[Endoscopic endoprosthesis insertion in the treatment of digestive diseases].

Over the last few years the use of endoscopically placed endoprostheses for benign and malignant digestive diseases has considerably developed. The endoscopic placement of prostheses is usually well tolerated by patients; it does not require anaesthesia and it is a relatively low-risk procedure. New self-expandable metallic prostheses allow to treat even very tight stenoses; they do not usually require dilatation, therefore reducing the risks involved in dilatation procedure.

[Esophageal perforations and fistulas: clinical management].

Aim of this study was the literature review regarding esophageal perforations and fistulas. We examined the most common causes, clinical findings (symptoms and signs), laboratory and imaging studies for differential diagnosis and complications. Finally, we examined the surgical or endoscopic treatment and the prognosis.

Epithelioid granulomas as main clinical manifestation at the outset of non-Hodgkin's lymphoma: report of two cases.

This article describes two cases of malignant lymphoma in which the finding of a striking epithelioid granulomatosis was the main clinical manifestation at the outset of the patients' history. Despite some suggestive clinical and laboratory data, the final diagnosis of lymphoproliferative disorder was made only after repeated histological studies in both patients. Although the association between a severe granulomatous reaction and a B-cell neoplasm is rare, the latter should be taken into account as a possible primary disease.

Amifostine promotes hemopoietic progenitor cell mobilization in patients with myelodysplastic syndrome.

The multilineage hematological effects of the chemoprotective agent amifostine suggested administration of the drug to patients with myelodysplastic syndromes. Partial but encouraging responses were seen. The aim of this research was to further evaluate amifostine activity on the hemopoietic progenitor cells of myelodysplastic patients.

Dexamethazone-induced acute tumor lysis syndrome in a T-cell malignant lymphoma.

We report a case of steroid-induced acute tumor lysis syndrome and review the literature. A 60-year-old woman was started on steroid therapy for dyspnea due to bilateral pleural effusion and a large mass involving the anterior mediastinum. The final diagnosis was precursor T-lymphoblastic lymphoma-leukemia.

Effects of retinoic acid and amifostine on in vitro growth of normal hemopoietic progenitor cells.

Association of all-trans retinoic acid (ATRA) and amifostine (AMF) might be an alternative in treatment of myelodisplatic syndromes. In this study we undertook a preliminary in vitro research on the effects of a combination of ATRA and AMF on normal hemopoietic progenitors. Mononuclear, non-adherent cells from peripheral blood of normal volunteers, were incubated with AMF, at a the concentration of 500 microM and then cultured for CFU-GM and BFU-E growth adding to culture dishes before gelling ATRA at the concentration 10(-6) and 10(-12)M.

Adenomas with severe dysplasia and early carcinoma of the colon-rectum: our experience of 27 patients.

Authors report their experience in the treatment of adenomas with severe dysplasia and early cancer of the colon-rectum confirming that the endoscopic resection of these lesions is safe and curative when completely removed and no submucosal invasion is found. Between 1995 and 1999, 219 patients underwent colonoscopy and 287 polyps were removed. Histologic examination showed 217 adenomatous polyps (75.

[The role of endoscopic sphincterotomy in the therapy of choledocholithiasis: a review of our experience].

The treatment of common bile duct stones is nowadays endoscopic sphincterotomy. The authors reviewed their series from 1992 to 1999 and confirm that this is a safe, definitive, with low complication rate treatment if is performed in specialized centers and reduces the duration of hospitalization. Operative ERCP is successful is about 96-97% of the cases.

Advanced colorectal cancer: quality of life and toxicity in patients after weekly 24-hour continuous infusions of biomodulated 5-fluorouracil.

It is generally agreed that chemotherapy prolongs survival and relieves symptoms more than the best supportive care in advanced colorectal cancer. Since its introduction over 35 years ago, 5-fluorouracil (5-FU) has been the only effective chemotherapeutic option available for the treatment of advanced colorectal cancer. Efforts have focused on the use of various 5-FU-based regimens.

