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Biomedical subjects

V Boddi

Publications and source records attributed to V Boddi.

At least 55 records · Page 3Linked to original sources
PubMed1996

["N2" carcinoma of the lung. Therapeutic considerations].

The follow-up of 240 N2 lung cancer cases operated in Thoracic and Cardiovascular Surgery Department of Florence is examined. The analysis is performed in compliance with global survival, "T", histology, therapeutic choices. Global survival is 81% after 6 months, 60% after 1 year, 37% after 2 years, 26% after 3 years, 23% after 4 years, 23% after 5 years. Significative difference on survival does not exist between principal histologic types (squamous, adenocarcinoma, adenosquamous). Raising the "T" survival decreases, but only for adenocarcinoma. Different therapeutic options (only surgery, surgery+radiotherapy, surgery+chemotherapy, surgery+radio and chemotherapy) do not influence the survival in a way statistically significative. From the literature, any certainty about radiotherapy and chemotherapy associated to surgery for N2 lung cancer treatment does not exist at the moment. Thus radical surgery is essential.

Adenocarcinoma↗
PubMed1996

Prediction of occult neck metastases in laryngeal carcinoma: role of proliferating cell nuclear antigen, MIB-1, and E-cadherin immunohistochemical determination.

The aim of this study is to investigate the predictive value of proliferative activity assessment and E-cadherin expression by means of immunohistochemistry in identifying patients with laryngeal squamous cell carcinoma at a high risk for occult node metastasis. Thirty consecutive patients treated for laryngeal carcinoma with false clinically negative nodes (occult metastases, pN+) between the years 1980 and 1990 were selected for this study. A group of 30 cases with negative cervical lymph nodes (pN-) having a similar anatomic site and tumor size distribution was used as control. In each case, several histological parameters, including grade, pattern of invasion, number of mitosis (x10 high-power field), tumor inflammatory infiltrate, and tumor sclerosis, were assessed. Proliferative activity was determined using immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and MIB-1. Other putative prognostic factors investigated at the immunohistochemical level were the cell adhesion molecule E-cadherin and two oncoproteins, p53 and c-erbB-2. In pN+ cases, the expression of PCNA and MIB-1 was significantly higher than in the pN- group. Moreover, a significant loss of E-cadherin expression was observed in carcinomas with occult metastases. No differences in p53 and c-erbB-2 oncoproteins were found between pN+ and pN- cases. Among the other pathological parameters examined, only histological grade was significantly associated with the presence of occult metastases, but on multivariate analysis, this relationship was lost. We conclude that PCNA, MIB-1, and E-cadherin are independent predictors of occult nodal disease in laryngeal squamous cell carcinoma, and their immunohistochemical determination could be useful in identifying patients with clinically negative lymph nodes who are at considerable risk for occult metastases and who may benefit from elective neck dissection.

Antigens, Nuclear↗
PubMed1996

bcl-2 protein expression correlates with recurrence and survival in early stage head and neck cancer treated by radiotherapy.

Inherent cellular radioresistance plays a critical role in the failure of radiation therapy (RT). The proto-oncogene bcl-2 encodes a protein that inhibits apoptosis, a common mechanism of cell death induced by several genotoxic agents, including gamma-radiation. Thus, it is likely that bcl-2 gene expression could be involved in the complex mechanisms of radioresistance in human tumors with some prognostic implications. In this study, we analyzed the predictive relevance of bcl-2 expression on 5-year disease-free and overall survival in patients with early stage squamous cell carcinoma of the head and neck (SCCHN) primary treated with RT. The expression of bcl-2 was analyzed by immunohistochemistry on paraffin-embedded sections from 71 consecutive stage I-II SCCHN patients treated with curative RT. We detected bcl-2 protein in 21% of SCCHN studied. A suggestive association was observed between tobacco exposure and bcl-2 protein expression (P < 0.1); this association was stronger in those patients who failed primary RT (P = 0.03). Moreover, we documented a higher rate of bcl-2 immunoreactive tumors in postirradiated biopsies from relapsed patients than in preirradiated ones (P = 0.03). In both univariate and multivariate analyses, bcl-2 expression was the most important indicator for disease-free survival (P = 0.08 and P = 0.01, respectively) and overall survival (P = 0.004 and P = 0.05) within 5 years of RT. The present study indicates that the proto-oncogene bcl-2 is abnormally expressed in some SCCHN, and its expression may prove to be a useful tool in selecting patients for conventional RT with clear prognostic implications.

Adult↗
PubMed1995

p53 oncoprotein expression in parotid gland carcinoma is associated with clinical outcome.

