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8. Testo Atlante di Chirurgia Laparoscopica in Ginecologia

Author

Bellacci A, Candiani M, Canis M, Dauri M, Luciano A, Marana R, Marconi D, Mencaglia L, Solima E, Tiso E, Wattiez A, Zocchi G, Zupi E., CUCINELLA, Gaspare, and Bellacci A, Candiani M, Canis M, Cucinella G, Dauri M, Luciano A, Marana R, Marconi D, Mencaglia L, Solima E, Tiso E, Wattiez A, Zocchi G, Zupi E.

Subjects
laparoscopia, ginecologia
Published
1997

10. Correlations between clinical presentation, brain natriuretic peptide, big endothelin-1, tumor necrosis factor-alpha and cardiac troponins in heart failure patients

Author

Boffa, Gm, Zaninotto, M, Bacchiega, E, Nalli, C, Forni, M, Tiso, E, Cacciavillani, L, Razzolini, Renato, and Plebani, Mario

Subjects
Heart Failure, Male, Endothelin-1, Tumor Necrosis Factor-alpha, Natriuretic Peptide, Brain, Troponin I, Humans, Female, Prospective Studies, Middle Aged, Biomarkers
Abstract

The term "biochemical marker" of heart failure is used to define a biochemical substance whose plasma levels correlate with the clinical and hemodynamic status and predict the prognosis of patients with heart failure. The aim of this study was to prospectively evaluate, in a single population of patients with heart failure, the correlations between the plasma levels of brain natriuretic peptide (BNP), big endothelin-1 (BET-1), tumor necrosis factor-alpha (TNF-alpha), cardiac troponin I (cTnI) and T (cTnT), the clinical presentation, and the left ventricular function.The study population included a series of 120 patients (97 males, 81%, mean age 56+/-12 years) in NYHA functional class I (49%), II (20%), III (26%), IV (5%) who were admitted to our institution or followed up as outpatients. All patients underwent cardiologic evaluation, standard electrocardiography, two-dimensional echocardiography, and venous blood sampling on the same day.At univariate analysis the following correlations were found to be significant: all the laboratory parameters correlated with the NYHA class (BNP r = 0.63, BET-1 r = 0.56, cTnI r = 0.25, cTnT r = 0.24, TNF-alpha r = 0.23); BNP (r = -0.39) and BET-1 (r = -0.27) with left ventricular ejection fraction; BNP (r = 0.37) and BET-1 (r = 0.21) with the degree of mitral insufficiency; BNP (r = -0.39), BET-1 (r = 0.25) and TNF-alpha (r = -0.19) with systolic blood pressure; cTnT (r = 0.34), cTnI (r = 0.33), BNP (r = 0.22) and BET-1 (r = 0.19) with heart rate; BNP with age (r = 0.33) and body mass index (r = -0.28). The plasma levels of BNP, BET-1, cTnT and cTnI were significantly higher in case of systemic or pulmonary congestion. At multiple regression analysis the following correlations were still present: BNP with the NYHA functional class (p0.005) and with pulmonary venous congestion (p0.05); BET-1 with the presence of pulmonary venous congestion (p0.005); TNF-alpha with the NYHA class (p0.05) and systolic blood pressure (p0.001); cardiac troponins with heart rate (p0.05).The plasma concentrations of BNP and BET-1 showed the best and comparable correlations with parameters describing the clinical status of patients with heart failure, in particular with the presence of pulmonary venous congestion. The value of the plasma concentration of TNF-alpha and those of cardiac troponins were found to be limited in patients with relatively stable heart failure.

Published
2005

12. Use of digitalis in the treatment of heart failure: data from the Italian Network on Congestive Heart Failure (IN-CHF)

