bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Malignant Tumors of the Thyroid Gland. Histology, Age and Sex Distribution and Pathologic Correlations in 139 Cases
Authors: Baroni Carlo D. , Manente Liborio , Maccallini Vincenzo , Di Matteo Giorgio
Published: April 2018

The classification proposed by Woolner et al. (1961, 1971) has been applied to 139 cases of primary malignant tumors of the thyroid gland diagnosed in one of the largest hospitals of Rome, Italy, over a period of 5 years, from 1977 to 1981. These cases come from 1418 patients with enlargement of the thyroid surgically treated at the 5th Surgical Clinic of the University of Rome. All the histologic slides were re-examined, and the pathology records were re-evaluated. Of these tumors, 56.8% were papillary, 30.9% follicular, 9.3% anaplastic or undifferentiated, and 2.1% medullary. There was a female predominance in all age groups and for all types of tumors, reflecting a total female to male ratio of 1.9:1. Papillary carcinoma occurred most commonly in young and young-adult patients, follicular in the middle-age group, and anaplastic in the elderly. The extent of the primary tumor, the presence of regional metastases, and the association with other thyroid nonneoplastic diseases such as lymphocytic and Hashimoto's thyroiditis, and nontoxic and toxic goiter were also recorded. Multicentric rumors were found in 38.9% of cases principally represented by papillary carcinomas. Regional lymph node metastases were observed mainly in young patients, and no correlation was found between thyroid cancer incidence and other nonneoplastic thyroid diseases.
Plasma Calcitonin and Tumors
Authors: Tabolli Stefano , Valtorta Carlo , Scarda Antonella , D'Erasmo Emilio , Minisola Salvatore , Antonelli Rossella , Medori Claudio , Mazzuoli Gianfranco
Published: April 2018

Plasma levels of calcium, phosphorus, immunoreactive calcitonin (iCT), immunoreactive parathyroid hormone (iPTH), and carcinoembryonic antigen (CEA) were measured in patients affected by tumors of various organs: 22 breast, 41 lung, 23 kidney, 16 gastrointestinal tract, and 8 other types. iCT plasma level was elevated in 53.6% of patients with bronchogenic cancer, in 31.8% with breast cancer, in 65.3% with renal cancer, in 31.2% with gastrointestinal cancer, and in 62.5% with other tumors. Blood calcium level was increased in 6 patients suffering from lung cancer; iCT plasma level was increased in all but one of these subjects. iPTH plasma level, measured in 35 patients, was elevated only in one case, in which normo-calcemia was present. Our results demonstrate that plasma iCT is increased in a high percentage of cancer patients and that it is probably a good tumor marker. The simultaneous measurement of CEA increases the diagnostic probability of the individual marker. The incidence of laboratory findings suggestive of primary or ectopic hyperparathyroidism was very low in our series of patients.
Gastric Juice Nitrite and Bacteria in Gastroduodenal Disease and Resected Stomach
Authors: De Bernardinis Giancarlo , Guadagni Stefano , Pistoia Maria Antonietta , Amicucci Gianfranco , Masci Claudio , Agnifili Alessio , Carboni Manlio
Published: April 2018

The N-nitroso-compounds and the bacteriological contamination of gastric juice could represent a risk factor for cancer of the stomach when the mucosal barrier is altered. In the unresected stomach and gastric stump, the hypo-achlorhydria and bilopancreatic reflux permit the development of bacterial flora and the production of N-nitroso-compounds in the presence of nitrite. A survey was performed on 71 patients: 15 normal controls, 31 with gastroduodenal disease (9 gastrites, 10 gastric ulcers, 10 duodenal ulcers, 7 neoplasias), 20 patients with gastric resection (8 BI, 12 BII), using an endoscopic-histopathologic control and a chemical-bacteriological analysis of the gastric juice. We studied the gastric juice for the following parameters: pH, concentration of nitrite, identification of bacterial type, count and nitrate-reductase activity. An inverse relationship was found between the concentration of nitrite and the hydrogen ion concentration. In the alkaline gastric juice, we identified aerobic bacteria with nitrate-reductase activity and anaerobic bacteria. The latter has the ability to transform biliary salts into carcinogenic and cocarcinogenic compounds and to catalyze the nitrosations. The chemicobacteriological characteristics of the gastric juice from gastric ulcers (Johnson type I), atrophic gastrites, and resected stomachs lead one to think that there is a risk of carcinogenesis brought about by the N-nitroso-compounds.
Renal Oncocytoma: Report of Two Cases
Authors: Parenti Anna , Palma Paolo Dalla , Piazza Mario
Published: April 2018

The clinico-radiologic, gross, microscopic and ultrastructural findings in 2 cases of renal oncocytoma are reported. The diagnosis of renal oncocytoma has important clinical and prognostic implications, since the neoplasia is usually benign despite its often large size. The differential diagnosis with other renal neoplasms, in particular renal cell carcinoma, is discussed. The problem of the pre-operatory diagnosis of renal oncocytoma is explored on the basis of clinico-radiologic findings and/or histologic examination of pre- or intraoperatory biopsy. In view of the tumor's benign nature, this diagnosis implies tumorectomy, but its close resemblance to renal cell carcinoma at present counsels nephrectomy. A final diagnosis of oncocytoma may be formulated only after histologic examination of several specimens and ultrastructural confirmation.
The Role of Surgery in Non-Localized Neuroblastoma. Analysis of 59 Cases
Authors: Cecchetto Giovanni , Luzzatto Claudia , Carli Modesto , Guglielmi Maurizio , Zanesco Luigi
Published: April 2018

