bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic and Prognostic Value of Lymphography in Patients with Cancer of the Endometrium
Authors: Musumeci Renato , Kenda Rado , Volterrani Fabio , Spatti Giovan Battista , Luciani Luciano , Attili Angelo , De Palo Giuseppe
Published: April 2018

The results of foot lymphography in 161 patients with endometrial carcinoma, observed from 1968 to 1977 at the Istituto Nazionale Tumori of Milan are reported. Ninety-three were new cases, 40 were recurrences, and 28 were patients who underwent restaging diagnostic procedures without clinical evidence of disease. The majority of the cases were adenocarcinomas (146/161, or 91%), 10 were mixed adenosquamous carcinomas (6%) and 5 (3%) were adenoacanthomas. The overall incidence of pathologic lymphograms was 30% (46/161 patients). The incidence of the lymphatic spread was related to the clinical stage and to the extent of recurrent disease. In fact, in the 93 new cases, lymphography was positive in 11% of patients at stage I, 39% at stage II, 57% at stage III and 67% at stage IV disease. In the 40 pretreated patients, lymph node involvement was 33% in vaginal recurrences, 52% in pelvic abdominal recurrences and 73% in widespread diffusion. Finally, in 28 pretreated patients with no evidence of disease, the incidence of lymph node involvement was 7%. Metastases were found only in the pelvic nodes in 59% of the patients and only in the para-aortic nodes in 10%; in 31%, both chains were simultaneously involved; bilateral involvement was found in 45% of the patients with radiologically proven metastases. The 5-yr survival rate for patients at stage I-II and III disease with positive lymphography was 47.6% as compared with 83.5% for negative cases. In patients at stage I and II, the difference of survival was equal to 23.4%. The reliability of the results is confirmed by the concordance with the data of the literature on histologic involvement, by the first radiologic-anatomic comparison, and by the clinical course of the positive cases. Lymphography is of unquestionable value for an appropriate staging and for a correct treatment. The prognostic significance of the procedure is evident and such as to justify a major therapeutic aggressiveness in positive cases.
Analysis of Some Factors Effecting Survival in Malignant Gliomas
Authors: Schiffer Davide , Cavicchioli Donatella , Giordana Maria Teresa , Palmucci Laura , Piazza Alberto
Published: April 2018

Many factors, including the histological aspect, are known to effect the survival of patients with malignant gliomas. The relation between survival and diagnoses such as primary and secondary glioblastoma, anaplastic astrocytoma, etc., is not definitely clear. In 324 malignant gliomas the relationship between survival and age, sex, tumor pathology, occurrence of lymphoplasmacytic infiltrations, and size of the examined specimen was studied. Preoperative intervals of primary and secondary glioblastomas do not differ; anaplastic astrocytomas show definitely longer preoperative intervals and slightly but not significantly longer postoperative patient survival. The correlations are discussed, focusing on importance of knowing the survival times of untreated cases in order to evaluate the efficacy of chemotherapeutic drugs in malignant gliomas.
Cyclophosphamide and Iphosphamide against Lewis Lung Carcinoma: Evaluation of Toxic and Therapeutic Effects
Authors: Greco Claudia , Corsi Anna , Caputo Marco , Cavallari Andrea , Calabresi Federico
Published: April 2018

In the present report, investigations have been carried out to evaluate toxic and therapeutic effects of cyclophosphamide vs its isomer iphosphamide. Cytostatic action of the 2 drugs was assayed on the murine Lewis lung carcinoma (3LL). It has been observed that iphosphamide is less toxic as compared to cyclophosphamide [Formula: see text]; on the other hand, to reach the same therapeutic effectiveness on 3LL, an iphosphamide dose 1.6 - 2 times higher than that of its parent compound is necessary.
A Report of the Histological Features in 12 Cases of Gonadoblastoma
Authors: Woodcock Arthur S. , Govan Alexander D.T. , Gowing Noel F.C. , Langley Fred A. , Anderson Malcolm C.
Published: April 2018

This report deals with 12 cases of gonadoblastoma submitted to the Ovarian Tumour Panel of the Royal College of Obstetricians and Gynaecologists. These tumours are found in children and young adults. Children may present with obvious genital malformation, retarded growth or precocious puberty. In adults the main complaint is amenorrhoea but sometimes there is associated masculinization. Histologically the gonadoblastoma has a distinctive structure, easily recognized in most instances. The most important feature is the instability of the germ cells in these tumours. Nine of these cases showed an associated dysgerminoma, bilateral in 4. In any cases of suspected gonadal dysgenesis presumptive evidence of diagnosis is suggested by the presence of a Y chromosome, raised gonadotrophin output and pelvic calcification on X-ray examination. At operation, streak tissue on both sides must be removed since these tumours are frequently microscopic in size. For the same reason the tissue removed should be serially sectioned.
Xeroradiography of Bone and Soft Tissue Tumors
Authors: Nessi Renato , Freri Fabrizio , De Yoldi Gianfranco Coopmans
Published: April 2018

Xeroradiography was used for the study of 233 cases of bone and soft tissue tumors, both benign and malignant, 177 of which were histologically proven. In 150 cases, comparative x-ray films were also available. In bone tumors, xeroradiography was more effective than film radiography in 33 cases (44%), less effective in 16 cases (22%) and the 2 techniques were substantially equivalent in 25 cases (34%). In soft tissue tumors, xeroradiography was more effective than film radiography in 59 cases (78%), less effective in 2 cases (3%) and equivalent in 15 cases (19%). Xeroradiography is held to be a useful second-line technique in selected bone tumors, in particular for the study of trabecular structure, periosteal calcifications and cortical bone. In the field of soft tissue tumors, xeroradiography can be a promising first-choice examination in the presence of a mass or when a recurrence is suspected. The advantages and drawbacks of this technique in both types of tumors are reviewed and discussed.
Endometrial Adenocarcinoma with Psammoma Bodies
Authors: Cefis Francesco , Carinelli Silvestro G. , Marzi Marco M. , Senzani Francomaria
Published: April 2018

