Quantum Bubbles in Microgravity.

The recent developments of microgravity experiments with ultracold atoms have produced a relevant boost in the study of shell-shaped ellipsoidal Bose-Einstein condensates. For realistic bubble-trap parameters, here we calculate the critical temperature of Bose-Einstein condensation, which, if compared to the one of the bare harmonic trap with the same frequencies, shows a strong reduction. We simulate the zero-temperature density distribution with the Gross-Pitaevskii equation, and we study the free expansion of the hollow condensate. While part of the atoms expands in the outward direction, the condensate self-interferes inside the bubble trap, filling the hole in experimentally observable times. For a mesoscopic number of particles in a strongly interacting regime, for which more refined approaches are needed, we employ quantum Monte Carlo simulations, proving that the nontrivial topology of a thin shell allows superfluidity. Our work constitutes a reliable benchmark for the forthcoming scientific investigations with bubble traps.

Bose-Einstein Condensation on the Surface of a Sphere.

Motivated by the recent achievement of space-based Bose-Einstein condensates (BEC) with ultracold alkali-metal atoms under microgravity and by the proposal of bubble traps which confine atoms on a thin shell, we investigate the BEC thermodynamics on the surface of a sphere. We determine analytically the critical temperature and the condensate fraction of a noninteracting Bose gas. Then we consider the inclusion of a zero-range interatomic potential, extending the noninteracting results at zero and finite temperature. Both in the noninteracting and interacting cases the crucial role of the finite radius of the sphere is emphasized, showing that in the limit of infinite radius one recovers the familiar two-dimensional results. We also investigate the Berezinski-Kosterlitz-Thouless transition driven by vortical configurations on the surface of the sphere, analyzing the interplay of condensation and superfluidity in this finite-size system.

Paclitaxel efficacy and tolerability in second-line treatment of refractory and relapsed ovarian cancer patients.

Nineteen patients with recurrent or refractory ovarian carcinoma after a first-line platinum-based chemotherapy were treated with a 3-hour i.v. infusion of paclitaxel 175 mg/m2 every 3 weeks from November 1992 to October 1996. The major hematologic toxicity was neutropenia (63.2%). No febrile neutropenia was observed. Other hematologic effects were leukopenia (47.4%) and anemia (47.4%). The main non-hematologic toxicities were as follows: neuropathy (52.6%), nausea and vomiting (36.8%), myalgia (36.8%), cardiac toxicity (15.8%) and mucositis (10.5%). Alopecia was observed in the majority of cases. The overall response rate was 47.4%, with 5 (26.3%) complete responses (CRs) and 4 (21.1%) partial responses (PRs). The median duration of response was 7 months (range: 3-19), with a median follow-up of 17 months (range: 3-61). Quality of life of responding patients was good. Our results confirm that paclitaxel as second-line therapy in relapsed and refractory ovarian cancer patients is an acceptable treatment with a good safety profile, and can be safely administered at the dose of 175 mg/m2. In our study paclitaxel was more active in relapsed than in refractory patients. Consequently, further studies are needed to identify more effective drugs for the refractory subset.

Vinorelbine chemotherapy in non small cell lung cancer: experience in elderly patients.

This study involved 25 elderly (> 65 years old) patients (pts) with unresectable non small cell lung cancer (NSCLC) who were not eligible for polychemotherapy. The diagnosis of NSCLC was histologically or cytologically documented, and all of them had measurable or evaluable disease. The median age of the patients was 71 (range 65-77); 9 had been pretreated. The pts received 25 mg/m2 of vinorelbine weekly or bi-weekly depending on the results of blood tests. The treatment continued until disease progression or tolerance. No complete response was achieved: 3 pts (12%) had a partial response (RP) (8-12-14 months), 13 (52%) stable disease (SD) with an improvement in symptoms, such as cough and/or pain, and 9 pts (36%) progressed. Compliance with the therapy was acceptable. The main toxicity was hematological: neutropenia was observed in 16 pts, with only 1 case of grade 4 neutropenia without sepsis; grade 1-2 anemia occurred in 8 patients. The other toxicities included grade 1-2 neurotoxicity in 8 pts, chemical phlebitis in 2 pts and grade 3 cardiotoxicity reversible with medical treatment in 1 patient. The median survival time was 10 months (lower quartile 5 months, upper quartile 23 months) (Kaplan and Meyer method). Vinorelbine can be considered a rational choice in elderly pts with advanced NSCLC who are not suitable for aggressive polychemotherapy, with the aim of improving their quality of life in terms of symptoms and outpatient treatment.