The authors considered 59 stage III and IV neuroblastoma cases, which were observed from January 1967 to June 1979. 13 patients (13/59 = 22%) are surviving in complete remission 3 years after surgery: 9/20 (45%) with stage III and 4/39 (10%) with stage IV disease. The children subjected to complete surgical excision are all alive irregardless of age; the children who were not operated on or subjected to a biopsy, have all died. Of the 33 patients who underwent a reductive excision, 6 (all under 2 years of age) are in complete remission (18%). A better prognosis was found in those patients in whom the site of the primary tumor was at the mediastinal level. These data show the importance of the role of the surgeon in the multidisciplinary treatment of stage III and IV neuroblastomas; our experience is also favorable to the practice of second-look surgery.
Prominent Plasmacytic Differentiation in the Recurrence of a Parotid Immunocytoma. A Morphologic and Immunohistochemical Study
Authors: Palestro Giorgio , Micca Flavia Botto , Novero Domenico , Valente Guido , Godio Laura , Stramignoni Aldo
Published: April 2018

We report and discuss a case consisting of 2 lesions that developed at different times in the same parotid gland. Although the first lesion showed morphologic features similar to those of the benign lymphoepithelial lesion, a monotoypic IgM/K pattern was also revealed by the immunoperoxidase method in its lymphoid infiltrates. Thus, on cytologic grounds, the first lesion was classified as lymphoplasmacytic immunocytoma (according to Kiel criteria). In the second lesion, which recurred 3 years later, the prominent feature was a marked predominance of plasma cells with the same monoclonal IgM/K as the preceding lymphoma. These findings suggests that a B-lymphomatous cell monoclone may undergo morphologic maturation along the lineage of its competence. Secondly, they indicate that every case of benign lymphoepithelial lesion of the salivary glands should undergo thorough immunologic evaluation to exclude the possibility of signs of precocious lymphomatous transformation.
Prognostic Role of Estrogen Receptor Determination in Breast Cancer
Authors: Ciatto Stefano , Bravetti Patrizia , Cardona Gaetano , Cataliotti Luigi , Crescioli Roberto , Herd-Smith Andrea , Messen Gianni
Published: April 2018

The authors report on 283 primary, non-metastatic, breast cancer cases consecutively referred after surgery and followed-up from a minimum of 10 months to a maximum of 3.5 years. All cases were studied according to the presence of estrogen receptors (ER). ER presence was correlated with age and menstrual status, with ER+ cases more frequent in older patients. No correlation was found between ER and nodal status. Prognosis was evaluated in terms of disease-free survival at 2 years (actuarial method). No correlation between ER and survival was evident for N– cases, whereas a better prognosis was recorded for ER+N+ patients compared to ER-N+, although the difference was not statistically significant. The observed results are compared with recent literature data and agree with other recent reports, which did not confirm the previously undiscussed statement regarding the prognostic role of ER determination. According to these studies and to the present study, the prognostic role of ER determination seems at least questionable and particularly the postoperative adjuvant treatment of ER-N– cases should be reconsidered.
VBM Chemotherapy before Curietherapy in the Treatment of T2 Oral Carcinomas
Authors: Volterrani Fabio , Sigurtà Davide , Chiesa Fausto , Molinari Roberto
Published: April 2018

According to previous personal experience with conventional 226-Ra sources, in T2 oral carcinomas treated with curietherapy alone the incidence of local failures was 23%. Moreover, 50% of the local relapses were marginal with respect to the treated volume. From May 1980 to November 1981, 29 T2 oral carcinomas suitable for correct curietherapy received 3 weekly courses of VBM chemotherapy: i.e., vincristine, 1 mg i.v.; bleomycin, 15 mg i.m. after 6 and 24 h; and methotrexate, 30 mg p.o. after 48 h. A full dose curietherapy was performed 2 weeks after the completion of VBM. Twenty-seven patients have had a minimum follow-up of 12 months. The overall treatment was well tolerated and immediate results were encouraging. However, the local failure rate does not seem to have decreased by the combined treatment in comparison with curietherapy alone in historical series.
Oral and Pharyngeal Cancer: Combined Approach for Multimodal Therapy
Authors: Fazio Massimo , Badellino Fausto , Sannazzari Gian Luca , Vercellino Vittorio , Airoldi Mario , Manca Aldo , Gandolfo Sergio
Published: April 2018

Five-year results in 60 oral and pharyngeal cancer patients treated with combined apporach chemoradiotherapy (39 patients) and chemoradiotherapy plus lymph node surgery (21 patients) are reported. Complete remission (CR) was achieved in 16/39 (41%) patients treated with chemoradiotherapy alone, and in 16/21 (76%) patients who had chemoradiotherapy plus surgery. The number of CR was statistically (chi-square test) higher (p < 0.025) in the second group. The 5-year actuarial survival was 39.7% in the group of patients treated with chemoradiotherapy plus surgery. After 5 years 53% of the patients who reached CR are living free of disease in the first group and 76% in the second group.
Regional Perfusion at High Temperature in Treatment of Stage IIIA-IIIAB Melanoma Patients
Authors: Vaglini Maurizio , Ammatuna Mario , Nava Maurizio , Prada Auguste , Rovini Dario , Santinami Mario , Cascinelli Natale
Published: April 2018

The results obtained with isolation perfusions in stage IIIA-IIIAB melanoma patients, performed at 42.5–43 °C for 2.5 h, are reported. These temperatures and perfusion times were chosen on the basis of experimental data in animal models and in vitro. The clinical results were impressive, but the high percentage of complications and the high cost from a social and human point of view make this experience negative with regard to its clinical applicability, at least with such a high temperature and long perfusion time.
HLA Antigen Frequencies in Malignant Melanoma Patients. A Second Study
Authors: Rovini Dario , Sacchini Virgilio , Codazzi Virginia , Vaglini Maurizio , Illeni Maria Teresa
Published: April 2018

