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- 저자 : Massimo Giusti (검색결과 3 건)
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Massimo Giusti,Lucia Conte,Anna Maria Repetto,Stefano Gay,Paola Marroni,Miranda Mittica,Michele Mussap 대한내분비학회 2017 Endocrinology and metabolism Vol.32 No.4
Background: Owing to its large molecular size, polyethylene glycol (PEG)-precipitable thyrotropin (TSH) can accumulate in the circulation, elevating TSH levels. PEG-precipitable TSH can be used to detect macro-TSH (mTSH) in serum. Our aim was to evaluate the prevalence of mTSH in patients who had undergone thyroidectomy for thyroid cancer. Methods: Seventy-three thyroid cancer patients and 24 control subjects on levothyroxine (LT4) TSH-suppressive or replacement therapy were evaluated. Screening for mTSH was performed by adding PEG to serum in order to precipitate γ-globulin. A percentage of PEG-precipitable TSH ≥80% was considered suggestive of mTSH. Results: No correlation between free-T4 (fT4) and TSH levels was found. PEG-precipitable TSH was 39.3%±1.9% in thyroid cancer patients and 44.1%±3.9% in controls. Macro-TSH was deemed to be present in one thyroid cancer patient and in two control subjects. Only in the thyroid cancer group was PEG-precipitable TSH found to be negatively correlated with fT4 concentration. No correlation was found between PEG-precipitable TSH and other clinical conditions in any patients. Conclusion: The presence of mTSH seems to be a rare phenomenon in thyroid cancer. In some patients with low PEG-precipitable TSH, a reduction in LT4 dosage could be suggested. LT4 dosage adjusted to body weight is the main factor in maintaining TSH in a semi-suppressed or normal range. Evaluation of mTSH could be necessary in patients in whom a balance is required between adequate TSH suppression and the avoidance of unnecessary exogenous hyperthyroxinemia.
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Silvia Oddo,Edineia Felix,Michele Mussap,Massimo Giusti 대한영상의학회 2018 Korean Journal of Radiology Vol.19 No.1
Objective: While many studies have reported that laser ablation (LA) for benign non-fuctioning thyroid nodules is efficacious in reducing nodular volume and neck symptoms, none have described changes in quality of life (QoL). The purpose of this study was to report post-LA changes in QoL in our cohort of patients. Materials and Methods: Fourteen patients with benign thyroid nodules were involved in a prospective, single-center study and underwent a single session of LA. We evaluated the following: changes in nodule volume, thyroid function, and autoimmunity; adverse events during and after LA; changes in neck discomfort by means of a visual analogic scale (VAS) at one week and 1, 3, 6, and 12 months; and changes in QoL through the 13-scale Thyroid-specific Patient Reported Outcome (ThyPRO) questionnaire at 1, 3, 6, and 12 months. ThyPRO is a validated questionnaire for thyroid diseases, which consists of 13 scales with multiple-choice answers. They investigate several aspects of life that may be impaired by goiter-related compression symptoms, by esthetic alterations and by hypo- or hyperthyroidism. Results: Nodule volume decrease was -37 ± 23%, -55 ± 22%, -53 ± 25%, -58 ± 25% (p < 0.01 vs. baseline) at the first, third, sixth, and twelfth month, respectively. No hypothyroidism or positivization of autoimmunity was observed. There were no major complications during or after LA. After LA, VAS scores improved significantly from 1 week onwards in 100% of patients, while a significant improvement was seen in the goiter symptoms score after one month, and in the general score and mean values of ThyPRO after six months. Scores on the other ThyPRO scales did not change significantly. Conclusion: Laser ablation is safe and effective in reducing nodule volume and neck symptoms; this is confirmed by improvements in the goiter scale, general score, and mean values of ThyPRO and in the VAS score.
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Fabio Grizzi,Gianluigi Taverna,Piergiuseppe Colombo,Mauro Seveso,Guido Giusti,Silvia Proietti,Girolamo Fiorini,Giovanni Lughezzani,Paolo Casale,Nicolò Buffi,Massimo Lazzari,Giorgio Guazzoni 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6
Purpose: Prostate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkerswith improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexityin prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlationsbetween the results and selected clinical and pathological parameters of prostate carcinoma. Materials and Methods: A total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostatecancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsysampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-μm sections were treated with CD34 antibodiesand were digitized by using an image analysis system that automatically estimates the surface fractal dimension. Results: Our results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlationswere found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathologicalstage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence. Conclusions: The value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancertissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmarkof intermediate- and high-risk prostate cancer.
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