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Biomedical subjects

P Pisani

Publications and source records attributed to P Pisani.

At least 37 records · Page 2Linked to original sources
PubMed1998

Metastases to parotid gland from cancers of the upper airway and digestive tract.

Forty-four cases of parotid metastases were diagnosed and treated in the period 1968-1994. In 10 patients (23%), the primary tumour was sited in the mucosal layer of the upper airway or digestive tract: oropharynx (n=3), larynx (n=3), nasopharynx (n=2), hypopharynx (n=1) and the maxillary sinus (n=1). Histologically, the primary tumour was squamous cell carcinoma in 9 cases and adenocarcinoma in one. One patient received surgical treatment only, two patients surgery and postoperative radiotherapy, one radiotherapy only, four chemotherapy and two symptomatic treatment only. Only one patient is alive, disease-free, 5 years after treatment. The other patients died: six within 1 year, two within 2 years and one within 3 years of diagnosis.

Adenocarcinoma↗
PubMed1998

Carcinogen DNA and protein adducts as biomarkers of human exposure in environmental cancer epidemiology.

Carcinogen DNA and protein adducts promise to provide a more objective measure of human exposure to environmental carcinogens than can be obtained by questionnaire data or environmental measurements. The adducts represent an integration of exposure, absorption, distribution, metabolism, DNA repair, and cell turnover, and thus provide a measure of biologically effective dose; the fact that DNA adducts are involved in the carcinogenic process means such a measure may be more relevant than exposure measures based on ambient levels of a given carcinogen. This approach has been successfully applied to situations where accurate questionnaire data on exposure are difficult to obtain (e.g., for the dietary carcinogens aflatoxins and heterocyclic amines, aromatic amine exposure via environmental tobacco smoke, etc.). Despite the promise of carcinogen DNA and protein adducts, there are a number of issues that must be addressed, including sensitivity, specificity, temporal relationship between exposure and disease, and their mechanistic role in the process of carcinogenesis. This information is a necessary prerequisite to the successful application of these biomarkers into appropriately designed epidemiological studies.

Animals↗
PubMed1998

[Pleomorphic adenoma of the nasal septum].

Pleomorphic adenoma is the most frequent form of tumor in the major and minor salivary glands. It can occasionally appear in other sites corresponding to areas with ectopic salivary tissue. A case is presented of pleomorphic adenoma of the nasal septum recently observed by the authors. Complete removal of the tumor lesion, with the entire support base, careful histopathological evaluation, a battery of immunohistochemical tests and a long-term follow-up constitute the correct approach to this pathology.

Adenoma, Pleomorphic↗
PubMed1997

Reproducibility and validity of oral visual inspection by trained health workers in the detection of oral precancer and cancer.

A randomized intervention trial is in progress in Kerala, India, to evaluate the effectiveness of oral visual inspection by trained health workers (HWs) in the prevention of oral cancer. Fourteen health workers with college graduation as the basic qualification were trained in oral visual inspection to identify oral cancers and precancers among the participants of the screening trial and to refer them for further confirmation and management. The aim of the present study was to evaluate the reproducibility and validity of the screening test provided by the health worker against the reference oral visual findings of three physicians. A total of 2069 subjects who had already been examined were re-examined by the health workers and physicians. The sensitivity and the specificity of the oral visual inspection were 94.3% and 99.3% respectively. There was moderate agreement between the findings of the initial and the repeat mouth examinations carried out by the health workers, which were on average 6 months apart. There was almost perfect agreement (kappa = 0.85) between the findings of the health workers and the physicians in identifying the different types of oral precancerous lesions. The findings of our study indicate that it is possible to train resource persons to perform the oral cancer screening test as accurately as doctors, although experience appears to be a crucial component of health workers' accuracy. The efficacy of such an approach to reduce the incidence of and mortality from oral cancer, however, remains to be proven.

Education↗
PubMed1997

Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres.