Author

Camerini, A, Griffo, R, Aspromonte, N, Ingrilli', F, Lucci, D, Naccarella, F, Maggioni, Ap, IN-CHF INVESTIGATORS- Piemonte Borgomanero (M. Zanetta, A. M. Paino), Casale Monferrato (M. Ivaldi, A. Giusti), Uslenghi, Cuneo (E., Milanese, U., Deorsola), A., Greco Lucchina, Orbassano (P., Pozzi, R., Rabajoli), F., Veruno (P. Giannuzzi, E. Bosimini), Valle d’Aosta Aosta (M. De Marchi, G. Begliuomini), Richichi, Lombardia Belgioioso (I., Ferrari, A., Barzizza), F., Bergamo Riabilitazione Cardiologica (A. Gavazzi, F. Dadda), Bergamo U. O. Cardiologia Cardiovascolare (A. Gavazzi, A. Fontana), Brescia (C. Rusconi, P. Faggiano), Cogo, Cassano D’Adda (R., Castiglioni, G., Gibelli), G., Chiari (F. Bortolini, A. L. Turelli), Como (G. Ferrari, R. Jemoli), Pirelli, Cremona (S., Bianchi, C., Emanuelli), C., De Martini), Desio (M., Erba (G. Maggi, D. Agnelli), Ferrara), Esine (E., Rovelli, Garbagnate Milanese (G., Lureti, G., Cazzani), E., Giordano, Gussago (A., Zanelli, E., Domenighini), D., Legnano (S. De Servi, C. Castelli), Mariano Comense (G. Bellati, E. Moroni), Milano Fondazione Don Carlo Gnocchi IRCCS (M. Ferratini, E. Gara), Malliani, Milano Sacco (A., Muzzupappa, S., Turiel, M., Guzzetti, S., Cappiello), E., Milano Niguarda (S. Klugmann, F. Recalcati), Milano Pio Albergo Trivulzio (S. Corallo, D. Valenti), Cobelli), Montescano (F., Monza (A. Grieco, A. Vincenzi), Schweiger, Passirana-Rho (C., Rusconi, F., Palvarini), M., Ferrari, Pavia IIAARR S. Margherita (E., Carbone), M., Tavazzi, Pavia IRCCS Policlinico San Matteo (L., Campana, C., Serio), A., Croce, Saronno (A., Nassiacos, D., Meloni), S., Seriate (P. Giani, T. Nicoli), Sondalo (G. Occhi, P. Bandini), Sondrio (S. Giustiniani, M. Moizi), Tradate Fondazione S. Maugeri (R. Pedretti, M. Paolucci), Onofri, Tradate Ospedale di Circolo Galmarini (M., Amati, L., Ravetta), M., Venco, Varese Medicina Interna Azienda Ospedaliera e Universitaria (A., Bertolini, A., Saggiorato), P., Salerno Uriarte, Varese U. O. Cardiologia Azienda Ospedaliera e Universitaria (J., Morandi, F., Provasoli), S., Vizzolo Predabissi (M. Lombardo, P. Quorso), P. A. Trento Rovereto Cardiologia Ospedale Civile (G. Vergara, A. Ferro), Rovereto Medicina Ospedale Civile (M. Mattarei, C. Pedrolli), Catania, Veneto Belluno (G., Tarantini, L., Russo), P., Castelfranco Veneto (L. Celegon, G. Candelpergher), Conegliano Veneto (P. Delise, C. Marcon), Guarnerio, Feltre (M., De Cian, F., Agnoli), A., Montebelluna (G. Neri, M. G. Stefanini), Iliceto, Padova (S., Boffa, G. M., Tiso), E., Pieve di Cadore (J. Dalle Mule, A. Stefania), San Bonifacio (R. Rossi, E. Carbonieri), Treviso (P. Stritoni, G. Renosto), Fontanelli, Vicenza (A., Ottani, F., Varotto), L., Perini), Villafranca (G., Friuli Venezia Giulia Gorizia (D. Igidbashian, G. Giuliano), Monfalcone (T. Morgera, E. Barducci), San Vito al Tagliamento (M. Carone, G. Pascottini), Fioretti, Udine A. O. S. Maria della Misericordia (P., Albanese, M. C., Fresco), C., Udine Casa di Cura Città di Udine (P. Venturini, F. Picco), Liguria Arenzano (R. Griffo, A. Camerini), Chierchia, Genova Ospedali Civili (S., Mazzantini, S., Torre), F., Spirito, Genova Ospedali Galliera (P., Derchi, G., Delfino), L., Genova-Sestri Ponente (S. Domenicucci, L. Pizzorno), Località S. Caterina-Sarzana (G. Filorizzo, D. Bertoli), Rapallo (G. Gigli, S. Orlandi), Gentile), Sestri Levante (A., Emilia Romagna Bentivoglio (G. Di Pasquale, R. Vandelli), Bologna Cardiologia Tiarini-Corticella (F. Naccarella, M. Gatti), Forlì (F. Rusticali, G. Morgagni), Modena Medicina d’Urgenza Ospedale Civile S. Agostino (S. Zucchelli, M. Pradelli), Modena U. O. Cardiologia Ospedale Civile S. Agostino (G. R. Zennaro, G. Alfano), Modena, Modena Ospedale Policlinico (M. G., Reggianini, L., Coppi), F., Parma (D. Ardissino, W. Serra), Piacenza (A. Capucci, F. Passerini), Riccione (L. Rusconi, P. Del Corso), Piovaccari, Rimini (G., Bologna, F., Caccamo), L., Gambarati), Scandiano (G., Bernardi, Toscana Castelnuovo Garfagnana (D., Mariani, P. R., Volterrani), C., Cosmi), Cortona (F., Empoli (V. Mazzoni, F. Venturi), Firenze Divisione di Cardiologia A. O. Careggi (D. Antoniucci, G. Moschi), Zuppiroli, Firenze U. O. Cardiologia 3 A. O. Careggi (A., Pieri, F., Beligni), C., Firenze U. O. Cardiologia 2 A. O. Careggi (M. Ciaccheri, G. Castelli), Santoro, Firenze Nuovo Ospedale San Giovanni di Dio (G. M., Minneci, C., Sulla), A., Firenze P. O. di Camerata (F. Marchi, G. Zambaldi), Fucecchio (A. Zipoli, A. Geri