bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptance of External Infusion Pumps in Patients with Advanced Breast Cancer Receiving Continuous Infusion Fluorouracil
Authors: Lombardi Davide , Di Lauro Vincenzo , Piani Barbara , Scuderi Cristina , Spazzapan Simon , Magri Maria Donatella , Crivellari Diana , Annunziata Maria Antonietta , De Cicco Marcello , Veronesi Andrea 
Published: April 2018

Background We investigated the physical and psychological adaptation to a protracted continuous infusion system in a series of patients receiving protracted continuous infusion of 5-fluorouracil for advanced breast cancer. Patients and methods The protracted continuous infusion of 5-fluorouracil was administered by means of a portable elastomeric pump (Baxter Seven-Day Infusor, 0.5 mL/hr) via an indwelling Groshong catheter. Patients were asked to complete a questionnaire exploring the impact of the continuous infusion system upon various aspects of daily life, the overall level of disturbance, the general judgement on its quality, and their willingness to resume the same kind of treatment in the future. All items were graded on a 4-point scale from 0 = not at all, to 4 = very much. Results Seventy-one patients were evaluated. All patients received 5-fluorouracil at the dose of 250 mg/m2/day as a protracted continuous infusion alone (n = 14) or in combination with vinorelbine (n = 45) or Taxol (n = 12). The median duration of the protracted continuous infusion before evaluation was 9 months (3–31). The mean level of disturbance to daily activities was 0.86 points. The activities most frequently disturbed by treatment included daily personal care (mean, 1.76 points) and sexual activity (mean, 1.20 points). Twenty-one patients required medical intervention because of problems related to the protracted continuous infusion system. The overall level of disturbance was rated at a mean level of 0.72 points, whereas the overall merits of the protracted continuous infusion system and the willingness of the patient to resume protracted continuous infusion in the future were rated at a mean level of 2.90 and 2.55 points, respectively. Conclusions The system for the protracted continuous infusion of 5-fluorouracil was well tolerated by the patients, who were able in most cases to perform their daily activities with little or no disturbance, needing only occasional help, and were willing to resume the same treatment modality if necessary.
Laparoscopic Adrenalectomy
Authors: Nicolai Nicola 
Published: April 2018

Purpose We investigated the following issues regarding laparoscopic adrenalectomy: techniques and advantages, indications in adrenal diseases, and the special case of pheochromocytoma. Methods Qualified literature reports were reviewed and integrated with results of our initial experience with laparoscopic adrenalectomy. Results Most authors prefer a transperitoneal approach, but some (including ourselves) use the retroperitoneal approach. Laparoscopic adrenalectomy is as effective and safe as traditional surgery, but the associated morbidity was found to be much lower in laparoscopic series. The need for conversion to open surgery does not exceed 5% of all cases. Practically all adrenal masses can be managed by laparoscopy. The only clinical situations where laparoscopy is not recommended as first choice are large adrenal masses (>6 cm) and gross cortical carcinoma, which are related conditions. Laparoscopy is also indicated in pheochromocytoma. No mortality and an elevated hypertension cure rate (75–100%) have been reported. Hypertension and plasma volume contraction must be normalized prior to surgery. Special attention should be paid to possible severe blood pressure variations during surgery. Partial adrenalectomy has been recently proposed for bilateral and familial pheochromocytoma in order to avoid lifelong mineral corticoid replacement therapy. Conclusions Laparoscopic adrenalectomy currently represents the first surgical choice for adrenal masses. Only large lesions that are suspected to be malignant should not be electively submitted to this procedure. Pheochromocytoma can be safely and effectively treated with laparoscopic surgery; special care for related symptoms is required.
Evaluation of Sentinel Nodes in the Assessment of Cervical Metastases from Head and Neck Squamous Cell Carcinomas
Authors: Akmansu Halit , Oğuz Haldun , Atasever Tamer , Abamor Evrim , Şafak Mustafa Asım , Haberal İlknur , Samim Erdal 
Published: April 2018

