1
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Fischer J, Bouhana K, Chicarelli M, Dahlke J, Fell B, Fulton J, Guarnieri A, Haygood L, Jalluri R, Johnson A, McLean B, Max M, Rieger R, Robinson J, Rodriguez M, Sullivan F, Wang Y, Winski S, Zhou Y. In Vivo Pre-clinical characterization of a Novel Series of FGFR2 Selective Inhibitors with Potency Against Clinically Relevant Mutations. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01016-4] [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: 11/03/2022]
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2
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Abstract
Twenty-nine advanced breast cancer patients, considered unable to tolerate conventional cytotoxic chemotherapy, were treated with a weekly schedule of epirubicin (15 mg/m2 i.v.). All patients were fully evaluable. A remission of 34.5 % was observed (2 CR; 8 PR), with a median duration of response of 9 months (range, 3–24 months). Side effects were mild, and on the whole the toxicity was negligible. This regimen showed a favorable therapeutic ratio in our series and seems active and well tolerated even in elderly and/or poor performance status patients.
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Affiliation(s)
- E Tucci
- Istituto di Radiologia, Università di Siena, Italia
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3
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Abstract
Metastatic involvement of the upper gastrointestinal tract from breast cancer has been reported in autopsy series as occurring in more than 15% of patients, usually associated with extensive systemic spread; clinical manifestations from such metastases have been described in less than 1% of cases. Lobular infiltrating carcinoma seems to have a different metastatic pattern than the ductal type, with an apparent predilection for the gastrointestinal tract. Metastatic presentation as an isolated intestinal obstruction without other signs of metastatic spread is extremely rare. We present a case of isolated duodenal metastasis from breast cancer, associated with intestinal obstruction, as the first sign of metastatic spread.
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4
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Abstract
Correction of the acid-base balance in uremic patients during hemodiafiltration (HFD) may be biased by an inadequate monitoring of phi and blood gases. HDF performed with the two-chamber technique (PFD) generates pure ultrafiltrate (uf) unmixed with dialysate. We carried out 84 determinations of HCO−3 levels in 15 different PFD patients by measuring the pH and pCO2 of the uf, then correlated the values with those simultaneously evaluated on arterial blood with standard methods. The mean HCO−3 levels (mmol/L) were 23.21±2.49 in blood samples and 25.54±3.07 in uf, with a mean difference of -2.33±1.46. Statistical analysis gave: t=13.5 (p=O) (one-sample analysis), r=0.86 (p=0) (linear regression analysis) and a good agreement between the two clinical measurements (81 out of 84 data points fell within the 95% confidence interval) (Bland-Altman analysis). In conclusion, we suggest that during HDF performed with the two-chamber technique, the patient's HCO−3 level can be monitored on the uf without blood sampling.
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Affiliation(s)
- P. M. Ghezzi
- Division of Nephrology and Dialysis, Ospedale S. Croce, Cuneo
| | - A. Guarnieri
- Division of Nephrology and Dialysis, Ospedale S. Croce, Cuneo
| | - C. Tetta
- Bellco Research Laboratories, Bellco S.p.A., Mirandola, (MO) - Italy
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5
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Molari G, Badodi M, Guarnieri A, Mattetti M. Structural strength evaluation of driver's protective structures for self-propelled agricultural machines. J Agric Saf Health 2014; 20:165-174. [PMID: 25174149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The high number of accidents due to rollovers of agricultural machines has increased the interest of researchers and organizations for standardization in this field. In the 1960s, standards to test rollover protective structures (ROPS) for tractors were designed and approved. Similar standards were introduced in the 1990s for earth-moving machinery, but ROPS standards were not defined for self-propelled agricultural machines. In the present work, the driver's protective structures of five different categories of self-propelled agricultural machines were analyzed with the goal of introducing ROPS with a strength level in accordance with the standards used for tractors while maintaining the same shape as the existing structure. The results show a low resistance level of the present structures on the machines selected for the tests. New structures that are able to sustain the loads specified by the tractor standard are not different in design from the existing structures, but an increase of the resistance of the materials or an increase of the thickness of the mountings is necessary.
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6
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Abstract
Abstract
The microwave spectrum of the (CH3)2NNO and (CH3)2
15N15NO species have been studied and the rotational constants evaluated. By comparison of the inertia defects of the two species it can be stated that the nuclear frame of the molecule is planar, which is in agreement with the reported electron diffraction results. The dipole moment of the (CH3)2
15 N15NO species has been determined. Further studies on the internal rotation of the two methyl tops are in progress together with the analysis of the spectra of other isotopically substitued species.
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Affiliation(s)
- F. Scappini
- Abteilung Chemische Physik im Institut für Physikalische Chemie, Universität Kiel
| | - A. Guarnieri
- Abteilung Chemische Physik im Institut für Physikalische Chemie, Universität Kiel
| | - H. Dreizler
- Abteilung Chemische Physik im Institut für Physikalische Chemie, Universität Kiel
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7
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Guarnieri A, Rohwer F, Scappini F. r0-Structure, Partial r-Structure, and Nitrogen Nuclear Quadrupole Coupling Constants of N-Nitroso-dimethylamine. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/zna-1975-6-730] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The microwave spectra of (CH3)2
15NNO, (CH3)2N15NO, syn-13CH3
12CH3NNO and anti-13CH3
12CH3NNO have been studied and the rotational constants evaluated. With these data and former results 1 the rs-structure of the carbon-nitrogen frame has been found to be planar. An r0-structure has also been calculated. From the hyperfine structure of the spectra the nuclear quadrupole coupling constants of the nitrogen nuclei have been determined. Further studies to complete the rs-structure are in progress.
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Affiliation(s)
- A. Guarnieri
- Abteilung Chemische Physik im Institut für Physikalische Chemie der Universität Kiel
| | - F. Rohwer
- Abteilung Chemische Physik im Institut für Physikalische Chemie der Universität Kiel
| | - F. Scappini
- Abteilung Chemische Physik im Institut für Physikalische Chemie der Universität Kiel
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8
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Abstract
Abstract
The microwave spectrum of fluoroacetylene (HCCF) has been measured in the frequency region 35 -260 GHz. Rotational constants of the ground state and rotational as well as rotation-vibrational interaction constants of several excited states of the C - C - H (ν4) and the C - C - F (ν5) bending vibrations have been obtained.
