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Gamerra M, Cantone E, Sorrentino G, De Luca R, Russo M, De Corso E, Bossa F, De Vivo A, Iengo M. Mathematical model for preoperative identification of obstructed nasal subsites. Acta Otorhinolaryngol Ital 2017; 37:410-415. [PMID: 28530257 PMCID: PMC5720869 DOI: 10.14639/0392-100x-1385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/23/2016] [Indexed: 11/23/2022]
Abstract
The planning of experimental studies for evaluation of nasal airflow is particularly challenging given the difficulty in obtaining objective measurements in vivo. Although standard rhinomanometry and acoustic rhinometry are the most widely used diagnostic tools for evaluation of nasal airflow, they provide only a global measurement of nasal dynamics, without temporal or spatial details. Furthermore, the numerical simulation of nasal airflow as computational fluid dynamics technology is not validated. Unfortunately, to date, there are no available diagnostic tools to objectively evaluate the geometry of the nasal cavities and to measure nasal resistance and the degree of nasal obstruction, which is of utmost importance for surgical planning. To overcame these limitations, we developed a mathematical model based on Bernoulli's equation, which allows clinicians to obtain, with the use of a particular direct digital manometry, pressure measurements over time to identify which nasal subsite is obstructed. To the best of our knowledge, this is the first study to identify two limiting curves, one below and one above an average representative curve, describing the time dependence of the gauge pressure inside a single nostril. These upper and lower curves enclosed an area into which the airflow pattern of healthy individuals falls. In our opinion, this model may be useful to study each nasal subsite and to objectively evaluate the geometry and resistances of the nasal cavities, particularly in preoperative planning and follow-up.
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Affiliation(s)
- M. Gamerra
- ENT Unit, "S. Leonardo" Hospital, Castellammare di Stabia, Italy
| | - E. Cantone
- Department of Neuroscience, ENT Unit, University of Naples "Federico II", Naples, Italy
| | - G. Sorrentino
- ENT Unit, "S. Leonardo" Hospital, Castellammare di Stabia, Italy
| | - R. De Luca
- Department of Physic "E. R. Caianiello", University of Salerno, Salerno, Italy
| | - M.B. Russo
- Department of Engineering Second University of Naples, Italy
| | - E. De Corso
- Catholic University of the Sacred Heart, A Gemelli Hospital, Department of Head and Neck Surgery, Rome, Italy
| | - F. Bossa
- Neuro Diagnostic Center "Bossa", Torre del Greco, Italy
| | - A. De Vivo
- Neuro Diagnostic Center "Bossa", Torre del Greco, Italy
| | - M. Iengo
- Department of Neuroscience, ENT Unit, University of Naples "Federico II", Naples, Italy
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Russo D, Malagola M, Skert C, Cancelli V, Turri D, Pregno P, Bergamaschi M, Fogli M, Testoni N, De Vivo A, Castagnetti F, Pungolino E, Stagno F, Breccia M, Martino B, Intermesoli T, Cambrin GR, Nicolini G, Abruzzese E, Tiribelli M, Bigazzi C, Usala E, Russo S, Russo-Rossi A, Lunghi M, Bocchia M, D'Emilio A, Santini V, Girasoli M, Lorenzo RD, Bernardi S, Palma AD, Cesana BM, Soverini S, Martinelli G, Rosti G, Baccarani M. Managing chronic myeloid leukaemia in the elderly with intermittent imatinib treatment. Blood Cancer J 2015; 5:e347. [PMID: 26383820 PMCID: PMC4648524 DOI: 10.1038/bcj.2015.75] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/21/2015] [Indexed: 01/18/2023] Open
Abstract
The aim of this study was to investigate the effects of a non-standard, intermittent imatinib treatment in elderly patients with Philadelphia-positive chronic myeloid leukaemia and to answer the question on which dose should be used once a stable optimal response has been achieved. Seventy-six patients aged ⩾65 years in optimal and stable response with ⩾2 years of standard imatinib treatment were enrolled in a study testing a regimen of intermittent imatinib (INTERIM; 1-month on and 1-month off). With a minimum follow-up of 6 years, 16/76 patients (21%) have lost complete cytogenetic response (CCyR) and major molecular response (MMR), and 16 patients (21%) have lost MMR only. All these patients were given imatinib again, the same dose, on the standard schedule and achieved again CCyR and MMR or an even deeper molecular response. The probability of remaining on INTERIM at 6 years was 48% (95% confidence interval 35-59%). Nine patients died in remission. No progressions were recorded. Side effects of continuous treatment were reduced by 50%. In optimal and stable responders, a policy of intermittent imatinib treatment is feasible, is successful in about 50% of patients and is safe, as all the patients who relapsed could be brought back to optimal response.
