bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Serum Total and Heat-Stable Alkaline Phosphatase in Leukemia Patients
Authors: Patel Prabhudas S. , Adhvaryu Siddharth G. , Baiar Damodar B. 
Published: April 2018

Aims and Background Variations in serum alkaline phosphatase (ALP) and placental-like (heat stable) alkaline phosphatase (PLAP) are found to be clinically useful in cancer patients. The present study evaluated serum ALP and PLAP levels to establish a blood-based biochemical index for leukemia patients. Study design ALP and PLAP levels were determined in 145 untreated leukemia patients, 77 anemia patients, 150 healthy individuals (controls), 47 leukemic patients in remission and 23 patients with persistent leukemic activity/accelerated leukemic phase (P. Leu./A. Leu.). The enzymes were estimated with highly specific spectrophotometric methods. Results Serum ALP and PLAP levels were significantly elevated in anemia patients and leukemia patients compared to controls. Comparison between anemia patients and leukemia patients showed insignificant differences for ALP, whereas PLAP levels were significantly raised (p < 0.001) in leukemia patients. ALP showed insignificant difference between untreated leukemia patients, patients with P. Leu./A. Leu. and leukemia patients in remission. PLAP levels were comparable in patients with P. Leu./A. Leu. and were significantly lower (p < 0.02) in leukemia patients in remission than in untreated leukemia patients. Conclusions The results indicate that serum PLAP levels are a useful biochemical marker for diagnosis and treatment monitoring of leukemia patients. However, serum ALP levels have limited utility for leukemia patients.
Ultrasoundguided Fineneedle Aspiration of Impalpable Breast Nodules
Authors: Barbano Pier Remigio , Reali Gaetano 
Published: April 2018

Aims This study was designed in an attempt to improve the sensitivity of cytologic examination of fineneedle aspiration biopsies. Methods and Results A prospective study was carried out on 79 patients with breast lesions less than 1 cm in diameter and clinically impalpable who were referred to the Radiodiagnostics Section of the Ca’ Granda Hospital of Milan in 1990 and 1991 for mammographic and ultrasound verification. The examination was carried out using a high frequency (10 MHz) ultrasound probe to which an aspiration needle had been soldered. This made it possible to quickly and accurately reach the target nodule and thus gave a high sensitivity of the examination (93 %). However, attachment of the needle to the probe prevented sampling from other points of the nodule and was responsible for the slight Increase in number of inadequate samplesfi which in turn worsened the specificity of the test (86 %). To check the gold standard of the examination, all the patients with positive or doubtful aspirations underwent surgical biopsy, whereas strict radiologic controls were performed in the negative cases. Conclusions Ultrasound-guided fineneedle aspiration may have advantages over needle aspiration performed with the stereotactic radiologic technique. The needle can be monitored even if the patient moves; even deep, peripheral nodules as well as those near a prosthesis can be reached; repeated samples can be taken, and costs are limited.
Down Regulation of Qa Gene Expression on Drug-Modified Tumor Cells
Authors: Leroy Elisabeth , Lattuada Donatella , Casnicl Claudia , Franco Paola , Marelli Ornella E.A. 
Published: April 2018

Background Mouse leukemia, L1210, strongly enhances its immunogenicity following in vivo treatment with 5-(3-3′-dimethyl-1-triazeno) imidazole-4-carboxamide (DTIC). Previous experiments have shown that transformed cells elicit a cell-mediated response accountable for rejection and resistance to a subsequent injection of parental tumor into a syngeneic host. L1210 expresses classical H-2 class I molecules, and since it has been shown that DTIC treatment does not modify the expression of these molecules, this is a suitable model to study nonclassical class I antigens, such as Qa2 glycoproteins, and their potential role in tumoregenicity. Methods Cloned cells from L1210 were treated with DTIC and then H-2D, and Qa antigen expression was studied on four clones, before and after xenogenization with DTIC. Results and conclusions a strong decrease of Qa2 molecule expression was demonstrated by radioimmunoassay and immunofluorescent staining and was confirmed by FACS and 2D-gel analysis. The presence or the absence of Qa antigens on tumor cells could thus be involved in tolerance or rejection of tumor cells in syngeneic animals.
Primary Site as Predictive Factor of Local Control in Advanced Head and Neck Tumors Treated by Concomitant Boost Accelerated Radiotherapy
Authors: Corvò Renzo , Sanguineti Giuseppe , Scala Marco , Garaventa Giacomo , Santelli Alida , Barbieri Marco , Vitale Vito 
Published: April 2018

