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Biomedical subjects

M Bussi

Publications and source records attributed to M Bussi.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Chemotherapy for recurrent salivary gland malignancies: experience of the ENT Department of Turin University.

Twenty-seven patients (17 males, 10 females; median age 59 years) with recurrent high-grade malignancies of major (22 cases) and minor (5 cases) salivary gland origin (10 adenoid cystic carcinomas, 9 adenocarcinomas, 4 poorly differentiated carcinomas, 1 mixed malignant tumor, 3 mucoepidermoid carcinomas) were treated by monochemotherapy--cisplatin (CDDP) in 8 cases, or adriamycin in 5 cases--or polychemotherapy--CDDP + epirubicin + 5-fluorouracil/cyclophosphamide in 9 cases or CDDP + 5-fluorouracil in 3 cases with mucoepidermoid carcinomas. In adenocarcinoma-like tumors, patients treated by polychemotherapy showed a better response (9.1% CR, 36.3% PR) than patients treated with monochemotherapy (no CR, 23% PR). Patients with local recurrence and adenocarcinoma exhibited a better response. Median response duration: 7.5 months after poly- and 4 after monochemotherapy. Median overall survival time was 8+ months (responders: 14+) in the polychemotherapy group and 5.5 (responders: 8) in the monochemotherapy group. In the 3 cases with mucoepidermoid carcinoma 1 patient achieved a PR (33.3%) and in 2 there was no change.

Adult↗
PubMedDate not supplied

Nasal secretory IgA circadian rhythm: a single-dose suppression test.

The existence of a clear circadian rhythm in the local secretion of nasal IgA is well-known phenomenon which is confirmed in the present research. Since the temporal pattern of secretory IgA (SIgA) strictly parallels the ACTH-cortisol cycle, a dependence was hypothesized in previous research, but the suppression of adrenal rhythm by means of massive doses of exogenous corticosteroids showed no influence on the SIgA cycle. In the present research a more sophisticated method of corticoid-incretion suppression was used; the single-dose suppression test with dexamethasone, which influences only the impulsive phase of the rhythm. In this case too, however, no influence was demonstrated on nasal SIgA secretion.

Circadian Rhythm↗
PubMedDate not supplied

Natural killer-mediated cytotoxicity in patients with laryngeal carcinoma.

Natural killer (NK)-mediated cytotoxicity against the K562 cell line was evaluated in normal subjects and in patients with laryngeal cancer. Results showed reduced lymphocyte cytotoxicity in patients with neoplastic disease and further reduction in NK activity following postoperative radiation therapy. The authors discuss the possibility of using this test in the immunological monitoring of patients with laryngeal carcinoma.

Cell Line↗
PubMedDate not supplied

Prognostic factors of cervical lymph node metastasis in head and neck squamous cell carcinoma.

AIMS AND BACKGROUND: The metastatic spread of squamous cell carcinoma of the head and neck (SCCHN) to the cervical lymph nodes is a negative prognostic factor in terms of survival. We have used multivariate analysis to identify the possible prognostic significance of a number of clinical and pathological characteristics in relation to possible involvement of the cervical lymph nodes in a series of 396 patients. METHOD: 396 patients with SCCHN were studied. Variables regarding the patient, the carcinoma and histology were analysed by multivariate analysis using BMDP's PLR programme. RESULTS: Some variables appear to represent predisposing factors for tumor spread to the lymph nodes: tumor site (supraglottic larynx: P = 0.005; base of the tongue: P = 0.02; hypopharynx: P = 0.02), grading (P = 0.001), and a number of histological parameters (lower degree of histological differentiation: P = 0.001; vascular permeation: P = 0.04; perineural invasion: P < 0.05; prevalently plasmocytic infiltrate: P < 0.05). CONCLUSION: The identification of cases at risk for metastasis can be improved by the assessment of prognostic factors, with a consequent improvement in treatment strategies.

Adult↗
PubMedDate not supplied

Squamous cell carcinoma of the lacrimal drainage system: case report and literature review.