Psammoma bodies were found in less than 9 % of 235 cases of endometrial carcinoma, considering both biopsies and surgical specimens. They may originate in papillary adenocarcinoma and do not indicate a slightly infiltrating or a well-differentiated tumor. The clinical profile of patients closely resembles that of women with endometrial carcinoma, but survival appears worse.
Angioimmunoblastic Lymphadenopathy with Dysproteinemia Complicated by Kaposi's Sarcoma
Authors: Tosi Piero , Auteri Alberto , Cintorino Marcella , Pasini Franco Laghi , Luzi Pietro
Published: April 2018

A case of clinically and morphologically typical angioimmunoblastic lymphadenopathy (AILD) in a 68-year-old man during a prolonged antibiotic treatment for urinary infection is presented. Lymph node biopsy at first showed findings suggestive of an exhaustion of the germinal center immunological activity (like those characterizing angiofollicular lymph node hyperplasia). A second lymph node biopsy showed the typical pattern of AILD without any clear transition into malignant lymphoma. The course of the disease was characterized by the occurrence of opportunistic infections (toxoplasmosis, herpes zoster), and finally by the onset of a cutaneous Kaposi's sarcoma. The possible relation of AILD to Kaposi's sarcoma is discussed, and the main clinical and morphological data of the cases of AILD (about 200) reported in the literature are reviewed.
Ewing's Sarcoma: An Approach to Radiological Diagnosis
Authors: Lombardi Fabrizio , Gasparini Marco , Gianni Cristina , Petrillo Raffaele , Tesoro-Tess John David , Volterrani Fabio , Musumeci Renato
Published: April 2018

All the pertinent radiographs of 83 patients with histologically proven Ewing's sarcoma were reviewed. Forty-nine patients were in the pediatric age group, and 34 were adults. The mean age, the symptoms and time from symptoms to diagnosis were evaluated in the 2 groups. The site of primary involvement was in 54 % the long bones, 35 % the flat bones, 8 % the small bones and 3 % extraosseous. For the primary site we considered the diagnostic results of the standard radiographic investigations and in some cases the usefulness of angiography, xeroradiography and telethermography. At presentation we also evaluated the possible diffusion of the disease with standard radiographic surveys (chest and skeletal, including limbs) and with foot lymphography in selected cases. In this way, 57 patients (69 %) were considered to have localized disease. In this group, we also considered the value of the periodic radiographic follow-up, which enabled us to disclose the appearance of metastases (chest 64 %, bone 54 %, lymph nodes 11 %) in 28 cases (49 %). Finally, we made a comparison of the different radiologic and epidemiologic findings between children and adults.
Prolactin Receptor in Human Mammary Carcinoma
Authors: Di Carlo Raffaele , Muccioli Giampiero
Published: April 2018

The specific binding of labelled human prolactin was determined in 83 human breast carcinomas. Twenty-seven tumors (32.5 %) contained specific binding for prolactin of at least 1 % and were considered prolactin receptor positive. The binding was found linearly related to membrane protein concentration and specific only for lactogenic hormones. By Scatchard analysis the dissociation constant appeared similar to that observed in other target tissues, with a low binding capacity.
Treatment of Advanced Breast Cancer with Norethisterone Acetate
Authors: Varini Marco , Tancini Gabriele , Mauri Maurizio , Di Pietro Sergio
Published: April 2018

The medical records of 84 postmenopausal women treated with oral norethisterone acetate (NTA) for advanced breast cancer were retrospectively analyzed. Treatment was devoid of significant toxicity. Twenty-one patients were not evaluable for treatment response either because of insufficient data or inadequate treatment trial. Complete plus partial response was obtained in 21 (33.3 %) of the 63 evaluable patients, with a median duration of 10 months. Disease stabilization was observed in 16 (25.4 %) patients for a median duration of 5 months, while 26 patients (41.3 %) showed progressive disease while on treatment. The best response was observed in women with dominant soft part disease and an age over 70 (CR+PR 48 %). The literature on norethisterone acetate is reviewed and compared with present results. The role of progestational agents in the treatment of advanced mammary carcinoma is discussed.
Induction of Stress Proteins in Murine and Human Melanoma Cell Cultures
Authors: Mattei Elisabetta , Delpino Andrea , Mileo Anna Maria , Ferrini Umberto
Published: April 2018

The induction of stress proteins was studied in two human and two murine melanoma cell lines. Exposure for 1 h to heat (42 °C), to ethanol (6%), to arsenate (100 μM) and to disulfiram (50 μM) induced the expression of SPs with apparent molecular weights of 100, 86, 70-72 and 24-26 Kd. Quantitation of the single SPs indicated that the basal level as well as the enhanced synthesis following the various stressors were different in each cell line. The induction of the 100 Kd species occurred in only one murine melanoma and not in the others. The 86 and in particular the 70-72 Kd species were the most prominent groups, whereas the 24-26 SPs were induced only following arsenate and disulfiram exposure in the three melanoma cell lines. In one of the murine melanomas, the expression of SPs was markedly reduced compared to the other cell lines. No definite specific patterns of SP expression could be identified in tumors of the same histologic type.
Uneven Distribution and Significant Concentration of Apocrine Metaplasia in Lower Breast Quadrants
Authors: Benigni Giuliana , Squartini Francesco
Published: April 2018