Aims and background The purpose of this phase II study was to assess the efficacy and toxicity of an accelerated radiotheraphy schedule with the concomitant boost technique in the management of patients with advanced head and neck squamous cell carcinomas (HN-SCC) of various primary sites. Methods From May 1989 to December 1992 45 patients were scheduled to receive a total dose of 75 Gy in 40 fractions over 40 days. The boost encompassing the macroscopic disease was given as a second daily dose during the last 2 weeks of the basic treatment. Results Severe mucositis was recorded in 27 (60%) patients. Late side effect occurred in 2. As regards local control the primary tumor site was the most significant prognostic factor: at a median follow-up of 24 months (range 12-52 months) the actuarial local control rate was 79%, 48% and 15% for oronasopharyngeal, laryngohypopharyngeal and oral cavity primary sites, respectively (p=0.004). Conclusions This high dose concomitant boost regimen appears feasible in advanced HN-SCC. However, our results indicate the primary tumor site as a major prognostic factor even with an accelerated treatment schedule.
First Recurrence Analysis of 840 Cutaneous Melanomas: A Proposal for a Follow-Up Schedule
Authors: Martini Laura , Brandani Paola , Chiarugi Cristina , Reali Umberto M. 
Published: April 2018

Aims and background A correct follow-up schedule for patients who underwent an excision for stage I cutaneous melanoma might allow the early detection of local and distant metastases. At present, there is no general agreement on follow-up protocols. In order to work out a follow-up guide, we have retrospectively evaluated the records of 840 stage I cutaneous melanoma patients surgically treated and followed during the postoperative period in the Division of Plastic Surgery of the University of Florence from 1975 to 1992. Methods We evaluated the patients’ records by analyzing time, pathway and site of any first recurrence in relation to the main prognostic factors such as patient sex, site, histological type and depth of invasion of each primary melanoma. A statistical analysis was performed. Results To summarize, the salient results were the following: 80% of relapses occurred in the first 3 years and they occurred significantly earlier when the primary melanoma was localized in the trunk and significantly later when the melanoma was localized in the lower limbs and for < 1.5 mm lesions. The first recurrence occurred earlier by the lymphatic than by the hematic pathway regarding the overall number of patients. The hematic pathway was the most frequent (with respect to the overall percentage of hematic metastases) for the melanomas localized in the head and neck region and for lentigo malignant melanomas, whereas the lymphatic pathway was most frequent for melanomas of the lower limbs and > 3 mm in thickness. Conclusions We suggest a follow-up schedule taking into consideration the postoperative behavior of stage I cutaneous melanoma patients (in terms of time and pathway of the first recurrence) in relation to the site and depth of invasion of the tumor.
Granular Cell Tumor: An Immunohistochemical Study
Authors: Cavaliere Antonio , Sidoni Angelo , Ferri Ivana , Falini Brunangelo 
Published: April 2018

Aims and background Granular cell tumor, usually a benign neoplasm, has been the object of many studies because of its uncertain histogenesis and based on many immunohistochemical and ultrastructural studies it has been suggested that it originates from the Schwann cell. Our recent observation that granular cell tumor is positive with PG-M1, a new anti-macrophage monoclonal antibody, led us to further investigate the immunophenotypic profile of the tumor. Study design We studied 11 granular cell tumors using a panel of 20 antibodies, 13 monoclonal and 7 polyclonal. Results The immunohistochemical study showed in all cases a constant diffuse positivity for S-100 protein, neuron-specific enolase, vimentin, KP1 and PG-M1, as well as occasional and focal positivity for alpha-1-antitrypsin, alpha-1-antichymotrypsin and lysozyme. Conclusions The immunophenotypic profile constantly observed could be the expression, on one hand, of the neuroectodermic nature of the neoplasm, proven by positivity for S-100 protein, neuron specific enolase and vimentin, and on the other could be the expression of the phagocytic activity of the tumor cell, proven by positivity for KP1 and PG-M1 antibodies and also by the presence of numerous phagolysosomes.
Mortality from Skin Melanoma in Italy and Friuli-Venezia Giulia Region, 1970-1989
Authors: Franceschi Silvia , Bidoli Ettore , Prati Sabrina , Fascioli Silvia , La Vecchia Carlo 
Published: April 2018

