening, since in asymptomatic women a large number of cancers are not clinically palpable. Moreover, PE shows lower sensitivity for small lesions and in younger women. Extensive use of fine needle aspiration cytology and other diagnostic methods in association with PE is therefore recommended to reduce the possibility of errors.
The Role of Surgery in Gestational Trophoblastic Disease
Authors: Bolis Giorgio , Belloni Carlo , Vergadoro Franca , Colombo Nicoletta , Buratti Elisabetta , Mangioni Costantino
Published: April 2018

Fifty-eight consecutive patients with malignant trophoblastic tumors of gestational origin were treated at the 1st Department of Obstetrics and Gynecology of the University of Milan between 1975 and 1981. Thirty-five (60.3%) of the patients were treated with combined surgery and chemotherapy. Of these, 44.8% had genital surgery, 12% extragenital surgery, and 5.1% had emergency laparotomies. Minor surgery was done to 17.1% of the patients. Five patients (20.8 %) with tumors limited to the uterus and treated with chemotherapy only became drug-resistant, whereas 3 patients (9%) later developed lung metastases. All the patients are alive without any clinical signs of the disease. When there were metastatic tumors, the survival of the group first submitted to a « debulking » operation of the primary focus was 80%, and the survival of the group treated only with chemotherapy was 78.5%. Seven cases required extragenital surgery for the indications discussed in detail and because they had measurable HCG. Six of these had thoracotomies and one had a craniotomy. Five of the 6 patients who underwent thoracotomy (83.4%) had a complete remission. Chemotherapy remains the treatment of choice for trophoblastic tumors. Nevertheless, our data confirm that for some cases, mostly in the high risk group, complete eradication cannot be obtained with antitumor agents. Adjuvant surgery of carefully selected patients helps to save some of those who no longer respond to chemotherapy.
Colorectal Cancer: Relationship of Histologic Grading to Disease Prognosis
Authors: Riboli Edoardo Berti , Secco Giovanni Battista , Lapertosa Gabriella , Di Somma Carmine , Santi Ferdinando , Percivale Pier Luigi
Published: April 2018

Ninety patients underwent curative surgery for colorectal adenocarcinoma and they were followed for a period of 3 years. The aim of this retrospective study was to relate the cell differentiation (grading) and TNM classification of the UICC (1978) with the disease evaluation and patient survival. The results showed a consistent relation between grading and lymph node metastasis in patients with moderately and poorly differentiated adenocarcinoma, whereas no relationship was found between grading and local invasion of the tumor. Therefore, histocytologic grading of colorectal cancer appears to significantly influence survival grading parameters, and it may be a good method for monitoring the disease and follow-up of the patients.
Plasma Cell Leukemia: A Report on Three Patients
Authors: Pacilli Leonardo , Ferraro Paolo , Cochi Silvia , De Laurenzi Antonio
Published: April 2018

Three patients with plasma cell leukemia are reported. Two of them had a previous history of myeloma; the third one started with a plasma cell leukemia. Diagnosis was made from the required presence of 20% plasma cells in the peripheral blood. In all 3 cases, bone marrow aspiration and peripheral blood showed plasma cells strongly positive for acid phosphatase and alpha-naphthyl acetate esterase, and negative for periodic acid-Schiff. The first patient was treated with a polychemotherapy regimen that included vincristine, cyclophosphamide, chlorambucil and prednisone, and the second patient with melphalan and prednisone; the third one, who started with plasma cell leukemia, received total body irradiation at the dose of 600 rad. The results of the therapy and survival time, which was never more than 3 months, are in accord with other reports in the literature.
Immunotherapy of Mouse Leukemia with Monoclonal Antibodies Directed against Type-C Virus Structural Proteins
Authors: Boiocchi Mauro , Mondellini Piera
Published: April 2018