Two hundred human breasts removed for clinical cancer by radical mastectomy were analyzed to determine whether apocrine metaplasia and apocrine cysts have predilective sites in the four mammary quadrants. One block of tissue randomly removed for each quadrant was examined in one or more histologic sections. The results showed a concentration of apocrine metaplasia and apocrine cysts in the lower mammary quadrants (17.5% versus 8.2%), which is highly significant (x2 = 15.25; P < 0.001). The different distribution between breast cancer (showing predilection for the upper quadrants) and apocrine metaplasia is emphasized, together with the higly significant association between apocrine metaplasia and breast cancer. Based on these data, the usefulness of the clinical detection of cysts in the lower mammary quadrants and needle aspiration of their fluid for the morphologic or biochemical diagnosis of apocrine metaplasia in the screening and management of women at risk is suggested.
Cumulative or Delayed Nephrotoxicity after Cisplatin (DDP) Treatment
Authors: Pinnarò Paola , Ruggeri Enzo Maria , Carlini Paolo , Giovannelli Maurizio , Cognetti Francesco
Published: April 2018

The present retrospective study reports data regarding renal toxicity in 115 patients (63 males, 52 females; median age, 56 years) who received cumulative doses of cisplatin (DDP) ≥ 200 mg/m2. DDP was administered alone or in combination at a dose of 50-70 mg/m2 in 91 patients, and at a dose of 100 mg/m2 in 22 patients. Two patients after progression of ovarian carcinoma treated with conventional doses of DDP received 4 and 2 courses, respectively, of high-dose DDP (40 mg/m2 for 5 days) in hypertonic saline. The median number of DDP courses was 6 (range 2-14), and the median cumulative dose was 350 mg/m2 (range, 200-1200). Serum creatinine and urea nitrogen were determined before initiating the treatment and again 13-16 days after each administration. The incidence of azotemia (creatinina levels that exceeded 1.5 mg/dl) was similar before (7.8%) and after (6.1%) DDP doses of 200 mg/m2. Azotemia appears to be related to the association of DDP with other potentially nephrotoxic antineoplastic drugs (methotrexate) more than to the dose per course of DDP. Of 59 patients followed for 2 months or more after discontinuing the DDP treatment, 3 (5.1%) presented creatinine values higher than 1.5 mg/dl. The data deny that the incidence of nephrotoxicity is higher in patients receiving higher cumulative doses of DDP and confirm that increases in serum creatinine levels may occur some time after discontinuation of the drug.
Mucin-Producing Adenoma of the Thyroid Gland
Authors: Brisigotti Massimo , Lorenzini Paolo , Alessi Alessio , Fabbretti Giovanna , Baldoni Cristina
Published: April 2018

The authors studied a case of mucin-producing adenoma of the thyroid gland. The tumor consisted almost entirely of signet-ring cells containing mucin, which was strongly positive with PAS, with and without diastase pre-treatment, and Alcian blue stain at pH 2.5. Immuno-peroxidase staining for thyreoglobulin was clearly positive within the cytoplasm of signet-ring cells and also in the follicle material, which indicates that the tumor derived from follicular epithelium.
A Radiologic Study by CT Scan of Pineal Size in Cancer Patients: Correlation to Melatonin Blood Levels
Authors: Tagliabue Marcello , Lissoni Paolo , Barni Sandro , Macchi Isabella , Tancini Gabriele , Crispino Sergio , Ferri Luigi , Salvini Enea
Published: April 2018

Alterations in size of the pineal body and melatonin secretion have been observed in cancer patients. The present study was carried out to evaluate pineal dimensions in a group of cancer patients and their relation to melatonin blood levels. The study included 70 oncologic patients. As controls, 41 patients with acute or chronic disease other than cancer entered the study. Melatonin serum levels were measured by radioimmunoassay on venous blood samples collected at 9:00 a.m. Pineal size was determined by brain CT scan, by considering the product of the two longest perpendicular diameters, multiplied by the thickness of the stratum. The volume of the pineal body was found to be enlarged in 12/70 (17%) cancer patients, and its mean value was significantly higher than that observed in controls. Melatonin levels were also significantly higher in oncologic patients than In controls. However, there was no correlation between melatonin levels and pineal size in cancer patients. Finally, cancer patients did not show a higher degree of pineal calcifications than controls. The clinical significance of pineal enlargement in cancer patients remains to be understood.
Phase II Study of Divided-Dose Vinblastine in Advanced Cancer Patients
Authors: Giaccone Giuseppe , Bagatella Matteo , Donadio Michela , Calciati Alessandro
Published: April 2018

A better therapeutic index has been obtained in breast cancer patients when vinblastine is given by a 5-day continuous infusion program than by i.v. bolus; the continuous infusion pharmacokinetics has been reproduced by an iv divided bolus at 0 and 48 h, which may be more easily applied to outpatients. We performed a broad phase II study in 97 advanced cancer patients in which vinblastine was administered by i.v. divided bolus at 0 and 48 h at the starting dose of 3.5–4 mg/m2, every 3 weeks. Our aim was to confirm the results achieved by continuous infusion and to investigate the toxicity pattern of this novel administration schedule. Neurotoxicity and myelosup-pression were the main side effects: constipation and peripheral neurotoxicity respectively developed in 28% and 38% of patients and were severe in 5% and 1%. Leukopenia and thrombocytopenia respectively occurred in 70% and 40% of patients and were severe in 11% and 4%. Four partial responses, 38 no changes and 42 progression were obtained out of 84 evaluable patients. Responses were seen in tumors of breast, lung, and head and neck. Our results do not support the use of vinblastine in divided doses in advanced cancer patients.
Fine Needle Aspiration Cytology and Breast Cancer Diagnosis
Authors: Ciatto Stefano , Cecchini Silvia , Iossa Anna , Grazzini Grazia , Bartoli Dusca
Published: April 2018