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Affiliation(s)
- F. Rohwer
- Institut für Physikalische Chemie der Universität Kiel, Abteilung Chemische Physik, Kiel, West Germany
| | - R. Hinze
- Institut für Physikalische Chemie der Universität Kiel, Abteilung Chemische Physik, Kiel, West Germany
| | - A. Guarnieri
- Institut für Physikalische Chemie der Universität Kiel, Abteilung Chemische Physik, Kiel, West Germany
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9
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Correale P, Cerretani D, Clerici M, Messinese S, Marsili S, Petrioli R, Cetta F, Savelli V, Guarnieri A, Pinto E, Giorgi G, Francini G. Gemcitabine (GEM), 5-Fluorouracil (5-FU) and Folinic Acid (FA) in Patients with Different Gastroenteric Malignancies. J Chemother 2013; 16:206-10. [PMID: 15216958 DOI: 10.1179/joc.2004.16.2.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/31/2022]
Abstract
This phase II clinical trial was performed in order to evaluate the pharmacokinetics, toxicity and anti-tumor activity of a novel combination of gemcitabine (GEM), 5-fluorouracil (5-FU) and folinic acid (FA) designed on a specific translational basis. Every 4 weeks, 44 patients with various gastroenteric malignancies, 29 of whom had pancreas carcinoma, received a short intravenous (i.v.) infusion of FA (100 mg/m2) and 5-FU (400 mg/m2) on days 1-5, and GEM 1000 mg/m2 on days 1, 8 and 16. Our results suggest that, although this treatment leads to hematological and gastroenteric toxicity, it is very active in patients with pancreatic carcinoma. We therefore believe that an improved version would merit further investigation in larger scale trials.
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Affiliation(s)
- P Correale
- Oncology Section, Department of Human Pathology and Oncology, Siena University School of Medicine, Siena, Italy
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10
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Licchetta A, Correale P, Migali C, Remondo C, Francini E, Pascucci A, Magliocca A, Guarnieri A, Savelli V, Piccolomini A, Carli A, Francini G. Oral Metronomic Chemo-Hormonal-Therapy of Metastatic Breast Cancer with Cyclophosphamide and Megestrol Acetate. J Chemother 2013; 22:201-4. [DOI: 10.1179/joc.2010.22.3.201] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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11
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Tirone A, Cesaretti M, Vuolo G, Gaggelli I, Guarnieri A, Piccolomini A, Verre L, Savelli V, Varrone F, D'Onofrio P, Di Bella C, Carli AF. The treatment of breast cancer in one day surgery. A four year experience. Ann Ital Chir 2013; 84:149-152. [PMID: 23698193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The number of short-stay surgery procedures has progressively increased since the concept of short-stay surgery was first introduced. Initially this type of surgery was reserved for patients undergoing inguinal hernia repair, proctological surgery, and various minor procedures. Careful patient selection makes it possible to apply one-day surgery to other surgical specialties including breast cancer surgery. Reducing the length of hospital stay lowers health care costs, and shortens waiting lists. The most important benefits for patients are a more rapid return to work and positive psychological effects. Exclusion criteria for one-day surgery are the lack of home care, excessive distance from place of treatment and the presence of any concomitant pathology that is a contraindication to this type of surgery. We report our experience in oncological surgery of the breast in one-day surgery.
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12
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Greco G, Rosa R, Beskin G, Karpov S, Romano L, Guarnieri A, Bartolini C, Bedogni R. Evidence of deterministic components in the apparent randomness of GRBs: clues of a chaotic dynamic. Sci Rep 2012; 1:91. [PMID: 22355609 PMCID: PMC3216577 DOI: 10.1038/srep00091] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 09/01/2011] [Indexed: 11/13/2022] Open
Abstract
Prompt γ-ray emissions from gamma-ray bursts (GRBs) exhibit a vast range of extremely complex temporal structures with a typical variability time-scale significantly short – as fast as milliseconds. This work aims to investigate the apparent randomness of the GRB time profiles making extensive use of nonlinear techniques combining the advanced spectral method of the Singular Spectrum Analysis (SSA) with the classical tools provided by the Chaos Theory. Despite their morphological complexity, we detect evidence of a non stochastic short-term variability during the overall burst duration – seemingly consistent with a chaotic behavior. The phase space portrait of such variability shows the existence of a well-defined strange attractor underlying the erratic prompt emission structures. This scenario can shed new light on the ultra-relativistic processes believed to take place in GRB explosions and usually associated with the birth of a fast-spinning magnetar or accretion of matter onto a newly formed black hole.
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Affiliation(s)
- G Greco
- INAF-Astronomical Observatory of Bologna, Italy.
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13
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Francioli N, Guarnieri A, Piccolomini A, Tirone A, Gaggelli I, Carli AF. The surgical palliative treatment of myelofibrosis. Personal experience. Ann Ital Chir 2011; 82:147-150. [PMID: 21682106] [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: 05/30/2023]
Abstract
We report a case of significant splenomegaly by myelofibrosis, treated in our institution, that we believe relevant to the completeness parade of symptoms and the exceptional size.
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Affiliation(s)
- Niccolò Francioli
- Dipartimento di Chirurgia e Bioingegneria, Sezione di Chirurgia, Università di Siena, Italy
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14
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Cesaretti M, Guarnieri A, Gaggelli I, Tirone A, Francioli N, Carli AF. Small cell carcinoma of the breast. Report of a case. Ann Ital Chir 2011; 82:61-64. [PMID: 21657157] [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: 05/30/2023]
Abstract
The recognition of undifferentiated forms of endocrine tumors in the extrapulmonary sites is considered as extremely infequent. Immunohistochemical patterns of this tumor are similar to small cell neuroendocrine cancer of the lung and as the pulmonary one, it is more aggressive than carcinoma without neuroendocrine differentiation. We report a case of a 68 years old woman with a primary small cell carcinoma of the breast gland presented as a palpable and mobile 2 cm mass, located in the upper outer quadrant of her right breast. It was treated with surgery and the diagnosis was made after surgical treatment, thanks to the immunohistochemical studies of tissue.
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15
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Machado F, Guarnieri A, Freitas FG, Assuncao M, Mazza B, Jackiu M. Prognostic value of central venous-arterial pCO2 difference in severe sepsis and septic shock patients. Crit Care 2010. [PMCID: PMC2934169 DOI: 10.1186/cc8387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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16
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Piccolomini A, Francioli N, Verre L, Guarnieri A, Vuolo G, Di Cosmo L, Tirone A, Chieca R, Tucci E, Carli AF. [Radiation proctitis: description of two cases refractory to pharmacological treatment]. Chir Ital 2009; 61:341-346. [PMID: 19694237] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Radiation proctitis, is a relatively frequent complication resulting from the direct or collateral irradiation of the rectum in radiotherapy treatment for genito-urinary or anorectal malignancies. The main symptoms are diarrhoea, tenesmus, proctorrhagia, anal pain, mucorrhoea and faecal incontinence. The evolution of chronic radiation proctitis requires treatment for related anaemia, anal incontinence and micturition disorders. The approach and type of treatment depend on the severity of the symptoms and on the endoscopic aspect, in relation to the response to previous medical therapy performed. In our experience, endoscopic treatment is the best choice in the presence of ongoing bleeding and the possible development of severe anaemia. The surgical option is mandatory in patients at high risk of sepsis, requiring a faecal diversion constructed using the Hartmann technique. We report two cases, observed during the last two years, one treated with endoscopic bipolar coagulation and the other with a double urinary and faecal diversion.