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Affiliation(s)
- D Russo
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - M Malagola
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - C Skert
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - V Cancelli
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - D Turri
- Ematologia 1-TMO, AOR Villa Sofia-Cervello, Palermo, Italy
| | - P Pregno
- S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - M Bergamaschi
- Dipartimento di Terapie Oncologiche Integrate, IRCCS AOU S. Martino-IST, Genova, Italy
| | - M Fogli
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - N Testoni
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - A De Vivo
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - F Castagnetti
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - E Pungolino
- Division of Hematology, Department of Oncology and Hematology, Niguarda Ca' Granda Hospital, Milan, Italy
| | - F Stagno
- Divisione Clinicizzata di Ematologia AOU Policlinico-V. Emanuele, University of Catania, Catania, Italy
| | - M Breccia
- Azienda Policlinico Umberto I, Sapienza Università, Roma, Italy
| | - B Martino
- Hematology Unit, ‘Bianchi-Melacrino-Morelli' Hospital, Reggio Calabria, Italy
| | - T Intermesoli
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - G R Cambrin
- University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - G Nicolini
- Hematology and Hematopoietic Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy
| | - E Abruzzese
- Hematology, S Eugenio Hospital Tor Vergata University, Rome, Italy
| | - M Tiribelli
- Division of Hematology and BMT, Azienda Ospedaliero—Universitaria di Udine, Udine, Italy
| | - C Bigazzi
- Hematology, Mazzoni Hospital, Ascoli Piceno, Italy
| | - E Usala
- U O Ematologia e CTMO Ospedale A., Businco-Cagliari, Italy
| | - S Russo
- UOC Ematologia AOU 'G Martino' Policlinico Universitario di Messina, Messina, Italy
| | - A Russo-Rossi
- Division of Hematology, University of Bari, Bari, Italy
| | - M Lunghi
- Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - M Bocchia
- Hematology and Transplants, University of Siena and AOUS, Siena, Italy
| | - A D'Emilio
- Department of Cellular Therapies and Haematology, San Bortolo Hospital, Vicenza, Italy
| | - V Santini
- Unità di Ematologia, AOU Careggi, University of Florence, Florence, Italy
| | - M Girasoli
- Hematology Department, 'A. Perrino' Hospital, Brindisi, Italy
| | - R Di Lorenzo
- Division of Haematology, Spirito Santo Hospital, Pescara, Italy
| | - S Bernardi
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - A Di Palma
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - B M Cesana
- DMMT, Unit of Medical Statistics, University of Brescia, Brescia, Italy
| | - S Soverini
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - G Martinelli
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - G Rosti
- Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy
| | - M Baccarani
- Department of Haematology-Oncology 'L. and A. Seràgnoli' – S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
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De Vivo A, Mancuso A, Giacobbe A, Savasta LM, De Dominici R, Dugo N, Dugo C, Vaiarelli A. Uterine myomas during pregnancy: a longitudinal sonographic study. Ultrasound Obstet Gynecol 2011; 37:361-365. [PMID: 20922776 DOI: 10.1002/uog.8826] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To evaluate volumetric changes of uterine myomas (fibroids) during pregnancy. METHODS This was an observational, longitudinal and prospective study of 38 consecutive Caucasian women with singleton pregnancies and a total of 42 uterine myomas, enrolled from a cohort of 1492 women who took part in our first-trimester Down syndrome screening program. Myoma volume was evaluated by ultrasound at 11-14, 20-22 and 32-34 weeks of gestation. RESULTS Mean myoma volume increased significantly throughout pregnancy. Taking a volumetric change of > 10% between gestational periods to be an increase in size, 71.4% of uterine myomas increased in size between the first and second gestational periods, while this percentage was slightly lower (66.6%) between the second and third periods. Logistic regression analysis revealed that greater maternal age was correlated with a reduction/no change in overall myoma size and multiparity was correlated with a decrease/no change between the first and second trimesters, while a higher prepregnancy maternal body mass index (BMI) was correlated with a volumetric increase between the first and second trimesters and a decrease/no change between the second and third trimesters. CONCLUSIONS Fibroids enlarge during pregnancy regardless of their initial size or local factors, and maternal age, prepregnancy BMI and parity are apparently correlated with these changes.
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Affiliation(s)
- A De Vivo
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University Hospital, Messina, Italy.
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Granata F, Alafaci C, Giacobbe A, De Vivo A, Mancuso A, Conti A, Pontoriero A, Pitrone A, Longo M. Endovascular Treatment of Cerebral Arteriovenous Malformation Bleeding during Pregnancy. Neuroradiol J 2010; 23:473-8. [DOI: 10.1177/197140091002300419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 04/04/2010] [Indexed: 11/15/2022] Open
Abstract
Cerebral arteriovenous malformations (AVMs) represent congenital anomalies of blood vessels composed of a nidus of anomalous arterial and venous vessels without a capillary network. We describe a case of bleeding cerebral AVM in a pregnant women at the second quarter of gestation and diagnosed by digital subtraction angiography showing a large principal arterial nidus supply. The AVM was treated by endovascular embolization at the 27th week of gestation. The post-operative course was uneventful and a caesarean section was performed at the 37th week of gestation. The endovascular approach may represent a safe method in the treatment of this cerebral condition during pregnancy.