The authors report on 315 histologically confirmed consecutive breast cancer (BC) cases undergoing fine needle aspiration cytology (FNAC). Inadequate smears were infrequent (7%), particularly when reaspiration of inadequate cases was employed (1–2%). FNAC suspected BC in 81% of the total or 88% of adequate smears. Univariate and multivariate (Cox's model) analyses showed no correlation between inadequacy or suspect/positive FNAC rate and patient age, T category or histologic type. Differences in the inadequacy and suspect/positive rate were recorded among 30 operators (surgeons, oncologists, radiologists) performing the sampling, but the average results were consistent with literature reports. FNAC was found to be a useful diagnostic tool for BC diagnosis, and proper training of the highest number of operators is recommended to allow the widest diffusion of this diagnostic technique.
Acute Bleeding from Leiomyoblastoma of the Greater Omentum. A Case Report
Authors: Rye Bjarne A.O. , Christiansen Erik , Larsen Lise Grupe
Published: April 2018

Extragastric leiomyoblastomas are extremely rare. This is the sixth reported case of leiomyoblastoma of the greater omentum, and the only one with acute major bleeding which required an emergency operation. Leiomyoblastomas are low-grade malignant tumors, and especially the gastric ones have an excellent prognosis after surgical removal. Extragastric leiomyoblastomas have a higher rate of dissemination. However, none of the previously reported omental leiomyoblastomas showed signs of metastatic spread at the time of operation. The present patient is alive and well 18 months postoperatively.
Smoking in Italy, 1986-1987
Authors: Ferraroni Monica , La Vecchia Carlo , Pagano Romano , Negri Eva , Decarli Adriano
Published: April 2018

Smoking trends and patterns in Italy were evaluated using data from the 1986-87 Italian National Health Survey, based on a sample of 30,096 males and 32,176 females aged 15 or over, randomly selected within strata of geographical areas and sizes of the place of residence and of the household in order to be representative of the whole Italian population: 40.8 % of Italian males and 17.3 % of females described themselves as current smokers (overall estimated prevalence, 28.6 %). In comparison with previous survey-based data, self-reported smoking prevalence in males has been steadily decreasing over the last three decades, whereas rates in females have been increasing up to the early 1980s, and have shown a levelling off only in more recent years. The apparent declines in self-reported smoking, however, were not reflected in official sales figures. In fact, in the mid 1980s, there were simultaneously the lowest overall prevalence of the last three decades and the highest sales figures ever reported. The inter-sex differences in smoking prevalence were smaller at younger ages. Education, but not occupation as a measure of social class, was inversely related to smoking prevalence in males. Furthermore, rates for males were lower in the northern (and richer) part of the country. The pattern was totally different in females, since smoking prevalence was higher in more educated women, of higher social class, living in North Italy. This suggests that, in the absence of adequate measures, smoking prevalence is likely to rise among Italian women in the near future. Continued monitoring of smoking patterns gives important information with which to identify the most likely future patterns in smoking and smoking-related diseases, besides providing data for targeting intervention programs.
Activation of a Ribosomal S6 Protein Kinase in Rapidly Emerging Diethylnitrosamine-Induced Gamma - Glut Amyltranspeptidase-Positive Hyperplastic Liver Lesions of the Rat
Authors: Comolli Roberto , Alberti Paola , Giribaldi Grazia
Published: April 2018

The gamma-glutamyl transpeptidase (GGT)-positive hyperplastic liver lesions which developed in the Fisher 344 rat 7 and 60 days following a single carcinogenic dose of diethylnitrosamine (DENA, 200 mg/kg body weight), short-term dietary exposure to 0.02 % 2-acetylaminofluorene (AAF) to suppress the growth of normal hepatocytes, and partial hepatectomy to actuate rapid growth of DENA altered hepatocytes not suppressed by AAF, showed an increased activity of a kinase which specifically phosphorylates the ribosomal S6 protein in vitro. Sham-operated animals showed, on the contrary, no GGT-positive cells and low S6 kinase activity, under the same conditions. After partial hepatectomy, activation of S6 kinase and elevated levels of phosphorylated S6 protein in vitro were detected in the early phases of « normal » hepatocyte proliferation, during liver regeneration, in DENA-treated, GGT-negative preparations, when the « selection » agent AAF was omitted from the diet. The observed activation of S6 kinase in GGT-positive hepatocytes and/or liver nodules could represent an early manifestation of the enhanced proliferation of altered hepatocytes during tumor induction and/or promotion under these conditions.
Creatine Kinase-BB Activity in Malignant Tumors and in Sera from Patients with Malignant Diseases
Authors: Roguljić Ante , Safwan Tayfour , Šeparović Viktor
Published: April 2018