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Affiliation(s)
- Alessandro Piccolomini
- U O C Chirurgia 2, Dipartimento di Chirurgia e Bioingegneria, Azienda Ospedaliera Universitaria Senese, Siena
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17
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Guarnieri A, Cesaretti M, Tirone A, Francioli N, Piccolomini A, Vuolo G, Verre L, Savelli V, Di Cosmo L, Carli AF. Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology. Case Rep Gastroenterol 2009; 3:5-9. [PMID: 20651957 PMCID: PMC2895168 DOI: 10.1159/000200014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up.
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Affiliation(s)
- A Guarnieri
- U.O.C. Chirurgia 2, AOU Senese, Siena, Italy
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18
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Berardinelli A, Ragni L, Giunchi A, Gradari P, Guarnieri A. Physical-Mechanical Modifications of Eggs for Food-Processing During Storage. Poult Sci 2008; 87:2117-25. [DOI: 10.3382/ps.2007-00216] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Racusin JL, Karpov SV, Sokolowski M, Granot J, Wu XF, Pal’shin V, Covino S, van der Horst AJ, Oates SR, Schady P, Smith RJ, Cummings J, Starling RLC, Piotrowski LW, Zhang B, Evans PA, Holland ST, Malek K, Page MT, Vetere L, Margutti R, Guidorzi C, Kamble AP, Curran PA, Beardmore A, Kouveliotou C, Mankiewicz L, Melandri A, O’Brien PT, Page KL, Piran T, Tanvir NR, Wrochna G, Aptekar RL, Barthelmy S, Bartolini C, Beskin GM, Bondar S, Bremer M, Campana S, Castro-Tirado A, Cucchiara A, Cwiok M, D’Avanzo P, D’Elia V, Valle MD, de Ugarte Postigo A, Dominik W, Falcone A, Fiore F, Fox DB, Frederiks DD, Fruchter AS, Fugazza D, Garrett MA, Gehrels N, Golenetskii S, Gomboc A, Gorosabel J, Greco G, Guarnieri A, Immler S, Jelinek M, Kasprowicz G, La Parola V, Levan AJ, Mangano V, Mazets EP, Molinari E, Moretti A, Nawrocki K, Oleynik PP, Osborne JP, Pagani C, Pandey SB, Paragi Z, Perri M, Piccioni A, Ramirez-Ruiz E, Roming PWA, Steele IA, Strom RG, Testa V, Tosti G, Ulanov MV, Wiersema K, Wijers RAMJ, Winters JM, Zarnecki AF, Zerbi F, Mészáros P, Chincarini G, Burrows DN. Broadband observations of the naked-eye γ-ray burst GRB 080319B. Nature 2008; 455:183-8. [DOI: 10.1038/nature07270] [Citation(s) in RCA: 376] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2008] [Accepted: 07/11/2008] [Indexed: 11/09/2022]
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20
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Vuolo G, Tirone A, Cesaretti M, Panunzio A, Verre L, Savelli V, Guarnieri A, Piccolomini A, Testa M, Francioli N, Di Cosmo L, Carli AF. [Treatment of liver metastases from colorectal carcinoma: our experience]. Chir Ital 2008; 60:529-533. [PMID: 18837253] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The latest hepatic surgical strategies enable liver resections to be performed on a larger number of patients, improving the survival rate. Moreover, the contribution of radiological techniques and chemotherapy to surgery has led to the multidisciplinary management of patients suffering from liver metastases, involving surgeons, radiologists and oncologists. If surgical treatment is not considered curative, it is appropriate to advise alternative strategies in order to down-stage the disease and make it resectable.
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Affiliation(s)
- Giuseppe Vuolo
- U.O.C di Chirurgia 2, Dipartimento di Chirurgia e Bioingegneria, Università degli Studi di Siena, Ospedale Santa Maria delle Scotte, Siena
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21
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Guarnieri A, Cesaretti M, Tirone A, Vuolo G, Verre L, Savelli V, Piccolomini A, Di Cosmo L, Carli AF, Burroni M, Pitzalis M. [Stapled transanal rectal resection (STARR) in the treatment of rectocele: personal experience]. Chir Ital 2008; 60:243-248. [PMID: 18689173] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Rectocele is an organic cause of chronic constipation, with a prevalence ranging from 8.95% to 12% in Europe and United States. Necessarily, the approach for rectocele repair is a surgical operation. Stapled transanal rectal resection (STARR) is safe and effective in the treatment of obstructed defecation syndrome. The authors' experience suggests that the surgical operation needs to be combined to rehabilitation exercises, before and after the surgical treatment, in order to strengthen the muscles of the pelvic pavement. From January 2005 to January 2007, 20 patients with outlet obstruction underwent STARR. Patients were selected for operation based on a strict diagnostic protocol: anamnesis, clinical examination, coloproctological and urogynaecological examinations, defecography, anorectal manometry, transrectal ultrasonography and peritoneal electromyography. The therapeutic protocol consists of 3 parts: phase I: rehabilitation of the pelvic pavement; phase II: surgical operation; III phase: post-surgical rehabilitation of the pelvic pavement; The clinical result was classified into: excellent (6 patients), when all constipation symptoms disappeared, good (11 patients), when patient has 1 or 2 obstructed defecation episodes treated with a laxative, fairly good (2 patients), more than 2 episodes, and poor (1 patient), when surgical operation doesn't improve any of the symptoms. Our results, confirmed by the literature, suggest that Longo's technique should be considered as gold standard for rectocele treatment.
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Affiliation(s)
- Alfredo Guarnieri
- Dipartimento di Chirurgia e Bioingegneria, Sezione di Chirurgia, Università degli Studi di Siena, Policlinico Le Scotte, Siena
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22
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Guarnieri A, Tirone A, Del Vecchio MT, Vuolo G, Verre L, Savelli V, Piccolomini A, Di Cosmo L, Cesaretti M, Carli AF. [Urachus' carcinoma: a case report]. Ann Ital Chir 2007; 78:451-452. [PMID: 18338557] [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: 05/26/2023]
Abstract
Urachus' carcinoma represents a rare oncologic disease with an unfavourable prognosis due to the usual delay of correct diagnosis for its anatomical localization. Its surgical treatment varies from radical cystectomy to segmentary resection of the bladder with pelvic lymphadenectomy. We report a case occurred in a ninety years old female, in which the diagnosis was achieved only at laparotomy. The patient was submitted to surgery with the only generic diagnosis of "lower abdominal mass", and treated with segmentary resection.
