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Biomedical subjects

F Carinci

Publications and source records attributed to F Carinci.

At least 55 records · Page 3Linked to original sources

Stage grouping reliability: TNM '97 versus TANIS in laryngeal cancer.

PURPOSE: To compare the correlation of TANIS and TNM '97 with the survival rate in laryngeal cancer. METHODS AND MATERIAL: From 1970 to 1990, 599 patients at the ENT Clinic, University of Ferrara, had a complete follow-up and met the criteria of enrollment. Data were analyzed by means of survival analyses (Kaplan-Meler and Cox algorithms). RESULTS: Both systems showed a significant correlation with the survival rate. TANIS advanced subcategories were better correlated with the mortality rate than TNM stages IVa and IVb. Again, in the final statistical model, TANIS was more highly correlated with survival rate than TNM.

Adult↗

Surgical treatment of choanal atresia in CHARGE association: case report with long-term follow-up.

A patient affected by a multisystem malformation, the CHARGE association, is described. The choanal atresia is one of the stigmata characterizing this syndrome. The main anomalies of the association, the surgical correction (choanoplasty with endoscopic transnasal approach followed by the application of nasal stenting) and a comparison with different techniques are reported.

Abnormalities, Multiple↗

Stage grouping of oropharyngeal cancer: evaluation of three systems by means of survival analysis.

Stage grouping is a method of summarizing multiple categories generated from the tumor, node, metastasis (TNM) classification system. Recently three different systems, the T and N integer score (TANIS), Hart, and 1997 Union Internationale Contre le Cancer systems, have been proposed. To verify their correlation to survival, a series of 64 patients affected by primary squamous cell carcinoma of the oropharynx was considered in this retrospective study. The data set was classified according to Union Internationale Contre le Cancer T stage and then grouped as recommended by the three systems. Results showed a crude survival rate of 28.13%. Univariate analysis by means of the logrank test yielded significant P values for the T and N integer score and Hart systems (0.0452 and 0.0179, respectively) and a borderline P value (0.0728) for the stratification based on the 1997 Union Internationale Contre le Cancer system. Multivariate analysis (Cox regression adjusted for age and sex) showed a significant correlation between the three staging systems and the mortality rate. Odds ratios were 1.36 (95% confidence interval, 1.12-1.66), 1.58 (95% confidence interval, 1.18-2.12), and 1.63 (95% confidence interval, 1.08-2.48) for the T and N integer score, Hart, and 1997 Union Internationale Contre le Cancer systems, respectively. The T and N integer score system showed the best statistical correlation, but a conclusive result could not be achieved because of the low number of patients in this study.

Adult↗

TGFbeta isoforms and decorin gene expression are modified in fibroblasts obtained from non-syndromic cleft lip and palate subjects.

Interaction between extracellular matrix (ECM) and cytokines is thought to be crucial for palatal development. The localization of transforming growth factors (TGFalpha and TGFbeta isoforms) in craniofacial tissues suggests that they carry out multiple functions during development. In the present report, we studied TGFalpha, TGFbeta1, and TGFbeta3 expressions and their effects on ECM macromolecule production of normal and cleft palatal fibroblasts in vitro, to investigate the mechanisms by which the phenotypic modulation of fibroblasts occurs during the cleft palate process. The results indicated that, while TGFalpha mRNA was not evidenced in CLP or normal fibroblasts, a reduced TGFbeta1 hybridization signal was detected in CLP fibroblasts. In addition, these secreted more active TGFbeta3 than TGFbeta1, as evaluated in a biological assay. The CLP phenotype, which differed from the normal one because of its higher PG decorin expression and greater production of GAG and collagen, was further modified by the addition of growth factors. In fact, in CLP fibroblasts, TGFalpha and TGFbeta1 down-regulated PG decorin transcript, TGFbeta1 increased collagen and GAG in both cellular and extracellular compartments, and TGFbeta3 promoted secretory processes of cells. In conclusion, the data represent the first report in a human model in vitro that TGFbeta1 and beta3 are differently expressed and are correlated to the CLP phenotype. Thus, strength is given to the hypothesis that TGFbeta isoforms are the potential inducers of phenotypic expression in palatal fibroblasts during development and that an autocrine growth factor production mechanism may be responsible for the phenotypic modifications.