Assessment of the RSCL quality of life instrument during chemotherapy in an Italian setting.

Evaluation of the quality of life of oncological patients is now perceived as a major element of cancer treatment, and various instruments for measuring it have been proposed. However, whatever instrument is used must be capable of reflecting the different ways in which different contexts and cultures respond to cancer. We administered the Italian version of the Rotterdam Symptom Checklist (RSCL) to 60 patients with advanced disease attending five oncological centres in Romagna (central Italy). The RSCL was found to be able to measure both psychological and physical well-being and to detect a difference between patients on low/medium and those on high-burden chemotherapy. The Italian version of the RSCL is an adequate scale that is capable of capturing patient perceptions and could be used for monitoring the quality of life of Italian patients participating in clinical trials.

Synergism between gamma interferon and doxorubicin in a human MDR colon adenocarcinoma cell line.

Recent interest in cancer therapy derives from the ability of interferons to synergistically increase the activity of chemotherapeutic agents. To understand the biological basis of this synergism we evaluated the effects of human recombinant IFN-gamma on the expression of the mdr1 gene and on the cellular growth of a human colon adenocarcinoma cell line (LoVo) and its MDR subline (LoVo/Dx) after coincubation with doxorubicin. Treatment with IFN-gamma showed unchanged levels of MDR1-glycoprotein, no perturbation on cell cycle distribution and a significant reduction of colony formation in both lines (P < 0.05) starting from 100 U/ml. A synergistic effect was observed in the LoVo/Dx cell line when doxorubicin was added after exposure to 0.1-10 U/ml of IFN-gamma. Our data indicate that the effects of IFN-gamma, independent from action on cell proliferation and from modulation of p-glycoprotein expression, are a cause of the synergistic activity between this lymphokine and conventional chemotherapeutic agents such as doxorubicin.

[Role of colposcopy in high-grade CIN (CIN II-III)]. / Il ruolo della colposcopia nelle CIN di grado elevato (CIN II-III).

We have considered the colpo-cytologic characteristic of 83 patients with CIN II-III histologic lesions over 900 colposcopic biopsies carried out at our Department from 1990-1992. In particular 38 cases were classified as CIN II of which 23 associated with HPV cytopathic feature, while 45 cases were, classified as CIN III, of which 13 associated with HPV c.f. 29% of CIN II were evident in women under 30 years of age; in this group the age decreased with the presence of HPV. 31% of CIN III were present in women under 35. A good correlation between cytologic and histological analysis on the same patient was observed particularly in CIN with the higher grade. Also a good correlation between colposcopy grading and CIN was observed. In CIN II, grade I images were present, while in CIN III, punctuation and white epithelium were the most common features. Our study shows also the impossibility of distinguishing between the images of simple viral infection and their related CIN morphologic patterns. Colposcopy represents a basic test for the definition of CIN, particularly for those with higher grade, and a complementary test for the definition of the topography of the lesions with the correct choice of the therapeutic treatment.

Etoposide, doxorubicin and cisplatin (EAP regimen) in advanced gastric cancer.