Aims and background Substantial upward trends for skin cancer mortality have been observed in most European countries in the last two decades. The distinction, however, between cutaneous malignant melanoma (CMM) and non-melanomatous skin cancers on the basis of death certification is unreliable Methods In order to assess the trends of CMM, analysis of the specific code for CMM (International Classification of Disease VIII and IX:172) was coupled with analysis of total skin cancer mortality rates, standardized on the 1981 Italian Census population, at all ages and in selected age groups (15-44, 45-64 and 65-84 years). The analyses were carried out for the whole of Italy and for Friuli-Venezia Giulia (FVG), a region in North-East Italy with a high proportion of fair-complexioned individuals, elevated frequency of sunbathing, and especially good diagnostic standards. Results In 1985-89 skin cancer mortality rates in men at all ages, as compared to 1970-74, were 33% higher in Italy and 46% higher in FVG. In women, there was a rise of 22% in Italy and 94% in FVG. More marked upward trends were observed in young and middle aged adults, especially among women in FVG (over 300% increase). In absolute terms, approximately 3000 more Italians died from skin cancers in 1985-89 as compared to 1970-74, about half of them prematurely (i.e., < 65 years). CMM was mentioned in death certifications for skin cancer increasingly often in all age groups, particularly in FVG. Conclusions The analysis of mortality trends from skin cancer is consistent with a substantial rise of CMM-related deaths. The sensitivity of death certification with respect to CMM diagnosis is also increasing, especially in FVG. A public health strategy with the aim of reducing intermittent intense exposure to ultraviolet light, especially in children, is urgent in Italy as CMM represents one of the few causes of premature death with unfavorable trends.
Volunteers in Hospital and Home Care: A Precious Resource
Authors: Fusco-Karmann Claude , Tamburini Marcello 
Published: April 2018

Aims and background Ten years ago, a program o intervention by volunteers in cancer hospitals and at home was started. Home care is accomplished by teams of palliative care givers, in which volunteers are included. After a selective interview, all voluntary candidates with the necessary qualifications are trained and specific apprenticeship is done. Hence, their professional training is carried out through regular groups of supervision followed by a psychologist and a coordinator. A study was carried out to evaluate the activity of volunteers, in the hospital and at home, as judged by patients, nurses and the volunteers themselves. Methods On the whole, the data analyzed concerned 216 patients, 163 nurses and 92 volunteers in the hospital and 30 patients, 16 nurses and 35 volunteers at home. The questionnaires used for the study had four possible answers (no, a little, much, very much) or required an answer on a scale of 0 to 10. Results A high quota of patients gave a very positive opinion (“much” or “very much”) on the importance of the presence of volunteers in the hospital (76%) and at home (90%). In the second case, volunteers were particularly useful to improve a patient's mood (80%) and to solve practical problems (47%). General agreement was noted among nurses and volunteers on the activity of the latter. The main form of intervention of all volunteers is to give psychosocial support to patients. A score of 7 to 10 was given to this item by 60% of the nurses and by 82% of the hospital volunteers. At home, respectively 80% and 89% gave such a score for the same item. Other activities of the volunteer were support for the family, assistance in social activities, and to give information. Conclusions The presence of the volunteer in the hospital and at home appears to be helpful to the patient and the family by becoming part of the team without becoming involved directly in its clinical activity.
Medical Treatment of Hepatocellular Carcinoma: Any Progress?
Authors: Colleoni Marco , Gaion Fernando , Liessi Guido , Mastropasqua Giorgio , Nelli Patrizia , Manente Paolo 
Published: April 2018

Background Hepatocellular carcinoma (HCC) remains one of the most common neoplasms worldwide. Curative treatment options include liver transplantation or resection. Unfortunately, most patients still have unresectable or untransplantable HCC due to disease extension or comorbid factors and are therefore candidate only for palliative treatments. Methods In this review we have analyzed the different medical approaches employed in the treatment of HCC in an attempt to better define their roles. Results Palliative medical treatments including systemic chemotherapy, immunotherapy or hormonal manipulation rarely influence survival of the patients. Although a high response rate is often reported with new local therapies such as transcatheter arterial embolization, intraarterial chemotherapy or percutaneous ethanol injection, the real impact of these treatment modalities on patient survival remains to be determined. Conclusion One way to improve the diagnosis of HCC patients would be an appropriate approach to evaluate new drugs or treatment modalities. To answer all the open questions, further trials, possibly randomized, should be conducted on a substantial number of patients with homogeneous prognostic factors.
A Pilot Clinical Trial of Surgical Adjuvant Treatment with High-Dose 6S-Leucovorin/5-Fluorouracil and Radiation Therapy for High-Risk Rectal Carcinoma
Authors: Cascinu Stefano , Veraldi Antonio , Foglietti Gian Paolo , Ghiselli Roberto , Saba Vittorio , Lungarotti Ferdinando , Babini Lucio , Catalano Giuseppina 
Published: April 2018

