Stop-flow technique for loco-regional delivery of antiblastic agents: literature review and personal experience.

AIMS: The therapeutic approach for primary or recurrent advanced solid tumours, particularly when unresectable, is still one of the main medical challenges in the management of cancer patients. The stop-flow (SF) technique has been recently proposed as a semi-invasive drug delivery system based on the blood supply blockage of the tumour-bearing area. Here, we discuss the principles underlying the SF technique as well as the worldwide experience published so far. We also report on the results of our pilot study on pelvic and limb SF perfusion. METHODS: We reviewed the worldwide experience on SF as reported by the literature published on PubMed from 1990 through 2001. In our series, we treated 20 patients affected with locally advanced melanoma, soft tissue sarcoma or colorectal cancer. RESULTS: This therapeutic modality - at least for some tumours - can achieve encouraging results in terms of clinical response even after conventional therapies have failed. Moreover, as a safe and relatively simple procedure, SF can be applied to patients for whom traditional treatments (i.e. surgery, systemic chemotherapy) are contraindicated because of poor general conditions. CONCLUSIONS: At present, the SF technique should be considered an investigational approach to locally advanced cancers. The encouraging results obtained with this procedure should be validated by large phase III trials.

Phylogeny of the genus Azospirillum based on 16S rDNA sequence.

The 16S rDNA of 17 strains of Azospirillum, 14 assigned to one of the known species A. amazonense, A. brasilense, A. halopraeferens, A. irakense and A. lipoferum, and the other three of uncertain taxonomic position, was sequenced after polymerase chain reaction amplification and analysed in order to investigate the phylogenetic relationships at the intra-generic and super-generic level. The phylogenetic analysis confirms that the genus Azospirillum constitutes a phylogenetically separate entity within the alpha subclass of Proteobacteria and that the five species are well defined. A. brasilense and A. lipoferum are closely related species and form one cluster together with A. halopraeferens; the pair of species A. amazonense and A. irakense forms a second cluster in which Rhodospirillum centenum is also placed.

[A case of neonatal extracorporeal membrane oxygenation after heart surgery]. / Un caso di extracorporeal membrane oxygenation neonatale dopo intervento cardiochirurgico.

There is international experience of Extracorporeal Membrane Oxygenation (ECMO) in children suffering acute Respiratory failure (eg. meconium aspiration syndrome); on the contrary there is a lack of consistent experience in pediatric ECMO application in cardiac surgery as bridge to cardiac transplantation and as heart mechanical support after postcardiotomy failure. In fact there are good standardization criteria for selection, inclusion and exclusion in ECMO application for neonatal respiratory failure; differently pediatric ECMO timing (that is when to start and to stop this ventricular support) is not clear and standardized. We present one case of pediatric ECMO application in a neonate, who underwent cardiac operation for pulmonary valve aplasia and who was impossible to wean from cardiopulmonary bypass.

[Gingival changes in pregnancy]. / Alterazioni gengivali in gravidanza.

Pregnancy represent a particular sistemic condition able to induce, because the tissutal metabolism is upset, an increase replay of the gingival tissues, caused by local factors as plaque and tartar. In this study are described effects determined from the increment ormone on the periodontal tissues, the alterations of the salivar components in pregnancy and the therapy to follow to reach as soon as possible the recovery.

[Serological typing and antibiotic resistance in urinary "E. coli" (author's transl)]. / Tipizzazione sierologiga ed antibiotico-resistenza di "E. coli" urinari.

The distribution of the O-groups of E. coli isolated in rivers (Arno, Serchio) and other surface waters is compared with the distribution of those isolated in urinary tract infections. The "chi square" test indicates a good correlation between the observed and expected frequencies in these two distributions, for all the O-groups, but six. Two of these (08 and 019) are significantly more frequent in the waters than in urinary isolates and four (02, 01, 018 and 075) viceversa. The O-group 6 its the most frequent in both, however the observed frequency in urine is greater than the expected one as regards the frequency in water isolates. These results would confirm, with the mentioned exceptions, the prevalence theory. The different patterns of resistance to the antibiotics suggest us to research a possible correlation between the antibotic resistance and the most frequent isolated O-groups. But no evidence of such correlation is demonstrated.

[The etiology of urinary tract infections]. / Contributo allo studio dell'etiologia delle infezioni delle vie urinarie.

The Authors have planned a program in order to file and elaborate with a computer the results of urine cultures. From 8.600 specimens, about 86% were negative or doubtful. The data obtained from 1201 positive cultures were processed in order to state the absolute and relative frequency of the bacterial species isolated and their distribution according to their genera, antibiotic resistence, month and sex. Among the most representative species the pattern of antibiotic resistence was surveyed. E. coli shows very high frequency (38%). The frequency of Pseudomonas increases while staphylococci frequency decreases as compared with the previous statements of various Authors. The analysis of the antibiotic sensitivity spectrum of 534 specimens shows that about 50% of E. coli strains are sensitive to 10, 11 and 12 antibiotics and their pattern of resistence involves no more than 9 antibiotics; on the contrary more than 60% of Pseudomonas and Proteus rettgeri are resistant to 10, 11 or 12 antibiotics and at any rate to no less than seven. Enterobacter and Proteus mirabilis present an intermediate pattern of resistence.