The treatment of advanced gastric cancer is unsatisfactory. The response rates for single chemotherapy agents: 5-fluorouracil, mitomycin-c, methotrexate, cisplatin, adriamycin, nitrosoureas and etoposide are approximately 10-25% and response duration ranges from 3 to 6 months. Complete responses with single agents are rare. Combination chemotherapy produces higher response rates, but these responses are short. Recently the combination of etoposide, adriamycin and cisplatin (EAP regimen) has been reported to produce results superior to what have been previously reported with other regimens. Twenty-four consecutive patients with locally advanced or metastatic gastric cancer (stage III-IV) were treated between June 1990 and December 1992 with the EAP regimen at our Department. Twenty-two patients were evaluable for response and toxicity. Objective responses were observed in 8 of 22 patients (response rate 36%; 95% confidence interval 17% to 59%). No clinical complete response was found. The median duration of the response was 7 months (range 2 to 22). Myelosuppression represented the primary toxicity associated with the EAP regimen. Grade 4 leukopenia was observed in 4 patients (18%). Grade 3-4 thrombocytopenia was registered in two patients, and grade 3 anemia was detected in 4 patients (18%). The median survival for all patients was 8 months and 12 months for the 8 responding patients. The EAP regimen seems to be an effective chemotherapeutic regimen, but cannot be considered the standard therapy for patients with locally advanced or metastatic gastric cancer, because of the high incidence of moderate to severe myelotoxicity and a response rate and duration of survival similar, but not superior, to those obtained using a less toxic schedule.

Patterns of Pap smear use in the Rimini area: an analysis of women's attitudes to the test.

The use of the Pap test is a method of the prevention of cervical cancer in our local division of the Sanitary Unit and has been studied with the help of a questionnaire which was completed by women who had adopted this test. The socioeconomic characteristics, level of education, occupation and general attitudes regarding the Pap test as well as how the women had acquired knowledge of the test, have all been examined. From an analysis of the answers, we have been able to trace a precise social, economic and cultural profile of the type of women who take advantage of this test. Principally, we are dealing with women aged 40-49 years, often with children, with a medium to low level of education, who are mainly housewives and white-collar workers. Very few elderly women present themselves for the Pap test. We have noticed that there is a direct decrease in the use of preventive methods, proportional to the increase in age. These results demonstrate that an erratic use of this preventive method, in the absence of an organized screening programme, seems only to involve women who are among those at less risk from cervical cancer.

[The role of colposcopy in the diagnosis of HPV infection]. / Il ruolo della colposcopia nella diagnosi dell'infezione virale da HPV.

Human papillomavirus (HPV) has been implicated as an important etiologic factor in cervical carcinoma. This study evaluates the efficacy of colposcopy in the detection of cervical lesions with koilocytosis features. Colposcopy, cervical smears and biopsy specimens from 217 women seen in our department between January-December 1991 were examined. The colposcopy examination detected 77.5% of the viral presence the histological diagnosis detected 85% of HPV, but the cytologic smears showed only 52% of infection. The data suggests that colposcopy is a good examination to evidence koilocytosis infection.

[Cervico-vaginal screening in some Local Sanitary Units of the Emilia-Romagna region]. / Lo screening cervico-vaginale in alcune USL della Regione Emilia-Romagna.

Some Local Sanitary Units (USL) of the Emilia-Romagna region were contacted to define cervical screening variables, such as adequacy of smear technique, data collection and evaluation, laboratory quality control modalities of invitations to screening. Our data show there are a lot of deficiencies in the present management of the cervical program in Romagna. The most serious inadequacies concern data evaluation, follow-up, cytologic quality control, modalities of active invitations of women to screening. The survey has confirmed the need for launching organized programs of cervical screening to promote their efficacy of diagnosis and therapy.

Idarubicin metabolism and pharmacokinetics after intravenous and oral administration in cancer patients: a crossover study.