Two groups of malignant melanoma (MM) patients were considered: the group of 140 patients previously published and a new one of 58, both typed for HLA-A, -B and -C antigens at the Istituto Nazionale Tumori of Milan. The control group consisted of healthy blood donors not related to the patients. Only the HLA-Bw35 antigen frequency was significantly decreased in both groups of patients. To investigate the HLA-A and -B blanks, 62 MM patients and 90 healthy controls, who showed non-homozygotic blanks when they were firstly HLA typed, volunteered to repeat the HLA typging three or more times in a 2-year period. A significant increase in both HLA-A and -B blanks in the patients as compared to controls was noticed (p = 3 × 10−4 and 3 × 10−5, respectively). In the future, attempts should be made to correlate the HLA antigen and blank frequencies with the evolution of the disease and, also, to verify the hypothesis that the HLA-Bw35 antigen may be an associated resistance factor against the tumor.
Controlled Study with Imidazole Carboxamide (DTIC), DTIC + Bacillus Calmette-Guérin (BCG), and DTIC + Corynebacterium Parvum in Advanced Malignant Melanoma
Authors:   W.H.O. Collaborating Centres for Evaluation of Methods of Diagnosis and Treatment of Melanoma, Veronesi U. , Aubert C. , Bajetta E. , Beretta G. , Bonadonna G. , Cascinelli N. , De Marsillac J. , Ikonopisov R. L. , Kiss B. , Krementz T. , Lejeune F. , Mechl Z. , Milton G. W. , Morabito A. , Mulder P. , Pawlicki P. , Priario J. , Rumke P. , Sertoli R. , Tomin R. , Trapeznikov N. , Wagner R.
Published: April 2018

From 1976 to 1980, 377 randomized patients were entered in a multicentric study supported by the W.H.O. Melanoma Group. In this report, only 196 patients are considered for analysis: 31.6 % were excluded because of inadequate treatment or protocol violations. Three arms of treatment were compared: DTIC alone, DTIC plus bacillus Calmette-Guérin, and DTIC plus Corynebacterium parvum. No significant difference in terms of complete response plus partial response was detected among the three regimens. Twenty-five patients (12.7 %) responded with complete tumor regression, and 18 (9.3 %) with partial regression. Complete plus partial responses were thus achieved in 22 % of evaluable patients. Responders had a longer median survival than nonresponders. Overall median survival was 6 months. Brain metastases were detected in 17 % of the patients. Median time from the beginning of treatment to the diagnosis of CNS involvement was 4 months. There is no evidence that active aspecific immunotherapy added to DTIC increases the response rate in patients with disseminated disease. The toxic effects were acceptable, and no drug-related death was observed.
The Role of Carcinoembryonic Antigen in the Postmastectomy Follow-Up of Primary Breast Cancer and in the Prognostic Evaluation of Disseminated Breast Cancer
Authors: Palazzo Salvatore , Liguori Virginia , Molinari Benedetto , Greco Luigi Maria , Mancini Vito
Published: April 2018

Serum levels of carcinoeinbryonic antigen (CEA) were evaluated in 145 patients with breast cancer. There were 107 patients with « indolent » disease: 8 had previous metastases in complete posttherapeutic remission and were CEA-negative; CEA became positive in 2 of 3 of these cases who subsequently relapsed. The other 99 patients were without clinical evidence of disease after mastectomy. Of these, 82 were disease-free and CEA-negative, 2 relapsed and simultaneously became CEA-positive, 4 had recurrences but remained CEA-negative, 4 became CEA-positive but without clinical signs of metastases, and 7 became CEA positive before the clinical-instrumental diagnosis of metastasis. CEA was positive in 23 of 38 patients (60.5 %) with « active » disease. Response to medical therapy occurred in 6.6 % of CEA-negative patients compared to 55.0 % of CEA-positive patients. Among CEA-positive patients, there was a similar percentage of response to medical therapy in patients with small (50.0 %) or large (56.5 %) tumor burden. A response to medical therapy was observed in all patients with a disease-free interval equal to or greater than 24 months and CEA-positive.
Neoplastic Colonic Polyp with Extensive Squamous Metaplasia. Case Report
Authors: Forouhar Faripour
Published: April 2018

Extensive squamous metaplasia in neoplastic colonic polyps is rare. This paper describes extensive squamous metaplasia in an adenomatous polyp evolving into adenocarcinoma. The origin of squamous cell carcinoma and adenocanthoma of the colon is not well understood. This case is the only case reported in the literature that demonstrates the development of squamous metaplasia in dysplastic colonic glands, in situ adenocarcinoma, and finally invasive adenocarcinoma of the colon. The pertinent literature is reviewed.
Serum Immunoreactive Calcitonin in Lung Cancer
Authors: Conte Nicola , Cecchettin Maurizio , Manente Paolo , Monco Maria Antonia , Salandin Ferruccio , Volpato Eleonora , Roiter Ignazio , Carniato Antonio
Published: April 2018

Serum immunoreactive calcitonin (iCT) assay was performed in 92 patients suffering from different kinds of cancer of the lung and in 42 healthy control subjects. Gel filtration of serum of patients suffering from microcytoma was carried out on Sephadex G75 to study the forms of circulating iCT. The obtained results (pg/ml M ± SE) were: 1) normal subjects, 73 ± 3; 2) epidermoidal cancer, 105 ± 19; 3) adenocarcinoma, 116 ± 47; 4) anaplastic carcinoma with large cells, 156 ± 74; 5) microcytoma, 354 ± 74; 6) chronic obstructive bronchitis, 38 ± 6. Gel filtration of serum of patients with microcytoma demonstrated the same behavior as in normal subjects. We can conclude that iCT increases significantly in microcytoma with extensive disease (84 % of cases): in this condition, the iCT assay can be useful as a marker in follow-up of disease.
Prognostic Significance of Progesterone Receptors Alone or in Association with Estrogen Receptors in Human Breast Cancer
Authors: Di Fronzo Giovanni , Cappelletti Vera , Coradini Danila , Ronchi Enrico , Scavone Gianfranco
Published: April 2018