AIMS AND BACKGROUND: Epithelial malignant tumors of the lacrimal drainage system are rare. The most prevalent type is squamous cell carcinoma. These tumors generally present with aspecific symptoms suggestive of chronic dacryocystitis, with the result that diagnosis and treatment are often delayed. METHODS AND STUDY DESIGN: We present the case of a patient with a squamous cell carcinoma of the lacrimal ducts and discuss the clinical and pathological features of these neoplasms, together with diagnostic and therapeutic strategies according to the data available in the literature. RESULTS AND CONCLUSIONS: The diagnostic and therapeutic approach to this kind of rare tumors has to be planned carefully. Radiographic examination of all masses arising in the medial canthus is essential. Dacryocystography allows the identification of space-occupying tumors in the lacrimal sac. Computed tomography and magnetic resonance imaging provide the most useful information about the extent of the neoplasm and its relationship with surrounding bone structures and soft tissues. Histological examination of a biopsy sample obtained by standard dacryocystectomy is essential to confirm the diagnosis. The treatment of choice is primarily surgical, consisting of complete resection with long-term follow-up. A number of surgical procedures have been described, which are more or less aggressive depending on the extension of the tumor. Radiotherapy is indicated when bone or lymphatic invasion is evident, and when neoplastic cells are present in the resection margins. Radiotherapy alone is not considered a treatment of choice, but only a palliative option in selected cases. The follow-up data available in the literature are incomplete. In most of the literature reports, relapse occurs in 50% of patients within 5 years.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Primary malignant melanoma arising in the parotid gland: case report and literature review.

Melanoma of the head and neck is an extremely rare disease, characterized by difficult and late diagnosis and poor prognosis; moreover, the definition of primary melanomas of the salivary glands remains controversial. In this paper we describe an unusual case of primary melanoma arising in the parotid gland. A 60-year-old woman presented to us for the persistence of a parotid neoplasm diagnosed as carcinoma by fine-needle aspiration and treated with radiation therapy. Wide destructive surgery was performed and immunohistochemical analysis of the surgical specimen led to a diagnosis of melanoma. Complete screening excluded other primary tumor sites. After five years of follow-up the patient Is alive and free of disease. Here we report the diagnostic procedures leading to the diagnosis along with a critical analysis of the literature, emphasizing the difficulties in the diagnosis and classification of melanoma as a primary tumor in the parotid gland and the need for destructive surgery.

Diagnosis, Differential↗
PubMedDate not supplied

Prospects and limitations of systematic monitoring in patients with laryngeal cancer.

The authors report the first results concerning the systematic use of "immunological monitoring" in patients suffering from well-developed laryngeal cancer. The authors have also studied, in 50 cases in different stages of development, the activity of T-cells using the cutaneous tests (BCG, PPD, PHA and SK-SD), the E-rosette test and the PHA-induced lymphocytic blastization test (it is well known that the T-cells are responsible for a cytotoxic effect against neoplastic cells). The authors have also studied the activity of B-lymphocytes by means of the EA and EAC rosette test and of IgG, IgA, IgM and complement serum titles. They have observed a progressive depression of the T-cell activity after surgical intervention, whereas the B-cell activity in several cases tends to increase. The authors discuss these immunological results and the possibility that these findings may represent the basis for a complementary immunotherapy following the surgical treatment and/or radiotherapy or chemotherapy. Finally, the authors discuss the possibilities and the limitations of these immunological methods from the point of view of clinical application.

B-Lymphocytes↗
PubMedDate not supplied

[Open rhinoplasty: indications and limits of a controversial method].

As Aufricht has said, rhinoplasty is "... an easy operation to do, but it is hard to get good results". As it clearly observed in ENT rhinoplasties which deal with severe and combined defects of the nose which result in functional impairment. The aim of this study was to analyse complications in a personal series of open rhinoplasties as well as those in literature in order to standardize different surgical approaches possible in correcting various nasal deformities, divided according to a personal classification. Other than the classical intramucosal technique (following Roe, Joseph and Weir), the more conservative extramucosal operation (described by Jost and Aiach) and the more aggressive external approach are available to the surgeon. Intramucosal rhinoplasty is still the most dependable and widely used technique. However open rhinoplasty which brings about complications in less than 10% of the procedures, offers clear-cut advantages if employed following precise indications. In our experience, the main indications for open rhinoplasty are: severely crooked nose, above all of the II and III arch: crooked nose with saddle deformity; asymetrical defects (including those due to a cleft lip); 50% of the secondary rhinoplasties (excluding minor procedures).