Creatine kinase (CK EC 2.7.3.2) and CK-BB activity was analyzed in 41 malignant tumors of 6 different sites and different histological structures. The same analyses were done on 150 sera of patients with malignant diseases of various localizations. The rate of CK activity was determined kinetical-ly, whereas tissue and serum CK-BB were separated chromatographically (Mercer). Insofar as malignant tumor tissues are concerned, the highest average rate of CK-BB activity was detected in tumors of the prostate (mean 1450 IU/g), and the lowest in tumors of the parotid gland (mean 5.2 IU/g). CK-BB was detected by the Mercer technique in 56 (37.3 %) of 150 analyzed sera of patients with malignant diseases. The rate of CK activity in sera of patients with malignant diseases was 8 to 74 IU/I. In comparison with the site of the malignant process no significant CK serum activity differences were observed. T2-T3 tumors did not significantly influence the activity of either CK or CK-BB in the case of either tissues or sera (T1-T3). Enzyme activity was found to be much higher - both in tumoral tissue and in sera - with T4 tumors. The highest rate of CK-BB activity was found in sera of patients with malignant tumors of the stomach (mean 8.1 IU/I), and the lowest in malignant tumors of the rectum (mean 1.8 IU/I).
Chemo-Radiotherapeutic Management of Advanced Head and Neck Cancer
Authors: Pirtoli Luigi , Tucci Enrico , Pepi Fiorella , Sebaste Lucio , Bindi Mirco , Sensini Isaia , Piccini Amos
Published: April 2018

Stage III and IV head and neck cancer patients usually achieve poor therapeutic results after radiotherapy. The search for more effective treatment modalities is justified, provided that tolerance is not lower than that of the usual radiation therapy schedules. Chemotherapy has been shown to be effective, and cisplatinum and bleomycin based treatments are reported to result in objective remissions in a substantial proportion of cases. There is also experimental evidence of a radiosensitizing activity of cisplatinum. Thirty-five locally advanced head and neck cancer patients were given combined chemo-radiotherapeutic treatment consisting of a cisplatinum and bleomycin induction followed by a standard radiotherapy course integrated with weekly administrations of cisplatinum. Before radiotherapy, an overall 48.5 % objective remission rate was achieved, that rose to 85.8 % after completion of the entire treatment, with a 31.5 % complete response rate. Incidence and severity of radiation mucositis seem not to be increased, and systemic toxicity is very low, with the adopted drug administration schedule. Overall results do not show any obvious superiority over those of radiotherapy alone.
Well-Differentiated Neuroendocrine Carcinoma of the Lung: A Case Report
Authors: Colleoni Marco , Di Bartolomeo Maria , Patriarca Carlo , Buzzoni Roberto , Bajetta Emilio
Published: April 2018

Well-differentiated neuroendocrine carcinoma (WDNC) of the lower respiratory tract displays clinical and radiologic features intermediate between carcinoids and small cell carcinoma and shares some biologic characteristics with both. We describe a case of WDNC resistant to three different treatments. The patient, a 42-year-old woman, received 2 cycles of chemotherapy before coming to our observation, including cyclophosphamide, adriamycin and vincristine, with progression of disease. We administered r-alpha-2a interferon for 2 months, but the patient showed clinical progression. Therefore, streptozotocln associated with epirubicin was utilized, but the patient died of disease progression after 4 cycles and 10 months from the first treatment. The case of WDNC described in this report showed an unusual aggressive clinical course and was refractory to conventional and unconventional treatments. The proper management for WDNC is still unknown. However, according to literature data, the chemotherapeutic schemes employed for small cell lung cancer represent the first treatment choice for WDNC. Further studies are needed to help define treatment strategies according to the biology of the tumor.
Chloroform Bioactivation Leading to Nucleic Acids Binding
Authors: Colacci Annamaria , Bartoli Silvana , Bonora Bruna , Guidotti Lia , Lattanzi Giovanna , Mazzullo Mario , Niero Alessandra , Perocco Paolo , Silingardi Paola , Grilli Sandro
Published: April 2018

Chloroform was bound covalently to DNA, RNA and proteins of rat and mouse organs in vivo after i.p. injection. Covalent Binding Index values of rat and mouse liver DNA classify chloroform as a weak initiator. Labelings of RNA and proteins from various organs of both species were higher than that of DNA. In an in vitro cell-free system, chloroform was bioactivated by cytochrome P450-dependent microsomal fractions, by cytosolic GSH-transferases from rat and mouse liver, and particularly by the latter enzymes from mouse lung. This observation suggests that GSH plays a role In the binding of chloroform metabolites to DNA. The presence of both microsomal and cytosolic enzymatic systems in the standard incubation mixture generally led to an additive or synergistic bioactivating effect for rat and mouse, respectively.
Pattern and Determinants of Diagnostic Interval in Cancers of the Prostate, Bladder and Kidney
Authors: Talamini Renato , Franceschi Silvia , Dal Bo Virginio , Monfardini Silvio
Published: April 2018

The present study examined the pattern of presentation and diagnostic interval, i.e. number of months between first cancer symptom or sign and first medical visit, in 444 cases of urological cancer (122 of prostate cancer, 187 of bladder cancer and 135 of kidney cancer). The mean diagnostic interval was 7.6 months for prostate, 5.6 for bladder and 4.5 kidney cancer. A chance diagnosis, i.e. in absence of any symptom or sign, was reported by 16%, 8% and 18% of patients with cancer of the prostate, bladder and kidney respectively. We observed on significant differences in diagnostic intervals according to patients’ demographic, sociocultural, and lifestyle characteristics, or tumor stage. Better quantitative and qualitative data on the pattern and determinants of delay in cancer diagnosis are clearly warranted, and the present study, although largely negative, shows the possibility of using large-scale epidemiological Investigations for this purpose.
Morphologic Analysis of Serous Effusion Cells by Scanning Electron Microscopy
Authors: Cappellari Antonio , Furlan Claudio , Cardellini Pietro , Bagarella Mariangela , Corradi Giuseppe
Published: April 2018