Aims and background The study was performed to evaluate the feasibility of combining leucovorin (LV) with 5-fluorouracil (5FU) and radiation therapy as adjuvant treatment for high-risk rectal carcinoma. Methods Twenty-five patients with histologically proven adenocarcinoma of the rectum, at high-risk of recurrence after potentially curative resection (T3 NO, T any N1-2; MO), received 5FU (370 mg/m2) and 6S-LV (100 mg/m2) on days 1-5, 4 and 8 weeks after surgery. On treatment day 64, radiotherapy on the pelvis (50 Gy) was initiated. Finally, three further courses of 5FU/LV were given at intervals of 4 weeks beginning 28 days after the completion of radiotherapy. Results The treatment was generally well tolerated. We observed only 2 cases of grade III toxicity (diarrhea) during the third cycle of chemotherapy. No severe complications were recorded following the use of radiotherapy. The mean overall 5FU dose intensity was 92%. After a median follow-up of 24 months, 4 patients had relapsed (liver, lung, and pelvis, 2 cases). Conclusions The association of LV to 5FU and radiation therapy seems to be feasible, with acceptable toxicity. The advantage of this combination, in terms of recurrence rate and survival with respect to 5FU/radiotherapy alone, will have to be evaluated in randomized trials.
Radiation Therapy of Spinal Metastases: Results with Different Fractionations
Authors: Tombolini Vincenzo , Zurlo Alfredo , Montagna Antonietta , Notarianni Ermanno , Osti Mattia Falchette , Enrici Riccardo Maurizi , Pirolli Carlo 
Published: April 2018

Aims and background Local radiotherapy plays an important role in the palliative treatment of all skeletal metastases, particularly those of the spine, with the purpose to obtain pain relief and prevent pathologic fractures or vertebral collapse. Methods From June 1991 to October 1993, 95 patients with a total of 103 sites of spinal metastases were treated at the Institute of Radiology of the University of Rome “La Sapienza”. Fractionations and total doses were divided as single fractions of 800 cGy, hypofractionated multiple fractions for a total dose of 20 Gy administered in 4-5 days, and conventional multiple fractions for a total dose of 30-40 Gy in 2-4 weeks. An evaluation of the efficacy of the different radiation treatments was performed with the use of a simplified descriptive pain scale. Results Seventy-three (70.9%) of 103 treatments were evaluables. An overall response rate of 82.2% was obtained: complete in 38.3% and partial in 43.8%, irrespective of total dose, fractionation and location of irradiated spinal metameres. The analysis of results did not show significant differences between the treatment courses. Conclusions We confirm that radiation therapy has a major role in the management of pain control and prevention of fractures in patients with spinal metastases. Hypofractionated and single fraction treatments showed equal efficacy compared to more prolonged therapy, with an advantage for the patient and the radiation therapy institution.
Congenital-Infantile Fibrosarcoma: Study of Two Cases and Review of the Literature
Authors: Corsi Alessandro , Boidrini Renata , Bosnian Cesare 
Published: April 2018

Background Congenital-infantile fibrosarcoma is a rare tumor of the pediatric age. It involves subjects under 5 years of age, and more than 200 cases have been reported in the literature. Methods The authors present the clinicopathologic findings of 2 cases and review the literature. Results Of our 2 patients, the first was a 2-years and 6-months-old female and the second a newborn male. The female presented a tumor in the retroperitoneum without recurrences or metastasis after 17 months, and the male on left foor with a recurrence after 3 months. Histologically, the tumors were mainly composed of spindle-shaped cells. Immunohistochemically, in both cases, neoplastic cells were positive for vimentin; focal positivity for muscular specific actin was present in the tumor of the female. Ultrastructurally, tumors were composed of mesenchymal cells with fibroblastic and myofibroblastic features. Flow cytometric analysis of the retroperitoneal tumor showed an aneuploid population of neoplastic cells. Conclusions Congenital-infantile fibrosarcoma should be considered a borderline tumor; its biologic behavior is better than that of adult fibrosarcoma. Histologic diagnosis is not easy; the microscopic picture may be confused with fibromatosis or with malignant mesenchymal neoplasms. Only a follow-up of many years can confirm the benignancy or malignancy of any individual tumor, even though clinico-pathologic features may be distinctive enough to permit its recognition.
Role of Granulocyte Colony-Stimulating Factor in Relapsed/Resistant Intermediate and High-Grade Non-Hodgkin's Lymphoma Patients Treated with the E-Shap Regimen
Authors: Mangiagalli Monica , Miccolis Isabella , Maffé Pierfranco , Pogliani Enrico Maria , Corneo Gianmarco 
Published: April 2018