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Affiliation(s)
- Alfredo Guarnieri
- Dipartimento di Chirurgia e Bioingegneria, Sezione di Chirurgia Università degli Studi di Siena, Siena.
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23
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Correale P, Sciandivasci A, Intrivici C, Pascucci A, Del Vecchio MT, Marsili S, Savelli V, Voltolini L, Di Bisceglie M, Guarnieri A, Gotti G, Francini G. Chemo-hormone therapy of non-well-differentiated endocrine tumours from different anatomic sites with cisplatinum, etoposide and slow release lanreotide formulation. Br J Cancer 2007; 96:1343-7. [PMID: 17437022 PMCID: PMC2360193 DOI: 10.1038/sj.bjc.6603734] [Citation(s) in RCA: 11] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We report the results of a phase II trial in patients with metastatic endocrine tumours from different sites, which aimed to evaluate the anti-tumour activity and toxicity of a cisplatinum and etoposide regimen administered in combination with the somatostatin agonist lanreotide given in slow release formulation. Between January 1999 and November 2003, 27 patients with histological diagnoses of endocrine tumours with different degrees of differentiation, excluding well differentiated carcinoid neoplasms, received intravenous (i.v.) administration of cisplatinum (30 mg m−2) and etoposide (100 mg m−2) on days 1–3 and intramuscular administration of 60 mg lanreotide on day 1, in a 21-day cycle. All of the patients were evaluable for toxicity and response. The treatment was very well tolerated as no grade 4 toxicity was observed. Four patients achieved a complete response, six a partial response, 12 experienced disease stabilisation and five disease progression. The average time to progression and to survival were 9 and 24 months respectively. These results suggest that this chemo-hormone therapy regimen is well tolerated and active in patients with non-well differentiated endocrine tumours.
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Affiliation(s)
- P Correale
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - A Sciandivasci
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - C Intrivici
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - A Pascucci
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - M T Del Vecchio
- Medical Pathology Section, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - S Marsili
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - V Savelli
- Second Division of General Surgery, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - L Voltolini
- Division of Thoracic Surgery, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - M Di Bisceglie
- Division of Thoracic Surgery, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - A Guarnieri
- Second Division of General Surgery, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - G Gotti
- Division of Thoracic Surgery, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
| | - G Francini
- Medical Oncology, Department of Human Pathology and Oncology, Siena University School of Medicine, Viale Bracci 11, 53100, Siena, Italy
- E-mail:
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Meinero S, Alloatti S, Triolo G, Guarnieri A, Inguaggiato P, Bainotti S, Formica M. [Withdrawing or discontinuing chronic dialysis in adult patients]. G Ital Nefrol 2007; 24:43-50. [PMID: 17342692] [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] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Dialysis treatment leads chronic uremic patients to a prolonged survival; incidence and prevalence of dialysis patients are increasing, the population is getting older and many comorbidities coexist, such as diabetes, heart diseases, vasculopathies, neoplasia. The question often arises of whether to start or continue dialysis treatment in compromised patients. Withdrawing and/or discontinuing dialysis represents a therapeutic option with different ratios among countries, due to various cultural, religious, legal and social aspects. Italy shows a low prevalence, but a future increase is likely to appear. The crucial issue is the doctor-patient relationship: thanks to recent legal regulations, the patient has started to play an active role in the therapeutic decision making, by signing or not the informed consent regarding the therapeutic options suggested. In the Piemonte Region we evaluated the behavior of the nephrology operating units, through a consultant- and head nurses team-oriented survey. Most interviewees assert that starting a dialysis treatment is not always mandatory for every patient. The choice of per-forming dialysis should always be based on patient informed consent and in agreement with the physician in charge, the family and the patient himself. It is fundamental to choose to discontinue dialysis consistently with patients' prognosis and their concept of quality of life. It is mostly believed to be a legal and deontological duty to continue dialysis treatment, should any clear patient's will declaration lack.
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Affiliation(s)
- S Meinero
- S.C. Nefrologia e Dialisi, ASO S. Croce e Carle, Cuneo - Italy
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Guarnieri A, Tirone A, Pallucca E, Testa M, Piccolomini A, Vuolo G, Savelli V, Di Cosmo L, Verre L, Carli AF. [Management of patients with non-functioning gastroentero-pancreatic neuroendocrine tumours]. Chir Ital 2006; 58:389-96. [PMID: 16845879] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The Authors examine the feasibility of diagnosing non-functioning gastroentero-pancreatic neuroendocrine tumours preoperatively or intraoperatively, with particular reference to laboratory examinations and octreoscan scintigraphy, which are capable of conditioning the surgical treatment and subsequent follow-up. Of the 4 cases reported here: three presented multiple intestinal localizations, and in only one case the origin of the primitive carcinoma was undefined. The suspicion of a non-functioning neuroendocrine tumour must be considered when yellowish or ochre-coloured intestinal lesions are found intraoperatively. Determination of specific markers and octreoscan scintigraphy must be performed without awaiting histological confirmation. Surgery plays a fundamental role in the debulking of these carcinomas. However, medical therapy with the aid of specific laboratory examinations and octreoscan scintigraphy may improve the long-term survival.
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Neri A, Marrelli D, Roviello F, De Stefano A, Guarnieri A, Pallucca E, Pinto E. Prognostic Value of Extracapsular Extension of Axillary Lymph Node Metastases in T1 to T3 Breast Cancer. Ann Surg Oncol 2005; 12:246-53. [PMID: 15827817 DOI: 10.1245/aso.2005.02.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [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: 02/23/2004] [Accepted: 10/21/2004] [Indexed: 11/18/2022]
Abstract
BACKGROUND The importance of extracapsular extension (ECE) of axillary metastases as a risk factor for either local or distant recurrence and poorer survival in breast cancer has been suggested, but its prognostic value has not been uniformly confirmed. METHODS From a prospective database including 1142 breast cancer patients operated on at the Department of General Surgery and Surgical Oncology of the University of Siena, we selected 376 cases with pT1 to pT3 node-positive breast cancer. The prognostic significance of ECE of axillary metastases was evaluated with respect to disease-free survival, overall survival, and the patterns of disease recurrence. Such prognostic significance was then compared with that of other clinical and pathologic factors. RESULTS With a median follow-up of 103 months, factors with independent prognostic value for disease-free survival by multivariate analysis included absence of estrogen receptors (P < .0005), pN category (P < .01), presence of lymphovascular invasion (LVI; P < .005), and ECE (P < .0001). An independent negative prognostic effect on overall survival was observed for absence of estrogen and progesterone receptors (P < .05), pN category (P < .05), and presence of LVI (P < .005) and ECE (P < .0001). The presence of ECE was significantly related to an increased risk of regional (13.4% vs. 6.6%; P = .037) and distant (43% vs. 16.2%; P < .001) recurrences. CONCLUSIONS ECE demonstrated a stronger statistical significance in predicting prognosis than the pN category and was also related to an increased risk of distant recurrences. We suggest that the decision on adjuvant therapy should consider the presence of ECE of axillary metastases and peritumoral LVI as indicators of high biological aggressiveness.