BACKGROUND: Recent studies of the molecular biology of cancer have demonstrated that p53 tumor suppressor gene aberration is associated with the development and progression of several different cancer types. METHODS: To analyze the expression of the p53 oncoprotein in parotid gland neoplasms, 72 parotid gland tumors (including 46 malignant and 26 benign cases) were studied immunocytochemically using the murine monoclonal DO-7 anti-p53 antibody. In parotid gland cancers, no and low expression (-/+) or moderate and high expression (++/+++) of the p53 oncoprotein were examined for correlation with patient survival and other clinicopathologic features, including clinical stage, tumor size, regional lymph node status, facial nerve paralysis, local infiltration, and distant failures. RESULTS: Positive staining was observed focally in 3 of 26 (11%) benign tumors and in 31 (67%) of 46 malignant tumors. Cancers showing moderate and high expression of p53 tended to be more advanced and larger than those with no expression or low expression, and presented at diagnosis more frequently, with signs of local aggressiveness. Tumors with moderate and high expression of p53 were associated more frequently with regional and distant metastases (P = 0.07 and P = 0.004, respectively). Multiple logistic regression analysis showed that regional and distant metastases were associated independently with p53 expression (P = 0.068 and P = 0.047, respectively). Moreover, patients whose cancers had moderate or high p53 expression had lower disease free and overall actuarial survival rates than those with no or low p53 expression (P = 0.021 and P = 0.033, respectively). Univariate and multivariate analysis confirmed the independent predictive prognostic value of p53 expression in patients with parotid gland cancer (P = 0.044 and P = 0.039, respectively). Furthermore, p53 expression did not correlate positively with patients' smoking habits in this series. CONCLUSION: The p53 tumor suppressor gene may be involved in salivary gland carcinogenesis, and its oncoprotein expression is an independent indicator of clinical aggressiveness in patients with carcinoma of the parotid gland.

Gene Expression↗
PubMed1995

Prognostic significance of clinically false positive cervical lymph nodes in patients with laryngeal carcinoma.

BACKGROUND: A significant proportion of clinically positive palpable cervical lymph nodes in patients with head and neck cancer are histologically benign. The biologic and prognostic significance of this reactive lymph node enlargement has not been fully clarified. METHODS: In this study, the incidence of clinically positive microscopically negative cervical lymph nodes in a series of 902 patients who had neck procedures as a part of their primary treatment for N0-2 laryngeal cancer was analyzed and survival rates of 342 patients with true negative lymph nodes (N0- necks) were compared with those of 106 patients with clinically false positive lymph nodes (N1-2b- necks). In 86 patients with false positive lymph nodes, a histopathologic analysis was performed to determine the histomorphologic pattern of the enlarged lymph nodes and to evaluate which parameters, if any, correlated with 5-year patient survival. RESULTS: Overall actuarial survival did not differ significantly in the two groups. However, the actuarial survival curves in the false positive group were clearly better compared with those of the true negative group with more advanced laryngeal cancers, particularly T4 lesions (P < 0.05). Interestingly, the analysis of pattern of recurrence showed a higher incidence of distant metastases in false positive patients with advanced stage laryngeal cancer than in true negative subjects. In addition, the histologic examination of 375 enlarged hyperplastic cervical lymph nodes from 86 neck specimens showed the prevalence of sinus histiocytosis in the false positive group and its favorable prognostic significance. No statistically significant differences with regard to the number and size of enlarged lymph nodes were found. On the contrary, lymph node location seems to have a prognostic impact on survival and the reactive benign enlargement of a digastric lymph node is a possible poor prognostic factor. CONCLUSIONS: Survival of patients with clinically false positive, histologically benign hyperplastic cervical lymph nodes who have more advanced laryngeal carcinoma is higher than clinically negative patients, suggesting that the presence of palpable benign nodes may be a sign of the host's immune activation, with favorable prognostic significance.

Actuarial Analysis↗
PubMed1995

Cardiovascular function during brain natriuretic peptide infusion in man.

To investigate the cardiovascular effects of pathophysiological levels of brain natriuretic peptide (BNP), 7 healthy subjects were submitted to equilibrium radionuclide angiocardiography in baseline conditions and during BNP infusion at increasing doses (4, 8, 10 and 12 pmol/kg.min for 20 min each). BNP induced a progressive, significant reduction in left ventricular end diastolic volume, stroke volume and end systolic volume and an increase in ejection fraction and heart rate. Cardiac output, arterial pressure and peripheral vascular resistance were unchanged. Activation of the sympathetic nervous system, as indicated by the significant increase in plasma norepinephrine levels, probably played a contributory role in the maintenance of cardiovascular homeostasis. These results indicate that BNP, at pathophysiological plasma concentrations, influences cardiovascular homeostasis in man.