Estrogen (ER) and progesterone (PgR) receptors were measured simultaneously in 1144 consecutive breast cancer patients to determine the distribution of patients according to receptor and menopausal status when receptor occurrence rates were considered. The prognostic signicance of PgR, either alone or in association with ER, was studied on 187 consecutive breast cancer patients treated only by radical mastectomy. All the cases, as regards axillary node status, were pathologically assessed as node negative. These patients did not receive any adjuvant treatment after mastectomy. At 36 months after mastectomy, the follow-up indicated that PgR- patients have a worse prognosis than PgR+ ones. This is evident when PgR alone is considered as a prognostic factor as well as when it is used to identify, within ER+ cases, those with a higher probability of relapse. In conclusion, it can be stated that although PgR status is an independent prognostic factor, it is useful to evaluate ER and PgR simultaneously for better patient management.
Leucovorin Protection on Pluripotent Hemopoietic Stem Cells in Mice Treated with High-Dose Methotrexate
Authors: Muzzulini Carlo , D'Amore Francesco , Sobrero Alberto , Massa Giulio , Bogliolo Giuseppe , Pannacciulli Ivo
Published: April 2018

Haematologic effects of delayed 16 h administration of leucovorin (LV) following high-dose methotrexate (HDMTX) were analyzed in C57B1×C3HF1 mice. Results show that 16 h administration of LV significantly reduces the toxic effects of HDMTX on hemopoietic progenitors and bone marrow cells. At 12 days after HDMTX administration, the bone marrow level of CFUs was significantly higher in HDMTX-LV treated mice than in HDMTX treated animals. In comparison with previous data obtained when LV was injected 2 h after HDMTX, the delay in administration of LV does not appear to reduce the protective effect of the vitamin.
Effect of Cisplatin on the Oxidative Metabolism of Polymorphonuclear Leukocytes in Cancer Patients
Authors: Fumando Ruggiero , Riccardi Silvana , Restaino Antonio , Giordano Domenico
Published: April 2018

Peripheral blood polymorphonuclear leukocytes of patients with ovarian or uterine-cervix carcinoma were studied during cisplatin chemotherapy for phagocytic oxidative metabolism. In particular, superoxide production by these leukocytes after stimulation with opsonized Zymosan particles was determined. The basal value of oxidative metabolism of leukocytes from neoplastic patients was lower than in normals. Superoxide production decreased after each dose administration, but returned to normal at the end of the entire chemotherapeutic treatment. It is suggested that cisplatin treatment, despite a short-lived depression of oxidative metabolism in polymorphonuclear cells, improves this function, most probably by interfering with neoplastic growth.
Salivary Gland Involvement in a Case of Dermal Eccrine Cylindroma of the Scalp (Turban Tumor). Report of a Case with Lung Metastases
Authors: Pingitore Raffaele , Campani Daniela
Published: April 2018

The onset of sweat gland and salivary gland tumors in the same patient is a rare association known only for a few years. The case is reported of a man who died at 63 with lung metastases and bearing a turban and salivary tumor (both of the eccrine cylindroma dermal type). This « cutaneous and salivary neoplastic syndrome » may be explained by a common stem cell in different organs.
Prognosis of Chronic Lymphocytic Leukemia: Analysis of One Hundred Cases
Authors: Molica Stefano , Puzzonia Pasquale , Iannaccaro Piergiorgio , Pane Carmela , Alberti Antonio
Published: April 2018

One hundred patients with chronic lymphocytic leukemia (CLL) followed in our department between November 1969 and December 1982 were reviewed and classified according to the staging system proposed by the International Workshop on CLL (IWCLL). Analysis of actuarial survival curves revealed a significant chisquare value for heterogeneity and trend. In addition, thrombocytopenia and anemia appeared to be the most important risk factors. A large variability in the course of disease, not well explained by the staging system of the IWCLL, was found among the nonanemic and nonthrombopenic patients. Analysis of A and B stage patients according to absolute peripheral blood lymphocytosis (less or more than 50 × 109/liter) showed two separate patterns of survival.
Phase II Study of Ifosfamide Combined with Mesna Uroprotection in Advanced Non-Small-Cell Lung Carcinoma and Other Solid Tumors
Authors: Nobile Maria Teresa , Rosso Riccardo , Brema Fulvio , Cinquegrana Angela , Santi Leonardo
Published: April 2018

Thirty six patients with advanced solid tumors (24 lung: 3 oat-cell, 14 squamous, 7 adenocarcinomas, 3 soft tissue sarcomas, 6 breast carcinomas; 1 seminoma; 2 ovarian adenocarcinomas) entered a phase II study of high-dose ifosfamide (IF) administered in combination with the uroprotective agent sodium 2-mercapto-ethane-sulfonate (Mesna). Fourteen patients had prior treatment; most patients with lung cancer (22/24) were previously untreated; all had measurable disease. The patients median age was 59 (range 31–74). IF was given at 1.8 g/m2 days 1–5 q 4 weeks. Mesna was given after each IF injection at 0, 4 and 8 h randomly, either i.v. (0.36 g/m2) or orally (0.72 g/m2). Twenty-four patients had ≥ 3 courses of therapy, 9 had 2 courses, and 3 had only 1 course; 129 courses were evaluated for toxicity. Mesna was given orally (17 patients, 57 courses) or i.v. (19 patients, 72 courses). The following side-effect were observed: no gross hematuria, microhematuria (14 courses), transitory mild proteinuria (34 courses), leukopenia grade I-II ECOG (26 courses), anemia grade I ECOG (31 courses), 1 case of pancytopenia, alopecia (31 patients), nausea (moderate, 33 courses; severe, 6 courses), vomiting (moderate, 17 courses; severe, 1 course). Five patients showed a partial response (1 oat-cell carcinoma, 2 with squamous lung cancer, 1 with ovarian carcinoma, 1 with breast carcinoma), 14 showed a minor response (2 patients with oat-cell carcinoma, 2 with lung adenocarcinoma, 5 with squamous lung cancer, 1 with seminoma, 1 with sarcoma, 1 with ovarian carcinoma), and 14 showed progression of disease (7 patients with squamous cell lung cancer, 4 with lung adenocarcinoma, 1 with sarcoma, 2 with breast carcinoma). Considering partial plus minor responses, ifosfamide produced some degree of tumor reduction (PR+MR) in 12/23 (52.1 %) lung cancer patients. The data reported support the conclusions that Mesna can prevent high-dose IF bladder toxicity, that IF is active in advanced solid tumors, including lung cancer, and that the IF + Mesna combination is a generally safe treatment procedure.
Relationship between Pulmonary Function Tests and Morphologic Changes in the Lung in Bleomycin-Treated Patients
Authors: Piotti Patrizia , Genitoni Valerio , Comazzi Roberto , Pagnoni Anna Maria , Guindani Antonio , Cerasoli Serenella , Villani Fabrizio
Published: April 2018