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Affiliation(s)
- F. Granata
- Department of Radiological Sciences, Neuroradiology Unit, Radiotherapy Unit
| | - C. Alafaci
- Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, Neurosurgery Unit
| | - A. Giacobbe
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina; Messina, Italy
| | - A. De Vivo
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina; Messina, Italy
| | - A. Mancuso
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina; Messina, Italy
| | - A. Conti
- Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, Neurosurgery Unit
| | - A. Pontoriero
- Department of Radiological Sciences, Neuroradiology Unit, Radiotherapy Unit
| | - A. Pitrone
- Department of Radiological Sciences, Neuroradiology Unit, Radiotherapy Unit
| | - M. Longo
- Department of Radiological Sciences, Neuroradiology Unit, Radiotherapy Unit
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Vigna E, De Vivo A, Gentile M, Morelli R, Lucia E, Mazzone C, Recchia A, Vianelli N, Morabito F. Liposomal amphotericin B in the treatment of visceral leishmaniasis in immunocompromised patients. Transpl Infect Dis 2010; 12:428-31. [DOI: 10.1111/j.1399-3062.2010.00519.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lemoli RM, D'Addio A, Marotta G, Pezzullo L, Zuffa E, Montanari M, De Vivo A, Bonini A, Galieni P, Carella AM, Guidi S, Michieli M, Olivieri A, Bosi A. BU/melphalan and auto-SCT in AML patients in first CR: a ‘Gruppo Italiano Trapianto di Midollo Osseo (GITMO)’ retrospective study. Bone Marrow Transplant 2009; 45:640-6. [DOI: 10.1038/bmt.2009.235] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Mancuso A, De Vivo A, Fanara G, Albiero A, Priolo AM, Giacobbe A, Franchi M. Caesarean section on request: Are there loco-regional factors influencing maternal choice? An Italian experience. J OBSTET GYNAECOL 2009; 28:382-5. [DOI: 10.1080/01443610802091545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fanara G, De Vivo A, Giacobbe A, De Dominici R, Savasta LM, Mancuso A. MOOD STATE IN PRE AND POSTMENOPAUSAL WOMEN. INFLUENCE OF PERSONOLOGICAL CONSTRUCT. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70406-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Giacobbe A, De Vivo A, Zoccali M, Corrado F, Mancuso A. DIFFERENCES IN BODY COMPOSITION BETWEEN POST-MENOPAUSAL WOMEN WITH AND WITHOUT DYSLIPIDEMIA. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Arpinati M, Chirumbolo G, Nicolini B, De Vivo A, Bonifazi F, Giannini M, Giovannini M, Bandini G, Martelli V, Stanzani M, Baccarani M, Rondelli D. 392: Delayed Recovery of Myeloid (mDC) and Plasmacytoid (pDC) Dendritic Cells at 3 Months after Allogeneic HSC Transplantation Correlates with an Increased Transplant-related and Overall Mortality Independently of GVHD. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Arpinati M, Chirumbolo G, Nicolini B, De Vivo A, Bonifazi F, Giannini M, Bandini G, Martelli V, Stanzani M, Baccarani M, Rondelli D. 118: Elevated CD14+ Cell Dose in Marrow Graft Correlates with Increased Mortality after Allogeneic Transplantation. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gori E, Arpinati M, Bonifazi F, Errico A, Mega A, Alberani F, Sabbi V, Costazza G, Leanza S, Borrelli C, Berni M, Feraut C, Polato E, Altieri MC, Pirola E, Loddo MC, Banfi M, Barzetti L, Calza S, Brignoli C, Bandini G, De Vivo A, Bosi A, Baccarani M. Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of the Gruppo Italiano Trapianto di Midollo Osseo nurses group. Bone Marrow Transplant 2007; 39:347-52. [PMID: 17277790 DOI: 10.1038/sj.bmt.1705590] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Severe oral mucositis is a major cause of morbidity following allogeneic hematopoietic stem cell transplantation (AHSCT). Cryotherapy, that is, the application of ice chips on the mucosa of the oral cavity during the administration of antineoplastic agents, may reduce the incidence and severity of chemotherapy-related oral mucositis. In this multicenter randomized study, we addressed whether cryotherapy during MTX administration is effective in the prevention of severe oral mucositis in patients undergoing myeloablative AHSCT. One hundred and thirty patients undergoing myeloablative AHSCT and MTX-containing GVHD prophylaxis were enrolled and randomized to receive or not receive cryotherapy during MTX administration. The incidence of severe (grade 3-4) oral mucositis, the primary end point of the study, was comparable in patients receiving or not cryotherapy. Moreover, no difference was observed in the incidence of oral mucositis grade 2-4 and the duration of oral mucositis grade 3-4 or 2-4, or in the kinetics of mucositis over time. In univariate and multivariate analysis, severe oral mucositis correlated with TBI in the conditioning regimen and lack of folinic acid rescue following MTX administration. Thus, cryotherapy during MTX administration does not reduce severe oral mucositis in patients undergoing myeloablative allogeneic HSCT. Future studies will assess cryotherapy before allogeneic HSCT.
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Affiliation(s)
- E Gori
- Department of Hematology and Medical Oncology Seragnoli, University of Bologna, Bologna, Italy
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Biasco G, Nobili E, Calabrese C, Sassatelli R, Camellini L, Pantaleo MA, Bertoni G, De Vivo A, Ponz De Leon M, Poggioli G, Bedogni G, Venesio T, Varesco L, Risio M, Di Febo G, Brandi G. Impact of surgery on the development of duodenal cancer in patients with familial adenomatous polyposis. Dis Colon Rectum 2006; 49:1860-6. [PMID: 17103055 DOI: 10.1007/s10350-006-0723-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Precancerous duodenal lesions in patients with familial adenomatous polyposis can be detected with duodenoscopy and treatment may prevent the development of cancer. We proposed to determine the frequency, natural history, cumulative risk, and risk factors of the precancerous duodenal lesions in a series of patients diagnosed in northern Italy. METHODS A prospective, endoscopic, follow-up protocol was performed in 50 patients examined by gastroduodenoscopy at two years of interval or less. The presence and severity of precancerous lesions of the duodenal mucosa were evaluated by Spigelman score. Twenty-five patients (50 percent) had proctocolectomy and ileoanal anastomosis, 15 (30 percent) had colectomy and ileorectal anastomosis, and 5 (10 percent) had proctocolectomy and definitive ileostomy from 0 to 3 years before the admission to the surveillance program. All patients showed more than a thousand adenomas in the colorectal mucosa. No patients with attenuated polyposis were found. RESULTS At the first endoscopy, duodenal adenomas could be detected in 19 of 50 patients (38 percent), whereas at the end of the follow-up, 43 (86 percent) had duodenal lesions. The final mean Spigelman score increased during the follow-up period (P<0.001 respect to baseline values). No duodenal cancer could be detected. Eleven patients had or developed severe precancerous duodenal lesions (Stage IV) treated with endoscopic or surgical resection. The distribution of patients with Stage IV according to the surgery of the colon was: 2 of 25 treated with ileoanal anastomosis and 8 of 15 with ileorectal anastomosis (P=0.0024, Fisher's exact test). CONCLUSIONS Patients with familial adenomatous polyposis are at risk of significant neoplasia. The natural history of precancerous lesions might be related to surgical treatment of colorectal neoplasms.