Brandinelli), Grosseto (S. Severi, G. Miracapillo), Pesola, Lido di Camaiore (A., Comella, A., Magnacca), M., Lucca (E. Nannini, A. Boni), Mantini, Montevarchi (G., Bongini, M., Palmerini), L., Vergoni, Pescia (W., Italiani, G., Di Marco), S., Pisa A. O. Pisana (M. De Tommasi, A. M. Paci), Pontedera (G. Tartarini, B. Reisenhofer), Umbria Città di Castello (M. Cocchieri, D. Severini), Foligno (L. Meniconi, U. Gasperini), Ambrosio, Perugia (G., Alunni, G., Murrone), A., Spoleto (G. Maragoni, G. Bardelli), Mocchegiani, Marche Ancona Centro Cardiologia Ambulatoriale G. M. Lancisi (R., Pasetti, L., Budini), A., Ancona Divisione di Cardiologia G. M. Lancisi (G. Perna, D. Gabrielli), Russo, Ancona Geriatrico Sestilli-INRCA IRCCS (P., Testarmata, P., Antonicelli), R., Camerino (R. Amici, B. Coderoni), Lazio Albano Laziale (G. Ruggeri, P. Midi), Frascati (G. Giorgi, F. Comito), Frosinone (G. Faticanti, F. Qualandri), Grottaferrata (D. Galileo Faroni, C. Romaniello), Roma INRCA (F. Leggio, D. del Sindaco), Majid Tamiz, Roma C. Forlanini (A., Avallone, A., Suglia), F., Roma Cristo Re (V. Baldo, E. Baldo), Roma I U. O. Cardiologia San Camillo (E. Giovannini, G. Pulignano), Roma II Divisione di Cardiologia con UTIC San Camillo (S. F. Vajola, E. Picchio), Tanzi, Roma Serv. Centr. Cardiologia-PS Cardiologico San Camillo (P., Pozzar, F., Terranova), A., Santini, Roma San Filippo Neri (M., Ansalone, G., Magris), B., Boccanelli, Roma San Giovanni (A., Cacciatore, G., Bottero), G., Palamara, Roma Sandro Pertini (A., Valtorta, C., Salustri), A., Roma S. Andrea (M. Volpe, L. De Biase), Gaspardone, Roma S. Eugenio (A., Amaddeo, F., Barbato), G., Ceci, Roma Santo Spirito (V., Aspromonte, N., Chiera), A., Scabbia, Viterbo (E. V., Pontillo, D., Castellani), R., Abruzzo Popoli (C. Frattaroli, A. Mariani), De Simone, Vasto (G., Levantesi, G., Di Marco), G., Molise Larino Medicina Generale-U. O. Geriatria (F. Porfilio, A. Pasquale Potena), Staniscia, Termoli (D., Colonna, N., Montano), A., Mininni, Campania Napoli Divisione di Cardiologia A. O. V. Monaldi (N., Miceli, D., Scherillo), M., Napoli I Divisione Med-Centro Diagnosi e Cura SCC A. O. V. Monaldi (P. Sensale, O. Maiolica), Napoli Medicina Incurabili (M. Visconti, A. Costa), Napoli Cardiologia San Gennaro (P. Capogrosso, A. Somelli), Vergara, Nola U. O. Cardiologia e UTIC P. O. Maria della Pietà (G., Napolitano, F., Provvisiero), P., Oliveto Citra (G. D’Angelo, P. Bottiglieri), Puglia Bari (G. Antonelli, N. Ciriello), Ignone, Brindisi (G., Angelini, E., Andriulo), C., Casarano (G. Pettinati, F. De Santis), Francavilla Fontana (V. Cito, F. Cocco), Galatina (F. Daniele, A. Zecca), Gallipoli (F. Cavalieri, C. Picani), Lecce Vito Fazzi (F. Magliari, A. De Giorgi), Santoro), Mesagne (V., San Pietro Vernotico (S. Pede, A. Renna), Scorrano (E. De Lorenzi, O. De Donno), Baldi, Taranto S. S. Annunziata (N., Polimeni, G., Russo), V. A., Tricase (A. Galati, R. Mangia), Basilicata Policoro (B. D’Alessandro, L. Truncellito), Calabria Belvedere Marittimo (F. P. Cariello, F. Rosselli), Catanzaro U. O. Cardiologia Policlinico (G. Borrello, M. Affinita), Catanzaro U. O. Malattie Cardiovascolari Policlinico (F. Perticone, C. Cloro), Sollazzo, Cetraro (G., Matta, M., Lopresti), Venneri, Cosenza Cardiologia Annunziata (N., Misuraca, G., Caporale), R., Cosenza Medicina Annunziata (A. Noto, P. Chiappetta), Tassone), Reggio Calabria E. Morelli (F., Salituri), Rossano (S., Iannopollo, Siderno (M., Errigo, C., Marando), G., Trebisacce (L. Donnangelo, G. Meringolo), Canonico), Sicilia Avola (G., Carini, Catania Cannizzaro (V., Coco, R., Franco), M., Catania Cardiochirurgia Ferrarotto (M. Abbate, G. Leonardi), Messina Papardo (R. Grassi, G. Di Tano), Consolo), Messina Piemonte (G., Coglitore, Messina (S., Cento, D., De Gregorio), C., Palermo Casa del Sole Lanza di Trabia (V. Sperandeo, M. Mongiovì), Palermo Buccheri La Ferla FBF (A. Castello, A. M. Schillaci), Palermo Civico e Benfratelli (E. D’Antonio, U. Mirto), Di Pasquale), Palermo G. F. Ingrassia (P., Palermo V. Cervello (A. Canonico, M. Floresta), Battaglia, Palermo P. O. Villa Sofia (A., Ingrillì, F., Cirrincione), V., Piazza Armerina M. Chiello (B. Aloisi, A. Cavallaro), Braschi, Trapani (G. B., Ledda, G., Rizzo), C., Sanna, Sardegna Cagliari San Michele Brotzu (A., Porcu, M., Salis), S., Lai, Cagliari SS. Trinità (C., Pili, G., Piras), S., Iglesias (E. Spiga, G. Pes), Nuoro (G. Mureddu, I. Maoddi), and Sassari SS. Annunziata (P. Terrosu, F. Uras).