A pilot questionnaire was developed for the EPIC centres of northern Italy, and validated in the feasibility part of the cohort project. The questionnaire was self-administered and of the food frequency type with portion size estimated by means of pictures. It was structured by courses within a meal characteristic of Italian dietary habits. Dietary intake estimated by the questionnaire was compared to the corresponding estimates obtained from 8-14 24-hour recall interviews administered over a 1-year period. The reference method was validated by means of urinary nitrogen in 4-6 repeated 24-hour urine collections. One hundred and ninety-seven volunteers (47 men and 150 women) were enrolled and completed the study lasting 1 year. They filled out two questionnaires at the beginning and at the end of the study, and had a 24-hour recall interview once a month. Twenty-four-hour urine samples were collected at regular intervals. Usual intake of energy, the major nutrients and some vitamins were estimated for the questionnaires and the reference method by means of food composition tables compiled for this study. The agreement between the questionnaire and the 24-hour recalls was only good for alcohol consumption: Pearson's correlation was 0.73 and 0.77 in men and women respectively. Otherwise the relative validity of the questionnaire ranged between 0.28 for fat to 0.52 for carbohydrates in men and 0.25 and 0.50 in women for the same nutrients. The validity of the two interview methods in estimating protein intake, compared to mean urinary nitrogen was 0.24 (M) and 0.18 (W) for the questionnaire and 0.63 (M) and 0.48 (W) for 24-hour recalls. The main causes of low performance of the questionnaire were identified to be the estimated intake of dressing and cooking fats, vegetables and meat. Remedies were devised and introduced in the final version of the questionnaire currently in use in the EPIC project.

Cohort Studies↗
PubMed1997

Cancer and infection: estimates of the attributable fraction in 1990.

Various estimates of the proportion of all cancers attributable to infections have been proposed but none have been numerically justified. We have reviewed the evidence for "causality" with respect to infectious agents linked with cancer and estimated the fraction of all cancer cases concerned that are attributable to it. The etiological fraction was applied to the estimated annual incidence of cancer at each specific site in 1990, and the number of attributable cases was obtained. We estimate that 15.6% (1,450,000 cases) of the worldwide incidence of cancer in 1990 can be attributed to infection with either the hepatitis B and C viruses, the human papillomaviruses, EBV, human T-cell lymphotrophic virus I, HIV, the bacterium Helicobacter pylori, schistosomes, or liver flukes. There would be 21% fewer cases of cancer in developing countries (1,000,000 fewer cases per year) and 9% fewer cases in developed countries (375,000 fewer cases per year) if these infectious diseases were prevented. The attributable fraction at the specific sites varies from 89% of cervix cancers attributable to the papillomaviruses to 1% of all leukemias attributable to human T-cell lymphotrophic virus I.

Adolescent↗
PubMed1997

Carcinogen-DNA and carcinogen-protein adducts in molecular epidemiology.

Carcinogen-DNA and carcinogen-protein adducts provide an integrated measure of carcinogen exposure, uptake and absorption, metabolism, DNA repair and cell turnover. As such they promise to provide a more objective and relevant measure of exposure than that which can be derived from questionnaires and measures of ambient levels of carcinogen. Nevertheless, the interpretation of adduct measurements made in human tissues and body fluids requires an understanding of a number of factors. These include the sensitivity and specificity of the measurement, the temporal relationship between exposure and adduct level and the mechanistic role of the adduct in the process of carcinogenesis. The application of such biomarkers in epidemiological studies therefore necessitates careful consideration of optimal study design. The above issues are illustrated in this chapter with examples from studies in both animal models and human populations.

Animals↗
PubMed1997

[CO2 laser treatment in laryngeal papillomatosis].

Laryngeal papillomatosis is a rare, unpredictable pathology which often recurs. Although several forms of surgery have been suggested for this pathology, CO2 laser surgery is the treatment of choice. This paper presents 30 cases of laryngeal papillomatosis, 12 of which arose in infancy, all treated by dissection and/or CO2 laser vaporization. The treatments were performed in one or more stages depending on the site and appearance of the lesions. Special care must be taken to preserve the anatomical integrity when a papillomatosis must be removed from the glottic area. The average number of surgical procedures per patient proved greater in multifocal vs. unifocal forms (4.7 vs. 1.6) and in children vs. adults (4.9 vs. 3.7). In four patients the pathology followed a neoplastic evolution. Today 57% of the subjects treated (17) are in clinical remission after an average 17 month follow-up. CO2 laser endoscopic microsurgery is presently the most suitable method for treating laryngeal papillomatosis although the biological features of this diseases often make treatment difficult.