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Affiliation(s)
- G Biasco
- Institute of Haemathology and Medical Oncology L and A Seràgnoli, Via Massarenti 9, 40138, Bologna, Italy.
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Abstract
OBJECTIVE To evaluate the importance of adiponectin and insulin resistance in early- and late-onset pre-eclampsia. DESIGN A nested case-control study in 72 pregnant women who participated in the first-trimester Down-syndrome-screening programme and who delivered at our hospital. SETTING University Hospital, Department of Obstetrics and Gynecology. POPULATION Pregnant women: 36 women with pre-eclampsia of which 20 late onset and 16 early onset were compared with 36 uncomplicated pregnancies who delivered at term. METHODS In all the women, insulin resistance was calculated by the homeostasis model assessment ratio (HOMA-IR) and plasma adiponectin was determined using an enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES Insulin resistance and adiponectin concentration. RESULTS First-trimester plasma adiponectin mean levels in the whole pre-eclampsia group were significantly lower than that in the control group (8.4 +/- 3.3 versus 14.8 +/- 4.6 microgram/ml; P < 0.001), whereas first-trimester mean HOMA-IR values were significantly higher in the pre-eclampsia group than that in the control group (2.0 +/- 1.1 versus 1.0 +/- 0.4; P= 0.01). Plasma adiponectin concentrations at delivery in the pre-eclampsia group were significantly higher than that in the control group (9.2 +/- 3.7 versus 7.8 +/- 2.6 microgram/ml; P= 0.04). First-trimester plasma adiponectin mean concentrations in the late-onset subgroup were significantly lower compared with the concentrations in early-onset subgroup (6.2 +/- 1.4 microgram/ml versus 11.1 +/- 3.2 microgram/ml; P < 0.001), and there was a significant difference in adiponectin plasma values only between women in the late-onset pre-eclampsia group versus those in the control group (P < 0.001). First-trimester mean HOMA-IR values were significantly higher in the late-onset subgroup compared with that of the early-onset subgroup (2.5 +/- 1.3 versus 1.3 +/- 0.3; P= 0.02), and there was a significant difference only between the control group versus the late-onset subgroup (P= 0.001). CONCLUSIONS First-trimester adiponectin and HOMA-IR values seem to select two completely different populations: early- and late-onset pre-eclampsia, which might suggest a different pathogenesis.
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Affiliation(s)
- R D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
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Mancuso A, De Vivo A, Triolo O, Irato S, Mazzù G. Hysterectomy: benefits of clinical performance indicators in the evaluation of healthcare facilities. CLIN EXP OBSTET GYN 2005; 32:233-6. [PMID: 16440821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE The aim of our study was to verify, by applying clinical performance indicators, the quality of healthcare given to hysterectomy patients and the benefits on their adoption in healthcare facilities. METHODS The different surgical approaches and indications for surgery were evaluated in 534 patients analysing postoperative short-term complications and triggered clinical performance indicators (CPIs). RESULTS Surgery was performed by the abdominal (80.9%) and vaginal route (19.1%). Postoperative complication rate was 13.5% and CPIs were triggered 108 times overall: 42 in benign conditions (10.3%) and 30 in malignancy (23.4%) (p = 0.001). In patients operated on for benign conditions the different approaches, abdominal or vaginal, showed differences in postoperative period (p = 0.4). In 10.9% of malignant and in 2.9% of benign conditions hospital stay was triggered (p = 0.001). Vaginal surgery showed a shorter average stay than laparotomy (p = 0.001). CONCLUSION The use of CPIs may determine a refinement of clinical performance with positive effects on health, patient satisfaction, postoperative morbidity hospitalisation and healthcare cost savings.
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Affiliation(s)
- A Mancuso
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Messina, Italy
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16
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Mancuso A, De Vivo A, Fanara G, Di Leo R, Toscano A. Upper body venous thrombosis associated with ovarian stimulation: case report and review of the literature. CLIN EXP OBSTET GYN 2005; 32:149-54. [PMID: 16433151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Thromboembolic events are a serious complication of assisted conception treatment. Thrombosis may be either arterial or venous but the latter is far more common. This phenomenon is more frequent in the lower limb, but several cases of upper extremity thrombosis have been described in the literature. Although the aetiology of these thromboembolic disorders is not fully understood, the mechanism is thought to be due to a hypercoagulable state associated with haemostasis and thrombophilia. Predisposing factors seem to be hyperoestrogenism, ovarian hyperstimulation syndrome, a hereditary hypercoagulable state and multifoetal pregnancy. We report a case of superior sagittal sinus thrombosis that developed in a patient following successful assisted conception in the absence of evident risk factors. In the current literature, the site of thrombosis, possible predisposing factors, oestrogen levels, number of foetuses, maternal and foetal outcomes, and management of thrombosis were analysed.
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Affiliation(s)
- A Mancuso
- Department of Gynaecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Italy
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17
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Brandi G, Calabrese C, Pantaleo MA, Morselli Labate A, Di Febo G, Hakim R, De Vivo A, Di Marco MC, Biasco G. Circadian variations of rectal cell proliferation in patients affected by advanced colorectal cancer. Cancer Lett 2004; 208:193-6. [PMID: 15142678 DOI: 10.1016/j.canlet.2003.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2003] [Revised: 11/10/2003] [Accepted: 11/14/2003] [Indexed: 12/12/2022]
Abstract
The circadian rhythm of the rectal cell proliferation was studied in five patients affected by advanced colon cancer. Biopsies were taken from apparently normal mucosa at 10 cm from the anal verge, every 6 h in a 24-h period. Fragments were incubated for 1 h in a culture medium containing bromodeoxyuridine (BrdUrd). As compared with the mean 24 h values, the percentage of BrdUrd-labelled cells in the crypts (Labelling Index, LI) was lower in the specimens collected at 10.00 PM (P = 0.02) The LI in such biopsies was also lower than the LI observed at the baseline time, 10.00 AM (P = 0.001) The results suggest that the rectal cell proliferation in patients with advanced colon cancer fluctuates during the day. The study of the rhythmicity of the intestinal cells may be useful to modulate the infusion of antiproliferative agents to prevent damage of the normal colorectal mucosa.