Adult↗
PubMedDate not supplied

[Orbital and endocranial complications in acute sinusitis in childhood].

Acute infection the paranasal sinus is a rather frequent pathology in children. On the contrary, local orbital complications are rare. The employment of antibiotics reduces the incidence of complications but can sometimes conceal their appearance so that diagnosis is delayed. Orbital as well as intracranial complications of ethmoidal and maxillary sinusitis are most often encountered in childhood. Within a brief time span, 8 patients with complicated frontal and ethmoid-maxillary sinusitis were diagnosed and treated: 4 cases of periorbital cellulitis, 2 of subperiorbital abscess and 2 of orbital abscess (one of which with cavernous sinus thrombosis). Particularly relevant from the diagnostic point of view was the employment of C.T. scan which furnished an accurate definition of the orbit and its surrounding structures which influenced treatment choice. Under antibiotic cover all patients but one (who had been treated very early and had responded immediately to intensive antibiotic therapy) were treated surgically and the clinical course of the disease showed significant improvement very shortly after surgical drainage.

Abscess↗
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[Local immunity following treatment with S-carboxymethylcysteine-lysine in tracheotomy patients].

Pathological modification in secretory IgA values as well as in circadian rhythms were found in tracheotomized patients in both nasal and tracheo-bronchial secretions. The protective role of the mucosal immune system in addition to the frequency of severe infectious respiratory diseases in laryngectomized patients justifies the efforts of clinicians to prevent and treat such modifications. Mucoregulatory drugs have a peculiar role in these therapeutical attempts. Forty tracheotomized subjects with neoplastic disease were studied. Twenty received SCMC-Lys as a mucoregulatory drug. IgA 7S, 11S and albumin values in nasal and tracheo-bronchial secretions, were evaluated at surgery, 15 and then 40 days later. In accordance with clinical data, an improvement in local antibody production, damaged by tracheostomy, was found in the treated group. The influence of SCMS-Lys on SIgA production, whose evaluation was made by means of an original, highly selective and sensitive Immuno-IsoElectroFocusing procedure, seems to encourage the use of mucoregulatory drugs in laryngectomized patients.

Carbocysteine↗
PubMedDate not supplied

[Recurrence after radiotherapy and/or surgery of carcinoma of the oropharynx and the pharynx. Possibilities of salvage surgery].

Forty-seven laryngeal and 21 oropharyngeal recurrences were treated with salvage surgery alone or combined with radiotherapy at the ENT Clinic and Radiotherapy Division of the University of Turin, Italy. Primary tumors had been treated with surgery alone in 10 cases (larynx) and in 21 cases (oropharynx), with combined surgery and radiotherapy in 2 and 8 patients, and with radiotherapy alone in 9 and 18 cases. We observed 26/47 (larynx) and 12/21 (oropharynx) recurrences at the site of primary tumor, 20/47 and 9/21 in loco-regional nodes, and 9/47 and 3/21 in locations adjacent to the primary tumor. Salvage treatment employed surgery alone in 12 (oropharynx) and 16 (larynx) cases; radiotherapy was combined in 9 and 31 cases. Five-year actuarial NED survival was 45.5% for laryngeal and 24% for oropharyngeal cancer patients. After salvage surgery, 50% of laryngeal lesions and only 25% of oropharyngeal recurrences were completely cured. In our series, in 2 cases only the complications caused the patient's death, while in the extant cases a prolonged postoperative hospitalization was necessary. Our study was aimed at investigating the curative potentials of secondary therapy for recurrent carcinomas. A review of the literature on the subject is reported. The small amount of published data prevents "universal" treatment protocol from being assessed. The authors suggest the opportunity of employing a multimodal treatment policy for recurrences of head and neck cancers.

Adult↗
PubMedDate not supplied

[Determination of 11S IgA in nasal secretions in the monitoring of local immunomodulating therapy].