The transfer factor of the lung for carbon monoxide (TLCO) and the respiratory response to moderate exercise were determined in 16 patients with pulmonary metastasis pretreated with bleomycin who underwent pulmonary partial resection. The results of pulmonary function tests were related to histologic findings. No significant correlation was found between pulmonary morphologic changes and the TLCO: this questions the usefulness of TLCO as a predictive method for detecting subclinical bleomycin pulmonary toxicity. No significant correlation was found between morphologic findings and cumulative dose of bleomycin: this confirms the limit of a dose limitation strategy. In contrast, evaluation of pulmonary response to exercise seemed to improve the sensitivity of monitoring such patients for clinical evidence of latent pulmonary toxicity; however, it seems that critical morphologic changes must occur before pulmonary performance begins to deteriorate.
Immediate Breast Reconstruction following Modified Radical Mastectomy
Authors: Santi Pierluigi , Benino Pietro , Galli Angelo , Quondamcarlo Cinzia
Published: April 2018

Reducing postoperative psychological morbidity is an important goal in breast cancer patient care; a mutlidisciplinary approach is crucial in order to select candidates for immediate breast reconstruction. There is no oncologic reason for a delay after a modified radical mastectomy. Our procedure allows immediate breast reconstruction without significantly prolonging operative time and hospitalization. Complete muscular coverage of the implant and shifting of the redundant skin to the mastectomy site minimize the risk of postoperative complications and provide a natural looking reconstructed breast. Delayed reconstruction of the nipple-areolar complex performed at the time of contralateral mammaplasty ensures satisfactory breast symmetry. Satisfactory reconstruction of the nipple-areolar complex is achieved without additional scars by means of grafts taken from the opposite breast or utilizing the cryopreserved nipple and areola.
Lipid Bound Sialic Acid in Cancer Patients
Authors: Salvagno Luigi , Ferrazzi Eros , Sileni Vanna Chiarion , Maggi Stefania , Tredese Flavio , Bedendo Claudia , Russo Michela Paola , Fiorentino Mario V. , Ceriotti Giovanni
Published: April 2018

Serum lipid-bound sialic acid (LSA) was measured with a recently described procedure in 108 healthy subjects and in 138 patients with a variety of solid tumors and hematologic malignancies. At the time of serum sampling, 128 patients had active disease and 10 patients had no evidence of disease. LSA was elevated in 104 of 128 (81.2%) patients with active disease, while carcinoembryonic antigen, analyzed in 74, was elevated only in 21 (28.4%) (P < 0.05). Sensitivity of the serum LSA test ranged from 66% for breast and gastrointestinal cancer to 92% for lung cancer. In patients with lung cancer, ovarian cancer or Hodgkin's disease, LSA was correlated with the extent of disease and it also proved to be useful in following the course of disease. Our preliminary data indicate that this test can be used as a monitor of tumor burden.
Inflammatory Malignant Fibrous Histiocytoma of the Kidney: An Immunohistochemical and Ultrastructural Study
Authors: Muretto Pietro , Lemma Enrico , Grianti Cesare , Staccioli Maria Pia , Fabbretti Giovanna , Sbarbati Andrea
Published: April 2018

A primary inflammatory malignant fibrous histiocytoma of the kidney is reported. The differential diagnosis from other sarcomas and pseudosarcomatous lesions is discussed on the grounds of the histologic, immunohistochemical and ultrastructural results. The neoplasm was made up of histiocytes, fibroblasts, myofibroblasts, foam cells and undifferentiated mesenchymal cells with admixed granulocytes, lymphocytes and plasma cells. The immunohistochemical study showed a positivity for alpha-1-antichymotrypsin and a weak positivity for alpha-1-antitrypsin in mononuclear and pleomorphic multinucleated tumor cells. PASpositive, diastase-resistant intracytoplasmic hyaline globules in necrotic cells, examined by electron microscopy, most likely represent lysosomal structures, in accordance with the theories of De Duve, Vattiaux and Von Ardenne.
Risk Factors for Benign Breast Disease and their Relation with Breast Cancer Risk. Pooled Information from Epidemiologic Studies
Authors: La Vecchia Carlo , Parazzini Fabio , Franceschi Silvia , Decarli Adriano
Published: April 2018

