Showing papers by "Università Campus Bio-Medico published in 1998"

Anatomical and pathological study of retroperitoneal nodes in endometrial cancer

Abstract: Benedetti-Panici P, Maneschi F, Cutillo G, D'Andrea G, Manci N, Rabitti C, Scambia G, Mancuso S. Anatomical and pathological study of retroperitoneal nodes in endometrial cancer. Int J Gynecol Cancer 1998; 8: 322–327. To assess the patterns of lymphatic spread in endometrial carcinoma, data from 91 endometrial cancer patients (surgical FIGO stage I: 59; II: 12; III–IV: 20) who underwent systematic pelvic and aortic lymphadenectomy were analyzed. The median number of nodes removed was 27 aortic (range 15–57) and 31 pelvic (range 20–68) nodes. Positive nodes were found in 16 patients (18%), seven having pelvic, one aortic, and eight both pelvic and aortic metastasis. The median number of positive nodes was three (range 1–29) aortic and two (range 1–18) pelvic nodes. Isolated pelvic node metastasis was observed in seven patients and aortic metastasis in one patient. Pre-paracaval, pre-paraortic and intercavoaortic, with superficial obturator, external iliac and common iliac were the node groups most frequently involved. These nodes may be considered primarily invaded by the tumor. The higher prevalence of pelvic with respect to aortic metastasis, and the low risk of isolated aortic spread, suggest that endometrial cancer spreads preferentially to the pelvic area. Multivariate analysis showed that depth of myoinvasion and adnexal metastasis were independent factors predicting the risk of lymphatic spread. The risk of aortic spread was also predicted by the pelvic node status. These data may be useful for tailoring lymphadenectomy.

Treatment of metastases of the cervical spine.

Abstract: On the experience of 73 patients, the authors state their guidelines on the treatment of bone metastases on the cervical spine. Most of the cases on which no vertebral collapse occur neither neurological deficit, radiation therapy and external support are suggested. Surgery is necessary on case of severe bone destruction, collapse with or without subsequent neurological impairment. Anterior excision is considered the best approach, sometimes complemented by posterior stabilisation.

BDNF and NT-3 applied in the whisker pad reverse cortical changes after peripheral deafferentation in neonatal rats

Abstract: It has been known for a long time that subcortical input drives the specification of cortical areas. Molecular signals mediating this instructive effect from the periphery are poorly understood. In foetal or neonatal rats, ablation of whisker follicles, transection of the infraorbital nerve, inhibition of axonal transport, but not impulse activity blockade, prevent formation of barrels in the primary somatosensory cortex (S1). These findings suggest that a chemical signal, possibly arising from the skin or the follicle, may be responsible for somatotopic pattern formation in S1. Neurotrophins promote survival and differentiation of primary sensory neurons, and are expressed in the whisker pad during development. Neonatal rats received gelfoam impregnated with NGF, BDNF or NT-3 under the whisker pad following surgical denervation of whisker rows D and E on P0. Barrel formation in S1 was assessed on P7 by acetylcholinesterase histochemistry and 5-HT-immunohistochemistry. BDNF and NT-3, but not NGF, promoted development of the cortical barrels corresponding to denervated whiskers. Furthermore, BDNF and NT-3 prevented the lesion-induced expansion of row C barrels, while NGF appeared to promote row C expansion. Our results suggest that BDNF and NT-3 arising from the whisker pad are involved in the formation and/or maintenance of the barrel pattern in S1. These findings are potentially relevant for the prevention of sensory disturbances possibly due to reorganization of central sensory circuits after peripheral nerve lesions in humans.

Intraperitoneal tumor spread in locally advanced cervical carcinoma undergoing neoadjuvant chemotherapy

Abstract: Greggi S, Benedetti-Panici P, Amoroso M, Scambia G, Paratore MP, Salerno MG, Bezzi I, Mancuso S. Intraperitoneal tumor spread in locally advanced cervical carcinoma undergoing neoadjuvant chemotherapy. Int J Gynecol Cancer 1998; 8: 207–214. The prognostic significance of peritoneal tumor involvement is still unclear, correlations with tumor characteristics are somewhat controversial, and little is known about the peritoneal influence of neoadjuvant chemotherapy and tumor extension in patients undergoing laparotomy following clinical response to neoadjuvant chemotherapy. In this study, 208 patients with previously untreated locally advanced cervical carcinoma were primarily treated by neoadjuvant chemotherapy. The 183 clinically responsive patients underwent laparotomy and, if judged to be radically operable, they were submitted to radical surgery. At laparotomy, 158 of the 183 patients (86%) were still amenable for radical surgery; 7 (4%) and 13 (7%) showed macroscopic and microscopic peritoneal tumor involvement, respectively. An intraperitoneal positive cytology was registered in 5 (3%) cases. Stage, histotype, and cervical tumor size were each independent predictors of peritoneal tumor involvement upon logistical analysis. The 10-year survival estimate of patients with no peritoneal tumor involvement was longer (72%) than that of patients with peritoneal tumor involvement (17%) (P = 0.001). Multivariate analysis showed that the peritoneal tumor involvement together with stage, pathological parametrial involvement, and lymph node status were independently associated with overall and disease-free survival. Adenocarcinomas have a higher propensity to peritoneal tumor involvement than squamous cell carcinomas; the incidence of atypical peritoneal cytology and, to a lesser extent, microscopic metastasis, are lower than expected in patients responsive to neoadjuvant chemotherapy, suggesting a possible effect on peritoneal tumor involvement by neoadjuvant chemotherapy. A positive relationship exists between tumor extent and peritoneal tumor involvement, even in a neoadjuvant chemotherapy setting. Peritoneal tumor involvement is an independent predictor of survival, but it is generally associated with other risk factors.

Lymphomatoid granulomatosis of the lung: a clinico-pathological study.

Abstract: Lymphomatoid granulomatosis is the only form of pulmonary angiitis histologically characterized by a necrotizing angiocentric and angiodestructive lymphoid infiltrate, with an admixed T-cell reaction. We evaluated three patients with a single lung nodule not diagnosed by routine radiological and endoscopic assays. Our investigations showed a prevalence of T-cells in areas of diffuse infiltration, which were actively replacing reactive follicular areas of B-cells, similarly to T-cell lymphomas. Further pathologic assays suggested the histologic diagnosis of grade I lymphomatoid granulomatosis for all three evaluated specimens. After two years, patients treated with a combination of surgical resection and chemotherapy were disease free, supporting the efficacy of aggressive therapy in the management of this often mistreated group of lymphoid proliferations.

Assessing the use of low cost PC-based ISDN videoconferencing in hospital training.

Abstract: A course on Italian safety rules and regulations has been delivered to the personnel of a University clinic using videoconferencing, based on an ISDN-2 connection through a multimedia PC. The goal was to evaluate the efficacy of this technology for the training of hospital personnel. To assess it, the trainees were divided into two groups, one at the trainer's site and the other in the University. Comparing the evaluating questionnaires that both groups were asked to complete at the end of each session (based on the comprehension of the subject taught), significant differences were found only when the quality of images was very poor (for technical reasons) or the level of interaction was low. The price/performance ratio was considered good, but there are some technical and psychological problems that must be taken in account before using videoconferencing for training.