Aims and Background To delineate the lymphatic drainage in head and neck squamous cell carcinoma (SCC) patients by lymphoscintigraphy and to investigate whether the results of histopathological evaluation of sentinel nodes have any diagnostic relevance with regard to the metastatic involvement of all cervical lymph nodes. Methods Forty-one patients clinically pre-diagnosed as having primary head and neck SCC underwent Tc-99m nanocolloid lymphoscintigraphy and were evaluated according to the Memorial Sloan Kettering cervical lymph nodes level system. Treatment of 24 of these patients included neck dissection in addition to surgery for the primary tumor. Results Among the 24 operated patients nine were found to be pathologically N+. In two (22%) of these nine patients there were histopathological metastases in non-sentinel lymph nodes. In one patient with a metastatic lymph node, no sentinel nodes were identified. Altogether, lymphoscintigraphic sentinel node detection failed in three (33%) cases. Conclusion The procedure of lymphoscintigraphic imaging of sentinel lymph nodes and its use in the determination of squamous cell carcinoma metastases is theoretically promising. However, in order to assess the true value of sentinel lymph node imaging and make treatment plans based on this technique, it's necessary to increase the number of cases included in the studies, and obtain results that are specific for the primary tumor and involved lymph nodes.
Concomitant Chemotherapy and External Radiotherapy plus Brachytherapy for Locally Advanced Esophageal Cancer Results of a Retrospective Multicenter Study
Authors: Tessa Maria , Rotta Paolo , Ragona Riccardo , Sola Barbara , Grassini Mario , Nassisi Daniela , Sciacero Piera , Airoldi Mario , Filippi Andrea , Gianello Luca , De Angelis Claudio , Ozzello Franca , Trotti Alessandro Boidi , Ricardi Umberto , Sannazzari Gian Luca 
Published: April 2018

Aims and Background In October 1995, the Piedmont AIRO (Italian Society of Radiation Oncology) Group started a multi-institutional study of radiochemotherapy on locally advanced esophageal cancer, characterized by external radiotherapy followed by an intraluminal high dose-rate brachytherapy boost. Most patients were re-evaluated for surgery at the end of the program. The primary aim of the study was to assess efficacy of curative radiochemotherapy regarding overall survival and local control rates. The secondary aim was to evaluate the ability of radiochemotherapy to make resectable lesions previously considered inoperable. Methods and Study Design Between January 1996 and March 2000, 75 patients with locally advanced esophageal cancer were enrolled. All were treated with definitive radiotherapy; due to age or high expected toxicity, chemotherapy was employed only in 53 of them. Treatment schedule consisted of 60 Gy external radiotherapy (180 cGy/d, 5 days/week for 7 weeks) concomitant with two 5-day cycles of chemotherapy with cisplatin and fluorouracil (weeks 1 and 5). One or two sessions of 5-7 Gy intraluminal high dose-rate brachytherapy were carried out on patients whose restaging showed a major tumor response. Surgery was performed in 14 patients. Results At the end of radiotherapy, dysphagia disappeared in 46/75 cases (61%), and in 20/75 (27%) a significant symptom reduction was recorded. Complete objective response at restaging after radiotherapy was obtained in 33% of patients and a partial response in 53%. At the end of the multimodal treatment program, including esophagectomy, complete responses were 34 (45%); 4 of 14 (28.5%) cases proved to be disease free (pTO) at pathological examination. No G3-G4 toxicity was recorded. Two- and 5-year overall survival rates of all patients were, respectively, 38% and 28%; 2- and 5-year local control rates were, respectively, 35% and 33%. In a subgroup of 20 nonsurgical patients in complete response after radiochemotherapy, the overall survival rate at 3 and 5 years was 65% and the local control rate at 3 and 5 years was 75%. According to multivariate analysis, prognostic factors for survival were Karnofsky index and esophagectomy. Conclusions For patients with locally advanced disease, radiochemotherapy showed improved clinical and pathologic tumor response and survival compared to surgery or radiotherapy alone. Intraluminal brachytherapy with a small fraction size allows an increased dose to the tumor without higher toxicity. Esophagectomy following radiochemotherapy could improve survival rates compared to definitive radiochemotherapy, but it is necessary to optimize selection criteria for surgery at the re-evaluation phase.
Cavernous Hemangioma of the Gallbladder Case Report and Review of the Literature
Authors: Crucitti Antonio , La Greca Antonio , Antinori Armando , Antonacci Vincenzo , Magistrelli Paolo 
Published: April 2018