Twenty pediatric patients with recurrent infectious diseases of the upper respiratory tract (tonsillitis, adenotonsillitis with or without involvement of the ear and/or lower respiratory tract) were studied. An immunological assay of the nasal secretum was performed at time of diagnosis and following treatment with a local immunomodulator drug, administered by spray. The 7S, 11S IgA and albumin rates were evaluated. The authors emphasize the importance of SIgA in mucose defense mechanisms as well as the need for a selective method for determining the 11S IgA level. An original method for immuno-isoelectrofocusing (IIEF) determination was employed in the present study. After treatment a significant increase in 11S IgA level was observed, especially in those patients with a significant basal SIGA deficit. The authors describe details of the technique for determination and discuss the results.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Prognostic significance of macrophage infiltration in laryngeal carcinoma].

We investigated the relationships between tumor associated macrofages (TAM) and tumor tissues and their possible prognostic significance in a laringeal carcinomas of patients operated in our Department for sovraglottic or total laringectomy. In our analysis we found a positive trend in Grade 3, but we could not find any correlations in the other cases. That shows that TAM have antithetic activities in the life of neoplasia.

Cell Movement↗
PubMedDate not supplied

[Nasosinus tumors: the problem of orbital invasion].

Neoplasms of the nasal cavity and paranasal sinuses constitute less than 1% of all malignant tumors and account for 3% of those within the E.N.T. field. The course of said pathologies is characterized by scant lymph node metastases and by a marked tendency toward local evolution. Since symptoms are not particularly specific diagnosis is normally arrived at late (approximately 6 months after the first symptoms) when the disease is already in an advanced stage. The orbital area and its contents are quite difficult to study both from a clinical point of view and in terms of testing methodology. Orbital symptoms exist at onset in from 25-30% of the cases. On the other hand, when evaluated upon surgery, orbital invasion is encountered in 40% of the patients. Unfortunately radiology is not always able to provide all the information a surgeon requires in order to establish the proper approach. Although CT is able to provide information regarding extension of the lesion to the soft parts it is not equally able to confidently diagnose initial infiltrations into the bony walls of the orbita. A sampling of 31 patients with tumors of the nasal cavity and paranasal sinuses was studied. All subjects underwent careful radiological examination and were treated with a combination of surgery and radiotherapy. Upon clinical examination orbital invasion was suspected for 50% of the cases. Only in 40% of the cases did radiology confirm this while in 60% it was confirmed by surgery. It is worth noting that during surgery only half of the cases of such invasion were deemed as requiring orbitectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Phenotype expression and production of IL-2 by tonsillar and blood lymphocytes in patients with tonsil pathology].

In recent years several studies have attempted to investigate immunological responses in different tonsillar pathologies, including recurrent tonsillitis and focal infections. The present study was performed on ten patients who had undergone tonsillectomy for a) simple hypertrophy, b) recurrent tonsillitis and c) recurrent tonsillitis with focal manifestations. The blood (PBMNC) and tonsillar (TMNC) lymphocytes were tested separately. A subsequent investigation was performed on the PBMNC six months after surgery. The phenotypical aspects of the different subpopulations were studied using fluorescent antiserums and monoclonal antibodies. A second field of investigation concerned the in vitro blastogenesis, which was measured under spontaneous and PHA-P induced conditions. Finally, the IL-2 production was evaluated using the induced-growth capacity of an IL-2 dependent clone of a T murine cell line. The most interesting findings are presented. The phenotypical studies confirmed some peculiar aspects of the representation of tonsillar subsets. According to the hyperactivation ratio, the proliferation data proved to be higher in the tonsil than in the blood. A greater number of positive HLA-DR and IL-2 receptor cells (both antibodies being activated cell markers) was seen in the tonsil than in the blood and this, as well as the sporadic presence of spontaneous blastogenesis, suggests the possibility of an in vivo pre-activated condition. As far as the secretion of IL-2 is concerned, when compared to the peripheral blood ratio, greater production was found in the tonsil. Finally, a different production kinetic appears to be a constant result of the present study. The performed tests were unable to demonstrate any particular differences among the three different groups of pathologies.

Adolescent↗
PubMedDate not supplied

[Does an immune reactivity to human laryngeal cancer exist?].

Authors reconsider the present state of knowledge about immunology of laryngeal cancer. Authors, besides, analyse, in a critical way, problems concerning immunological monitoring of patients bearing solid carcinomas. They conclude that, up to date, it is impossible to have a biological test which can concretely show the patient's immune state.

Antigen-Antibody Reactions↗