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Affiliation(s)
- Alessandro Neri
- Department of General Surgery and Surgical Oncology, Surgical Oncology Unit, University of Siena, Policlinico Le Scotte, V. le Bracci, 53100 Siena, Italy.
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Vuolo G, Verre L, Testa M, Perrotta ME, Pallucca E, Di Cosmo L, Guarnieri A, Savelli V, Piccolomini A, Carli AF. [Preoperative radio-chemotherapy in the treatment of locally advanced rectal cancer]. Chir Ital 2004; 56:683-8. [PMID: 15553440] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Rectal cancer is characterised by a substantial incidence of recurrences despite radical surgical treatment. The combination of preoperative radio- and chemotherapy has afforded functional and prognostic advantages through the prospect it offers of performing a greater number of conservative operations and the enhanced control of locoregional recurrences it allows. In our institute we treated 27 patients with locally advanced rectal cancer over the period from January 1997 to December 2002. All 27 patients underwent preoperative radiochemotherapy (45 Gy on the pelvis and 5-fluorouracil administered on the first and last 5 days of radiotherapy). The patients were then submitted to surgery consisting in 12 abdomino-perineal resections of the rectum, 14 anterior rectal resections and 1 Hartmann's resection. Tumour regression was complete in 22.22% of cases and minimal in 14.81%; 50% reduction was achieved in 22.22% and 50-80% reduction in 40-70% of cases. The toxicity was 14.91%. The incidence of local failure was 3.7% with a follow-up of 52 months. In this series, preoperative radio-chemotherapy proved to be a powerful means of downstaging the tumours and of controlling local failure.
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Affiliation(s)
- Giuseppe Vuolo
- UO Chirurgia II, Dipartimento di Chirurgia e Bioingegneria, Università degli Studi di Siena
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Correale P, Messinese S, Caraglia M, Marsili S, Piccolomini A, Petrioli R, Ceciarini F, Micheli L, Nencini C, Neri A, Vuolo G, Guarnieri A, Abbruzzese A, Prete SD, Giorgi G, Francini G. A novel biweekly multidrug regimen of gemcitabine, oxaliplatin, 5-fluorouracil (5-FU), and folinic acid (FA) in pretreated patients with advanced colorectal carcinoma. Br J Cancer 2004; 90:1710-4. [PMID: 15150625 PMCID: PMC2409742 DOI: 10.1038/sj.bjc.6601783] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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] [Indexed: 11/09/2022] Open
Abstract
Previous results suggest that GEM affects 5-fluorouracil (5-FU) metabolism and pharmacokinetics in cancer patients, while combined with oxaliplatin, levo-folinic acid, and 5-FU (GOLF regimen), at doses achievable in cancer patients, determines high cytotoxic and proapoptotic antitumour activity in colon cancer cells in vitro. On these bases we designed a phase I-II clinical trial testing the GOLF regimen in patients with metastatic colorectal carcinoma, who had received at least a prior line of chemotherapy. In total, 29 patients (20 males and nine females) enrolled in the study received every 2 weeks, gemcitabine (patients #1-3 received 600 mg m(-2); patients # 4-6 received 850 mg m(-2); while patients # 7-29 received 1000 mg m(-2)) on the day 1, levo-folinic acid (100 mg m(-2)) on the days 1 and 2; 5-fluorouracil (400 mg m(-2)) in bolus injection, followed by a 22-h continuous infusion (800 mg m(-2)) on the days 1 and 2, and oxaliplatin (85 mg m(-2)), 6 h after the 5-FU bolus on day 2. The most frequent side effect was grade I-II haematological toxicity. In total, 28 patients were evaluable for response: three achieved a complete response, nine a partial response, 10 had a stable disease, and six progressed. The average time to progression and overall survival of the patients was, respectively, 7.26 and 22 months. Our GOLF combination is well tolerated and seems promising for the treatment of advanced colorectal cancer.
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Affiliation(s)
- P Correale
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
| | - S Messinese
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
| | - M Caraglia
- Oncology Operative Unit, Frattamaggiore Hospital, Italy
| | - S Marsili
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
| | - A Piccolomini
- Surgical Science Department, University of Siena School of Medicine, Italy
| | - R Petrioli
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
| | - F Ceciarini
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
| | - L Micheli
- ‘Giorgio Segre’ Pharmacology Department, University of Siena School of Medicine, Italy
| | - C Nencini
- ‘Giorgio Segre’ Pharmacology Department, University of Siena School of Medicine, Italy
| | - A Neri
- Surgical Science Department, University of Siena School of Medicine, Italy
| | - G Vuolo
- Surgical Science Department, University of Siena School of Medicine, Italy
| | - A Guarnieri
- Surgical Science Department, University of Siena School of Medicine, Italy
| | - A Abbruzzese
- Biochemistry Section, Second University of Naples, Naples, Italy
| | - S D Prete
- Oncology Operative Unit, Frattamaggiore Hospital, Italy
| | - G Giorgi
- ‘Giorgio Segre’ Pharmacology Department, University of Siena School of Medicine, Italy
| | - G Francini
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy
- Section of Oncology, Human Pathology and Oncology Department, University of Siena School of Medicine, Viale Bracci 11, Siena 53100, Italy. E-mail:
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Guarnieri A, Marazzi F, Giorgi MP, Canepari G, Pino C, Moggia E, Manca A, Ghezzi PM. [Steroids, interferon-alpha and ribavirin treatment of cryoglobulinemic glomerulonephritis concurrent with HCV infection]. G Ital Nefrol 2002; 19:79-81. [PMID: 12165950] [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] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
The treatment of mixed cryoglobulinemia concurrent with HCV infection is still under debate. We report the case of a patient referred to our unit for a membranoproliferative glomerulonephritis associated with HCV infection. A nephrotic syndrome and a slight reduction of glomerular filtration rate were present. We treated him with alpha-interferon for six months and prednisone for two months. We achieved a remission of the nephrotic syndrome without any significant reduction of the viral load. One year after the therapy had been suspended, the nephrotic syndrome relapsed and subsequently responded to a combined treatment with interferon ribavirin and prednisone. HCV-RNA became suddenly and persistently negative.
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Affiliation(s)
- A Guarnieri
- UU. OO. Nefrologia e Dialisi, A.O. S. Croce e Carle, Cuneo, Italy.