The authors used scanning electron microscopy (SEM) to examine the cells obtained from serous effusions of patients affected with a neoplasm or benign disease. Cellular morphology was studied in non-neoplastic effusions to distinguish benign cells from cancer cells with which they are almost always suspended in malignant effusions. Tumor cells differ in some features such as shape, size, arrangement and especially in surface structures (microvilli), the latter being very noticeable when using this method. The investigation enabled us to note several changes in the cell surface that could reflect particular activities of the cells themselves. For this reason we believe that the technique may be considered very useful to gain knowledge of cellular morphology. However, it cannot be considered suitable for making routine diagnostic conclusions.
Estimated Incidence and Prevalence of Female Breast Cancer in Italian Regions
Authors: Micheli Andrea , Verdecchia Arduino , Capocaccia Riccardo , De Angelis Giovanni , Gatta Gemma , Sant Milena , Valente Fulvia , Berrino Franco
Published: April 2018

Female breast cancer incidence and prevalence in Italy have been estimated by region and vast areas from population-based survival data of breast cancer patients and 1970–1987 specific mortality data using a mathematical model. Italian age-standardized incidence rates (ASR) for 1987 range from 70 to 90 per 100,000 women-year in the Northern regions, 55 to 73 in the Center, and 45 to 72 in the South. Overall, the ASR is about 80 in the North, 70 in the Center and 60 in the South. In the absence of competitive mortality, breast cancer cumulative risk in the 0–74 years life span is about 7 women out of 100 in the North, 6 in the Center and 5 in the South. The decreasing risk pattern from North to Center then South appears less evident when under 45 age-specific rates are considered. Very high levels for young age-groups are present both in the North (Liguria and Emilia Romagna) and South (Sardinia and Apulia). The incidence pattern by age differs from region to region and over the considered period, suggesting that a birth-cohort effect is crossing the whole country. Using to model, it can be estimated that the risk by cohort increases from the generations born at the beginning of the century to those born in the 40s, after which, for subsequent generations, it has been decreasing in all the considered areas and is similar in the North and South. We can infer that for the whole country the incidence will increase up to the years 2000–2010 when those birth-cohorts at higher risk will also be at higher risk for age. In 1987, about 250,000 Italian women had a present or past history of breast cancer: for the 1970–1987 period, prevalence has increased by approximately 5,500 cases per year.
Determinants of Non-Attendance to Mammographic Screening. Analysis of a Population Sample of the Screening Program in the District of Florence
Authors: Ciatto Stefano , Cecchini Silvia , Isu Antonio , Maggi Alessandra , Cammelli Sabrina
Published: April 2018

The characteristics associated with non-attendance to mammographic breast cancer screening were studied by interviewing a random sample (213 attenders, 121 non-attenders in the 1989 screening) of residents in one of the municipalities of the Florence District Program, where screening has been ongoing since 1970. The overall attendance rate was 60%, and it was dependent on age (40–49 years, 66.5%; 50–59 years, 62.5%; 60–70 years, 55.5%), whereas a significant association with socio-economic status, educational level and health-behavior reported in other programs was not confirmed in the study. This finding suggests that determinants of non-attendance may vary and should be evaluated in each local setting. The belief that screening is useless, fear of cancer being detected, postponement and laziness were the most common motivations of refusal stated by non-attenders, and such a negative attitude towards screening was rather strong since most non-attenders stated they would not like to be informed or stimulated to attend future screenings. Rapid improvement of attendance rates in such a context might be achieved only by putting special pressure on women aimed to change their negative attitude towards screening and their opinion about the benefits of early breast cancer detection. This might be regarded as unacceptable and however would involve high costs and a major organization effort.
Concurrent Adrenal Pheochromocytoma and Papillary Adenocarcinoma of the Thyroid in a 20-Year old Man
Authors: Kido Yuichiro , Kuwano Hiroyuki , Yano Kazuhiro , Mori Masaki , Kitamura Kaoru
Published: April 2018

A 20-year-old man was admitted to Kyushu University Hospital with complaints of severe headache and episodic hypertension (200/100 mmHg). Ultrasonograms and computed tomographs revealed tumors in the left adrenal region and in the right lower lobe of the thyroid gland. Total thyroidectomy and left adrenalectomy were performed. The excised thyroid tumor and adrenal tumor were pathologically diagnosed as papillary adenocarcinoma and pheochromocytoma, respectively. A chromosome analysis revealed no karyotypic abnormality. Whereas the world literature records such occurrences in women, this is the first report of a simultaneous occurrence of pheochromocytoma and papillary adenocarcinoma of the thyroid in a young man.
Radiation-Induced Schwannomas of the Neuraxis. Report of Three Cases
Authors: Salvati Maurizio , Ciappetta Pasquale , Raco Antonino , Capone Raffaela , Artico Marco , Santoro Antonio
Published: April 2018

We report 3 cases of possible radiation-induced schwannomas observed in our Department. Their salient clinical and pathogenetic features are analyzed and the role of radiation therapy in the oncogenesis of these lesions is discussed. Several cases of radiation-induced tumors, including some of the nervous system, have been reported, but schwannomas have only occasionally been reported in connection with ionizing radiation. The possible adjuvant role of antineoplastic drugs is also discussed, and the literature on this topic is reviewed.
Histology as a Prognostic Factor in Early Gastric Cancer
Authors: Ferrari Massimo , Ghislandi Enrico , Landonio Giuseppe , Majno Margherita , Porretta Tiziano , Scanzi Francesco
Published: April 2018