Information from published case-control studies on benign breast disease was pooled using standard statistical methods to obtain single, overall risk estimates. This analysis showed that higher socio-economic status (pooled relative risk, RR = 1.24, 95% confidence interval, CI = 1.13-1.37), later menopause (pooled RR = 1.87, 95%, CI = 1.67-2.11) and late age at first birth (pooled RR = 1.30, 95%, CI = 1.13-1.50) were associated with an increased risk of benign breast disease, whereas an apparent protection was given by greater body mass index (pooled RR = 0.58, 95%, CI = 0.50-0.67) and the use of oral contraceptives (pooled RR = 0.75, 95%, CI = 0.67-0.83). The role of these factors did not appear to be materially different in the various histopathologic categories considered, although available information allowed only a general distinction between breast dysplasia (fibrocystic disease) and benign tumors, chiefly fibroadenoma. In conclusion, the general evidence from published studies indicates that benign breast lumps appear to share a number of important risk factors with breast cancer.
Non-Functioning Parathyroid Carcinoma: A Case Report
Authors: Merlano Marco , Conte Pierfranco , Scarsi Pietro , Tatarek Rita , Barbieri Angelo , Santelli Alida , Scarpati Daniele , De Angelis Paolo
Published: April 2018

Non-functioning parathyroid carcinoma is a very rare disease. Only 12 cases have been reported in the literature. The clinical behavior is characterized by the appearance and growth of a neck mass or nodule, which often has been present for many years, and is not accompanied by clinical or laboratory evidence of hypercalcemia or elevated levels of parathyroid hormone (PTH) in peripheral blood. Pathologic findings are similar to those of functioning tumors, and the proof of malignancy is established on the basis of an increased mitotic index only. Data on survival from cases reported in the literature are not conclusive; however, the non-functioning type of parathyroid carcinoma seems to be a more aggressive disease. Radiotherapy seems to be effective in the local control of the disease, but most patients become metastatic. Even if no data are available on response to chemotherapy, the course of the disease is relatively indolent.
Solitary Pancreatic Metastasis Occurring 20 Years after Nephrectomy for Carcinoma of the Kidney
Authors: Audisio Riccardo A. , La Monica Gaudenzio
Published: April 2018

This report describes a case observed in December 1983: a woman who underwent right nephrectomy in 1963 for kidney carcinoma, developed a solitary metastasis to the pancreas, and was operated on again. She is disease free more than one year after.
Serum Glycolytic Enzymes in Breast Carcinoma
Authors: Yeshowardhana  , Gupta M.M. , Bansal Geeta , Goyal Sindhu , Singh V.S. , Jain Km. Sangita
Published: April 2018

Serum levels of lactate dehydrogenase and its isoenzymes, phosphohexos isomerase, aldolase and hexokinase were determined in 152 cases of breast carcinoma, in search of proper diagnostic and prognostic parameters. The enzyme levels showed a relation to the clinical stage of the tumor and were, on an average, higher in advanced stages of disease. Phosphohexose isomerase and lactate dehydrogenase-isoenzyme levels were of best diagnostic significance even at an early stage of the disease. The enzyme levels correlated well with the prognosis of the disease. In group three, the prognosis was very poor and the patients responded only slightly to the treatment, and only up to the third month; after that enzyme levels again increased.
Normal T-Lymphocyte Function in Patients with Hodgkin's Disease in Long-Lasting Remission
Authors: Lauria Francesco , Raspadori Donatella , Foà Robin , Tazzari Pier Luigi , Lusso Paolo , Fierro Maria Teresa , Matera Lina , Baccarani Michele , Tura Sante
Published: April 2018

In 18 patients with Hodgkin's disease (HD) in long-lasting remission (more than 5 years), the distribution of circulating T-lymphocytes was analyzed using a series of monoclonal antibodies (OKT3, T4, T8, Leu-7, Leu-11 and T10) and correlated with cell function (helper capacity in a pokeweed mitogen system and natural killer (NK) activity). A reduced proportion of OKT4 (helper/inducer)-positive cells associated with a normal absolute number was consistently accompanied by a significant increase (p < 0.005) in the proportion and absolute number of OKT8 (suppressor/cytotoxic)-positive cells. The OKT4-positive cells, despite their moderate percentage reduction, showed normal helper activity. A more extensive characterization of the lymphoid population in these patients documented a preserved cytotoxic function in a 51Cr release assay and increased proportion of cells expressing NK-associated antigens (Leu-7, Leu-11, OKT10) with a high number of cells coexpressing OKT8 and Leu-7. It is suggested that in patients with Hodgkin's disease in long-lasting remission no laboratory (or clinical) evidence of cellular immunodeficiency can be documented.
Combined Treatment of 4′-EPI-Doxorubicin and Radiation on Hamster Lung Cells
Authors: Ban Jasna , Bistrović Matija , Maričić Željko , Kolarić Krsto
Published: April 2018

The purpose of this study was to test the type and the degree of cytotoxic effects of epirubicin and radiation in combined treatment on Chinese hamster lung cells in vitro. Experiments were performed with proliferating tissue culture cells. Cell kill was determined by colony-forming ability. The maximum killing effects were obtained when simultaneous action of drug treatment and irradiation occurred. Their interaction was synergistic. Synergism depended on time of drug incubation (epirubicin present for 1 h). Slight antagonism was noted after prolonged drug action (24 h).
Metastatic Growth of a Murine Tumor: Evidence of Dissemination to the Lungs in the Absence of Subcutaneous Growth
Authors: Alberti Saverio , Filippeschi Stefania , Spreafico Federico , Alberti Elsa , Colotta Francesco
Published: April 2018

Growth of MCA-38/B colon adenocarcinoma was detectable 30-33 days after subcutaneous (s.c.) tumor cell inoculation in mice. Seventy percent of the mice receiving 107 tumor cells, 50 % of those receiving 104, and 15% of the mice given 105 cells developed s.c. tumors (mean of 4 experiments, total of 80 mice per group). Metastases in the presence of a primary tumor were observed in 11% of 107 and in 10% of 106 tumor-cell injected animals. Lung metastases were detected in the absence of tumor growth at the site of s.c. cell injection in 19% of 107, in 8% of 106 and in 5% of 105 and 104 tumor-cell inoculated mice. In parallel experiments an intravenous (i.v.) inoculum of tumor cells produced lung colonies in 40% of 106 and in 14% of 105 tumor-cell injected animals. Smaller inocula did not give rise to lung colonies, thus making it unlikely that accidental i.v. inoculations of tumor cells during the s.c. injections caused the observed metastatic dissemination to the lungs.
A Case of Classical Kaposi's Sarcoma in B-Cell Chronic Lymphocytic Leukemia (B-CLL)
Authors: Contu Licinio , Carcassi Carlo , La Nasa Giorgio , Zurrida Stefano M. , Sirigu Franco , Del Giacco Sergio , Cerimele Decio , Longinotti Maurizio , Pitzus Franco
Published: April 2018