Adolescent↗
PubMed1996

Serum sex hormone levels after menopause and subsequent breast cancer.

BACKGROUND: High levels of androgens and estrogens have been reported to be associated with breast cancer. However, the multiplicity of factors that influence hormone levels and methodologic issues complicate the study of the relationship between steroid sex hormones and breast cancer. PURPOSE: Using an improved study design, we assessed prospectively the relationship between the principal steroid sex hormones in serum and the subsequent occurrence of invasive breast cancer in postmenopausal women. METHODS: Four thousand fifty-three healthy postmenopausal women aged 40-69 years, were enrolled from June 1987 through June 1992 in a prospective investigation of hormones and diet in the etiology of breast tumors (ORDET study) as part of a larger volunteer cohort of 10 788 premenopausal and postmenopausal women from Varese Province, northern Italy. At recruitment, blood samples were taken between 8:00 AM and 9:30 AM (after overnight fasting), and sera were preserved in -80 degree Celsius freezers. Women who had received hormone treatment in the 3 months prior to enrollment, who had bilateral ovariectomy, or who had a history of cancer or liver disease were not recruited. Twenty-five women in the final eligible cohort of postmenopausal women developed histologically confirmed, invasive breast cancer during the first 3.5 years of follow-up for the cohort (13 537 women-years). For each case subject, four control subjects were randomly chosen after matching for factors possibly affecting hormone preservation in serum. One case subject and eight control subjects were excluded because premenopausal hormonal patterns were found; thus, after also excluding the four control subjects matched to the ineligible case subject, we included 24 case and 88 control subjects. In the spring of 1994, stored sera of case and control subjects were assayed in a blinded manner for dehydroepiandrosterone sulfate and estradiol (E2) by in-house radioimmunoassay and for total and free testosterone and sex hormone-binding globulin by commercially available nonextraction iodination kits. Mean differences in risk factors were tested by analysis of variance for paired data. Relative risks (RRs) were estimated by conditional logistic regression analysis. All P values resulted from two-sided tests. RESULTS: Age-adjusted mean values of total testosterone, free testosterone, and E2 were significantly higher in case subjects than in control subjects: total testosterone, 0.34 ng/mL versus 0.25 ng/mL (P<.001); free testosterone, 1.07 pg/ml versus 0.77 pg/mL (P= .006); and E2, 25 pg/mL versus 22 pg/mL (P= .027). Age-adjusted RRs for breast cancer in increasing tertiles were as follows: for total testosterone, 1.0, 4.8, and 7.0 (P for trend =.026); for free testosterone, 1.0, 1.8, and 5.7 (P for trend=.005); and for total E2, 1.0, 7.1, and 5.5 (P for trend= .128). CONCLUSIONS AND IMPLICATIONS: This prospective study provides further evidence in support of the already established association between elevated estrogen levels and breast cancer. Even more importantly, it provides new evidence that high serum testosterone levels precede breast cancer occurrence.

Adult↗
PubMed1996

The deep parotid lymph nodes: an anatomical and oncological study.

In order to better define the anatomical and clinical importance of the deep parotid lymph nodes, the surgical specimens obtained from a series of 18 total parotidectomies were evaluated. In 10 cases primary parotid pathology was found, whereas in the remaining eight cases metastases to glandular lymph nodes were present. One hundred and forty-nine lymph nodes, in all, were identified (range 3-14, average 8.2, mean 8), 118 located in the superficial parotid lobe (range 3-11, average 6.5, mean 7), and 31 in the deep lobe (range 0-5, average 1.7, mean 2). In the group of patients with oncological pathology, of the total 64 lymph nodes examined, 21 were found to be sites of metastasis, 11 in the superficial lobe, and 10 in the deep lobe. The above findings confirm the anatomical and oncological importance of the deep parotid lymph nodes, and highlight the necessity of a total parotidectomy in all cases in which intraglandular spread of lymph node metastases is certain or suspect.