Subjects
Adult, Heart Failure, Male, Dose-Response Relationship, Drug, Digitalis Glycosides, Middle Aged, Prognosis, Risk Assessment, Severity of Illness Index, Survival Analysis, Drug Administration Schedule, Drug Utilization, Treatment Outcome, Italy, Atrial Fibrillation, Heart Function Tests, Multivariate Analysis, Ambulatory Care, Confidence Intervals, Odds Ratio, Humans, Female, Registries, Aged, Retrospective Studies
Abstract

Since the large multicenter DIG trial has shown no effects of digitalis on the all-cause mortality of patients with chronic heart failure (HF), the broad prescription of this drug in patients with HF appears to be at the very least, questionable. The aims of this study were: to analyze prescription patterns of digitalis, from 1995 to 2000, in a large group of outpatients with HF; to analyze the independent predictors of digitalis prescription and to evaluate the impact of the results of the DIG trial on the prescription rate of this drug.From 1995 to 2000, 11 070 HF outpatients (mean age 64 +/- 12 years, ejection fraction 35 +/- 12%) were enrolled in a large Italian database.Out of 11 070 patients, 7198 (65%) were treated with digitalis. At multivariate analysis, the following variables were independently associated with digitalis prescription; atrial fibrillation (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.9-3.8), ejection fraction30% (OR 1.7, 95% CI 1.5-1.9), NYHA class III-IV vs II-III (OR 1.3, 95% CI 1.2-1.5), admission for HF during the previous year (OR 1.4, 95% CI 1.2-1.5). After the publication of the DIG trial, there was a significant reduction in the rate of digitalis prescription: the percentage of patients taking digitalis fell from 68% in 1996-1997 to 61% in 1998-1999 (p0.001).Over 60% of Italian outpatients with HF were treated with digitalis; as expected, patients with a low ejection fraction, atrial fibrillation and in a more advanced stage of HF are more likely to receive this drug. Finally, after the publication of the DIG trial, the rate of digitalis prescription significantly decreased.

Published
2004

16. [Hysteroscopic evaluation of the endometrium in 63 postmenopausal patients treated with tamoxifen for breast cancer]

Author

Baldini B, Gl, Taddei, Tiso E, Carmen Beatriz Visioli, Kj, Campos, Ac, Napolitano, and Tantini C

Subjects
Adult, Aged, 80 and over, Postmenopause, Postoperative Care, Tamoxifen, Humans, Breast Neoplasms, Female, Hysteroscopy, Middle Aged, Mastectomy, Aged, Endometrial Neoplasms
Abstract

This retrospective analysis intends to evaluate by histeroscopy the endometrial findings in a group of 63 patients in post-menopausal treated with tamoxifen for breast cancer. Our patients assumed tamoxifen for a different period between 6 and 120 months. Patients have been divided in two groups: I) patients undergoing hysteroscopy because of some clinical symptoms; II) patients who undergoing hysteroscopy as a routine examination. The most important observation of this work is the correlation between the presence of negative endometrium and low risk hyperplasia (LRH) associated to: symptomatology and duration of therapy. In the group of asymptomatic patients the LRH is found only after 3 years of treatment, while in the group of symptomatic patients, LRH is present within the first two years of treatment; beyond this period high risk hyperplasia (HRH) and endometrial carcinoma have been diagnosed. We also observed a higher incidence of endometrial polyps in this population than among the non treated group and among the symptomatic patients. From these data we conclude that hysteroscopy follow-up has to be performed in the group of patients treated with tamoxifen and that it would be necessary to have a hysteroscopy before the beginning of therapy and that this one has to be repeated once a year through the treatment. Obviously the symptomatic patients have to undergo hysteroscopy as soon as possible as a higher incidence of HRH and endometrial carcinoma has been detected in this group of patients.

