[Cellular immunity in two familial cases of thyroid carcinoma (author's transl)]. / Aspetti dell'immunità cellulare in due casi di carcinoma tiroideo nella stessa famiglia

Cellular immunity in two brothers with thyroid carcinoma in a family presenting pathological thyroid changes is investigated. In these brothers a low PHA lymphocyte blast-transformation and an elevated number of surface membrane Ig bearing lymphocytes were observed. These data are discussed in relation to the question of immunological defects which frequently are present in carcinoma patients.

[Clinical and hormonal evaluation of recurrence of goiter after thyroidectomy]. / Valutazione clinica ed ormonale della recidiva di struma dopo tiroidectomia.

The incidence and features of goitre recurrences were investigated in a sample population of patients operated at the University of Turin Endocrine Surgery Centre. The following parameters were examined: sex, age, familial history of goitre, number of pregnancies, T3 and T4 levels, and TSH levels. Attention is drawn to the finding of significantly higher TSH values in the patients operated for recurrent goitre than in a series of persons free of recurrences after they had been operated on for goitre. Other workers have made the same observation, which is therefore regarded as a pointer to the correct interpretation of the recurrence of goitre.

[Treatment of differentiated carcinoma of the thyroid gland]. / Il trattamento del carcinoma differenziato della tiroide.

In this paper the Authors, after a description of the prognostic factors in patients with differentiated thyroid carcinoma, propose a rationale for the therapy. The role of surgery, radioiodine treatment, endocrine therapy, radiotherapy and chemotherapy is described. The follow-up for the disease is briefly outlined. The authors suggest that treatment and follow-up protocols should be in accordance with the prognostic factors.

[Clinical studies on peripheral arteriosclerotic lesions in the Piedmont region]. / Ricerche cliniche sulle lesioni arteriosclerotiche periferiche nella Regione Piemonte.

The assistance of the Piedmont Region calculation centre was obtained in the evaluation and detailed examination of data on all patients admitted to hospitals in the Region for peripheral atherosclerotic arteriopathy during a three-year period. Age, sex, site of lesion, occupation, geographical distribution, and type of treatment employed were all analysed statistically. A difference between age categories in relation to sex was noted for incidence and site of lesions, while occupation was not correlated to the clinical progress of the disease. Regional incidence (for all Piedmont local health units) was both above and below the general average in some areas. It also appeared that the greatest incidence lay along the Alps.

[Initial immunologic evaluations in breast and thyroid cancer]. / Prime valutazioni immunologiche nel carcinoma dell mammella e della tiroide.

In evaluating pre- and post-operative immunological status of 15 patients with malignant breast and thyroid tumors and of 9 patients with benign breast and thyroid lesions, rosette E test, CEA, cortisol, immunocomplexes and determination of circulating leukocytes, B lymphocytes and immunoglobulins was employed. The obtained data were not significative to show a lack of immune response in tumor bearing patients. Among the reexamined parameters, CEA was the only one that apparently correlated with prognosis; its serum levels, being at a high rate in a high percentage of malignancies, tended to fall down after surgical treatment.

[Blood cholesterol in patients with cancer]. / La colesterolemia nei soggetti affetti da neoplasia.

Cholesterolaemia values have been investigated in a simple of colon cancer patients and in two control samples consisting of age and sex corresponding subjects suffering respectively from peripheral arteriopathy and minor pathologies (hernias and varices). The study was extended subsequently to a sample of subjects suffering from thyroid neoplasia and two similarly constituted control samples. Cholesterolaemia was significantly lower in colon cancer patients than in the control samples whereas in subjects suffering from thyroid cancer, statistical significance was not attained even though a similar reduction was recorded. The reduction in cholesterol in cancer patients is, in the light of the most recent studies, an effect of cancer on cholesterolaemia, thus giving the lie to the theory that low blood cholesterol is a factor favouring the onset of cancer, and is a finding with by no means indifferent repercussions on the study of the behaviour and physiopathology of cancers.

[Relations between hypercalcemia and peptic ulcer]. / Rapporti tra ipercalcemia e ulcera peptica.

Calcaemia and phosphoraemia have been evaluated in a group of patients suffering from gastroduodenal ulcer and in a control group suffering from various pathologies of surgical interest. A significant correlation was found to exist between these values and the presence of gastroduodenal ulcer and this is considered worthy of further clinical and experimental study.