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Affiliation(s)
- G Brandi
- Institute of Hematology and Medical Oncology 'L and A Seràgnoli', pad 8, S. Orsola Hospital, via Massarenti 9, 40138 Bologna, Italy
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18
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Triolo O, Mancuso A, De Vivo A, Falcone S. Term angular pregnancy with placenta accreta. A case report. CLIN EXP OBSTET GYN 2004; 31:147-8. [PMID: 15266774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A 27-year-old primigravida, with two prior adnexal operations, had retained placenta with postpartum haemorrhage following an uncomplicated vaginal delivery. Laparotomic removal revealed placental accretism. Pharmacological treatment (oxytocin and sulprostone) and right cornual resection failed to control profuse bleeding. In the end, subtotal hysterectomy was unavoidable.
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Affiliation(s)
- O Triolo
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, "G. Martino" University Hospital, University of Messina, Messina, Italy
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19
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Mancuso A, De Vivo A, Triolo O, Irato S. The role of transvaginal ultrasonography and serum CA 125 assay combined with age and hormonal state in the differential diagnosis of pelvic masses. EUR J GYNAECOL ONCOL 2004; 25:207-10. [PMID: 15032283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
PURPOSE OF INVESTIGATION To evaluate the ability of CA 125 and echography, alone and in combination with clinical parameters (age over 50 years and post-menopausal state), in the diagnosis of a malignant pelvic mass. METHODS 125 women were enrolled and underwent echography and CA 125 assay. For each methodology, positive and negative predictive value, sensitivity, specificity, diagnostic accuracy, pre- and post-test probability and likelihood ratios were calculated. RESULTS Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy (DA) and positive likelihood ratio were identical for echography and CA 125 considered alone. Paired with the patient's age, the CA 125 assay showed better results than the associations echography-age (LR+ 26.9 vs 10.1) or CA 125-echography (LR+ 26.9 vs 17.8). Furthermore the combination of the postmenopausal state with CA 125 obtained the best result of a positive likelihood ratio (LR+ 29.7). CONCLUSION Our study pointed out that, in the prediction of a malignant adnexal mass, the best results were obtained from the association between CA 125 and menopause, probably because in this period there is a lower incidence of benign diseases related to this marker so that an increase of CA 125 level is more likely associated with a malignant mass.
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Affiliation(s)
- A Mancuso
- Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Messina, Italy
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20
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Rosti G, Bonifazi F, Trabacchi E, De Vivo A, Bassi S, Martinelli G, Testoni N, Russo D, Baccarani M. A phase II study of alpha-interferon and oral arabinosyl cytosine (YNK01) in chronic myeloid leukemia. Leukemia 2003; 17:554-9. [PMID: 12646944 DOI: 10.1038/sj.leu.2402850] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
YNK01 (Starasid) is a prodrug that is adsorbed in the gut and is transformed in the liver in arabinosyl cytosine (AC). Low-dose AC (LDAC) is useful for the treatment of Philadelphia positive (Ph+) chronic myeloid leukemia (CML), especially in combination with alpha-interferon (alphaIFN). The use of YNK01 can avoid the daily s.c. injection of conventional AC. To assess the safety and the efficacy of alphaIFN and YNK01, we enrolled 86 consecutive previously untreated chronic phase Ph+ CML patients in a phase II study of alphaIFN (Intron-A) 5 MIU/m(2) daily and YNK01 600 mg daily 14 days a month. The 6-month complete hematologic response and the 12-month major cytogenetic response rates were 78 and 28%, respectively. In a prior study of alphaIFN and conventional LDAC, they were 62 and 22%, respectively. However, the compliance to the treatment was poor, with 25% of cases discontinuing the treatment within the first year. This was not because of the severity of the side effects but because of the frequency, duration and repetition of the side effects, for an overall frequency of 13.17 adverse events, mostly grade 1 and 2, per patient per year. Therefore, the study of this effective combination is being pursued, testing lower doses of alphaIFN and YNK01.
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Affiliation(s)
- G Rosti
- Institute of Hematology and Clinical Oncology L. and A. Seràgnolí, University of Bologna, S. Orsola Hospital, Italy
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21
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Affiliation(s)
- A Mancuso
- Institute of Gynecology, University of Messina, Via Duca degli Abruzzi isol. 520/D 98121, Messina, Italy
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22
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Russo D, Pricolo G, Michieli M, Michelutti A, Raspadori D, Bertone A, Marin L, Pierri I, Bucalossi A, Zuffa E, De Vivo A, Mazza P, Gobbi M, Lauria F, Zaccaria A, Baccarani M. Fludarabine, arabinosyl cytosine and idarubicin (FLAI) for remission induction in poor-risk acute myeloid leukemia. Leuk Lymphoma 2001; 40:335-43. [PMID: 11426555 DOI: 10.3109/10428190109057932] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Progress in treatment of acute myeloid leukemia (AML) is slow and treatment intensification alone has limited effects, particularly in poor-risk cases. Poor-risk cases, that are identified mainly by prior history, leukemic cell mass and cytogenetic abnormalities, share multiple mechanisms of drug resistance that are responsible for treatment failure. Since Pgp-mediated resistance to anthracycline can be reduced with Idarubicin (IDA) and resistance to arabinosyl cytosine (AC) can be reduced with Fludarabine (FLUDA), we tested a combination of high dose AC (2000 mg/sqm, 5 doses), FLUDA (30 mg/sqm, 5 doses) and IDA (12 mg/sqm, 3 doses) for remission induction and consolidation in 45 consecutive cases of poor-risk AML. The complete remission (CR) rate was 71% after the first course and 82% overall, with a projected 2-year survival and relapse-free survival of 44% and 50% respectively. Non-hematologic toxicity was very mild, that is very important in elderly patients, but hemopoietic toxicity was substantial, with a time to hematologic recovery of 3 to 4 weeks and two cases of death in CR. Peripheral blood stem cells (PBSC) could be mobilized and collected successfully only in 11 cases. This three-drug combination is effective and has a limited non-hematologic toxicity, but FLUDA may increase the difficulty of obtaining PBSC early after remission induction.