The monoclonal antibody A6, isolated during a study on the natural immunoresponse of BALB/c mice against leukemia cells (4), reacts with the envelope glycoproteins gp70 of the MuLV and with the cell surface of the SL2 AKR leukemia. In the present paper, we describe the in vivo immunotherapeutic effect exerted by the A6 monoclonal antibody on the growth of the transplanted leukemia SL2. The greater therapeutic effect observed when the A6 was used with exogenous complement cooperation suggests that the immunotherapeutic activity is mediated by C'-dependent cytotoxicity.
Effect of Medroxyprogesterone Acetate and of Some Antiinflammatory Agents on Mouse Erythroleukemia Cell Differentiation
Authors: Supino Rosanna , Mazzoni Alessandra , Formelli Franca
Published: April 2018

The effects of medroxyprogesterone acetate (MPA) on differentiation were examined using mouse erythroleukemia (MEL) cells and compared with those of antiinflammatory agents. MPA at low doses (10−6 - 10−7 M) induced 10–15 % cells to differentiate, whereas high doses (10−4 - 10−5 M) caused a 30 % inhibition of dimethylsulfoxide (DMSO)-induced differentiation. Dexamethasone (10−4 - 10−8 M), a steroid antiinflammatory agent, significantly inhibited (77–70 %) DMSO-induced differentiation, whereas indomethacin, aspirin, flurbiprofen and BW755c (non steroid antiinflammatory agents) at the same concentrations had no effect. If added 24 h before DMSO, the inhibitory effects of MPA and dexamethasone increased to 65 % and 95 %, respectively, whereas indomethacin (10−5 M) caused only a 30 % inhibition and the other drugs were inactive. None of these antiinflammatory agents affected differentiation when used without DMSO. MPA and dexamethasone inhibitory effects on DMSO-induced differentiation did not seem to be mediated through the inhibition of the synthesis of prostaglandins, since non-steroid prostaglandin inhibitors were slighly active only when added 24 h before DMSO.
Tween-80 Alters Natural Resistance of Sarcoma-180 to Bouvardin (NSC 259968)
Authors: Menon Ravi , Chitnis Manik , Adwankar Manohar , Basrur Vathsala , Amonkar Ashok
Published: April 2018

Sarcoma-180 tumour (S-180) exhibits natural resistance to bouvardin (NSC 259968), a protein synthesis inhibitor that also inhibits RNA and DNA synthesis when administered over a range of non-toxic doses using 0.9 % NaCl as a vehicle. However, using Tween-80 as a vehicle, there is a substantial enhancement of cytotoxicity and a subsequent increase in the life span of animals bearing the S-180 tumour. This observation was substantiated in vitro by exposing S-180 cells to 10−6 M bouvardin in the presence and absence of Tween-80. Bouvardin, 10−6 M, in the absence of Tween-80, inhibited the incorporation of [3H]uridine by 46 %, whereas the presence of Tween-80 resulted in a 66 % inhibition of uridine incorporation.
Antibody-Dependent Cellular Cytotoxicity in Some Lymphoreticular Diseases
Authors: Voltarelli Júlio César , Falcão Roberto Passetto , Bottura Cássio
Published: April 2018

Antibody-dependent cellular cytotoxicity mediated by K cells against chicken erythrocytes was measured in 113 patients with malignant lymphoreticular disorders and compared with 230 controls. The results were expressed as the specific cytotoxicity of a fixed number of cells and also by cytotoxic capacity, which measures the number of cytolytic units in 1 ml of blood. The values for cytotoxic capacity were normal in the group of untreated patients with non-Hodgkin's lymphomas, multiple myeloma or chronic lymphocytic leukemia and in most of the patients with Hodgkin's disease or acute lymphoblastic leukemia. However, decreased specific cytotoxicity was observed in these same lymphoid leukemia patients, which may be due to dilution of effector cells. The effect of chemotherapy in reducing K-cell activity is more evident in patients with multiple myeloma, followed by patients with Hodgkin's disease, and finally by patients with non-Hodgkin's lymphomas. No case of K-cell neoplastic disease was observed in this series.
The Value of Two Combined Chemoradiotherapy Approaches in the Treatment of Inoperable Esophageal Cancer
Authors: Kolarić Krsto , Roth Anton , Dujmović Ivo
Published: April 2018