[Endoscopic polypectomy in benign adenoma and in early colo-rectal lesions].

The Authors report their results in 219 patients who underwent endoscopic polypectomy for benign adenomatous polyps and early colorectal cancer. This is safe and curative technique associated with low-risk of complications and in an ideal therapy to prevent the development of colorectal cancer. In fact, nowadays, dysplasia-carcinoma sequence has been described.

Effects of docetaxel on the in vitro growth of human myeloid progenitors.

Haemotoxicity is usually the primary and dose-limiting side-effect of docetaxel (TXT) a semysyntetic analogue of paclitaxel which has acquired an important role in anticancer treatment. This research presents the results of an in vitro toxicity study of TXT on myeloid progenitors obtained from healthy volunteers and assayed as CFU-GM. Peripheral blood mononucleated non-adherent cells (MNAC) were incubated for 24 h at standard conditions with increasing concentrations of TXT and then cultured for CFU-GM assay.

[Endoscopic treatment of polyps of the large intestine: authors' experience with 250 cases of polypectomy].

The Authors report their experience of endoscopic polipectomy. This technique represents a gold standard treatment for polyps of the colon-rectum because it is safe and effective, being correlated with low-risk of complications as perforation and hemorrhage. Hospitality stay was only 24-48 hours.

[Endoscopic ligation in the prevention of hemorrhage after polypectomy: our experience].

The Authors report their experience with the use of the Olympus Endoloop HX-20L for the prevention of haemorrhages after endoscopic polypectomy. They emphasize the utility of this therapeutic device that will find its right application only in a well selected group of patients.

Cisplatin inhibits erythroid committed progenitor (BFU-E) mobilization in peripheral blood.

Circulating myeloid (CFU-GM) and erythroid (BFU-E) progenitor levels were evaluated weekly throughout 3 courses of treatment with vinorelbine (VNB) ifosfamide (IFO) and filgrastim (G-CSF) with or without addition of cisplatin (DDP) in 20 stage IIIB or IV non small-cell lung cancer patients. In IFO, VNB, DDP-treated patients, BFU-E mobilization in peripheral blood following chemotherapy and G-CSF was completely lacking, in contrast with the patients treated with IFO, VNB plus G-CSF. CFU-GM release, however, was of the same order in the 2 groups of patients.

[Current status of the use of the endoscopic cholangiography technique].

The endoscopic retrograde cholangiopancreatography as a diagnostic technique employed to obtain an accurate radiological study of the biliary path, and the biliary duct-pancreatic-duodenal junction. However, during the initial diagnostic studies, both echography and nuclear magnetic resonance have taken a priority. Currently, their importance is as a preliminary diagnostic method during endoscopic intervention.

Surveillance after colorectal cancer surgery.

Early diagnosis of local and distant recurrences of colorectal cancer remains difficult and there is no agreement on the effectiveness of follow-up in these patients. The aim of this study is to assess the value of our method of follow-up. We consider 239 patients with colorectal cancer and at least 2 years follow-up following radical resection.

[Endoscopic ligation and sclerotherapy in the treatment of esophageal varices].

Endoscopic variceal ligation (EVL) and esophageal variceal sclerotherapy (EVS) are both used in the treatment of esophageal varices. Sclerotherapy is widely used with success, however it is associated with multiple local and systemic complications. To overwhelm the complications of sclerosis, Stiegmann in 1986 proposed the elastic band variceal ligation which demonstrated to be efficient as sclerotherapy though with minor side effects.

[Endoscopic treatment of benign esophageal stenosis].

Benign esophageal stenosis is the most frequent type of stenosis of the digestive tract. Surgical treatment is still affected by a high percentage of morbidity and mortality. This is not acceptable for a condition which is not neoplastic in nature.

Feasibility and toxicity of combination chemotherapy with ifosfamide, vinorelbine, cisplatin versus ifosfamide, vinorelbine in patients with advanced non small cell lung cancer.