Published
1996

23. [Critical analysis of the new TNM staging (UICC, 1987) of cancer of the cervical esophagus in relation to therapeutic decisions]

Author

Peracchia, A, Ruol, A, Narne, S, Tiso, E, Segalin, A, Lazzaro, S, Anselmino, M, and Bardini, Romeo

Subjects
Esophagus, Esophageal Neoplasms, Lymphatic Metastasis, Palliative Care, Humans, Lymph Node Excision, Prognosis, Neck, Neoplasm Staging
Abstract

66 consecutive patients with a tumor confined to the cervical esophagus underwent surgical resection. The comparison between clinical and pathological TNM stage showed a clinical understaging in 30 patients. 25 of the 56 patients who had undergone curative resection had lymph node metastases: positive mediastinal and abdominal nodes were found in 8 (32%) and 0 cases, respectively. The mean survival after curative resection of the 10 evaluable patients with metastatic periesophageal, recurrent and/or paratracheal nodes was 22.4 months; of the 6 evaluable patients with positive mediastinal nodes it was 10.3 months; and of the 5 patients with positive deep latero-cervical nodes it was 5.8 months. The 2-year actuarial survival after curative resection (in the 53 operative survivors) was as follows (according to pathologic TNM staging): Stage I (n = 3) 100%, Stage IIA (n = 17) 30%, Stage IIB (n = 3) 33%, and Stage III (n = 30) 22%. The exact location of neoplastic recurrence after curative resection was documented in 13 cases; it was in the neck in 8 cases (61%); both neck and at a distance in 3 cases (23%) and only at a distance in 2 (16%). The clinical TNM staging of cervical esophageal cancer was not in agreement with the pathological findings in nearly 50% of the cases and is, therefore, inaccurate and unreliable both for therapeutic decision-making and for prognostic evaluations. Endoscopic ultrasound, which was not used in most of the patients studied here, may improve the accuracy of clinical TNM staging. The N classification, which defines only the cervical nodes as regional nodes, appears to be arbitrary since the pathological staging showed metastatic mediastinal nodes in 32% of the N + cases, with a survival comparable to that of patients with metastatic nodes only in the neck. The prognostic value of pathological TNM staging was not confirmed in the present study since only Stage I patients had a significantly better prognosis than patients in the other stages. This may be due to the small number of patients considered or to lymph node understaging caused by the fact that most patients did not undergo mediastinal lymphadenectomy through a thoracotomy or a sternum splitting.

Published
1990

25. [Cancer of the hypopharynx and cervical esophagus. Role and limits of the surgical treatment]

Author

Peracchia, A, Bardini, Romeo, Ruol, A, Castoro, C, Tiso, E, and Asolati, M.

Subjects
Adult, Hypopharyngeal Neoplasms, Esophageal Neoplasms, Colon, Carcinoma, Stomach, Suture Techniques, Laryngectomy, Middle Aged, Pharyngectomy, Actuarial Analysis, Esophagoplasty, Humans, Neck, Aged
Abstract

From 1975 to 1988, we observed 169 patients with a carcinoma of the cervical esophagus, 85 with a carcinoma involving the hypopharynx and the cervical esophagus, and 27 with a carcinoma of the cervical esophagus occurring after laryngectomy for laryngeal carcinoma. The average age was 57.5 years (41-73). Exploration was surgical for 167 patients (operability ratio 59.5%), and the lesion was resected in 152 cases (resectability ratio 81.1%). Resection was complete in 129 patients (84.5%) and palliative in 23 (14.5%). A laryngopharyngoesophagectomy involving the cervical esophagus and requiring the transplantation of a free intestinal loop was performed in 33 cases, with an operative mortality rate of 6.1%. Pharyngolaryngectomy with total esophagectomy was performed in 101 patients, and the digestive tract was reconstructed by means of pharyngogastrostomy or pharyngocolostomy (respectively 85 and 16 cases) with an operative mortality rate of 12.9% and 18.3%, respectively. Complete esophagectomy without laryngectomy was performed for 18 patients with carcinoma of the distal cervical esophagus who refused laryngectomy, the hospital mortality rate being of 5.5%. The actuarial survival rate after 5 years (not including operative mortality) was 15.8%. Better results were achieved after complete resection for carcinoma of the hypopharynx than for carcinoma of the cerebral esophagus. The actuarial survival rates after 2 and 5 years were 59% vs. 26% and 43% vs. 17% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990

27. [Surgical treatment of carcinoma of the hypopharynx and cervical esophagus]

Author

Peracchia, A, Bardini, Romeo, Ruol, A, Castoro, C, Segalin, A, Asolati, M, Lazzaro, S, and Tiso, E.