The antitumor activity of 5-fluorouracil (5-FU), combined either with bleomycin or adriamycin plus radiation, was studied in a controlled randomized clinical trial. Sixty-one previously untreated inoperable esophageal cancer patients entered the study and 56 have been evaluated: 58 male and 3 female patints with a mean age of 57 years (range 37–74). Concerning localization of the tumors in the esophagus, 2 were in the upper third, 36 in the middle third and 18 in the lower third. The length of the filling defects in the esophagogram (X-ray) was in 9 patients < 5 cm, in 31 5–8 cm, and in 16 patients > 8 cm. Squamous cell carcinoma was found in 51 patients, adenocarcinoma in 3, and anaplastic (squamous cell) carcinoma in 2 patients. Modality A consisted of a combination of 5-FU (10 mg/kg i.v. 2 × weekly, 4 weeks) and bleomycin (10 mg/m2 i.v., 2 × 4 weeks) which was given concurrently with radiation (3600–4000 rad - 1000 rad weekly). In modality B the combination of 5-FU (same dose) and adriamycin (30 mg/m2 i.v. day 1, 2, 23 and 24) was applied with the same schedule and dosage of radiation. Seventy-five percent of the patients (21/28) have responded to treatment (CR + PR) in modality A, with 11 complete and 10 partial responses. In arm B, response was recorded in 64 % of patients (18/28), with 2 complete and 16 partial responses. The difference in complete responses (39 % vs 8 %) was statistically significant (P < 0.05). The median remission duration in complete responders was 12 months in modality A (range 6–18 months), and 6.8 months in modality B (range 3–10 months). All the responses occurred in patients with squamous cell carcinoma, except one partial response in a case of adenocarcinoma. As far as the age is concerned (< 55 vs > 55 years), no significant difference in response rate was found (67 % vs 71 %). More favorable results were observed in the group of patients with < 10 % weight loss (79 % vs 63 %). Toxicity was moderate (myelosuppression, cardiotoxicity), but one treatment-related death (pulmonary fibrosis, cardiac failure) was recorded in arm A, as well as one death (rupture of aorta) in group B. Approximately 60 % of patients in both modalities suffered from severe mucositis and retrosternal pain. The results of the study showed that the combination of 5-FU with adriamycin and particularly with bleomycin, given concurrently with lower radiation dosage, is an effective palliative treatment for inoperable esophageal cancer.
Moderate Chemo-Radiotherapy in Non-Small Cell Lung Cancer: Results in 21 Patients with Advanced Disease and Low Performance Status
Authors: Tummarello Diego , Porfiri Emilio , Cellerino Riccardo
Published: April 2018

Twenty-one patients with advanced non-small cell lung cancer and low performance status (Karnofsky: 40–60) were treated with moderate doses of chemo-radiotherapy. Seven patients (33 %) had partial response and a median survival time of 10 months; 5 patients (24 %) had stable disease and a median survival time of 5 months; 9 patients (43 %) had progression of disease and a median survival time of 6 months. Median survival time for the whole group was 7 months. Toxicity related to treatment was minimal and posttreatment performance status was: stable in 10 patients and improved in 5 responsive patients. We conclude that this therapeutic strategy has some efficacy in this category of patients although it failed to show substantial benefit in terms of survival.
Chondromyxoid Fibroma of the Iliac Bone: A Case Report with Ultrastructural Observations
Authors: Montaguti Adriana , Esposito Cristina , Segato Patricia , Melanotte Pier Luigi , Pennelli Natale
Published: April 2018

Ultrastructural findings in an unusual case of chondromyxoid fibroma are reported. The tumor was located in the iliac bone of a 42-year-old woman with left hip pain of 5 years duration.
Tracheal Hodgkin's Disease Report of a Case
Authors: Muretto Pietro , Ugolini Marcello , Grianti Cesare , Fabbretti Giovanna
Published: April 2018

