Search PubMedSearch

Biomedical subjects

G Almadori

Publications and source records attributed to G Almadori.

13 recordsLinked to original sources

Cathepsin D in primary squamous laryngeal tumors: correlation with clinico-pathological parameters and receptor status.

Using an immunoradiometric assay, Cathepsin D (Cath D) levels were measured in the cytosol of 23 normal and 39 neoplastic human laryngeal tissues. Scattered Cath D levels (from 2.2 to 17.8 pM/mg protein; median = 7.6) were found in normal mucosa specimens. Cath D concentrations range from 2.0 to 29.3 pM/mg protein (median = 8.5) in laryngeal tumors. When a comparison between Cath D levels in normal and neoplastic tissue specimens from the same patient was done, Cath D levels were significantly higher in laryngeal cancers than in their normal counterparts (P = 0.03). No correlation with clinico-pathological parameters and steroid hormone and epidermal growth factor receptor status was found. Further studies should investigate whether the production of Cath D by laryngeal tumors could have a clinical relevance for this neoplasia.

Adult

EGF receptor expression in primary laryngeal cancer: correlation with clinico-pathological features and prognostic significance.

Epidermal-growth-factor-receptor(EGFR) expression was evaluated in 103 primary laryngeal tumors and in 42 normal laryngeal tissue specimens. Significantly higher EGFR levels were found in cancer specimens than in normal mucosa (p = 0.0053). EGFR expression did not correlate with age, tumor localization, T classification, cervical-lymph-node involvement or type of surgery, whereas it was higher in poorly differentiated tumors (G3) than in well/moderately differentiated (G1-G2) tumors (p < 0.05). Follow-up data were available for 74 patients. When EGFR status and the most important clinico-pathological characteristics were submitted to univariate analysis, tumor localization, type of surgery and EGFR status were found to be significantly correlated with disease-free survival. The 24-month disease-free survival rate was 58% for EGFR+ cancer patients and 82% for EGFR- ones. With multivariate analysis, only EGFR status and tumor localization were identified as significant independent prognostic parameters. Data reported here suggest that high EGFR levels may identify a sub-set of laryngeal-cancer patients with a particularly unfavorable prognosis.

Adult

Plexiform neurofibroma of the cervical portion of the vagus nerve.

The authors describe a rare case of plexiform neurofibroma of the cervical portion of the vagus nerve, and discuss its aetiopathogenesis, clinical, histological and therapeutic features, emphasizing the difference from other benign tumours of the vagus nerve. The clinical characteristics of the mass, ultrasound tomography, CT scanning and digital subtraction angiography were useful in defining its extension and relationships with the surrounding structures. Surgery is the treatment of choice. After mentioning the most commonly employed surgical approaches, they emphasize the advantages of the lateral-cervical approach which allows a wide exposure of the possible sites of origin of the tumour and its complete removal. Finally they stress the need of an accurate histological and immunohistochemical examination in order to differentiate neurofibromas from neurilemmomas.

Adult

Functional study of the eustachian tube with sequential scintigraphy.

The authors investigated the tubal function by means of sequential scintigraphy in 16 patients affected by chronic otitis media and in 3 patients with posttraumatic perforation of the tympanic membrane. Evaluated parameters were: appearance time (AT), radioactivity peak time, rise time in the tympanic cavity, eustachian tube and rhinopharynx, and radioactivity percent values passed in the rhinopharynx. The tubal pressure-equilibrating function was determined by means of the manometer pump section of the impedance meter. A significant relationship between the pressure-equilibrating function and the tubal scintigraphy parameters has been detected. The variability of the AT in the tube and the almost constant time needed by the radioactive tracer to go through the tube and reach the rhinopharynx could indicate that a major role in the tympanic cavity drainage is played by the tympanic ostium and the surrounding mucosa.

Chronic Disease

Receptors for epidermal growth factor and steroid hormones in primary laryngeal tumors.