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Abstract
Abstract The rotational spectrum of H2CC17O in the ground vibrational state has been investigated between 20 and 330 GHz. From 82 R-branch transitions a set of rotational constants and several centrifugal distortion constants could be derived, employing the Watson 5-reduction formalism. The obtained rotational constants in MHz are: A = 282071.6(223), B = 10013.4764(28), C = 9655.9118(24). The nuclear quadrupole coupling structure of the J'Ka'Kc' <- JKaKc = 101 O00 line has been recorded by means of molecular beam Fourier transform microwave spectroscopy allowing the determination of the nuclear quadrupole constant Xaa. = -1.534(54) MHz (without considering the spin-rotation interaction). A recalculation of the rs-structure has also been carried out, using the constants of the new isotopomer. The result agrees with the values reported by East et al. in 1995. This is, to our knowledge, the first reported investigation of the H2CC17O rotational spectrum.
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Affiliation(s)
- A. Guarnieri
- 1Technische Fakultät der Christian-Albrechts-Universität zu Kiel, Lehrstuhl für Hochfrequenztechnik, Kaiserstr. 2, D-24143 Kiel; Institut für Physikalische Chemie der Christian-Albrechts-Universität zu Kiel, Ludewig-Meyn-Str. 8, D-24098 Kiel, Germany
| | - A. Huckauf
- 1Technische Fakultät der Christian-Albrechts-Universität zu Kiel, Lehrstuhl für Hochfrequenztechnik, Kaiserstr. 2, D-24143 Kiel; Institut für Physikalische Chemie der Christian-Albrechts-Universität zu Kiel, Ludewig-Meyn-Str. 8, D-24098 Kiel, Germany
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Guarnieri A, Neri A, Correale PP, Lottini M, Testa M, Mariani F, Tucci E, Megha T, Cintorino M, Carli A. Prediction of Lymph Node Status by Analysis of Prognostic Factors and Possible Indications for Elective Axillary Dissection in T1 Breast Cancers. ACTA ACUST UNITED AC 2001; 167:255-9. [PMID: 11354316 DOI: 10.1080/110241501300091381] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 10/16/2022]
Abstract
OBJECTIVE To identify those patients with T1 breast cancers with lower risk of nodal metastases who can safely be spared axillary dissection. DESIGN Retrospective study. SETTING University hospital, Italy. SUBJECTS Review of clinical records and histopathological slides of 547 patients with T1 breast cancer, operated on between 1984 and 1997. MAIN OUTCOME MEASURES Incidence of axillary metastases in relation to age, menopausal status, diameter and grade of tumour, vascular invasion, DNA ploidy, S-phase fraction and hormone receptor state, by univariate and multivariate analysis. RESULTS Axillary metastases were present in 159 patients (29%). On univariate analysis, diameter of tumour 10 mm or less (pT1a/pT1b cancers), no vascular invasion, and grade 1 tumour were significantly correlated with a lower risk of nodal metastases, but only vascular invasion (p = 0.0001, odds ratio = 3.1) and diameter of tumour (p = 0.04, odds ratio = 1.6) were independent predictors on multivariate analysis. Among 34 pT1a/pT1b cancers, with low grade of tumour and no vascular invasion, only 2 (6%) had axillary metastases. When only one favourable predictive factor was associated with diameter of tumour of 10 mm or less, the incidence of axillary metastases ranged from 12% for 43 patients with grade 1 cancers to 13% for 76 patients with no vascular invasion. CONCLUSIONS Axillary dissection may be avoided in pT1a and pT1b breast cancers (< or = 10 mm), with low grade of tumour or no vascular invasion. T1 breast cancers 10 mm or less in diameter should be treated by a two-step approach, first wide excision of the tumour and then axillary dissection or not depending on pathological examination of the primary tumour.
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Affiliation(s)
- A Guarnieri
- Institute of Surgical Sciences, University of Siena, Italy
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Neri A, Mariani F, Testa M, Piccolomini A, Vuolo G, Guarnieri A, Carli AF, Di Cosmo L. Initial Experience with Laparoscopic Adjustable Gastric Banding and Pouch Dilatation: Two Cases. Obes Surg 2001; 11:229-31. [PMID: 11357837 DOI: 10.1381/096089201321577956] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Late proximal pouch dilatation (LPPD) has occurred occasionally following gastric banding for morbid obesity. At present, laparoscopic conservative resetting and oversuturing of the band is considered the standard procedure for pouch dilatation without any important posterior component. METHODS Two cases of LPPD are presented, which occurred in our initial experience with the Lap-Band, corrected via a laparoscopic approach. RESULTS The reintervention was necessary in both patients, with conservative laparoscopic repositioning and oversuturing of the band in the first case and laparoscopic substitution of the gastric band in the second. We have not observed further complications, and weight loss has been maintained in a midterm outcome in both cases (30 and 18 months follow-up). CONCLUSIONS LPPD can be corrected with a conservative laparoscopic surgical approach, without complications and negative functional effects on mid-term outcome.
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Affiliation(s)
- A Neri
- Centro di Studio Interdisciplinare per il Trattamento della Grande Obesità, Surgical Sciences Institute, University of Siena, Italy
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Castro-Tirado AJ, Zapatero-Osorio MR, Caon N, Cairos LM, Hjorth J, Pedersen H, Andersen MI, Gorosabel J, Bartolini C, Guarnieri A, Piccioni A, Frontera F, Masetti N, Palazzi E, Pian E, Greiner J, Hudec R, Sagar R, Pandey AK, Mohan V, Yadav RK, Bjornsson C, Jakobsson P, Burud I, Courbin F, Valentini G, Piersimoni A, Aceituno J, Montoya LM, Pedraz S, Gredel R, Claver CF, Rector TA, Rhoads JE, Walter F, Ott J, Hippelein H, Sàsnchez-Bèjar V, Gutiérrez C, Wei J, Zhou A, Guziy S, Shlyapnikov A, Heise J, Costa E, Feroci M, Piro L. Decay of the GRB 990123 optical afterglow: implications for the fireball model. Science 1999; 283:2069-73. [PMID: 10092226 DOI: 10.1126/science.283.5410.2069] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Broad-band (ultraviolet to near-infrared) observations of the intense gamma ray burst GRB 990123 started approximately 8.5 hours after the event and continued until 18 February 1999. When combined with other data, in particular from the Robotic Telescope and Transient Source Experiment (ROTSE) and the Hubble Space Telescope (HST), evidence emerges for a smoothly declining light curve, suggesting some color dependence that could be related to a cooling break passing the ultraviolet-optical band at about 1 day after the high-energy event. The steeper decline rate seen after 1.5 to 2 days may be evidence for a collimated jet pointing toward the observer.