Vinorelbine (VNB) and Ifosfamide (IFO) have recently been proposed for treatment of non small cell lung cancer (NSCLC). The two drugs separately induce response rates in excess of 20% and, when combined, of 32.56%.

Carboplatin and cisplatin pharmacokinetics after intrapleural combination treatment in patients with malignant pleural effusion.

Background: Cisplatin (DDP) and carboplatin (CBDCA) are two of the most effective drugs in a locoregional approach. Since simultaneous combined treatment with intrapleural DDP and CBDCA has not been reported in humans, we investigated its use in patients with malignant effusions, focusing on pharmacokinetics.

Patients And Methods: The pharmacokinetics of DDP and CBDCA were studied in 10 patients with malignant pleural effusion treated intrapleurally with a combination of DDP (60 mg/m2) and CBDCA (270 mg/m2) and in additional patients who received the same doses of drugs administered intravenously as single agents or in combination.

In vitro synergistic inhibition of human bone marrow hemopoietic progenitor growth by a 3'-azido-3'-deoxy-thymidine, 2',3'-dideoxycytidine combination.

In vitro growth of human normal bone marrow granulocyte-macrophage colony forming units (CFU-GMs) and erythroid burst forming units (BFU-Es) was dose-dependently inhibited by 3'-azido-3'deoxythymidine (AZT) (from 0.1 microM to 4 microM) and 2',3'-dideoxycytidine (ddC) (from 0.01 microM to 1.

[Pneumatic dilatation in the treatment of esophageal achalasia].

The purpose of therapy in esophageal achalasia is to reduce the pressure at the level of the lower esophageal sphincter. In this study 26 patients (16 males and 10 females) between 30 and 50 years of age, affected by esophageal achalasia underwent esophageal dilatation with Rigiflex pneumatic dilators. A total of 40 dilatations were performed.

Interferon-alpha inhibits CFU-GM mobilization following chemotherapy and G-CSF administration.

Changes in routine hematologic data and in circulating granulocyte-macrophage colony-forming units (CFU-GM) during granulocyte colony-stimulating factor (G-CSF) administration were evaluated in non-small cell lung carcinoma (NSCLC) patients treated with a combination of 5-fluorouracil (5-FU) and cisplatin (DDP) with and without the addition of interferon-alpha (IFN-alpha). The patterns of leukocyte changes following chemotherapy plus G-CSF were similar in both the IFN-alpha-inclusive and the IFN-alpha-devoid courses. However, the twofold increase in CFU-GM observed in patients receiving chemotherapy plus G-CSF was completely absent following the course including IFN-alpha.

In vitro activity on myeloid progenitors of a combination of 2-chloro-2'-deoxyadenosine and interferon alpha: the effects of IL-1 and GM-CSF.

The toxic effects of a combination of 2-chloro-2'-deoxyadenosine (CDA) and interferon alpha (IFN-alpha), with and without addition of interleukin 1 (IL-1) and/or granulocyte macrophage colony stimulating factor (GM-CSF), on the in vitro growth of peripheral blood granulocyte macrophage committed progenitors (CFU-GM) from 10 normal subjects were investigated. CDA concentration ranged from 15.6 nmol/l to 1 mumol/l, IFN-alpha sole concentration was 10 IU/ml.

[Polyethylene glycol versus sodium phosphate: comparison of 2 preparations for colonoscopy].

The intention of this study is to compare the efficacy and tolerability of an electrolytic solution containing polyethylene glycol (PEG) with a saline solution containing sodium phosphate in the preparation of colon for an endoscopic examination. 80 patients were subdivided at random into two groups: Group 1; PEG 4 liters - Group 2; sodium phosphate 3 packets plus one microenema. The efficacy of the two preparations was decided on the basis of: presence or absence of liquid/solid faecal residues observed by the endoscopist during the exploration of the large intestine, and classified as follows: perfect, good, mediocre and bad.