Biomedical subjects
Publications and source records attributed to A Gallo.
The Authors valued on 18 periodontal patients the bleeding, probing depth, plaque indexes before and after antibiotic therapy with spiramycin. After bacteriological test and coaggregation test the Authors concluded spiramycin all day long is endowed with a good activity in periodontal diseases.
Multiple primary malignant neoplasms occur relatively frequently today and are quite important. If the primary tumor ("index tumor") develops in the upper aero-digestive tract, the incidence of these neoplasms ranges from 10 to 20%, especially in males. The most common second primary site is again in the upper aero-digestive tract and, less frequently, in the lungs or thoracic esophagus. Among head and neck tumors laryngeal cancer is certainly one of the neoplasms most often playing the role of index tumor in association with malignant cephalic and extracephalic tumors. Among the most frequent associations of multiple primary malignant tumors one finds: larynx-lung and larynx-esophagus. As a high incidence of metachronous primary pulmonary cancers were observed during follow-up of patients who had undergone laryngeal surgery, a preventive flexible bronchofiberscope study was performed in 101 patients who had undergone surgery for laryngeal cancer over the ten years period from 1978 to 1987. The patients had a median age of 58.7 years (range 42-81) and were prevalently males (98 males, 3 females). The incidence of second primary neoplasm in the lung was 3%. During this bronchoscopic study the chest x-ray for 2 of the 3 patients with second primary neoplasm in the lung was normal, all 3 had an evident familiar neoplastic predisposition, one had been treated for colon carcinoma prior to laryngectomy. The authors report some personal opinions regarding the larynx-lung neoplastic association and emphasize the application of bronchoscopy in following-up laryngeal cancer patients.
The treatment of patients with occult primary tumors presenting cervical metastases is still controversial. Thus the treatment of 10 patients with cervical metastases from unknown primary sites observed from 1978 to 1987 is reviewed. The average age of these patients was 56 years with a male: female ratio of 9:1. Any patients previously treated for cephalic or extracephalic neoplasms were excluded from the study as were those with lymphomas. According to TNM classification (1978) 7 cases (70%) were N1, one (10%) was N2 and two (20%) were N3. Only in one case were the cervical metastases multiple and unilateral, in one case (N2) they were bilateral. Histopathological diagnosis was performed with open biopsy in all cases prior to radical or conservative neck dissection. Five patients (50%) had metastases from epidermoid carcinoma, two (20%) from undifferentiated carcinoma (non nasopharyngeal), one (10%) from a papillary thyroid carcinoma, one (10%) from undifferentiated nasopharyngeal carcinoma and one (10%) from adenocarcinoma. The neck locations of the metastases were as follows: 3 (30%) at the upper cervical nodes (as was the N2 case), 3 (30%) at the mid-jugular nodes, 1 (10%) at the lower cervical nodes, 1 (10%) at the supra-clavicular nodes and 1 (10%) at the jugulo-digastric node. In the only case of multiple and unilateral nodes (10%) a contemporary involvement of the mid-jugular and lower cervical nodes was observed. A complete history was taken and a general physical and E.N.T. examination, X-ray, radioisotope and endoscopic studies were performed for all patients. In all cases treatment was: surgery on N + radiation therapy on the most common sites of unknown primary tumors. In particular, 7 conservative neck dissections (bilateral in one case), 2 radical neck dissections and 1 modified radical neck dissection were performed. The survival rate was 60% at 3 years and 40% at 5 years; it may be due to the radical treatment and to the high number of N1 and epidermoid carcinomas. In conclusion some considerations about the treatment of this pathology were reported.
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Laryngeal keratosis may frequently precede the appearance of carcinoma of the larynx which might well indicate that these diseases have a common denominator. A retrospective study of 120 subjects with laryngeal keratosis was examined. The intention of the Authors was to verify whether the principle risk factors involved in the appearance of laryngeal carcinoma were the same as those implicated in laryngeal keratosis formation. Sex age, work activity, cigarette smoke, alcohol consumption and vocal chord abuse were considered. Laryngeal keratosis takes keratosis with dysplasia as well as keratosis without. A link between these two types of keratosis and cancer was sought. In particular, the possibility that a persistent action of the mentioned risk factors could cause laryngeal dysplasia-free keratosis to change into dysplastic lesions and subsequently into cancer was investigated. A case-control study was performed in order to analyze the importance of work activity. Results were statistically significant (P < 0.001). The Cramer V2 calculation demonstrated a clear correlation between the number of cigarettes smoked and the appearance of dysplasia (V2 = 0.117; P < 0.005). Results showed a clearly different behaviour between sexes. The number of males was much higher than females as was the age at which keratosis appeared greater in males. The fact that the average age in which keratosis appeared preceded the appearance of laryngeal cancer by ten years indicates that this interrum is sufficient for keratosis with dysplasia to be transformed into cancer (due to the continued action of the mentioned etiologic factors, mainly referred to cigarette smoke). In our data analysis, no correlation was demonstrated between keratosis without dysplasia and cancer.
The aim of this study was to evaluate the value of second surgery in the combined and multidisciplinary treatment of mullerian ovarian cancer. A retrospective study was carried out in 86 consecutive patients with advances stages of mullerian ovarian cancer (stage 3-4) referred to the Division of Gynecological Surgical Oncology of the Oncological Reference Centre at Aviano for continuation of treatment following initial surgery and chemotherapy performed in various peripheral institutions. Second surgery only revealed 11.6% of complete endocelomatic pathological responses (10 patients) to earlier treatments; among the 76 patients with persistent disease it was possible to achieve optimal redebulking in 50 (65.8%) (31 R0 and 19 R1 after second surgery), whereas it was not possible to perform adequate second surgery in 26 (34.2%). The impact of second surgery on the probability of survival (mean survival rate) was highly significant in the 50 patients in whom it was possible to perform adequate second surgery compared to the non-operated group (14.34 months versus 6.10, chi square = 12.671, p = 0.0004). The authors underline both the prognostic value of lymph node status with increased mortality among patients with positive retro-peritoneal lymph nodes (LN+), and the value of retroperitoneal re-evaluation in predicting endo-peritoneal recidivation in patients with free abdomen who subsequently relapsed.
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