Subjects
Adult, Hypopharyngeal Neoplasms, Colon, Anastomosis, Surgical, Palliative Care, Stomach, Methods, Humans, Pharynx, Middle Aged, Laryngeal Neoplasms, Neck, Aged
Abstract

Between 1975 and 1988 we observed 169 patients with carcinoma of the cervical esophagus, 85 a carcinoma involving the hypopharynx and the cervical esophagus, and 27 patients with a carcinoma of the cervical esophageal region arose after laryngectomy for laryngeal cancer. The mean age was 57.5 years (range 41-73). 167 patients underwent surgical exploration (operability rate 59.5%) and in 152 cases the tumor was resected (resectability rate 91.1%). The resection was complete in 129 patients (84.9%) and palliative in 23 (14.1%). In 33 cases of laryngo-pharyngo-cervical segmentary esophagectomy with free intestinal loop transplantation was performed with an operative mortality of 6.1%. 101 patients underwent laryngo-pharyngo-total esophagectomy and the digestive tract was reconstructed by means of pharyngo-gastrostomy and pharyngo-colostomy in 85 and 16 cases, with an operative mortality of 12.9% and 18.3%, respectively. Total esophagectomy without laryngectomy was performed in 18 patients with a carcinoma of the distal cervical esophagus refusing laryngectomy with an hospital mortality of 5.5%. The overall 5-year actuarial survival, excluding the operative mortality, was 15.8%. After complete resection, better results were recorded with patients operated for carcinoma of the hypopharynx than with patients with carcinoma of the cervical esophagus: the 2-year and 5-year actuarial survival was 59% vs 26% and 43% vs 17%, respectively. No patient undergoing palliative resection was alive at the 3-year interval.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990

28. Heart myxomas

Author

Doria, A., De Micheli, S., Tiso, E., Scalia, D., and Gambari, P. F.

Published
1990

36. Reduced Fibrinolytic Potential in Patients with Arterial Occlusive Disease (AOD) in Comparison with Normal Subjects

Author

Hartl, D., Tiso, E., Anderle, K., Philapitsch, A., and Anger, G.

Abstract

When combining angioplasty and local lysis with urokinase (UK) in treatment of peripheral arterial occlusions we have observed marked differences in the individual patient’s response irrespective of the age of the thrombus. The extensive arteriosclerotic changes revealed by angioghraphy in some of these patients suggest a reduced fibrinolytic potential depending on the underlying disease. In the standard in vitro test system we measured the UK-dependent thrombolysis in blood samples from 10 normal controls at UK concentrations of 150, 200, and 300 IU/ml of whole blood. In comparison we determined the whole blood thrombolysis time (WBTT) of 10 patients with AOD using UK concentrations of 150, 200, and 300 IU/ml of whole blood. The mean WBTT values for normal controls obtained at UK concentrations of 150 IU/ml, 200 IU/ml, and 300 IU/ml, respectively, amounted to 9.5, 5.5, and 3.5 minutes, respectively, while in patients mean values of 20.7, 8.1, and 5.5 minutes, respectively, were found. Studies on plasma samples had shown that the lysis time could be shortened in a dose-dependent manner by addition of lys-plasminogen (LYS-PLASMINOGEN Steam Treated) and to some extent also glu-plasminogen. Since lys-plasminogen gave clearly superior results we tried to improve the lytic potential in terms of a shortening of the WBTT by adding different doses of lys-plasminogen (0.14 – 0.56 CU/ml whole blood) to each patient sample. Although the individual response varied, the addition of lys-plasminogen to the patient samples resulted in a clear dose-dependent improvement of pathologically prolonged lysis times. We conclude from these in vitro findings that the failure of fibrinolytic therapy may in some cases be due to a reduced lytic potential, which may be enhanced by administration of lys-plasminogen, even when the plasminogen level is normal.

Published
1988
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46. A Randomized Trial of Pharmacogenetic Warfarin Dosing in Naïve Patients with Non-Valvular Atrial Fibrillation.

Author

Pengo V, Zambon CF, Fogar P, Padoan A, Nante G, Pelloso M, Moz S, Frigo AC, Groppa F, Bozzato D, Tiso E, Gnatta E, Denas G, Padayattil Jose S, Padrini R, Basso D, and Plebani M

Subjects
Adult, Aged, Aged, 80 and over, Algorithms, Anticoagulants adverse effects, Anticoagulants therapeutic use, Cytochrome P-450 CYP2C9 metabolism, Cytochrome P-450 Enzyme System metabolism, Cytochrome P450 Family 4, Female, Humans, International Normalized Ratio methods, Male, Middle Aged, Pharmacogenetics methods, Polymorphism, Single Nucleotide, Stroke prevention & control, Treatment Outcome, Vitamin K Epoxide Reductases metabolism, Warfarin adverse effects, Warfarin therapeutic use, Anticoagulants administration & dosage, Atrial Fibrillation drug therapy, Drug Monitoring methods, Warfarin pharmacokinetics
Abstract

Unlabelled: Genotype-guided warfarin dosing have been proposed to improve patient’s management. This study is aimed to determine whether a CYP2C9- VKORC1- CYP4F2-based pharmacogenetic algorithm is superior to a standard, clinically adopted, pharmacodynamic method. Two-hundred naïve patients with non-valvular atrial fibrillation were randomized to trial arms and 180 completed the study. No significant differences were found in the number of out-of-range INRs (INR<2.0 or >3.0) (p = 0.79) and in the mean percentage of time spent in the therapeutic range (TTR) after 19 days in the pharmacogenetic (51.9%) and in the control arm (53.2%, p = 0.71). The percentage of time spent at INR>4.0 was significantly lower in the pharmacogenetic (0.7%) than in the control arm (1.8%) (p = 0.02). Genotype-guided warfarin dosing is not superior in overall anticoagulation control when compared to accurate clinical standard of care., Trial Registration: ClinicalTrials.gov NCT01178034.