Of 431 patients with gastric cancer observed in our Istitution, 23 (5.3 %) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.
Cationic Content in Multiple Mammary Cysts
Authors: Ballerini Paola , Callegari Laura , Del Prato Ivan , Moglia Daniele , Cerrotta Annamaria , Adorni Laura , Ferrari Leonardo , Secreto Giorgio
Published: April 2018

One hundred and ninty-six breast cyst fluid samples from 78 consecutive patients with multiple cysts were subdivided according to the K+/Na+ ratio: type 1 (K+/Na+ ratio > 1) and type 2 (K+/Na+ ratio ≤ 1). Cysts of the same type were found in 57.7 % of patients (concordant group). Such a finding suggests that in patients bearing multiple cysts, all aspirated fluids need to be classified on the basis of their cationic composition. In the concordant group, type 1 cysts were more frequent than in the discordant group (80.3 % vs 59.5 %, P = 0.002). High K+/Na+ ratios (> 4.0) were present in 64 % of type 1 cysts in the concordant group compared to 37.7 % in the discordant group (P = 0.001), which suggests a different activity of the epithelium lining the cyst wall.
Colonic Metastasis of a Renal Carcinoma. A Case Report
Authors: Zerbib Frank , Bécouarn Yves , Stöckle Eberhard , Ravaud Alain , Brunet René
Published: April 2018

A 64 year-old man with a metastatic clear-cell renal carcinoma experienced low intestinal bleeding. The endoscopy revealed a polypoid mass in the left colon which proved to be a metastasis of the renal carcinoma. This is an uncommon cause of intestinal hemorrhage, and a rare localization of metastatic deposits.
Pathogenesis of Human Reactive-Appearing «Non-Monomorphous» Malignant Lymphoproliferative Disorders: A Hypothesis
Authors: Beiocchi Mauro , Dolcetti Riccardo , Carbone Antonino
Published: April 2018

Human reactive-appearing « non-monomorphous » malignant disorders, such as Hodgkin's disease, T-cell-rich B-cell lymphomas and angioimmunoblastic lymphadenopathy display a peculiar and unifying characteristic, which biologically differentiates them from « monomorphous » non-Hodgkin's lymphomas. It consists in the coexistence within the pathologic tissue of a polyclonal, normal-appearing, presumed reactive cellular component, mainly composed of T-lymphocytes together with a clonal cell component constituting a minority of the pathologic mass. To explain the long-lasting coexistence of such polymorphic cell populations in the pathologic tissue of synchronous and metachronous localizations of the disease, it is hypothesized that they are interconnected by « biological interactions » which determine and sustain the pathologic process. Based on the biological characteristics of an experimental model (the follicular center cell « lymphoma » of the SJL murine strain), it is suggested that these human « non-monomorphous » malignant diseases should be regarded as a continuous spectrum of lymphoproliferative disorders sustained by a biological loop which interconnects different cell populations able to stimulate each other for growth.
Spontaneous Screening for Cervical Cancer and Diagnostic Histories of Incident Cases
Authors: Bucchi Lauro , Serafini Monica
Published: April 2018

Cytologic and colposcopic histories of cases of invasive cervical cancer and cervical intraepithelial neoplasia grade III (CIN III) registered in Ravenna (northern Italy) between 1986 and 1990 were evaluated. During the 5 years prior to diagnosis, 10/49 invasive cancer patients and 25/61 CIN III patients had had at least one pap smear reported as negative. At the time of the most recent false-negative report, 9/10 and 17/25 of these cases had been recommended for a repeat smear within 2 to 6 months. Of the 9 patients with invasive cancer, 5 had also undergone an inconclusive colposcopy (with biopsy unperformed). Among invasive cancer patients aged under 50, half of incident cases (7/14) and most of those with some cytologic experience (7/8) had had a false-negative report; each of these patients (7/7) had been recommended for an early repeat smear. For invasive cancer patients as well as for CIN III patients, the suggested intervals for the early repeat were largely exceeded. Median delay in diagnosis was about 2 years. Although the frequency of negative reports recommending repeat smears within a few months was estimated to be some 10 % of total screening patients, current concepts in cervical cytology suggest that cancer cases with such false-negative reports should be regarded as follow-up failures rather than laboratory errors. In fact, they passed quite unnoticed. In unplanned (spontaneous) cervical screening practice, sensitivity needs to be maximized, but even the occurrence of false-negative cases is not monitored. The present study points out what may result from such a contradiction.
The Cost of Hospital Stay for Operable Breast Cancer
Authors: Capri Stefano , Majno Edoardo , Mauri Maurizio
Published: April 2018