Analysis of Variance↗

Is the new TNM (1997) the best system for predicting prognosis?

In 1997, the U.I.C.C. (International Union against Cancer) modified the previous TNM stage grouping published in 1987. In the present study, TANIS and TNM '97 systems were compared in order to evaluate their prognostic ability. Data from 164 patients affected by primary squamous cell carcinoma cancers of the oral cavity (n=100) and oropharynx (n=64) were analyzed by means of survival analyses. Both systems showed a significant correlation with survival rate. TANIS yielded better results in association with the survival rate as compared with TNM '97.

Adult↗

Granular cell tumor of the parotid gland. A case report.

Granular cell tumor (GCT), or granular cell myoblastoma, is a relatively uncommon lesion of the soft tissues. The tumor is thought to derive from a Schwann cell or from a perineural undifferentiated mesenchymal cell. GCT can occur in any organ, but the parotid gland is very unusual. A case of GCT of the parotid gland in a 30-year-old woman is described.

Adult↗

Suggestive linkage between markers on chromosome 19q13.2 and nonsyndromic orofacial cleft malformation.

Nonsyndromic cleft lip with or without cleft palate (OFC) is a common birth defect that has genetic bases. The nature of the genetic contribution is still to be clarified; however, some chromosome regions and candidate genes have been proposed for this malformation. We examined linkage between BCL3, a proto-oncogene located in 19q13.2, and OFC in a sample composed of 40 multiplex pedigrees using both nonparametric and parametric methods. The affected pedigree member statistics and the transmission disequilibrium test supported a role for BCL3 in causing OFC, while no evidence of linkage or genetic heterogeneity was found with the lod score method.

B-Cell Lymphoma 3 Protein↗

A locus in 2p13-p14 (OFC2), in addition to that mapped in 6p23, is involved in nonsyndromic familial orofacial cleft malformation.

An allelic association between the transforming growth factor alpha gene (TGFA) situated in the chromosome 2p13 region and nonsyndromic cleft lip with or without cleft palate, also named orofacial cleft (OFC), was found in several population studies. However, no linkage between gene and malformation has shown up until now, probably due to the presence of genetic heterogeneity and the small sample size analyzed. Previously, we employed a collection of 38 OFC families to demonstrate linkage to the 6p23 chromosome region with the presence of genetic heterogeneity. In the present study we tested whether, in the same sample, linkage between OFC and markers on 2p13 could be determined. Evidence for genetic heterogeneity in our family set was apparent, by both pairwise and multipoint linkage analyses. Moreover, lod scores > 3 were found for marker D2S378 when families linked to the 6p23 markers were analyzed. Taken together these results indicate a role for the TGFA, or for another gene physically close to it, and suggest an interaction between two different genes, OFC1 and OFC2, mapped in 6p23 and 2p13, respectively, in the development of the cleft.

Chromosomes, Human, Pair 2↗

Lack of linkage disequilibrium between transforming growth factor alpha Taq I polymorphism and cleft lip with or without cleft palate in families from Northeastern Italy.

Cleft lip with or without cleft palate (CL +/- P) is the most frequent craniofacial malformation in different human populations and its cause is largely unknown. Several studies based on population associations have suggested that an allele mapping in the transforming growth factor alpha locus could be responsible, as a risk factor, for the development of the defect. Our investigation of the Taq I polymorphism at the transforming growth factor alpha locus, performed in 40 CL +/- P families, did not find evidence for linkage disequilibrium with particular alleles. Moreover, tight linkage was excluded with the traditional LOD score method.

Alleles↗

Interleukin pattern of Apert fibroblasts in vitro.