Adenocarcinoma↗
PubMed1995

[Myoepithelial-epithelial carcinoma of the parotid: cyto-histological description of a case].

We report a case of epithelial-myoepithelial carcinoma of the parotid gland arised in a 72 years-old woman, in which the diagnosis was suspected on fine-needle aspiration and confirmed on surgical specimen. Immunohistochemical evidence for the dual differentiation (glandular and myoepithelial) of the tumour was obtained both on surgical specimen and cytological inclusion. Morphological features and proliferating index (MIB1) analysis suggest that this case is an intermediate grade malignant neoplasm. Main differential diagnosis of the epithelial-myoepithelial carcinoma with predominantly clear cell tumours of the salivary glands were discussed.

Adenocarcinoma, Clear Cell↗
PubMed1994

At least one in seven cases of cancer is caused by smoking. Global estimates for 1985.

Tobacco smoking is accepted as a major cause of cancers of the lung, larynx, oral cavity and pharynx, oesophagus, pancreas, kidney and bladder. The proportions of these cancers that are due to smoking were estimated for the year 1985 for 24 areas of the world. Fifteen percent--1.1 million new cases per year--of all cancer cases are attributed to cigarette smoking, 25% in men and 4% in women. In developed countries, the tobacco burden is estimated at 16% of all annual incident cases. In developing countries, the corresponding figure is 10%. In total, 85% of the 676,000 cases of lung cancer in men are attributable to tobacco smoking. The highest attributable fractions (AF: 90-93%) are estimated in areas where the habit of cigarette smoking in men has been longest established: North America, Europe, Australia/New Zealand and the former USSR. Among the other 6 cancer sites considered in this analysis, those with the largest fractions of tobacco-related cases are the larynx, mouth and pharynx (excluding nasopharynx) and oesophagus. In regions where males have smoked for several decades, 30 to 40% of all cancers in this sex are attributable to tobacco. Unless tobacco-control efforts in developing countries are strengthened, the massive rise in cigarette consumption over the last few decades will produce a comparable rise in cancer in these countries within the next 20 to 30 years.

Adult↗
PubMed1994

Herpes simplex virus genomes in human nervous system tissue analyzed by polymerase chain reaction.

Herpes simplex virus (HSV) is known to establish latency in human trigeminal ganglia. It has been speculated that the virus might also be present in latent fashion in normal human brain, where it might be responsible for conditions such as herpes simplex encephalitis, and less plausibly as a cause for multiple sclerosis or Alzheimer's disease. To test the possibility that HSV exists in normal human brain, we utilized the polymerase chain reaction to assess the frequency and distribution of HSV genomes in the nervous system tissues of patients dying of nonneurological causes. Nine samples were obtained in a systematic fashion from olfactory bulb, gyrus rectus, hippocampus amygdala, calcarine cortex, pons, medulla, cerebellum, and trigeminal ganglia from each of 40 individuals dying of nonneurological disease. HSV genomes were sought in each sample using primers from four regions of the HSV genome. The primers were capable of detecting HSV genomic sequences from as little as 10 fg of DNA. HSV genomic sequences were identified in 26 (65%) of 40 samples of trigeminal ganglia. From 30 patients seropositive to HSV, sequences were amplified from 23 (77%). HSV genomic sequences could be amplified and detected in 14 (35%) of 40 brains. The positive areas included medulla, olfactory bulbs, pons, gyrus rectus, amygdala, and hippocampus. The study has confirmed the previous demonstration of latent HSV in trigeminal ganglia in normal humans. The frequency of latent HSV in trigeminal ganglia is in general agreement with results obtained by explanation of ganglia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Angiosarcoma of the hypopharynx.

Angiosarcoma is a tumour of endothelial origin rarely found in the head and neck. A case of angiosarcoma of the pyriform sinus, treated by surgery and post-operative radiotherapy, is reported, providing a cue for discussion of the diagnostic, clinical and pathological peculiarities of the tumour in the light of personal experience and the published data.

Aged↗