Hemangiomas are common benign tumors; they frequently occur in the liver but very rarely in the gallbladder, with only seven cases reported in the scientific literature to date. We here report an additional patient, a 49-year-old white woman presenting with an echogenic lesion of the gallbladder that was incidentally discovered. Cholecystectomy was performed after computed tomography had revealed a gallbladder neoplasm; pathological examination showed the mass to be a cavernous hemangioma. No postoperative complications occurred and the patient is alive and free of recurrence five years after the operation. We present a review of the literature on this topic with special emphasis on the diagnostic and therapeutic challenges these lesions may entail. Hemangiomas of the gallbladder may have extremely variable presentations (from non-specific abdominal pain to acute syndromes resembling cholangitis or choledocholithiasis) and can mimic different lesions (liver tumors, sarcoma). Only surgical exploration can provide a correct diagnosis. Excision is indicated as these lesions may grow to huge sizes, compress adjacent structures or bleed. Conclusions Gallbladder hemangiomas are uncommon benign tumors. A preoperative diagnosis is difficult to make. Surgical excision is mandatory both in reaching a final diagnosis and in preventing bleeding or compression of vital structures.
Alterazioni Del Derma Nell'Oncogenesi Sperimentale Cutanea. Studio Comparativo Condotto Sul Topo, Coniglio, Ratto, Cavia, Hamster ()
Authors: Prodi G. , Maltoni C. 
Published: April 2018

The changes which take place in the dermis during skin treatment with oncogenic hydrocarbons and co-carcinogenic irritating substances were comparatively studied in various animal species (mouse, rabbit, rat, guinea-pig, hamster). The alterations induced in the extracellular structures of the dermis by both oncogenic and irritating substances are qualitatively analogous in different animal species. During the treatment the dermis collagen fibres are metachromatically stained; this peculiar behaviour takes place first in the upper layers, then in lower ones. Such staining properties precede the morphological changes of the fibres and become more marked with the progressing of these changes. The morphologic and staining modifications of the fibres are proportional to the proliferation of the overlying epithelium, whether this be provoked by either oncogenic or irritating substances. These changes are more evident in correspondence to the areas of higher epidermic proliferation. It is concluded that the same substance promotes in different animal species a different degree of dermal alterations, in relation to the different epidermic responses. In the rabbit, besides the above described changes, the appearance of interfibrillar chromotrope substances during the treatment with oncogenic agents as observed in previous experiments, is confirmed; such appearance was not observed during the treatment with the irritating substances used.
Dati Bioptici Nella Granulomatosi Maligna Con Particolare Riguardo ai Problemi Prognostici
Authors: Ippolito G. 
Published: April 2018

Starting from consideration of literature data, the limits and forms of malignant granulomatosis are considered. Para-granuloma, gigantofollicular lymphopathy, types and stages of granulomatous proliferation, differentiation with histiosarcomatosis, acute malignant granulomatosis and the controversial question of atypical lymphogranuloma are particularly concerned. The above problems are studied by means of a predictable and statistical method. It was found that: I) the various classifications and subdivisions proposed are of no significance from a nosographical and clinical point of view; II) the proliferative aspects of cells of histiocitary type are found to be prevalent. The conclusion is drawn that, though microscopical features are of very scarce prognosticai value, a highly « typical » malignant granulomatosis generally corresponds to a chronic nature of the disease; in addition, the presence of histocitary cells has a particular theoretical significance in determining the course of the disease.
Dosimetria Con Cristallo Di Solfuro Di Cadmio.: La Linea Di Isodose Di Un Roentgen Al Minuto Come Limite Di Effetto Terapeutico
Authors: Ricci S. Basso , Felci U. 
Published: April 2018

The dosimetry with CdS crystal shows considerable advantages in, radiumtherapy, owing to the small size of the crystal as well as to its remarkable sensitivity to radiations, comparatively to the size. The crystal, which is insulating under resting conditions, becomes a conductor material when excited by radiations, the intensity of current being proportional to the intensity of radiations. Erroneous data may be obtained when the crystal is hit by low energy radiations; to avoid this, the crystal is shielded with a gold sheath wich rejects radiations below 100 KeV. These dosimeters allow with relative ease the determination of isodose lines. Basing also on Verhagen's experience, the dose distribution at the periphery of the tumours is considered both in relation to the amount and time of administration. As far as uterine tumours are concerned, it is important to determine accurately a given line of isodose in the depth, representing the distance from the radioactive preparation at which the tumour destruction can be obtained. Such line is marked by the value of 1 roentgen/minute, and the importance of its determination is also related to the frequent necessity of submitting the patient to complementary telecobaltotherapy. Some therapeutic schemes concerned with Ra and Co60 are reported.
Results of 22 Cases of Breast Sarcoma over Five Years after Surgery
Authors: Baptista José , Neto Da Silva 
Published: April 2018