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Affiliation(s)
- D Russo
- Department of Bone Marrow Transplantation, University of Udine, Italy. Domenico@
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23
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Bonifazi F, De Vivo A, Rosti G, Tiribelli M, Russo D, Trabacchi E, Fiacchini M, Montefusco E, Baccarani M. Testing Sokal's and the new prognostic score for chronic myeloid leukaemia treated with alpha-interferon. Italian Cooperative Study Group on Chronic Myeloid Leukaemia. Br J Haematol 2000; 111:587-95. [PMID: 11122107 DOI: 10.1046/j.1365-2141.2000.02366.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As it has been shown that alpha-interferon (alphaIFN) treatment modifies the survival of chronic myeloid leukaemia (CML) patients in comparison with conventional chemotherapy, a new prognostic score was devised with the aim of providing a treatment-adapted risk evaluation. We have tested the new prognostic score (the Euro score) in an independent series of 272 patients less than 56 years old with previously untreated, chronic phase, Philadelphia (Ph)-positive CML who had been assigned prospectively to alphaIFN treatment between 1989 and 1991. The Sokal score system was used as a reference. The new Euro score predicted the response to alphaIFN as the Sokal score. The median survival of low-risk, intermediate-risk and high-risk patients was similar using the Euro score (105, 65 and 45 months) and Sokal score (105, 76 and 45 months) but, by multivariate analysis, the Euro was more potent than Sokal for predicting survival time. The new Euro score identified more low-risk cases (59% vs. 48%) and fewer high-risk cases (9% vs. 23%) than the Sokal score. The main differences between the Euro and Sokal scores concerned age (it is more important in the Euro than in Sokal), spleen size and the percentage of myeloblasts in peripheral blood (more important in Sokal than in Euro). We conclude that the new Euro score marks an improvement in the prognostic evaluation of CML treated with alphaIFN. By comparison with the Sokal score, the Euro was more potent and identified more low-risk patients but left only a small number of cases in the high-risk group.
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Affiliation(s)
- F Bonifazi
- Institute of Haematology and Clinical Oncology 'L. and A. Seràgnoli', Bologna University, Italy
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24
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Martinelli G, Testoni N, Amabile M, Bonifazi F, De Vivo A, Farabegoli P, Terragna C, Montefusco V, Ottaviani E, Saglio G, Russo D, Baccarani M, Rosti G, Tura S. Quantification of BCR-ABL transcripts in CML patients in cytogenetic remission after interferon-alpha-based therapy. Bone Marrow Transplant 2000; 25:729-36. [PMID: 10745258 DOI: 10.1038/sj.bmt.1702207] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We measured using a competitive quantitative polymerase chain reaction-capillary electrophoresis (PCR-CE)-based assay, the levels of bcr-abl transcripts in 44 patients with chronic myeloid leukemia (CML) after interferon-alpha (IFN-alpha) therapy, who achieved a major (10 patients, MCR group) or complete (34 patients, CCR group) cytogenetic response. All 34 CCR patients had molecular evidence of residual disease detected in bone marrow samples at the time of best karyotypic response. The median number of bcr-abl transcripts of 34 evaluable patients in the CCR group at the time of complete cytogenetic remission was 4/microg RNA (range 3-4600), while the median number of bcr-abl transcripts of 10 patients in the MCR group at the time of best cytogenetic response was 4490/microg RNA (range 600-23 900) (P = 0.000024). In nine CCR and five MCR patients we were able to quantify the amount of bcr-abl transcript both at diagnosis and after interferon therapy: no statistical difference (P = 0.18) was found between the two groups at diagnosis (median bcr-abl transcripts/microg RNA was 30 000 vs. 39 650, respectively). During IFN-alpha therapy, the two groups were evaluable at the time of major karyotypic conversion: at this point, there was a statistical difference of expression of bcr-abl transcript between the CCR group (17 patients) (median 2700; range 76-40 000) and the MCR group (10 patients) (median 4490; range 600-23 900), respectively (P = 0.046). No differences of bcr-abl amount of transcript were found in patients with CCR obtained either by IFN-alpha therapy alone (20 patients) vs. IFN-alpha plus ABMT (13 patients) (P = 0.47). We firstly demonstrated that although the CCR and MCR groups were clinically, cytogenetically and molecularly indistinguishable at diagnosis, the two groups could be recognized successfully during interferon therapy based on the level of bcr-abl transcript.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Agents/therapeutic use
- Bone Marrow Cells/pathology
- Bone Marrow Transplantation
- Combined Modality Therapy
- Cytarabine/therapeutic use
- Disease-Free Survival
- Female
- Follow-Up Studies
- Fusion Proteins, bcr-abl/genetics
- Genes, abl
- Humans
- Interferon alpha-2
- Interferon-alpha/therapeutic use
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Recombinant Proteins
- Remission Induction
- Reverse Transcriptase Polymerase Chain Reaction
- Time Factors
- Transcription, Genetic
- Transplantation, Autologous
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Affiliation(s)
- G Martinelli
- Institute of Haematology and Medical Oncology 'Seràgnoli', University of Bologna, Italy
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25
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Martinelli G, Vianelli N, De Vivo A, Ricci P, Remiddi C, Testoni N, Visani G, Baravelli S, Farabegoli P, Tura S. Granulocytic sarcomas: clinical, diagnostic and therapeutical aspects. Leuk Lymphoma 1997; 24:349-53. [PMID: 9156665 DOI: 10.3109/10428199709039023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Granulocytic sarcomas (GS) are extramedullary tumor masses of immature myeloid cells most frequently associated with acute myeloblastic leukemia. We report our diagnostic, clinic and therapeutic approaches in the treatment of 6 patients affected by GS who presented with different localizations and symptoms: mediastinal mass with chest pain, rectal tumor with bowel occlusion, bladder mass with acute kidney failure, quadriceps tumor with pain, vertebral localization with pain and bowel mass with pain, respectively. The correct diagnosis of GS by bone biopsy, the immunohistological evaluation of the tumor masses, the prompt use of active drugs in the first line therapy schedule as for acute myeloblastic leukemia are the parameters for the achievement of the long-term remission.