Published
2015
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47. Contrast-enhanced cardiovascular magnetic resonance in primary and ischemic dilated cardiomyopathy.

Author

Calore C, Cacciavillani L, Boffa GM, Silva C, Tiso E, Marra MP, Bacchiega E, Corbetti F, and Iliceto S

Subjects
Contrast Media, Coronary Disease complications, Diagnosis, Differential, Female, Humans, Image Enhancement, Male, Middle Aged, Myocardial Infarction complications, Sensitivity and Specificity, Ventricular Dysfunction, Left diagnosis, Cardiomyopathies diagnosis, Cardiomyopathy, Dilated diagnosis, Magnetic Resonance Imaging methods
Abstract

Objectives: Differentiation between primary dilated cardiomyopathy and ischemic cardiomyopathy has an important clinical significance. Contrast-enhanced cardiovascular magnetic resonance can play a role in this task, identifying myocardial scarring or fibrosis as presence of delayed enhancement. The aim of the present study was to evaluate the diagnostic potential of contrast-enhanced cardiovascular magnetic resonance in differentiating dilated cardiomyopathy from ischemic cardiomyopathy., Methods: Contrast-enhanced cardiovascular magnetic resonance was performed in 100 patients with left ventricular dilatation and reduced systolic function: 24 had normal coronary arteries (dilated cardiomyopathy group) and 76 had significant coronary artery disease (ischemic cardiomyopathy group), with or without previous myocardial infarction., Results: In the dilated cardiomyopathy group, only seven (29%) patients showed delayed enhancement and its pattern was characterized by mid-wall, patchy or diffuse location. All patients with ischemic cardiomyopathy and prior myocardial infarction (54 subjects) showed delayed enhancement with subendocardial (n = 4) or transmural (n = 50) extension. Among the 22 patients with ischemic cardiomyopathy but without previous myocardial infarction, 13 (59%) showed either subendocardial (n = 4) or transmural (n = 9) delayed enhancement., Conclusions: Patterns of delayed enhancement are different in dilated cardiomyopathy and ischemic cardiomyopathy, reflecting the presence of scarring or various degrees of fibrosis in left ventricular myocardium. The presence of subendocardial or transmural delayed enhancement at contrast-enhanced cardiovascular magnetic resonance allowed distinction between dilated cardiomyopathy and ischemic cardiomyopathy with high sensitivity (88%) and specificity (100%). Integration of cardiovascular magnetic resonance results with angiographic information can be useful in the identification of pathogenic mechanisms underlying left ventricular dysfunction.

Published
2007
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48. Urocortin expression is downregulated in human endometrial carcinoma.

Author

Florio P, De Falco G, Leucci E, Torricelli M, Torres PB, Toti P, Dell'Anna A, Tiso E, Santopietro R, Leoncini L, and Petraglia F

Subjects
Aged, Case-Control Studies, Corticotropin-Releasing Hormone analysis, Corticotropin-Releasing Hormone genetics, Endometrium chemistry, Endometrium metabolism, Female, Humans, Immunohistochemistry methods, Middle Aged, RNA, Messenger analysis, Reverse Transcriptase Polymerase Chain Reaction, Urocortins, Adenocarcinoma metabolism, Corticotropin-Releasing Hormone metabolism, Down-Regulation, Endometrial Neoplasms metabolism
Abstract

Urocortin (UCN) is a 40-amino acid neuropeptide sharing 45% sequence homology with corticotropin-releasing factor (CRF). The human endometrium expresses both UCN and CRF, and CRF/UCN receptors type-1 (CRF-R1) and -2 (CRF-R2). CRF-R1 activation inhibits cell growth and proliferation of a tumor cell line derived from the human endometrium, and the UCN signaling pathway has been implicated in tumorigenesis of several tissues. Therefore, we investigated whether UCN mRNA and peptide are expressed by human endometrial adenocarcinoma, and whether their expression changes compared to controls. Samples of well (grade 1; n = 6 endometrioid adenocarcinoma, of whom n = 1 with squamous differentiation, and n = 1 clear-cell carcinoma) and poorly differentiated (grade 3; n = 3 endometrioid adenocarcinoma) endometrial adenocarcinoma were collected from nine women (age range 61-79 years) enrolled at the time of diagnosis. Healthy endometrium was collected from postmenopausal women (controls; n = 13; age range 64-78 years), who underwent hysterectomy for uterine prolapse. Immunohistochemistry was used to evaluate cellular UCN localization, with the intensity of immunostaining scored on a subjective scale. Quantitative real-time reverse transcriptase (RT)-PCR analysis was used to estimate mRNA expression changes and restriction analysis was used to confirm PCR products identity. UCN mRNA expression was significantly reduced (P < 0.0001) in endometrial adenocarcinoma than in healthy controls. Immunoreactive UCN was found in luminal and glandular epithelial cells in healthy, but not in neoplastic samples. UCN mRNA and peptide expressions are decreased in endometrial adenocarcinoma. These data and the evidence that endometrial cancer expresses UCN receptors and UCN is involved in tumorigenesis of several tissues together suggest a role for UCN in endometrial tumoral cell growth and proliferation.