The results of treatment in 22 cases of breast sarcoma operated on more than 5 years ago are reported. The operations performed were: simple mastectomy in 16 cases, radical mastectomy in 2 cases and miscellaneous procedures in 4 patients. The 5 year cure rates were 54.54 % for all the series and 71.42 % for the fibrosarcomas, definite or derived from intracanalicular fibroadenomas.
Performance of Fine-Needle Aspiration Cytology. of the Breast-Multicenter Study of 23,063 Aspirates in ten Italian Laboratories
Authors: Ciatto Stefano , Bonardi Rita , Cariaggi Maria Paola 
Published: April 2018

Aims and background The aim of this study was to assess the performance of routine breast cytology in a group of Italian laboratories, as a basis for interlaboratory quality control. Methods A multicenter retrospective consecutive series of 23,063 aspirates from breast lesions (5,130 invasive carcinoma, 247 intraductal carcinoma, 2,386 benign lesions [histological], 13,144 benign lesions [follow-up], 2,156 other [no follow–up]) was reviewed. Standard accuracy measurements (inadequacy rate, sensitivity, specificity, predictive value) were determined, as well as the contribution of diagnostic tests such as physical examination and instrumental diagnostic procedures (mammography, sonography). Results Overall, inadequacy rate was 6.5% for malignant and 23.2% for benign lesions. Sensitivity was 92.2%, specificity was 95.3%, and the positive predictive value of an equivocal or malignant report was 53.4% or 96.9%, respectively. Sensitivity was associated with histological type (intraductal vs invasive: 77.0% vs 92.9%, p < 0.000001; lobular vs other invasive: 85.5% vs 94%, p = 0.0025) as well as with tumor size (pT1 = 91.6%, pT2 = 94.3%, pT3–4 = 96.0%, p < 0.000001). Observed differences in performance indicators between centers may be explained by variability in sampling or reading accuracy, and warrant the need for some adjustment in single centers, especially, as far as the criteria to report an equivocal smear are concerned. Cytology contributed to detect otherwise unsuspected carcinomas, although in some centers this benefit was poor and not cost-effective because a large number of unnecessary biopsies were caused by false equivocal/positive reports. Conclusions Although centers scored, on average, well within standards recommended by national authorities, this study suggests the opportunity of interlaboratory quality control to achieve more homogeneous criteria.
Second-Line Therapy with Interferon-Alpha plus Vinblastine in Metastatic Renal Cell Cancer Patients Progressed under Interleukin-2 Subcutaneous Immunotherapy
Authors: Paolorossi Franco , Villa Silvia , Barni Sandro , Tancini Gabriele , Andres Marco , Lissoni Paolo 
Published: April 2018

Aims and background Interferon (IFN) ± vinblastine (VNB) has appeared to be effective as first–line therapy of metastatic renal cell cancer. This study was performed to establish the efficacy of IFN plus VNB in metastatic RCC previously treated with interleukin-2 (IL-2). Methods The study included 14 metastatic renal cell cancer patients who did not respond to IL-2 subcutaneous therapy or who relapsed after initial response or stable disease. IFN-alpha 2a was given subcutaneously at 3 million U thrice a week in association with VNB (0.1 mg/kg i.v. every 21 days) until progression or toxicity. Patients were considered as evaluable when they were treated for at least 1 month. Results Evaluable patients were 13/14. No patient had a complete response. Partial response was achieved in 2/13 (15%) patients. Stable disease was seen in 5/13 patients, and the last 6 progressed. Conclusions This study, by showing a tumor response rate comparable to that reported with first-line therapy, suggests that previous IL-2 immunotherapy does not influence negatively the efficacy of IFN + VNB in metastatic renal cell cancer.
Latissimus Dorsi Pedicled Flap Applications in Shoulder and Chest Wall Reconstructions after Extracompartimental Sarcoma Resections
Authors: Capanna Rodolfo , Manfrini Marco , Briccoli Antonio , Gherlinzoni Franco , Lauri Giulio , Caldora Patrizio 
Published: April 2018