[Evaluation of survival in a sample of patients treated with radical mastectomy for mammary carcinoma]. / Valutazione della sopravvivenza in un campione di pazienti operate di mastectomia radicale per carcinoma mammario.

Survival and its modalities were studied in 40 patients subjected to Halsted's operation for breast cancer between 1960 and 1972. The following parameters were considered: age at time of surgery, onset of tumour before or after menopause, age of commencement of menopause, married or single, number of pregnancies, breast feeding, regularity of menstrual cycle, prior breast disease, time elapsed between first symptoms and mastectomy, side affected, quadrant affected, involvement of ipsilateral lymph nodes, histological type, complementary X-ray treatment, ovariectomy, and medical hormone therapy.

[Clinical contribution to the surgery of adrenal glands]. / Contributo clinico alla chirurgia del surrene

The anatomopathological and clinical features of 131 cases subjected to adrenalectomy for metastasis of breast cancer, hypercortico-adrenalism and pheochromocytoma are described. The results of surgical management are analysed.

[Correlations between splenoportographic findings and risk of digestive hemorrhage in portal hypertension]. / Correlazioni fra reperti splenoportografici e rischio d'emorragie digestive nell'ipertensione portale.

In 102 cases examined by splenoportography (93 cirrhosis with patent splenoportal axis and 9 splenoportal thrombosis without appreciable liver changes), the occurrence of episodes of digestive haemorrhage was statistically correlated with age, sex, type of portal impediment, type of collateral circulation, and the presence or otherwise of ascites, and with portal pressure values measured by splenomanometry. The only statistically significant correlation was that concerning the type of hepatofugal collateral circulation, as digestive haemorrhage proved gradually less frequent in patients with gastro-oesophageal collateral circulation, in those with so-called infraportal collateral circulation and, finally, in those where angiography was unable to demonstrate the presence of any collateral circulation at all.

[Diagnostic approach to extra-renal pheochromocytoma]. / Approccio diagnostico ai feocromocitomi extra-surrenalici.

Stress is laid on certain principles of diagnostic research in the event of extra-suprarenal pheochromocytomas. The importance of CT is recalled, specifying the usefulness of complementary examinations such as selective venous catheterism and above all of scintigraphy with 131I MIBG.

[Appendectomy and colo-rectal carcinoma. Clinico-statistical and experimental studies]. / Appendicectomia e carcinoma colo-rettale. Ricerche clinico-statistiche e sperimentali

A clinico-statistical investigation has been carried out with a view to establishing whether or not there is any correlation between appendicectomy and onset of colorectal cancer. The analysis showed that the frequencies of appendicectomy in the sample studied and in the control sample were not statistically different. On the other hand, it was observed that in patients suffering from colorectal carcinoma, the age at which appendicectomy was performed is is greater than in control subjects, with a constant mean interval in males and females (17 years). Experimental research on appendicectomized rats confirmed that the incidence of clinically induced tumours is no greater than that observed in control animals.

[Surgical treatment of functional tumors of the adrenal gland]. / Le traitement chirurgical des tumeurs fonctionnelles de la glande surrénale.

The authors evaluated and operated 40 cases of Cushing's syndrome, 8 cases of Conn's syndrome and 19 cases of phaeochromocytoma. The diagnosis was frequently delayed due to inadequate hormonal analysis. Cancer of the adrenal gland was observed in 17% of cases of Cushing's syndrome, while all cases of Conn's syndrome corresponded to an adenoma. There was a female predominance for both Cushing's syndrome and Conn's syndrome. Four malignant lesions were observed in the series of 19 tumours of the adrenal medulla (21% of cases). CT scan was found to be the most accurate of modern diagnostic techniques and was able to define the site and the dimensions of the adrenal tumour. Arteriography was particularly useful in cases with large, highly vascular tumours. The preferred surgical approach was lumbotomy, less frequently laparotomy, and, in cases of invasive tumour, thoraco-phreno-laparotomy. Removal of the tumour by adrenalectomy led to resolution of the symptoms and, in benign cases, complete cure.

[Thyroid tumors in the mediastinum]. / I tumori tiroidei a sede mediastinica.

The Authors studied 46 cases of thyroid neoplasm, characterized by a mediastinal involvement of different degrees, and analysed the epidemiologic, anatomo-pathological and clinical aspects thereof. Then, they, on the basis of their experience, outlined the formulation of the diagnostic ascertainments and surgical treatment.