The cost of the first hospital stay for operable breast cancer was deducted by analysing a random sample of 100 admissions to the National Institute of Cancer during the period January-December 1989. The aims of the study were: (1) to describe and calculate the cost component of the stay; (2) to analyse whether any procedure, service rended or stage of the pathology might explain differences in the total costs of the stay; and (3) to acquire a better knowledge of the organizational aspects to be improved. With an average length of stay of 14.1 days, the overall total cost observed was 4.9 million lira (US $ 3.800, 1989 US dollars). A significant correlation between total cost and duration of stay was found (R2 = 0.982), while no or very little correlation was found between cost and the anatomical extent of disease (TNM stage) and different cost items (laboratory, imaging tests, operating room, etc.). Two homogeneous groups of cases were found: patients with quadrantectomy and patients with mastectomy. The cost of the latter was 40% greater than that of the former (P < 0.001) with a length of stay 52% longer (p < 0.001). This study does not concern the costs immediately following the stay, which namely are higher for the quadrantectomy because the radiotherapy outpatient procedures. Attention should be paid to reducing the length of stay, keeping waiting time for organizational procedures to a minimum during the stay.
Adjuvant Therapy for Primary Breast Cancer in a Female Patient Affected by Autoimmune Liver Disease: Does it Cure Breast Cancer and Primary Biliary Cirrhosis?
Authors: Crivellari Diana , Cannizzaro Renato , Galligioni Enzo , Valentini Maurizio , Monfardini Silvio , Castiglione Monica
Published: April 2018

Polychemotherapy (CMF or CMF-like regimens) is the treatment of choice in premenopausal breast cancer patients with 1–3 positive nodes. In clinical practice, patients with abnormal biochemical tests of liver function are usually excluded from this potentially curative methotrexate-containing regimen in order to avoid worsening of hepatic damage. On the other hand, recent reports have shown a beneficial effect of methotrexate in a particular autoimmune liver disease such as primary biliary cirrhosis. We discuss the case of a female patient with breast cancer and primary biliary cirrhosis whose biochemical tests of liver function and the titer of antimitochondrial antibody persistently improved after treatment with 3 cycles of CMF. In conclusion, we suggest that the CMF regimen is potentially useful in patients with breast cancer and primary biliary cirrhosis.
Primary Spinal Epidural Non-Hodgkin's Lymphoma the Contribution of Nuclear Magnetic Resonance Imaging, Therapeutic Approach and Review of the Literature
Authors: Ron llan G. , Reider Irith , Wigler Nelly , Chaitchik Samario
Published: April 2018

Primary spinal epidural lymphoma (Stage I) is diagnosed predominantly late after a long prodromal phase of local back pain resulting in spinal cord compression. The use of CT and NMR images in the early stage of investigation and their analysis may help to diagnose these cases prior to the appearance of neurologic deficit. We report on 2 patients who presented with prolonged localized back pain with sudden symptoms of spinal cord compression. CAT scan and NMR imaging demonstrated the characteristic appearance of lymphoma. Decompressive laminectomy supported the diagnosis. Radiotherapy treatment to the region of the non-Hodgkin's lymphoma resulted in complete resolution. Thereafter, systemic chemotherapy with CHOP achieved a good response.
Bladder Leiomyoma in Pregnancy: A Case Report
Authors: Kulkarni Jagdeesh N. , Kamat Murali R. , Chinoy Roshni F.
Published: April 2018

We herein report a rare case of an asymptomatic bladder mass seen during pregnancy in a young woman. A hypogastric mass was detected at antenatal checkup in the 7th month of pregnancy. The mass increased in size as the pregnancy went to term. Three months after normal delivery, she underwent surgery and a tumor arising from the bladder wall was excised completely. Histology showed a symplastic leiomyoma.
Conservative Treatment for T2-T4 Bladder Cancer with Primary Chemotherapy and Radiotherapy: A Pilot Study
Authors: Cruciani Giorgio , Dazzi Claudio , Montanari Francesco , Voce Salvatore , Salerno Vincenzo , Giannini Massimo , Emiliani Ermanno , Marangolo Maurizio
Published: April 2018

Aims and Background

After radical cystectomy, with or without pelvic radiotherapy, more than 50 % of patients affected by infiltrating bladder cancer died of distant metastases. Polychemotherapy yields 25 % complete remissions (CR) in patients with invasive transitional cell bladder carcinoma; although many concerns exist about the duration of such CR. This study was undertaken with the aim of evaluating the efficacy and safety of an integrated chemo-radio-therapeutic treatment, in order to broaden indications to a conservative surgical therapy.

Methods

Thirty-three consecutive patients with bladder urothelial cancer T2-T4, N0, M0, have been treated. Patients received neoadjuvant chemotherapy (rescue-M-VEC) consisted of methotrexate 30 mg/sqm plus folinic acid 15 mg after 24 h on days 1, 15, 22; vinblastine 3 mg/sqm on days 1, 15 and 22; epidoxorubicin 30 mg/sqm on day 1; cisplatin 70 mg/sqm on day 1. This cycle was repeated on day 29. After 2 cycles of rescue-M-VEC, patients underwent pelvic cobalt teletherapy 40 Gy combined with low dose cisplatin 25 mg/sqm/week. After restaging, responding patients underwent further radiation therapy (24 Gy) as booster consolidation.

Results

After 2 cycles of chemotherapy and pelvic radiotherapy 14/31 evaluable patients (45.2 %) achieved CR and 11/31 (35.4 %) partial remission, with an overall response rate of 80.6 % (25/31). With a median follow up of 21 months the actuarial survival rate at 24 months was equal to 79.8 %. Eleven radical cystectomies were performed, 6 of which at restaging in non responding patients and 5 during the follow up due to relapse. Of the 25 patients selected for bladder conservation, 12 (48 %) have not yet shown relapses. Three out of 31 (9.7 %) patients died of distant metastases. No severe toxicity has been observed: moreover no patient developed stomatitis after chemotherapy.

Conclusions

Our results seem encouraging but longer follow-up and further phase III studies need to be carried out to demonstrate the feasibility of conservative treatment in muscle infiltrating bladder cancer.