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Affiliation(s)
- A J Castro-Tirado
- Instituto de Astrofisica de Andalucia, IAA-CSIC, Granada, Spain. Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain. Astronomical Observatory, University of Copenhagen, Copenhagen, Denmark. Nordic Optical Telescope, La Palma, T
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Neri A, Guarnieri A, Tucci E, Pepi F, Mazzocchi B, Algeri R. Mitomycin (M), epirubicin (E) and vinorelbine (V) first-line chemotherapy for metastatic breast cancer (MBC). A feasibility study. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(98)80170-6] [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: 10/27/2022]
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Guarnieri A. [Original procedure of functional plasty of primary inguinal hernias]. Chirurgie 1998; 122:534-8. [PMID: 9616901] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We describe a novel autoplasty method we developed for primary inguinal hernia repair and report our results in nearly 150 operations. The method is based on novel principles: priority given to an individual stato-dynamic conception of the inguinal region; effect on physiological defense mechanisms of the inguinal canal; absence of tension on the sutures by autoplastic repair.
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Abstract
The millimeter-wave spectrum of deuteroethynylisocyanide has been observed and analyzed in the ground and in the first excited vibrational states (v4, v5, v6, v7) = (0100), (0010), and (0001). Rotational, centrifugal distortion, and l-type doubling constants are given. Copyright 1998 Academic Press.
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Affiliation(s)
- A Huckauf
- Institut für Physikalische Chemie, Christian-Albrechts-Universität zu Kiel, Ludewig-Meyn-Strasse 8, Kiel, 24118, Germany
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Castro-Tirado AJ, Gorosabel J, Benitez N, Wolf C, Fockenbrock R, Martinez-Gonzalez E, Kristen H, Broeils A, Pedersen H, Greiner J, Costa E, Feroci M, Piro L, Frontera F, Nicastro L, Palazzi E, Bartolini C, Guarnieri A, Masetti N, Piccioni A, Mignoli M, Wold M, Lacy M, Birkle K, Broadhurst T, Brandt S, Lund N. Photometry and spectroscopy of the GRB 970508 optical counterpart. Science 1998; 279:1011-4. [PMID: 9461429 DOI: 10.1126/science.279.5353.1011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An optical transient within the error box of the gamma ray burst GRB 970508 was imaged 4 hours after the event. It displayed a strong ultraviolet excess, and reached maximum brightness 2 days later. The optical spectra did not show any emission lines, and no variations on time scales of minutes were observed for 1 hour during the decline phase. According to the fireball and afterglow models, the intensity should rise monotonically before the observed optical maximum, but the data indicate that another physical mechanism may be responsible for the constant phase seen during the first hours after the burst.
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Affiliation(s)
- A J Castro-Tirado
- A. J. Castro-Tirado and J. Gorosabel, Laboratorio de Astrofisica Espacial y Fisica Fundamental, INTA, Madrid, Spain. N. Benitez and E. Martinez-Gonzalez, Instituto de Fisica de Cantabria, Santander, Spain. C. Wolf, R. Fockenbrock, K. Birkle, Ma
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Varoli L, Burnelli S, Garuti L, Guarnieri A, Rossi M. Synthesis and antimicrobial activity of N, N-dialkyl-2-substituted-5-diazo-imidazole-4-carboxamides. Pharmazie 1997; 52:578-81. [PMID: 9292914] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A series of 2-substituted-5-diazoimidazole-4-carboxamides has been synthesized, and their antimicrobial activity has been tested in vitro. Some of the compounds show antifungal activity related to the presence of small groups on the 4-carbox-amido moiety, while the presence of substituents in position 2 was detrimental.
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Affiliation(s)
- L Varoli
- Dipartimento di Scienze Farmaceutiche, Università di Bologna, Italy
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Hinze R, Lesarri A, López JC, Alonso JL, Guarnieri A. Rotational spectrum, internal rotation barrier andabinitiocalculations on 1‐chloro‐1‐fluoroethane. J Chem Phys 1996. [DOI: 10.1063/1.471734] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barbato A, Roviello F, De Stefano A, Marrelli D, Messano A, Guarnieri A, Pinto E. [A case of pancreatic somatostatinoma]. MINERVA CHIR 1996; 51:475-9. [PMID: 8992398] [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: 02/03/2023]
Abstract
The authors describe a case of somatostatinoma localized in the body and tail of the pancreas. They emphasize the rarity of this finding (only 33 cases with certain pancreatic localization are reported in literature) and the absence of a distinctive syndrome, which could direct to an early diagnosis, the authors are in doubt about the real incidence of this disease. The absence, generally, of a distinctive syndrome, the poor condition of these patient and then the lack of surgical treatment and histological examination, could lead to a lower valuation. Delayed diagnosis and then the local extension of this neoplasm often make surgical treatment vain. Nevertheless since somatostatinoma has more possibilities of radical resection than pancreatic cancer, it's required to know its features and course so to increase possibilities of an early diagnosis. In fact disregarding surgical treatment, the survival of these patients, one year after diagnosis, is about 48%. This result is better than the survival of patients with pancreatic or biliary duct cancers. Current diagnostic procedures are reported.
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Affiliation(s)
- A Barbato
- Istituto Policattedra di Scienze Chirurgiche, Università degli Studi, Siena
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Ghezzi PM, Guarnieri A, Tetta C. Acid-base balance determination on ultrafiltrate in two-chamber technique hemodiafiltration (PFD). Int J Artif Organs 1995; 18:726-30. [PMID: 8964636] [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: 02/03/2023]
Abstract
Correction of the acid-base balance in uremic patients during hemodiafiltration (HFD) may be biased by an inadequate monitoring of pH and blood gases. HDF performed with the two-chamber technique (PFD) generates pure ultrafiltrate (uf) unmixed with dialysate. We carried out 84 determinations of HCO3- levels in 15 different PFD patients by measuring the pH and pCO2 of the uf, then correlated the values with those simultaneously evaluated on arterial blood with standard methods. The mean HCO3- levels (mmol/L) were 23.21 +/- 2.49 in blood samples and 25.54 +/- 3.07 in uf, with a mean difference of -2.33 +/- 1.46. Statistical analysis gave: t = 13.5 (p = O) (one-sample analysis), r = 0.86 (p = 0) (linear regression analysis) and a good agreement between the two clinical measurements (81 out of 84 data points fell within the 95% confidence interval) (Bland-Altman analysis). In conclusion, we suggest that during HDF performed with the two-chamber technique, the patient's HCO3- level can be monitored on the uf without blood sampling.