Published
2006
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49. Inhibin alpha-subunit and the inhibin coreceptor betaglycan are downregulated in endometrial carcinoma.

Author

Florio P, Ciarmela P, Reis FM, Toti P, Galleri L, Santopietro R, Tiso E, Tosi P, and Petraglia F

Subjects
Activin Receptors, Adenocarcinoma metabolism, Adenocarcinoma pathology, Aged, Down-Regulation, Endometrial Neoplasms metabolism, Endometrial Neoplasms pathology, Female, Gene Expression Regulation, Neoplastic, Humans, Inhibins metabolism, Middle Aged, Postmenopause, Proteoglycans metabolism, RNA, Messenger analysis, Receptors, Peptide metabolism, Receptors, Transforming Growth Factor beta metabolism, Adenocarcinoma physiopathology, Endometrial Neoplasms physiopathology, Inhibins genetics, Proteoglycans genetics, Receptors, Peptide genetics, Receptors, Transforming Growth Factor beta genetics
Abstract

Objective: In the present study we evaluated the protein distribution and mRNA levels of inhibin alpha-subunit and its coreceptor betaglycan in endometrial adenocarcinoma., Design: Two groups of postmenopausal women were studied: the first group had recently diagnosed endometrial adenocarcinoma (n = 16; age range 61-79 years), and the second group (n = 12; age range 64-78 years) had undergone hysterectomy for uterine prolapse and served as control., Methods: Inhibin alpha-subunit and betaglycan gene expression and tissue distribution were evaluated by semiquantitative RT-PCR and immunohistochemistry respectively., Results: Inhibin alpha-subunit and betaglycan mRNAs were expressed by both healthy and tumoral endometria, but their expression was significantly lower in endometrial carcinoma (P < 0.001, based on Student's t test). Inhibin alpha-subunit expression was much weaker in the glands of tumours than in non-neoplastic specimens. Betaglycan protein was identified in the epithelial cells lining non-tumoral endometrium, and in endothelial cells of both normal and tumoral endometria. Well-differentiated neoplastic cells had a faint and scarce betaglycan staining, and poorly differentiated cells did not express betaglycan at all., Conclusions: The lower inhibin alpha and betaglycan expression in endometrial adenocarcinoma suggests that the inhibin action may be disrupted. However, the expression of betaglycan in the endothelia of the tumour vasculature suggests that a selective vascular response to inhibin may be possible in these tumours.

Published
2005
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50. Plasma levels of tumor necrosis factor-alpha correlate with the six-minute walk test results in patients with mild to moderate heart failure.

Author

Boffa GM, Zaninotto M, Nalli C, Forni M, Tiso E, Razzolini R, and Plebani M

Subjects
Adult, Aged, Biomarkers blood, Cardiomyopathy, Dilated blood, Cardiomyopathy, Dilated complications, Coronary Artery Disease blood, Coronary Artery Disease complications, Endothelin-1 blood, Exercise Tolerance physiology, Female, Humans, Male, Middle Aged, Mitral Valve Insufficiency blood, Mitral Valve Insufficiency complications, Multivariate Analysis, Natriuretic Peptide, Brain blood, Severity of Illness Index, Statistics as Topic, Troponin blood, Ventricular Dysfunction, Left blood, Ventricular Dysfunction, Left etiology, Heart Failure blood, Tumor Necrosis Factor-alpha metabolism, Walking
Abstract

Background: The plasma levels of brain natriuretic peptide, tumor necrosis factor-alpha, big endothelin-1 and cardiac troponins have been reported to correlate with the severity of heart failure., Methods: In a single population of 80 outpatients with mild to moderate chronic heart failure the correlation between the patient's functional capacity, as evaluated at a 6-min walk test, the clinical parameters and plasma levels of brain natriuretic peptide, tumor necrosis factor-alpha, big endothelin-1 and cardiac troponins was evaluated., Results: A significant inverse correlation was found with the patient's age (p < 0.0001), NYHA functional class (p < 0.0001), left ventricular dysfunction etiology (ischemic vs dilated cardiomyopathy, p < 0.0005), heart rate (p < 0.05), plasma levels of brain natriuretic peptide (p < 0.05) and of tumor necrosis factor-alpha (p < 0.0005). At multiple regression analysis a correlation was found between the 6-min walk test results and the patient's age (p < 0.05), NYHA functional class (p < 0.01), left ventricular dysfunction etiology (ischemic vs dilated cardiomyopathy, p < 0.05) and tumor necrosis factor-alpha plasma levels (p < 0.05)., Conclusions: In our patients with mild to moderate heart failure, a significant correlation was found between the results of the 6-min walk test and only the plasma concentrations of tumor necrosis factor-alpha among the laboratory parameters analyzed in this study.

Published
2004

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