We report a case of classical Kaposi's sarcoma (KS) in a patient affected by B-cell chronic lymphocytic leukemia for 2 years and who had not received any antiblastic treatment. At the ultrastructural analysis the leukemic cell showed rather immature features, and the immunologic phenotype (absence of detectable cytoplasmic Ig, and expression only of the DR, B2 and IgDλ molecules on the surface membrane) proved its intermediate level of maturity, its monoclonality and relative rarity. The patient presented a complex immunologic deficiency, revealed not only by the monoclonality of the B lymphocytes and their low degree of maturity, but also by the almost total absence of T helper lymphocytes, by the high reduction in NK activity, by the very scarce proliferative response to the polyclonal mitogens PHA, ConA and PWM, and by a complete anergy to the skin test of delayed reactivity. The search for antibodies against the viruses EBV, CMV, HTLV-I and HTLV-III in the serum was negative. At the HLA typing, the patient was DR5, as are most classical KS and/or B-CLL patients. The data are discussed in relation to documented non-casual association between B-CLL and KS. We stress that immunosuppression may play an important role in the pathogenesis of both diseases and the possibility of their being conditioned by common genetic HLA-associated factors of predisposition.
Infusion of Autologous Alloactivated Lymphocytes in Melanoma Patients: Toxicity and Immunologic Monitoring
Authors: Gambacorti-Passerini Carlo , Marolda Raffaele , Tona Gabriella , Sciorelli Gianalfredo , Fossati Giuseppe , Cascinelli Natale , Parmiani Giorgio
Published: April 2018

Previous work has shown that infusion of autologous helper-enriched, alloactivated lymphocytes in melanoma patients may induce, in addition to other mild signs of toxicity, a transient but sharp elevation of blood pressure. To avoid such a disturbing symptom, the in vitro protocol of peripheral blood lymphocyte activation has been modified. In the present study we show that such a modification has led to a lower toxicity of autologous lymphocyte infusion in 4 melanoma patients; in particular, hypertension was no longer observed. In addition, an immunologic monitoring was carried out in these patients. In 1 of 4 patients the treatment enhanced the in vitro cytotoxic activity of peripheral blood lymphocytes against autologous tumor cells. Other parameters such as NK activity and T4/T8 ratio did not show significant trends. The possible implications of these findings for clinical trials of adoptive immunotherapy with lymphocytes are discussed.
Cisplatin plus Vindesine versus Cisplatin plus VP16 versus Doxorubicin plus Cytoxan in Non-Small-Cell Carcinoma of the Lung. A Randomized Study
Authors: Paccagnella Adriano , Brandes Alba , Pappagallo Giovanni L. , Simioni Giuliana , Fosser Vinicio P. , Vinante Orazio , Salvagno Luigi , De Besi Pietro , Sileni Vanna Chiarion , Fornasiero Adriano , Fiorentino Mario V.
Published: April 2018

From March 1981 to January 1984, 116 patienst with advanced non-small-cell carcinoma of the lung (NSCCL) were randomly assigned to 3 combinations as follows: CDDP + DVA, CDDP + VP16 and DXR + CTX. 94 patients were evaluable for response, 106 for toxicity and survival. Of 31 patients, 15 (48%; 3 CRs and 12 PRs) responded to CDDP + DVA; of 33 patients, 12 (36%, 2 CRs and 10 PRs) responded to CDDP + VP16; of 30 patients, 3 (10%) obtained a PR with DXR+CTX (CDDP+DVA vs DXR + CTX, P < 0.005; CDDP + VP16 vs DXR + CTX, P < 0.05; CDDP + DVA vs CDDP + VP16, P = NS). The median duration of response was 22 weeks in the CDDP-DVA group, 17 weeks in the CDDP-VP16 group, and 16 weeks in the DXR+CTX group. No significant difference in survival was observed among the 3 groups (median: 43, 47, 41 weeks, respectively). Hematologic and neurologic toxicities were significantly higher in the DVA-containing regimen. Despite the lack of improvement of overall survival with the CDDP-containing combinations over the DXR + CTX control group, the good response rate makes them suitable to be used in combined therapeutic strategies.
CYTO-Histologic Evaluation of the Endometrium in Climacteric Women at Risk for Endometrial Carcinoma
Authors: de Aloysio Domenico , Rocca Giovanna , Miliffi Loredana
Published: April 2018

The authors evaluated the diagnostic effectiveness of a triple specimen technique (cyto-histologic) performed by the Perma device. The incidence of endometrial hyperplasia (according to Dallenbach-Hellweg's classification) was estimated in 254 climacteric women selected from outpatients who come spontaneously to the Menopause Clinic of the Obstetrics and Gynecology Department (Bologna University). The selection criterion was the evidence of risk factors for endometrial carcinoma, climacteric bleedings (obesity, late menopause, high blood pressure, diabetes), or endometriotropic estrogen therapy in the postmenopause. Results showed that the cyto-histologic sampling is most useful for diagnosing endometrial hyperplasia and early carcinoma (diagnostic effectiveness: 89.0-93.8%). Also, endometrial hyperplasia was found to have a significant incidence in the group we examined. This incidence was highest in women with climacteric bleedings, secondly in women using high-dose estrogens, and thirdly in women with risk factors for endometrial carcinoma. When evaluating the different kinds of endometrial hyperplasia, we never found adenomatous hyperplasia in women on estrogen therapy. Affinity between histologic and cytologic classes was around 50% in endometrial hyperplasia and 100% in early carcinoma. This emphasizes that both samplings are needed to perform an accurate diagnosis.
Gastric Cancer: Histopathologic Patterns According to Lauren's Classification in a High-Risk Area and Distribution by Residence
Authors: Amadori Dino , Palli Domenico , Padovani Franco , Falcini Fabio , Buiatti Eva , Saragoni Ariele , Ravaioli Alberto
Published: April 2018