[Survival in a sample of patients operated on for carcinoma of the colorectum]. / Studio della sopravvivenza in un campione di pazienti operati per carcinoma del colon-retto.

The authors report the results of different types of surgical treatment performed on a sample group of 51 patients chosen on a total of 308 patients operated for cancer of the colon rectum in the period 1965-1979. They also make their considerations about the most common complications arising in the early and late post operative period, the quality of life achieved by the patients and the survival rate related to the various types of operations performed.

[Precedents of benign thyroid pathology in carcinoma of the thyroid]. / Precedenti di patologia tiroidea benigna nel carcinoma della tiroide.

The clinical history of 125 thyroid cancer (99 women and 26 men) operated on between 1985 and 1992 is reviewed. Previous benign thyroid disease is recorded in 52% of all cancers; this was generally goitre or a thyroid nodule, and in few cases hyperthyroidism. Previous disease is observed in 75% of insular, in 68% of follicular, in 51.5% of papillary, in 35% of anaplastic carcinomas. It is supposed that previous thyroid disease is a risk factor in the development of cancer.

[Transduodenal papillotomy and divulsion of the papilla in the treatment of benign obstructions of the common bile duct (retrospective analysis of 186 cases)]. / Papillotomia transduodenale e divulsione della papilla nel trattamento delle ostruzioni benigne della via biliare principale (analisi retrospettiva di 186 casi).

An analysis is presented of 186 cases of biliary benign obstruction, treated with transduodenal sphincterotomy or dilatation-divulsion of the papilla of Vater. The morbidity and mortality rates due to specific complications were 5.4% and 1.6% respectively. No cases of post-operative pancreatitis were observed. Long-term results were re-evaluated in 46 patients after a mean post-operative interval of 18 years. The follow-up demonstrated that the result was completely satisfactory in 70% of cases; fair in 17%, with gastroenterological symptoms not likely related to the biliary disease; poor in 13%, with residual stones or stenosis of the sphincter of Oddi.

[Prognostic value of nuclear morphology in colorectal neoplasms]. / Valore prognostico della morfologia nucleare nelle neoplasie del colonretto.

Cytomorphometry measures the main geometric parameters of the cell nucleus (area, min. and max. diameter, circunference) on ordinary histological preparations. It has been employed to asses the prognosis of breast and ovary tumours. The possibility that cytomorphometry, when allied with other parameters, such as age, sex, Duke's stage, bleeding etc., can be used in the prognosis of tumours of the large intestine is examined through a study of intraoperative biopsies from 44 patients followed after surgery. Univariate analysis showed that the Duke's stage and tumour site were significantly related to prognosis. The standard deviation of the maximum diameter and circunference were also related to survival with a negative correlation. Multivariate analysis confirmed the significance of the maximum diameter and the Duke's stage. These parameters were then used to calculate the relative risk. If due account is taken of the reservation expressed in the literature concerning the reproducibility of the data offered by cytomorphometry and its heavy dependence on the skill of the operator, it can be used to advantage in the prognosis of the colorectal tumours.

[Prognostic value of nuclear morphometry in follicular carcinoma of the thyroid gland]. / Valore prognostico della morfometria nucleare nel carcinoma follicolare della tiroide.

Histological material from 60 cases of follicular carcinoma of the thyroid operated between 1962 and 1987 was examined morphometrically to see whether this would produce data that could be correlated with survival. Nuclear parameters (area, perimeter, minimum and maximum diameter and their ratio, form factor) and the mitotic index were investigated. At the same time, account was taken of certain clinical parameters (sex, age, degree of differentiation, size of the primary lesion, extension of the tumour) potentially correlated with prognosis. Survival in relation to all these variables was examined by means of an actuarial method and subjected to both uni- and multivariate analysis. The results, although suggesting the existence of a relationship between nuclear size and the aggressiveness of this type of tumour, failed to demonstrate a significant correlation between these morphometric parameters and survival after treatment. By contrast, survival was significantly influenced by some of the clinical variables, particularly loco-regional extension of the disease and the patient's age. The prognostic significance of nuclear size was recently demonstrated in breast cancer and in a series of thyroid carcinomas including tumours with different morphologies and progression patterns. In follicular thyroid carcinoma the degree of cellular pleomorphism is usually low. So, morphometry does not seem able to provide information regarding prognosis more valuable than those obtained by the clinical data.