The phenotype of cultured fibroblasts from patients affected by Apert's syndrome, a rare connective disorder, differs from that of normal cells in its extracellular matrix macromolecule composition (glycosaminoglycans, collagens and fibronectin) and is further modulated by treatment with interleukins (ILs). As the mechanisms responsible for the changes are unknown, we used our recently described model system for Apert periosteal fibroblasts to ascertain whether the pattern of ILs they secrete into the medium is comparable to that of normal fibroblasts. The results obtained by enzyme-linked immunosorbent assay (ELISA) show that the levels of interleukin-1 (IL-1) and interleukin-6 (IL-6) were lower in Apert than in normal media, whereas levels of IL-1 receptor antagonist (IL-1ra), the natural inhibitor of IL-1, were markedly higher. IL-1 specific bio-activity on thymocyte proliferation was also decreased in Apert supernatants. As we provided also evidence that active transforming growth factor beta (TGFbeta1), an IL-1 antagonist, was not secreted in greater amount in Apert media with respect to normals, the enhancement of IL-1ra appeared critical in down-regulating IL-1. Northern blot analysis of cytokine mRNA revealed no detectable IL-1 or IL-6 gene expression in normal fibroblasts, but high amounts of IL-6 mRNA transcripts in Apert cells. As the increased IL-6 gene expression did not translate into a parallel increase of secreted IL-6, the control of IL-6 secretion may be mainly post-transcriptional. Furthermore, the result that a treatment of the cultures with IL-1ra was able to induce a decrease of IL-6 secretion, suggests that the observed decreased secretion of IL-6 may be due to the autocrine action of overproduction of IL-1ra. The observed imbalance in the production of ILs which we show for the first time suggests ILs may be the natural autocrine regulators of ECM production in Apert fibroblasts. We hypothesize that in vitro differences previously reported in fibroblast phenotypes and several clinical features of Apert's syndrome may correlate with different cytokine patterns.

Acrocephalosyndactylia↗

Extension as a prognostic factor in oropharyngeal cancer: largest mucosal dimension compared with number of (sub)sites involved.

We report a retrospective study of 64 patients with primary squamous cell carcinoma of the oropharynx. The tumours were classified by the UICC (Union Internationale Contre le Cancer) system and a New Tumour Staging (NTS) system. Results showed a crude survival of 29% at 5 years. The most important prognostic factor for survival rate was the tumour (T) stage in both classifications. NTS recommendations that consider the number of sites and subsites involved yield a better correlation between survival and T stage. NTS also discriminates better between the T stages than the UICC criteria.

Adult↗

A comparison between TNM and TANIS stage grouping for predicting prognosis of oral and oropharyngeal cancer.

PURPOSE: The 1987 TNM classification system modified some T and N definition but it did not change stage grouping. Consequently it has not improved the prognostic validity of the advanced stage groups. In 1993, a new stage grouping was purposed, TANIS, that seems to have a higher correlation with survival. In this report, the TNM classification and TANIS system were compared to evaluate this prognostic ability. PATIENTS AND METHODS: Data from 164 patients affected by primary cancers of oropharynx or oral cavity were analyzed by means of Kaplan-Meier and Cox regression analysis. RESULTS: The crude survival rate at 5 years was 43.9%. Both systems showed a significant correlation with the survival rate by means of Cox regression analysis. TANIS subcategories were correlated to the mortality rate in the stage IV patients. TANIS resulted a better predictor of mortality when compared with TNM. CONCLUSION: The TANIS system was able to separate the TNM stage IV patients into prognostic groups, yielding more information with respect to TNM for such a category of patients. When a comparison between TNM and TANIS was performed, it was observed that TANIS had a higher correlation with survival rate, whereas TNM did not add any information in defining the survival function.

Adult↗

Neurofibromatosis of the orbit and skull base.

Von Recklinghausen's disease is characterized by multiple neurofibromas, pigmentations, and pachydermatoceles of the skin depending on the disorder of the neural crest derivative. We report on a 25-year-old patient suffering from neurofibromatosis localized in the cranio-orbital region, whose main problem was a pulsating right exophthalmos caused by herniation of the frontotemporal lobe through a defect of the greater wing of the sphenoid. The lesion was approached through a combined route (i.e., transfrontally and transfacially [upper eyelid incision]). Surgical strategy and associated problems are discussed.

Adult↗

Diphenylhydantoin affects glycosaminoglycans and collagen production by human fibroblasts from cleft palate patients.