A total of 1061 advanced gastric cancers with histologic confirmation, diagnosed from 1973 to 1982 at the Morgagni-Pierantoni Hospital (Forlì) were reclassified according to Lauren, and histologic types were related to the source of the histologic specimen, sex, age at diagnosis, place of birth and residence. This large case series showed a high percentage of intestinal type cancers, consistent with the high risk for gastric cancer which characterizes the area under study. Intestinal type carcinomas tend to be represented more in the older age groups, in males and in subjects born in the Forlì province and resident in hilly and mountainous areas. The distribution over time of biopsy specimens in this case series showed an increased use of gastroscopy for diagnosis in the population under study.
Results of Combined Radiotherapy and Multidrug Chemotherapy in Advanced Squamous Cell Cancer of the Head and Neck
Authors: Reinfuss Marian , Korzeniowski Stanislaw
Published: April 2018

Treatment results of combined radiotherapy and polychemotherapy in a group of 38 patients with advanced squamous cell of the head and neck cancer are presented. The radio-chemotherapy schedule included 60Co irradiation with 20 Gy in 10 fractions over two weeks followed by multidrug chemotherapy with vincristin, bleomycin, methotrexate and leucovorin. Three series of radio-chemotherapy were given. In 14 patients the total dose of irradiation was increased to 70-105 Gy. The probabilities of overall and symptom-free survival at 2 years were 32% and 20%, respectively. Treatment results correlated with stage of the disease. Patients who received higher doses of radiation seemed to have better chances of symptom-free survival.
Primary Malignant Lymphoma of the Salivary Glands
Authors: Hjorth Lisbet , Dommerby Hans , Kruse Steen , Nielsen Annemarie
Published: April 2018

Five cases of primary malignant lymphomas of the salivary glands are reported. Four lymphomas arose in the parotid gland and one in the submandibular gland. All were non-Hodgkin lymphomas. In 4 cases the lymphomas were of low-grade malignancy, viz. 2 immunocytomas and 2 centroblastic/centrocytic malignant lymphomas, and 1 was a T-immunoblastic malignant lymphoma of high-grade malignancy. Four patients with localized disease were treated with radiotherapy and 1 patient with disseminated disease was treated with chemotherapy. One patient died from a disease unrelated to the malignant lymphoma, and 4 patients were alive at 66-136 months after treatment.
Combination Chemotherapy in Advanced Ovarian Carcinoma
Authors: Amadori Dino , Ravaioli Alberto , Maltoni Marco , Ridolfi Ruggero , Gentilini Patrizia , Giunchi Donata Casadei , Frassineti Luca , Falcini Fabio , Amadori Marinella
Published: April 2018

Ovarian carcinoma is the fifth most common cause of death among women in western countries. It is often diagnosed in an advanced stage (FIGO Stage III and IV) and requires effective chemotherapy as first-line treatment. The advent of cisplatin combined with adriamycin and cyclophosphamide has remarkably increased the response rate in advanced disease. The authors report 31 cases of epithelial ovarian neoplasia, without prior chemotherapy, treated with cisplatin, adriamycin and cyclophosphamide (PAC I). Of the 30 evaluable patients, 15 had clinical complete remissions (cCR = 50%), 10 clinical partial remissions (cPR = 33%) and 5 no response (NR = 17%). The total response (cCR + cPR) was equal to 83%. Twelve of the 15 patients in cCR underwent second-look laparotomy; in 8 of these cases, histologic and cytologic confirmation of CR was obtained. PAC I was found to be a highly effective therapeutic regimen with moderate toxicity. The individual toxicity reported was gastroenteric (nausea and vomiting), but transitory. No chronic toxic side-effects from cisplatin or adriamycin were noted. However, more definitive results must be obtained to verify its impact on the prolongation of survival.
The Influence of Amphotericin B on Differentiation Induced by Dimethylsulfoxide and Actinomycin D in HL60 and Friend Cell Lines
Authors: Ciomei Marina , Pastori Wilma , Giuliani Fernando Carlo
Published: April 2018

We use murine erythroid Friend cells and human promyelocytic HL60 cells to investigate the influence of a transmembrane signal in triggering myeloid or erythroid cell differentiation. Combined treatments were given with dimethylsulfoxide, actinomycin D and amphotericin B, a substance which resembles a deviant membrane lipid and which seems to influence exclusively membrane activity. Our results suggest that a membrane modification alone is sufficient for in vitro HL60 cell differentiation, whereas both a transmembrane and a nuclear signal are necessary for Friend cell differentiation.
Reduction of Liver Glutathione Peroxidase Activity and Deficiency of Serum Selenium in Patients with Hepatocellular Carcinoma
Authors: Corrocher Roberto , Casaril Massimo , Bellisola Giuseppe , Gabrielli Giovanbattista , Hulpe Minerva , Garofoli Enrico , Nicoli Nicola
Published: April 2018

Twelve adults with hepatocellular carcinoma (HCC) and 8 individuals with hystologically normal liver, were measured for serum selenium concentration and glutathione peroxidase (GSH-Px) of liver tissue. It was found a reduced serum selenium and liver GSH-Px in patients with HCC. Serum selenium concentration and the enzyme activity were positively correlated (p < 0.01). The increased risk of carcinoma in selenium deficiency may be partially due to a reduced activity of GSH-Px, one of the most important scavenger enzymes of oxygen toxic radicals.