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Affiliation(s)
- P M Ghezzi
- Division of Nephrology and Dialysis, Ospedale S. Croce, Cuneo, Italy
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44
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Hinze R, Guarnieri A, Alonso J, López J. Electric dipole moments of thietane in excited states of the ring puckering vibration: an experimental and ab initio study. J Mol Struct 1995. [DOI: 10.1016/0022-2860(94)08475-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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45
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Varoli L, Burnelli S, Guarnieri A, Sabatino P, Lumachi B. Nonsteroidal antiinflammatory agents. XXIII. Synthesis and activity of stereomeric (+/-)-erythro- and (+/-)-threo-2-(4-biphenylyl)-3-hydroxy-2-methyl-3-phenyl-propionic acids. Farmaco 1995; 50:341-7. [PMID: 7626169] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In pursuing our research on the NSAIDs, the diastereomeric (+/-)-erythro- and (+/-)-threo-2-(4-biphenylyl)-3-hydroxy-2-methyl-3-phenyl-propionic acids (4 and 5) were synthesized; the last was also resolved in its optical isomers (6 and 7). The attribution of the relative configuration to 4 and 5 was performed by means of X-ray analysis. The compounds were tested for their antiinflammatory activity. The acid 4, which resulted very interesting, was tested also for analgesic and antipyretic activity, as well as for behavioural effects, gastric tolerability and acute toxicity. On the basis of the obtained data, this compound resulted a very promising one.
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Affiliation(s)
- L Varoli
- Dipartimento di Scienze Farmaceutiche, Università di Bologna, Italy
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46
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Guarnieri A, Neri A, Savelli V, Ruggieri G, Mariottini G, Collini A, Nepi S, Carli A. [Cervical esophageal perforation caused by a foreign body: a clinical case]. G Chir 1995; 16:181-3. [PMID: 7669499] [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: 01/26/2023]
Abstract
The Authors report a case of cervical esophageal perforation from foreign body. Comparing their experience with data from literature, they point out the diagnostic importance of both X-ray studies, in order to demonstrate the site of the lesion, and CT scans, to have accurate information on perilesional infective complications (abscesses). Early surgical treatment, with primary closure of perforation and adequate drainage, associated with antibiotics and enteral or total parenteral nutrition, allows good results in most cases.
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Affiliation(s)
- A Guarnieri
- Istituto Policattedra di Scienze Chirurgiche, Università degli Studi di Siena
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47
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Guarnieri A, Guarnieri AE, Moscatelli F, Guarnieri F. [New surgical technique for the repair of abdominal hernia with mesh]. MINERVA CHIR 1994; 49:967-70. [PMID: 7808672] [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: 01/27/2023]
Abstract
The use of prostheses is indispensable in major anterior abdominal hernias when it is not possible to close the edges of the hernial opening without strain. The most commonly used prostheses are made from dacron, polypropylene (PPNE) and expanded polytetrafluoroethylene (EPTF) mesh. It is important to point out that, in spite of the excellent characteristics of these materials, there is no ideal prosthesis. There is a well-known increase in the risk of rejection and infection when mesh is placed in contact with the subcutis and the formation of adhesions, with the possibility of occlusions and fistulas, when it is in direct contact with the intestine. Whereas EPTF does not cause problems of adhesion, it has a greater tendency to cause rejection and infection if placed in the subcutaneous area. Moreover, there is a increased risk of displacement and it is also very costly. The opposite is true of dacron and PPNE mesh. When the mesh serves to "replace" a wall defect and it cannot be isolated by the interposition of the peritoneum or muscular fascia, it comes into direct contact with the intestine and subcutaneous tissue. The technique outlined here aims to isolate the prosthesis from the intestinal loops and subcutaneous tissue. The hernial sac itself is used for this purpose and is divided into two flaps by a cut perpendicular to the wall. The free edge of one flap is sutured to the inside of the hernial opening. The mesh is then sutured half inside and half outside the hernial opening.(ABSTRACT TRUNCATED AT 250 WORDS)
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48
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Doose J, Mäder H, Schwarz R, Guarnieri A. Investigations of the pressure broadening of OCS and CO rotational lines in the millimetre wave range using a new type of Fourier transform spectrometer. Mol Phys 1994. [DOI: 10.1080/00268979400100361] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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49
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Seveso M, Ceresoli A, Zanetti G, Trinchieri A, Guarnieri A. Ritenzione urinaria acuta in giovani donne con sindrome uretrale. Protocollo diagnostico e terapeutico. Urologia 1994. [DOI: 10.1177/039156039406101s71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Urethral Syndrome is defined as lower urinary symptoms in women in the absence of bladder bacteriuria. Symptoms include straining to void, urgency frequency, hesitation, incontinence, retention and subpubic pain. In females affected by urethral syndrome some authors have found histological degeneration and urodynamic alterations, such as significantly higher than normal maximum urethral closure pressure, low urinary flow rates. The authors studied 5 women with urethral syndrome, and acute or chronic urinary retention. A personal therapeutic approach is presented.
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Affiliation(s)
- M. Seveso
- Istituto di Urologia - Università degli Studi - Milano
| | - A. Ceresoli
- Istituto di Urologia - Università degli Studi - Milano
| | - G. Zanetti
- Istituto di Urologia - Università degli Studi - Milano
| | - A. Trinchieri
- Istituto di Urologia - Università degli Studi - Milano
| | - A. Guarnieri
- Istituto di Urologia - Università degli Studi - Milano
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50
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Pacini P, Tucci E, Algeri R, Rinaldini M, Guarnieri A, Valzelli S, Neri B. Combination chemotherapy with epirubicin and mitomycin C as first-line treatment in advanced breast cancer. Eur J Cancer 1994; 30A:460-3. [PMID: 7517150 DOI: 10.1016/0959-8049(94)90419-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
From December 1988 to February 1991, 112 consecutive patients were submitted to epirubicin + mitomycin C chemotherapy as first-line treatment for advanced breast cancer. Epirubicin (75 mg/m2) was given every 3 weeks and mitomycin C (10 mg/m2) every 6 weeks. Only patients with visceral involvement or with a disease-free interval of less than 12 months were considered eligible. 102 patients were evaluated for response and toxicity in the present analysis. The main sites of involvement were viscera, soft tissues, bone in 71 (69.6%), 19 (18.6%) and 12 (11.8%) patients, respectively. Multiple site involvement was present in 66 (64.7%) cases. A total of 726 courses of therapy were administered (range 2-14; mean 7.2). Follow-up ranged from 96 to 210 weeks (median follow-up 138 weeks). Response rate was complete response (CR): 21.6% [95% confidence interval (CI) +/- 0.8], partial response (PR) 49.0% (95% CI +/- 0.1), stable disease (SD) 12.7% (95% CI +/- 0.1), progressive disease (PD) 16.7% (95% CI +/- 0.1), CR + PR: 70.6% (95% CI +/- 0.1). Median values of survival and time to progression were 79.4 and 42 weeks, respectively. At 2 years, 37.2 +/- 4.7% and 12.8 +/- 3.3% of the patients, respectively, were alive or without evidence of progression. Toxicity was generally mild. One hundred and four (14.3%) cycles in 53 patients were delayed due to haematological (82) or cardiac (3) toxicity, infectious disease (11) or causes not related to the treatment (8).
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Affiliation(s)
- P Pacini
- Day Hospital Oncologico, Policlinico Careggi, Firenze, Italy
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