During embryonic development, the proper production of extracellular matrix molecules mediates morphogenetic processes involved in palatogenesis. In the present study, we investigated whether any differences exist in glycosaminoglycan (GAG) and collagen synthesis between palate fibroblasts from infants, with or without cleft palate, in two age ranges. Subsequently, the effects of diphenylhydantoin (PHT), a teratogen known to induce cleft palate in human and mammalian newborns, on extracellular matrix (ECM) production were studied. We found that cleft palate fibroblasts (CPFs) synthesize greater amounts of GAG and collagen than normal fibroblasts (NFs). CPFs produced less cellular hyaluronic acid (HA) and more sulphated GAG. HA was the principal GAG species in the medium, and its percentage was lower in one- to three-year-old CPFs. Cleft palate fibroblasts produced more extracellular chondroitin 4- and 6-sulphate (CS) and dermatan sulphate (DS). Associated with a higher production of sulphated GAG, we observed a higher synthesis of type III and type I collagen with a normal ratio of alpha2(I) to alpha1(I) chains. PHT treatment of NFs reduced collagen and GAG synthesis, with a marked effect on sulphated GAG. The drug changed collagen synthesis, whereas it did not affect GAG production in CPFs whose phenotype may already be impaired. These findings indicate that, in CPFs, modifications in the pattern of ECM components, which are most likely responsible for the anomalous development, persist in infants. In addition, NFs and CPFs with a different phenotype respond differently to PHT treatment.

Cells, Cultured↗

Stratifying patients at risk of diabetic complications: an integrated look at clinical, socioeconomic, and care-related factors. SID-AMD Italian Study Group for the Implementation of the St. Vincent Declaration.

OBJECTIVE: The aim of this study was to identify subgroups of patients for whom the interactions among clinical, socioeconomic, and care-related factors determine a substantial increase in the risk of developing long-term diabetic complications. RESEARCH DESIGN AND METHODS: We performed a case-control study aimed at identifying and quantifying the risk factors for the development of major diabetic complications (eye, renal, and lower limb complications) in type 1 and type 2 diabetic patients. A total of 886 patients with renal, eye, or lower limb complications and 1,888 control subjects were enrolled in 35 diabetes outpatient clinics and 49 general practitioners' offices in 17 out of the 20 Italian regions. The main results were obtained using recursive partitioning and amalgamation (RECPAM), a technique that attempts to integrate the advantages of main effect logistic regression and tree-growing. RESULTS: The application of RECPAM led to the detection of important interactions involving clinical, socioeconomic, and care-related characteristics and allowed the identification of internally homogeneous subgroups characterized by a marked difference in the risk of developing major complications. In type 1 diabetic patients, the interaction between hypertension and smoking habits led to a dramatic increase in the complication risk, while in type 2 diabetic subjects, a poor compliance with visit scheduling was the most important predictor of complications. Furthermore, a marked difference in the risk profile was associated with patient characteristics (age, years of education, occupation). CONCLUSIONS: In the definition of the risk profile for each individual patient, socioeconomic status and level of education need to be taken under serious consideration, since they can determine a complication risk not dissimilar from hard clinical variables, such as hypertension and diabetes duration. Specific educational interventions, targeted to the socially disadvantaged strata of the population, need to be designed and implemented.

Adult↗

DEHP-induced alterations in the lining tissue of the rat air pouch.

The direct effects of D(2-ethylhexyl)phthalate (DEHP), on subcutaneous tissue were studied in the rat, using the air pouch technique. Two ml of DEHP either undiluted or diluted in olive oil (10 microm/ml), were introduced into a previously created air pouch in the rats. The air pouch was removed and specimens of the lining tissue examined by optical and electron microscopy. The persistence of DEHP for 7 days is sufficient to cause alterations in the tissue. The major histological changes were the destruction of the tissue organization with cytoplasmic and nuclear alterations resulting in apoptotic bodies. The histochemical data showed an increase of sulphated glycosaminoglycans, showing proof of alterations in fibroblast functions. The authors suggest that the hyperplastic-type alteration induced by DEHP may be connected with the sclerosis of the peritoneal membrane described in uremic patients in CAPD.

Administration, Cutaneous↗

[A case of a midline cervical cyst].

Midline cervical cysts are one of the most common embryological anomalies of the neck. They are due to the failure of a complete obliteration of the thyroglossal duct. This endodermal structure arises from the floor of the mouth and proceeds caudally in the midline of the neck until it reaches its final position around the trachea. Finally, the inferior portion of the thyroglossal duct develops into the median lobe of the thyroid gland whereas its cranial portion disappears. In the present paper, the clinical feature and the surgical treatment of a case is described.

Adult↗