A tracheal localization of a Hodgkin's disease is described in a 28-year-old man. The diagnosis was made on a tissue fragment spontaneously emitted and was confirmed by a tracheoscopic biopsy. Radiologic examination revealed adenopathy of the anterosuperior mediastinum, but no other localization. It was not possible to determine whether the tracheal localization was initial or consequent to the mediastinal one. However, Hodgkin's lymphomas of this site have not been previously described.
Adriamycin and its Analogs
Authors: Arcamone Federico
Published: April 2018

Among the biologically active metabolites produced by Streptomyces peucetius adriamycin (syn. doxorubicin) appeared the most effective anthracycline. Because of the low yield of the biosynthetic process, the chemical conversion of daunorubicin to adriamycin represent the key-step of the development of the drug. The therapeutic importance of adriamycin prompted us to begin since 1972 a research program aimed to the development of the second generation anthracyclines. The studies carried out during this research program allowed to discover three new synthetic anthracyclines, which, for the time being, are under clinical investigation: 4'-epidoxorubicin (epirubicin), 4-deme-thoxydaunorubicin (idarubicin) and 4'-deoxydoxorubicin (esorubicin). These compounds, like daunorubicin and doxorubicin, show affinity to DNA, but some of their pharmacological properties and metabolism in animals as well as in humans are different in respect to those of the parent drugs. Herein the stages of the search for new analogs and the outlooks of further progress in the filed of the antitumor anthracyclines are shortly reported.
Assessment of Liver and Spleen Involvement in Hodgkin's Disease
Authors: Miseria Salvatore , Cetto Gianluigi , Cellerino Riccardo , Martinelli Loredana , Tummarello Diego , Perona Giuseppe
Published: April 2018

Prognosis and proper treatment in Hodgkin's disease (HD) are strictly related to staging accuracy: liver and spleen involvement is of particular importance in this regard. We have evaluated, in 113 consecutive patients, the accuracy of clinical parameters to detect histologically documented HD involvement by comparing hepatosplenomegaly, liver function tests, liver and spleen scan, inspection of liver and spleen surface at laparoscopy with histologic findings. Our data suggest that of all the parameters studied, laparoscopy has the highest sensitivity and specificity values (about 100 %). Laparoscopy may precede laparotomy as a staging procedure in HD and may give, in patients not submitted to laparotomy whatever the reasons, very reliable information.
Cefoperazone versus Cefotaxime, plus Amikacin or Sisomicin, in Fever and Infection in Hematologic Granulocytopenic Patients
Authors: Santini Gino , Cardella A. Michele , Bacigalupo Andrea , Van Lint M.T. , Congni A. Marina , Occhini Domenico , Costa Giuseppe , Sbaffi Andrea , Accontero Luisa , Sdutto Claudia , Giordano Domenico , Cerri Raffaella , Risso Marco , Nati Sandro , Marmont Alberto Mario
Published: April 2018

Forty patients with leukemia or aplastic anemia were randomized to receive one of the following antibiotic regimens at the onset of fever during granulocytopenia: cefoperazone + amikacin (regimen A), cefoperazone + sisomicin (regimen B), cefotaxime + amikacin (regimen C), cefotaxime + sisomicin (regimen D). All patients were receiving gut decontamination at the time of randomization. Patients were monitored twice weekly with swabs and cultures for bacteria and fungi. Overall, there were 56 febrile episodes: 31 were proven bacterial, 3 were probable, and 16 were of unknown origin. Response rates were comparable in all 4 treatment regimens: 90 %, 91 %, 92 % and 92 %, respectively. Three patients died of bacterial infections (2 Gram +, 1 Gram-), one patient died with probable infection, 6 febrile episodes were related to fungal infection (Candida), and 2 patients died. The mortality rate was comparable in all groups. Two patients died of renal failure. Abnormalities in liver function tests were observed, but were without consequences. There were no statistical differences in renal-hepatic toxicity in the 4 arms.