The authors investigated the presence of epidermal growth factor (EGF-R), estrogen (ER), progesterone (PR), and androgen (AR) receptors in 42 laryngeal squamous cell carcinomas and 20 normal laryngeal mucosa specimens. EGF-R were expressed in all tumor specimens analyzed, with significantly higher levels in tumor samples compared with normal mucosa (P less than 0.05). The immunohistochemical study demonstrated the presence of EGF-R in basal and parabasal cells of normal mucosa and in most of the cancer cells. There was no correlation between EGF-R and tumor localization or T classification. On the other hand, the authors did find an interesting correlation between EGF-R levels and grading, EGF-R levels being significantly higher in G3 than in G1-G2 tumors. Moreover, the three patients whose tumors expressed the highest EGF-R levels had disease recur within 8 months. Among tumor specimens, 9.5%, 35.7%, and 9.5% expressed very low but detectable ER, PR, and AR levels, respectively. No statistically significant difference was found between the levels of steroid receptors in the tumor and normal mucosa specimens, and neither was there any correlation of ER, PR, and AR with the pathologic findings. The authors' results suggest that the EGF-R system may play a role in regulating the growth of laryngeal cancer. Additional studies should demonstrate whether, as in other tumor types, EGF-R expression may have prognostic significance in human laryngeal cancer.

Adult

Marijuana smoking as a possible cause of tongue carcinoma in young patients.

A case of T1N0M0 carcinoma of the tongue in a male 23-year-old 'regular' marijuana smoker is described. Hemiglossectomy and complete bilateral neck dissection were carried out. No post-operative radiotherapy was given as the resection margins were histologically negative. The tumour recurred one year later in the left cervical region involving the mandible and surgery was again performed, but after three months, neck disease was still evident. The case described case implies the introduction of marijuana as a possible new risk factor in the development of oral cavity tumours. Resection of the primary lesion has to be as wide as possible even in T1 cases, due to the aggressive biological behaviour of such tumours in young subjects.

Adult

Auditory brainstem responses in the aged.

The auditory brainstem responses (ABR) in a group of 74 aged subjects (60-80 years), affected by presbycusis were evaluated for presence of a retrocochlear involvement. The comparison of results from subjects with presbycusis with those from normally-hearing elderly subjects, and young subjects, affected by a cochlear sloping hearing loss, revealed that the latency increase of ABR observed in presbycusis is mainly correlated to the audiometric shape of the hearing loss and not to age per se.

Acoustic Impedance Tests

40-Hz steady-state responses in newborns and in children.

The authors investigated the 40-Hz steady-state responses (SSR) in 32 full-term newborns and in 10 normal children (5-8 years old), using 500-Hz tone bursts. The 40-Hz SSR threshold is located at about 50 and 30 dB nHL in newborns and older children, respectively. The latencies of both P1 and N1 waves decreased significantly with age, while the amplitudes increased. No significant latency and amplitude intersex differences have been observed. Moreover, with age, the 40-Hz SSR became more stable, their test-retest replicability improved, and P1-N1 wave occurrence increased. The authors finally discuss the possible underlying mechanisms of these findings and conclude that the 40-Hz SSR are difficult to obtain and are scarcely reliable in defining the low-frequency threshold in newborns. The stability and reliability of the responses increase with age, and the electrophysiological and behavioral thresholds to low-frequency stimuli tend to overlap.

Audiometry, Evoked Response

Auditory brain-stem (ABRs) and middle latency auditory responses (MLRs) in the prognosis of severely head-injured patients.

Auditory brain-stem responses (ABRs) were studied in 66 subjects with severe head trauma. Middle latency responses (MLRs) were also recorded in 22 of them. Patients were carefully selected to avoid conditions such as pre-existing or acute deafness, hypothermia or ethanol intoxication. In order to evaluate the usefulness of potentials in predicting recovery, patients were classified according to the Glasgow Coma Scale (GCS). ABR tracings were classified into 5 groups and MLR into 2 groups. The recovery was good in the presence of a type 1 ABR, poor in the presence of types 3, 4 and 5. Concerning type 2 ABR, the outcome is related to the MLR type, and to the presence of an electrophysiological improvement within the first 3 months following trauma. The reliability of ABR and MLR in predicting the outcome of severe head injury appears to be greater than other usually considered clinical and instrumental data (age, GCS, CT scan, EEG).