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Affiliation(s)
- G Martinelli
- Istituto di Ematologia L e A. Seràgnoli, Ospedale S. Orsola-Malpighi, Università di Bologna, Italy
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26
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Leoncini L, Spina D, Close P, Megha T, Pacenti L, Tosi P, Pileri S, De Vivo A, Kraft R, Laissue JA, Cottier H. Abortive mitoses and nuclear DNA fragmentation in CD30+ large cells of Hodgkin's disease. Leuk Lymphoma 1996; 22:119-24, follow. 186, color plate XI. [PMID: 8724538 DOI: 10.3109/10428199609051738] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study was undertaken to better comprehend the reasons for the scarcity of Hodgkin and Reed-Sternberg (H-RS) cells in Hodgkin's disease (HD) despite their expression of "proliferation-associated antigens". To this end, we assessed the relative frequency of mitotic phases and nuclear damage (detected by in situ end-labeling of DNA strand breaks) in CD30+ large cells of nodular sclerosis and mixed cellularity HD. Our results show that a) most CD30+ cells in HD exhibit abortive mitoses, with a highly significant arrest at the metaphase-ana/telophase transition, and b) many of these elements, i.e. mainly H-RS cells, show fragmentation of nuclear DNA, suggesting imminent or actual death. Percentages of CD30+ cells that entered mitosis and those with DNA strand breaks were of a similar order of magnitude and correlated significantly in a linear fashion. These findings are consistent with the concept that cell deletion is the major cause of the paucity of H-RS cells in HD.
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Affiliation(s)
- L Leoncini
- Institute of Pathologic Anatomy and Histology, University of Siena, Italy
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27
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Rosti G, De Vivo A, Zuffa E, Baccarani M. Interferon-alpha in the treatment of chronic myeloid leukemia. A summary and an update of the Italian studies. Bone Marrow Transplant 1996; 17 Suppl 3:S11-3. [PMID: 8769692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Six-hundred patients were recruited between 1986 and 1991 for studies of the treatment of Ph positive chronic myeloid leukemia (CML) with interferon-alpha (IFN-alpha). The median survival of the patients who were assigned to treatment with IFN-alpha was 6 years or longer than 6 years, and was more than the survival of the patients who were assigned to conventional chemotherapy. Survival prolongation was significantly related with the achievement of a cytogenetic response. IFN-alpha treatment was not harmful for subsequent allogeneic or autologous bone marrow transplantation.
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Affiliation(s)
- G Rosti
- Institute of Hematology L and A Seràgnoli, Bologna University, Udine University, Italy
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28
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Leoncini L, Spina D, Nyong'o A, Abinya O, Minacci C, Disanto A, De Luca F, De Vivo A, Sabattini E, Poggi S, Pileri S, Tosi P. Neoplastic cells of Hodgkin's disease show differences in EBV expression between Kenya and Italy. Int J Cancer 1996; 65:781-4. [PMID: 8631592 DOI: 10.1002/(sici)1097-0215(19960315)65:6<781::aid-ijc13>3.0.co;2-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The Epstein-Barr Virus (EBV) has been implicated in the pathogenesis of Hodgkin's disease (HD). However, the association of EBV with this disease varies greatly from series to series and from country to country. Epidemiological studies have shown differences in HD occurring in different parts of the world. In particular, it has been reported that HD in developing countries differs from HD in Western countries in terms of epidemiological, pathological and clinical characteristics. These discrepancies among populations suggest an interaction with environmental factors and a direct role of different etiological agents. At present, there are no data on the frequency of association of EBV with HD in equatorial Africa. In this study, a large series of HD cases have been collected at the University of Nairobi, Kenya, and at the Universities of Bologna and Siena, Italy. The cases have been reviewed and classified according to the REAL Classification and the presence of EBV has been assessed by in situ hybridization (ISH). A statistical difference in EBV expression was found between HD from Kenya and HD from Italy. EBV-positive neoplastic cells were detected in 92% of Kenyan cases, whereas only 48% of Italian cases showed EBER1/2 positivity in the neoplastic cells. Our results suggest that, in Kenya, EBV plays a more direct role in the pathogenesis of HD, as it does for endemic Burkitt lymphoma.
