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G Baroni

Publications and source records attributed to G Baroni.

61 records · Page 4Linked to original sources
PubMedDate not supplied

Prognostic significance of microvessel density and vascular endothelial growth factor expression in advanced ovarian serous carcinoma.

The aim of the study was to test the prognostic value of the microvessel density (MVD) within the tumor and the vascular endothelial growth factor (VEGF) expression on clinical response to chemotherapy, on brief disease-free interval, and on cause-specific survival in advanced ovarian serous carcinoma. We evaluated 83 ovarian carcinomas homogeneous for stage, type and grade histologic, surgical, and chemotherapeutic treatment. Brief disease-free interval and cause-specific survival rates (Kaplan-Meier method) were compared using the log-rank test. A multivariate analysis (Cox-proportional hazards model) was used to determine the independent effect of each variable on prognosis. Overall 60 and 120 months cause-specific survival rates were 27.7% and 2.4%, respectively. The brief disease-free interval rate was 66.2%. In univariate analysis, VEGF (P = 0.0001 and P = 0.016), MVD (P < 0.0005), and the FIGO stage IIIC even more than FIGO stage IIIA (P = 0.01 and P < 0.0005, respectively) were associated with survival and brief disease-free interval, and the residual tumor was associated with survival (P = 0.021). In multivariate analysis, the factors that were independent predictors of survival were MVD (P < 0.0005), VEGF (P = 0.027), and the FIGO stage IIIC even more than FIGO stage IIIA (P = 0.013). Moreover, MVD was an independent predictor also of brief disease relapse (P = 0.001). Both MVD and VEGF were correlated with clinical response to chemotherapy (P = 0.01 and P = 0.037). Our data suggest that MVD and VEGF may have prognostic significance in advanced ovarian serous carcinoma.

Adult↗
PubMedDate not supplied

Microvessel density in ovarian carcinoma: computer image analysis in patients with shorter and longer survival.

We previously reported that tumor microvessel density (MVD) may have prognostic significance in ovarian carcinoma. The aim of this study was to compare the intratumoral microvessels using a computer-aided image analysis system between FIGO stage IIIC, serous, G3, ovarian carcinomas obtained from living patients who had no evident disease 5 years after primary treatment and ovarian carcinomas, matched for stage, histopathology, grade of differentiation, and treatment, obtained from patients who had died of progression of disease no later than 1 year after primary treatment. We observed that MVD is statistically correlated, according to the logistic regression in univariate and multivariate ways, with the survival (P= 0.03 and P= 0.05, respectively) and with the progression of the disease during first-line chemotherapy (P= 0.009 and P= 0.012, respectively). In the past years, the modulation of first-line chemotherapeutic treatment has been a question of discussion, because the oncologist observes extremely unpredictable behaviors with surprisingly long survivals and also short survivals. Pathologists may give clinicians some additional prognostic information useful in the management of ovarian carcinoma patients. The results of this study support the hypothesis that the evaluation of MVD with computer image analysis can help clinicians in the choice of the tailored treatment of the single case.

Age Factors↗
PubMedDate not supplied

The role of apoptosis in the pathogenesis of dermatitis herpetiformis.

Apoptosis is a form of cell death that is claimed to be involved in a number of chronic inflammatory and malignant skin diseases. The aim of this study was to investigate whether apoptosis may contribute to the pathogenesis of epidermal changes in dermatitis herpetiformis (DH) and, in particular, whether certain apoptosis-related markers such as Bax, Bcl-2, Fas and Fas ligand (FasL) take part in this process. For the detection of apoptotic nuclei, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling technique (TUNEL) was employed on cryostat sections. Skin lesions from six and perilesional skin from four DH patients were stained with monoclonal antibodies to Bax, Bcl-2, Fas and FasL. The same evaluation was also performed on three patients affected by bullous pemphigoid (BP) and in two healthy donors. Using TUNEL technique, a remarkable increase in the apoptotic rate within the epidermal compartment was observed in DH and BP patients in comparison with normal controls. In our immunohistochemical analysis, Bax/Bcl-2 ratio was almost the same in the epidermis of perilesional/lesional DH, BP and healthy skin specimens. In DH and BP specimens both Bax and Bcl-2 proteins were increased in the dermal perivascular compartment. Fas showed a prevalently epidermal staining, both in DH and BP lesions, while FasL was distributed in perivascular and subjunctional dermis; some FasL+ cells infiltrated the DEJ and the basal layer of epidermis. This study allowed us to highlight conspicuous apoptotic phenomena in basal and suprabasal keratinocytes within lesional and perilesional skin of DH. We conclude that in DH, as well as in BP, apoptosis plays a role in the pathogenesis of cutaneous lesions in concert with other pathogenetic mechanisms.