Aims and background The study assessed the role and potential benefit of rhG-CSF in reducing the frequency, duration and severity of neutropenia following cytotoxic chemotherapy according to the E-SHAP protocol and, at the same time in improving the response rate. Methods Twenty patients with resistant/relapsed intermediate or high-grade non-Hodgkin's lymphoma were treated with the E-SHAP regimen (etoposide + methyl prednisolone + high dose cytosine arabinoside and cisplatin), and in 15 of them, we administered rhG-CSF between chemotherapeutic courses. Results The 15 patients who received G-CSF after E-SHAP were neutropenic for a short time and experienced no febrile episodes or infective complications. In contrast, in the group (5 patients) who did not receive G-CSF, the WBC nadir was lower and the number of days with a neutrophil count below 1.0 × 109/L was longer, with a greater risk of inferctious complications. Of the 15 patients, only one had a delay in chemotherapy administration, and the RDI was 95% in the 65% of patients who received G-CSF. Of 5 patients treated with chemotherapy alone, 4 had a delay and the RDI was over 95% in only one patient. We obtained a good overall response rate (70%) in the group who received G-CSF. In the historical group of 5 non-Hodgkin lymphoma patients, we observed only 1 partial response and 4 had progression of disease. Conclusions Administration of G-CSF is associated with an acceleration of neutrophil recovery, indicating its potential to reduce the risk of infection. The use of G-CSF permitted us to administer intensive chemotherapy without delay and according to standard dosage, with an improved response rate.
The Feasibility of Repetitive Courses of High-Dose Continuous Intravenous Infusion Interleukin-2 and Subcutaneous Alpha-Interferon with Polychemotherapy in Advanced Malignant Melanoma
Authors: Foppoli Marco , Citterio Giovanni , Polastri Daniela , Guerrieri Rossella 
Published: April 2018

Aims and background A Phase I study of repetitive courses of chemotherapy (carmustine, cis-platinum, dacarbazine) and immunotherapy (continuous intravenous infusion recombinant interleukin-2 (rIL-2) and subcutaneous (sc) alpha-interferon 2b) plus tamoxifen was performed in order to establish a more efficaciuous way to sequence this kind of treatment for advanced malignant melanoma. Study design Patients who had measurable metastatic melanoma, a Karnofsky performance status ≥ 80, and no clinically significant hematologic or cardiac disfunction were considered eligible. Treatment consisted of BCNU, 150 mg/m2 i.v. day 1 in alternating cycles; DTIC, 220 mg/m2 i.v. days 1, 2 and 3; CDDP, 25 mg/m2 i.v. days 1, 2 and 3; tamoxifen 10 mg twice/day per os continuously; rIL-2, 18 × 106 IU/m2/day continuous i.v. infusion days 5-8 (96 h) and days 19-22 (96 h); alpha-interferon (IFN) s.c. 3 × 106 U day 12, 6 × 106 U day 14, 9 × 106 U days 16, 19, 21, 23, 26, and 28 (from cycle 2, 9 × 106 U days 2, 5, 7, 9, 12, 14, 16, 19, 21, 23, 26, and 28). Two consecutive cycles were planned until response evaluation. Results Three patients were treated according with the protocol; none of them was able to respect the planned dose-intensity schedule. The given dose intensity/planned dose intensity ratios were as follows: DTIC, 0.74 (range, 0.70-0.80); CDDP, 0.77 (0.72-0.80); BCNU, 0.77 (0.72-0.80); rIL-2, 0.65 (0.36-0.80); alpha-IFN, 0.01 (0-0.03); tamoxifen, 1.0. Systemic side effects of rIL-2 and myelotoxicity were the main reasons for treatment delay and/or dose-reduction, and for the long period of hospital care. Conclusions We conclude that the treatment schedule is not feasible. However, since we believe that combined chemo-immunotherapy is a potentially active treatment in metastatic malignant melanoma, we have modified it in order to make it more feasible and consequently efficacious.