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Affiliation(s)
- L Leoncini
- Institute of Pathological Anatomy and Histology, University of Siena, Italy
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29
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Martinelli G, Farabegoli P, Buzzi M, Panzica G, Zaccaria A, Bandini G, Calori E, Testoni N, Rosti G, Conte R, Remiddi C, Salvucci M, De Vivo A, Tura S. Fingerprinting of HLA class I genes for improved selection of unrelated bone marrow donors. Eur J Immunogenet 1996; 23:55-65. [PMID: 8834923 DOI: 10.1111/j.1744-313x.1996.tb00264.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The degree of matching of HLA genes between the selected donor and recipient is an important aspect of the selection of unrelated donors for allogeneic bone marrow transplantation (UBMT). The most sensitive methods currently used are serological typing of HLA class I genes, mixed lymphocyte culture (MLC), IEF and molecular genotyping of HLA class II genes by direct sequencing of PCR products. Serological typing of class I antigenes (A, B and C) fails to detect minor differences demonstrated by direct sequencing of DNA polymorphic regions. Molecular genotyping of HLA class I genes by DNA analysis is costly and work-intensive. To improve compatibility between donor and recipient, we have set up a new rapid and non-radioisotopic application of the 'fingerprinting PCR' technique for the analysis of the polymorphic second exon of the HLA class I A, B and C genes. This technique is based on the formation of specific patterns (PCR fingerprints) of homoduplexes and heteroduplexes between heterologous amplified DNA sequences. After an electrophoretic run on non-denaturing polyacrylamide gel, different HLA class I types give allele-specific banding patterns. HLA class I matching is performed, after the gel has been soaked in ethidium bromide or silver-stained, by visual comparison of patients' fingerprints with those of donors. Identity can be confirmed by mixing donor and recipient DNAs in an amplification cross-match. To assess the technique, 10 normal samples, 22 related allogeneic bone marrow transplanted pairs and 10 unrelated HLA-A and HLA-B serologically matched patient-donor pairs were analysed for HLA class I polymorphic regions. In all the related pairs and in 1/10 unrelated pairs, matched donor-recipient patterns were identified. This new application of PCR fingerprinting may confirm the HLA class I serological selection of unrelated marrow donors.
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Affiliation(s)
- G Martinelli
- Istituto di Ematologia L. e A. Seràgnoli, Università di Bologna, Italy
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30
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Monteverde A, Sabattini E, Poggi S, Ballarè M, Bertoncelli MC, De Vivo A, Briskomatis A, Roncador G, Falini B, Pileri SA. Bone marrow findings further support the hypothesis that essential mixed cryoglobulinemia type II is characterized by a monoclonal B-cell proliferation. Leuk Lymphoma 1995; 20:119-24. [PMID: 8750632 DOI: 10.3109/10428199509054762] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
One-hundred-sixteen consecutive bone-marrow biopsies were taken from 76 patients with essential mixed cryoglobulinemia type II (type II cryo), whose median follow-up was 97 months. Fifty-four out of fifty-six subjects who underwent ELISA and RIBA tests for HCV, were found to be positive. At conventional light microscopic examination, 64/76 patients showed discrete lymphoid infiltrates consisting of small elements with plasmacytoid differentiation and with frequent paratrabecular location. Thirty-nine biopsies were studied by immunohistochemistry that revealed the B-cell nature of the infiltrates (CD20+, CD45RA+, CD79 alpha+, CD3-, CD45RO-), with demonstrable monotypic Ig light-chain restriction in 22 cases. It is worthy of note that the lymphoid elements usually appeared protected against apoptosis, because of the strong expression of the bcl-2 oncogene product, and provided with a very low proliferative capacity, the Ki-67 index being lower that 3%. The latter findings are in keeping with the indolent behaviour of the clonal lymphoid population observed in type II cryo and allow some speculation as to the need for environmental stimuli for its maintenance as well as further mutagenic events for its eventual transformation into an overt lymphoma.
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Affiliation(s)
- A Monteverde
- Seconda Divisione di Medicina Generale, Ospedale Maggiore della Carità, Novara, Italy
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31
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Abstract
The problem of anaplastic large cell lymphoma (ALCL) is extensively reviewed by depicting the clinical, pathological and biological characteristics of the four main varieties of ALCL: common, Hodgkin's like/Hodgkin-related, lympho-histiocytic, and giant-cell rich. Special emphasis is given to the differential diagnosis between ALCL Hodgkin like and Hodgkin's disease in the light of possible therapeutical differences.
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Affiliation(s)
- S A Pileri
- Sezione di Istologia Emolinfopatologica, Istituto di Ematologia L. & A. Seràgnoli, Università di Bologna, Policlinico S. Orsola, Italy
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32
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Abstract
The theoretical bases of Hodgkin's disease (HD) have recently been revised in the light of new findings obtained by means of immunohistochemistry and molecular analysis. These findings have questioned the concept that HD is a unique entity and have made the borders between HD and non-Hodgkin's lymphomas unclear. The clinical relevance of nodular lymphocyte predominance HD (LP-HD), the distinction between T-cell rich B-cell lymphoma and diffuse LP-HD, and the relationships between HD and anaplastic large cell lymphoma are reviewed and discussed.
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Affiliation(s)
- S A Pileri
- Istituto di Ematologia L. & A. Seràgnoli/I Servizio di Anatomia ed Istologia Patologica, Università di Bologna, Policlinico S. Orsola, Italy
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33
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Pileri S, Piccaluga PP, De Vivo A, Sabattini E, Poggi S, Melilli G, Falini B, Piccaluga A. Malignant lymphomas of the gastro-intestinal tract: a reappraisal on the basis of the newly proposed Revised European American Lymphoma Classification. Ital J Gastroenterol 1994; 26:405-18. [PMID: 7703515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- S Pileri
- Sezione di Istologia Emolinfopatologica, Istituto di Ematologia L & A Seragnoli, Università di Bologna, Italy
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