Adolescent↗
PubMedDate not supplied

Hyperbaric oxygen in diabetic gangrene treatment.

We treated a group of 18 hospitalized adult diabetic patients (all with retinopathy, 17 with symptomatic neuropathy, and 6 with macroangiopathy) presenting with gangrenous lesions of the foot by a combined regime consisting of strict metabolic control, daily debridement of necrotic tissues, and daily hyperbaric oxygen (HBO) treatments given in a multiplace oxygen chamber. Another group of 10 adult subjects with comparable foot lesions (all with retinopathy, 9 with symptomatic neuropathy, and 4 with macroangiopathy) was treated in exactly the same way except for HBO. In the test treatment group, 16 patients were healed, and the remaining 2 showed no improvement and later underwent amputation. The number of HBO treatments required for healing was significantly related to the size of gangrenous lesions. In the non-HBO-treated group, only 1 patient improved, 5 of 10 showed no change, and 4 of 10 worsened until leg amputation was unavoidable. Comparison of the two groups by chi 2-test revealed a highly significant difference (P = .001). In practical terms, HBO treatment drastically reduced leg amputations in patients so treated in the last 3 yr compared with earlier and current figures for patients not receiving HBO treatment.

Adult↗
PubMedDate not supplied

[Automatic opto-electronic control of patient position in radiotherapy for breast carcinoma].

INTRODUCTION: We report on the technical and clinical validation of a system for real-time analytical control of patient position at simulation and treatment units in radiotherapy. MATERIAL AND METHODS: The positioning control system uses a technology for motion analysis consisting of an optical component (a pair of TV cameras) and of a unit for real-time image processing. The system can provide real-time (up to 100 times a second) three-dimensional (3D) coordinates of a set of passive markers (small plastic hemispheres, 5 mm O) previously positioned on the patient and located within the field of view of the system's TV cameras. The method for positioning quality control is based on the analytical comparison between the current positions of the set of markers placed on the patient's skin and a corresponding reference pattern, the latter acquired at the end of the simulation procedure or at the first irradiation session. The system was used at the Radiotherapy Division of the European Institute of Oncology for the analytical control of repositioning in three patients submitted to irradiation after conservative surgery (quadrantectomy) for breast cancer. This showed the clinical feasibility of both the technology and the method, and permitted to quantify improvement in patient positioning relative to current repositioning procedures. In particular, the possibility to evaluate the patient's breathing phases allowed to distinguish the different factors (repositioning inaccuracies and cyclic and random patient movements) contributing to global localization errors. RESULTS: This method is independent of physical and geometrical irradiation parameters and permits efficient real-time quantitative control of specific repositioning quality and of actual patient immobility during irradiation. Assessment of the accuracy of conventional repositioning methods based on laser alignment showed a fair performance of the optical centering procedure (with 3D displacements < 5 mm) only for the markers placed close to the skin landmarks used for laser alignment. On the contrary, the markers within the irradiation field but not directly controlled during the repositioning procedure exhibited localization errors > 5 mm; this happened even though the inaccuracies related to patient's breathing movements had been excluded from analysis. Moreover, quantitative assessment of global localization errors confirmed the high influence of breathing movements on the position repeatability and maintenance. In this case, even the markers which were on average well repositioned turned out to be significantly displaced during the radiation dose delivery. CONCLUSIONS: Our results confirm that real-time motion analysis based on opto-electronic techniques can play a crucial role as a means of improving patient positioning and assessing immobility. Thus, the system permits to quantify errors in target volume localization, which permits to adopt suitable countermeasures to reduce uncertainties during actual irradiation. This is a crucial requirement, particularly when the complexity of the irradiation geometry (conformal radiotherapy) or radiation type (hadrontherapy) calls for optimal application of the simulated treatment plan to each actual irradiation session.

Breast Neoplasms↗
PubMedDate not supplied

[Extra-mammary Paget's disease. An HPV-correlated neoplasia?].

Eight cases of Paget's disease of the vulva and anogenital region are presented. Seven cases presented intraepithelial lesions and only one showed superficial intraepidermal diffusion. The average age of the patients in our series was 58.8 years. In all cases histochemical and immunohistochemical reactions were positive, except for the CEA reaction (only one case was positive). Specimens from our series were tested for presence of HPV 6, 11, 16, 18, 31, 33, 35 by in situ DNA hybridization. All cases were negative. Paget's disease, at the moment, is the only tumor of the low female genital tract non HPV-associated. Recurrences are very frequent even many years after radical surgery treatment.

Aged↗