Adolescent

[Carotid body tumors: the clinical, diagnostic and therapeutic aspects].

The authors discuss the epidemiology, histology, symptomatology, diagnosis and therapy of carotid body tumors, basing their discussion on three personal observations and on a case of cervical dermatocyst which showed clinical and radiological data consistent with diagnosis of a glomus tumor. Chemodectomas of the neck are more often seen in the carotid body and are considered histologically benign, although they might induce local or distant metastases. Clinical presentation is often non-specific and may only consist in a slowly growing mass in the higher jugular-carotid region. Among the various imaging techniques (CT, MR), supra-aortic selective angiography, including digital subtraction techniques, is now considered the most reliable tool, while ultrasonography and gammagraphy with 99mTc-gluconate or 131I-MBG are recommended for screening and family testing purposes. Biopsy is to be avoided as it is very likely to cause massive bleeding and because of the high percentage of false negatives. Surgery is the choice treatment, and lateral cervicotomy is the recommended approach for exeresis of the mass, while radiotherapy should be planned in patients with precise contra-indications for surgery and when the tumor mass has already reached the skull base. Pre-operatory selective embolization is still controversial.

Adult

[Ectopic thyroid gland].

Based upon the observation of four cases of ectopic lingual thyroid the authors discuss the etiopathogenetic, clinical-diagnostic and therapeutic aspects of this pathology. The clinical characteristics of the mass, scintigraphy, echography and CT scan of the neck, the T3, T4, TSH doses in the blood and fine needle aspiration of the mass have made adequate appraisal of its possible nature and have led to the identification of the presence of thyroid tissue in other sites. In regard to therapy, the authors believe that surgery is compulsory for patients showing clinical signs of upper airway obstruction despite suppressive therapy or when the lesion shows signs of malignant degeneration. After having mentioned the more commonly employed surgical approaches, emphasis is placed on median pharyngotomy as it permits the best visualization of the region, a careful excision of the mass and a valid control over bleeding. In most cases a tracheotomy proves unnecessary. The post surgical hormonal situation suggests the opportunity of a possible substitutive therapy with synthetic hormones or thyroid derivatives.

Adolescent

[Brain mapping of middle latency auditory potentials in normal subjects].

The MLRs of 20 normal hearing adults were recorded by cerebral mapping. In regard to the Pa and Na waves, it is suggested that two different generation sites exist because of the different spatio-temporal distribution of the waves over the scalp. It is demonstrated that amplitudes measured by the "grand average" technique are constantly lower than those obtained with the manual determination, and they conclude that manual determination represents the most reliable method in order to calculate waves amplitude. Finally, it is suggested that, due to the different generation sites for Pa and Na waves and to the uneven distribution of the Na wave over the scalp, Pa amplitude should be measured from the baseline and not from the Na negative deflection. Moreover, in 14 cases, when one ear was stimulated the Pa wave obtained at most recording points was significantly larger than the one recorded contralaterally.

Acoustic Impedance Tests

[Ultrastructural aspects of cholesteatoma of the middle ear].

Middle ear cholesteatomas were intraoperatively obtained from 6 male patients and studied under light (L.M.), transmission (T.E.M.) and scanning (S.E.M.) electron microscopy. Cholesteatoma proved to be formed by keratinizing squamous epithelium, or matrix, and by connective tissue, chorion or perimatrix. With regard to the matrix, a progressive differentiation of cells belonging to the stratum germinativum could be observed towards spinosum, granulosum and corneum cells with formation of keratinized lamellae. Moreover, keratinocytes and Langerhans cells were found in the stratum spinosum. The perimatrix consisted of granulation tissue, or inflamed subepithelial connective tissue displaying inflammatory cells. Furthermore, the advancing front of cholesteatoma proved to be formed by lymphocytes and plasma cells, partially covered by respiratory type epithelium.

Adult