Aims and background In sarcomas of shoulder and of chest wall, latissimus dorsi muscle gives the opportunity to solve any plastic problem without recourse to free flaps. The authors report their experience in the use of latissimus dorsi pedicled flap as adjuvant procedure in the surgery of bone and soft tissue sarcoma. Methods The latissimus dorsi pedicled flap was used in seventeen patients to reconstruct composite tissue defects after sarcoma resection of the shoulder or of the chest wall. Three groups were recognized. The eight patients of Group I received the flap to close the chest cavity after a multiple rib resection performed to remove a tumor of the chest wall. In Group II four patients had the latissimus dorsi transported to reconstruct the soft tissue coverage over a proximal humerus prosthesis previously appiled after bone tumor resection. The five patients of Group III had the flap performed at the same time of the resection of a tumor arising in the shoulder area (1 bone and 4 soft tissue sarcoma). Results Two patients of the Group II presented a recurrent skin failure. A satisfactory coverage without any flap complication was provided in all the other 15 patients (88%). Conclusions Latissimus dorsi pedicled flap represents a reliable and effective technique to reconstruct large chest wall or shoulder soft tissue defects.
Ifosfamide and Etoposide in Previously Treated Patients with Advanced Breast Cancer
Authors: Kiraz Sedat , Baltalı Esomen , Güler Nilüfer , Barisota İbrahim , Benekli Mustafa , Çelik İsmail , Güllü İbrahim H. , Kars Aysoe , Tekuzman Gülten , Firat Dinrçer 
Published: April 2018

Aims and background Ifosfamide is an active alkylating agent in the treatment of breast cancer, as a first-line therapy and in advanced disease. Since the combination of etoposide with an alkylating agent produces a synergistic and tolerable activity in various malignancies, in the present study, ifosfamide and etoposide were administered to patients with advanced breast cancer to evaluate the response characteristics and the toxicity profile. Study design The combination of ifosfamide, mesna and etoposide was prospectively administered to 41 previously treated patients with stage IV breast carcinoma. The treatment schedule consisted of ifosfamide, 1500 mg/m2, infused over 24 hrs with 1500 mg/m2 mesna on days 1 to 5 and 120 mg/m2 etoposide, infused over 1 hr on days 1 to 3, to be repeated every 4th week. Results After a median follow-up of 10 months, an objective response rate of 23% (overall 2.5% complete remission and 20.5% partial remission) and a median response duration of 5.3 months were obtained in 39 assessable patients. The non-responder group consisted of 28.3% stable disease and 48.7% progressive disease. The prior status of chemotherapy was the only significant prognostic factor with an impact on the response rate. The overall toxicity was generally mild, with grade 3 myelotoxicity encountered in 25.7% of patients. Conclusions The tolerable side effect profile of the ifosfamide and etoposide combination might be advantageous as regards the quality of life. To improve the rate and/or the duration of response and to clarify the precise role of the ifosfamide-etoposide combination in previously treated advanced breast cancer, further trials are warranted.
Total Parenteral Nutrition and Tumor Growth in Malnourished Patients with Gastric Cancer
Authors: Bozzetti Federico , Gavazzi Cecilia , Cozzaglio Luca , Costa Aurora , Spinelli Pasquale , Viola Giovanna 
Published: April 2018

Aims and Background Evidence that total parenteral nutrition (TPN) can stimulate tumor growth in humans is scanty and contradictory. The purpose of this study was to evaluate the impact of TPN on tumor cell proliferation in malnourished patients receiving preoperative TPN. Methods We evaluated variations in the S-phase cell fraction, defined as 3H-thymidine labeling index (TLI), before and after 10 days of TPN or non-administration of nutritional support in 19 malnourished patients (weight loss, ≥ 10%) with gastric cancer. TLI was determined on endoscopic biopsies at the time of diagnosis, and subsequently on the operative specimen or through intraoperative sampling. Results At diagnosis, a higher median TLI value was observed in the control than in the TPN group. Administration of TPN enhanced tumor cell proliferation in 50% of patients; however, at surgery there was no difference in the median TLI value of the two groups. Conclusions The TPN regimen seems to be associated with increased tumor cell proliferation, even though this stimulating effect was moderate and at surgery the TLIS of TPN patients and controls were not different. Although the potential stimulation probably has little consequence for patients receiving short-term preoperative nutrition, it may call for further investigation in cancer patients undergoing long-term home TPN.