The pharmacokinetics and metabolism of 4-demethoxydaunorubicin (idarubicin, IDA) were studied in 21 patients with advanced cancer after i.v. (12 mg/m2) and oral (30-35 mg/m2) treatment according to a balanced crossover design. Patients were divided into four groups: subjects who showed normal liver and kidney function (group N), those who presented with normal kidney function and liver metastases (group L), those with kidney dysfunction (creatinine clearance, less than or equal to 60 l/h; group R), and those with both liver and kidney dysfunction (group LR). Five patients showed variations in liver or kidney function after the first treatment and were considered to be nonevaluable for the crossover study but evaluable for the liver/kidney function study; some of them appeared in different groups for the i.v. as opposed to p.o. treatments. After i.v. administration, IDA plasma levels followed a triphasic decay pattern. The main metabolite observed in all patients was the 13C-reduced compound (IDAol), which attained plasma levels 2-12 times higher than those of the parent compound. IDA pharmacokinetics was not dependent on the presence of liver metastases but was related to the integrity of kidney function. Analysis of variance indicated a significant correlation between IDA plasma clearance and creatinine clearance; it was also found that IDA plasma clearance was lower in patients whose creatinine clearance was less than 60 ml/min [group N, 122.8 +/- 44.0 l/h; group L, 104.4 +/- 27.7 l/h (P = 0.58) vs group R, 83.4 +/- 18.3 l/h (P = 0.037)]. The IDAol terminal half-life and mean residence time (MRT) were significantly increased in patients with impaired kidney function [MRT: group N, 63.6 +/- 10.8 h; group L, 69.9 +/- 10.2 h (P = 0.27) vs group R, 83.2 +/- 10.9 h (P = 0.025) and t1/2 gamma: group N, 41.3 +/- 10.1 h; group L, 47.0 +/- 7.4 h (P = 0.31) vs group R, 55.8 +/- 8.2 h (P = 0.025)]. After oral treatment, drug absorption occurred during in the first 2-4 h after IDA administration; a biphasic decay pattern was observed thereafter. The main metabolite observed in all patients was again IDAol. The AUC of IDAol was greater after oral administration than after i.v. treatment in proportion to the AUC of IDA (i.v.: AUC-IDAol/AUC-IDA, 2.4-18.9; p.o.: AUC-IDAol/AUC-IDA, 4.1-21.4). Following oral dosing, a substantial amount of 4-demethoxydaunomycinone (AG1) was found in 11/21 patients.(ABSTRACT TRUNCATED AT 400 WORDS)

5-fluorouracil + folinic acid with cisplatinum and bleomycin in the treatment of advanced head and neck squamous cell carcinoma.

Thirty-six patients with advanced squamous cell carcinoma of the head and neck (SCCHN) were treated with a regimen including cisplatinum (CP) 30 mg/m2 i.v., 5-fluorouracil (5-FU) 500 mg/m2 i.v. bolus, folinic acid (FA) 200 mg/m2 i.v. in a continuous one-hour infusion, and bleomycin (B) 15 mg i.m. on the first and second days and repeated every 28 days. Thirty-three patients (25 with recurrent disease and 8 untreated) are evaluable for objective response. Of these, 4 (12%) achieved CR and 15 (45%) PR. All of the untreated patients responded. The mean duration of response in the patients with recurrent or metastatic disease was 5.5 months (range 2-10+). Remission of symptoms, such as pain and dysphagia, was obtained in 58% and in 44%, respectively. Subjective remission occurred almost exclusively in objectively responsive patients. The major side effects were leukopenia (55%) and nausea/vomiting (58%). This regimen is active in the treatment of advanced SCCHN. The quality of life may be improved in responsive patients.

Low dose intermittent 5-fluorouracil, epirubicin and cyclophosphamide (FEC) in poor risk patients with advanced transitional cell bladder cancer: a pilot study.

Fifteen patients with locally advanced or metastatic bladder carcinoma and with cardiac and/or renal impairment were treated with a combination of 5-fluorouracil, 400 mg/m2, epirubicin, 40 mg/m2, and cyclophosphamide, 400 mg/m2. No complete or partial remissions were observed among the 14 evaluable patients. The toxicity level was very low. We are now trying to "tailor" platinum-based combinations to renal function.

A phase III study on intermittent versus weekly cisplatin and etoposide in the treatment of advanced non-small cell bronchogenic carcinoma.

A group of 55 patients with advanced non-small cell bronchogenic carcinoma entered a random study on combined cisplatin (CDDP) and etoposide (VP16), either intermittently (I = CDDP 60 mg/m2 day 1 and VP16 120 mg/m2 day 1-3 every 3-4 weeks) or weekly (W = CDDP 20 mg/m2 and VP16 120 mg/m2). Five out of 31 (16%) evaluable patients in group I and 6/27 (22%) in group W obtained partial remission (no statistical difference). Toxicity was mild and survival was similar for both groups. The authors conclude that the weekly combination of CDDP plus VP16 is neither less toxic nor more effective than the intermittent one.