Adult↗
PubMed1995

Comparison of dose-response slopes obtained by simultaneous assessment of changes in FEV1 and transcutaneous oxygen partial pressure during methacholine challenges in asthmatic patients.

We aimed to ascertain whether monitoring changes in transcutaneous (tc) oxygen partial pressure (PO2) may be used to determine the slope of the dose-response curves to inhaled methacholine. In 10 adult asthmatic patients, FEV1 and tcPO2 were simultaneously measured during inhalation of doubling methacholine concentrations. In each patient, the slopes of the methacholine dose-response curves for FEV1 and tcPO2 were similar and strongly correlated (r = 0.72; p < 0.05). The results indicate that tcPO2 monitoring represents a useful, reliable tool for analysis of the slope of dose-response curves to inhaled methacholine in asthmatic patients. It can also be used to investigate the pathophysiological implications of bronchial hyperreactivity.

Adult↗
PubMed1994

Second solid tumors and leukemia after treatment for Hodgkin's disease: an analysis of 1121 patients from a single institution.

PURPOSE: To define the risk of having a second malignant neoplasm (ST) in different subsets of Hodgkin's disease patients and possibly to identify potentially avoidable therapeutic behaviors, linked with an increased second tumor probability. METHODS AND MATERIALS: Cumulative probability of having a ST has been calculated for the different clinical and therapeutic subgroups of a population of 1121 patients consecutively treated (1960-1988) for Hodgkin's disease. Age groups at diagnosis were as follows: < 20 years, 18%; 20-40, 48%; 41-60, 26%; > 60, 8%. Initial treatment consisted of radiation alone (67%), combined modality treatment (24%), chemotherapy alone (9%). Treatment for relapse was also coded, and the occurrence of ST was related both to initial treatment (considering relapsed patients as censored at relapse) and to the "overall" treatment burden, without censoring at relapse. RESULTS: An increased ST risk has been observed in patients older at HD diagnosis. Second tumors cumulative probability rates were significantly higher in patients initially treated with chemotherapy, especially when associated with subtotal or total nodal irradiation (relative risks of 3.1 and 4.1, p = .03 and .005, respectively, when compared to involved field radiotherapy alone). The same trend was observed for second solid tumors. Acute leukemia was more frequent in patients initially given chemotherapy alone or associated with radiotherapy (p = .01), and in those treated with an increasing number of cycles (p = .004). "Salvage" chemotherapy after radiation alone at presentation does not seem to be linked with an increased risk of leukemia. CONCLUSION: The 15-year cumulative ST probability (11%) should be evaluated in the context of the very good cure rates achieved for Hodgkin's disease. The use of chemotherapy, particularly when associated with subtotal or total nodal irradiation, entails an increased risk of second malignancies and might be inappropriate in early stage Hodgkin's disease patients.

Adult↗
PubMed1994

Prognostic value of flow cytometric deoxyribonucleic acid index in endometrial carcinoma: comparison with other clinical-pathologic parameters.

OBJECTIVE: The aims of the current study were to verify the impact of flow cytometric deoxyribonucleic acid index on clinical outcome in endometrial carcinoma and to assess whether its value is independent from the other clinical-pathologic features. STUDY DESIGN: In a prospective series 74 cases of endometrial carcinoma with surgery performed at our institution were studied. Flow cytometry was performed on fresh tumor samples. The median follow-up period was 31 months (range 8 to 52). Disease-free survival and actuarial survival were the end points of the study. RESULTS: Among the 74 patients (53 with diploid and 21 with aneuploid tumors) there were 14 recurrences and 10 deaths caused by the disease. The recurrence rate was 7.5% for the diploid and 47.6% for the aneuploid tumors (p < 0.001). Mortality was 3.8% for diploid and 38% for aneuploid cases (p < 0.001). Disease-free survival was 89.1% in the former group and 36.3% in the latter. Actuarial survival (Kaplan-Meier method) was 94.7% and 49.5%, respectively. Deoxyribonucleic acid index, stage (International Federation of Gynecology and Obstetrics), and grade of differentiation were significantly correlated with survival, whereas age, depth of myometrial invasion, and histologic type were not. In a multivariate analysis (Cox proportional hazards) deoxyribonucleic acid index was the strongest independent predictor of clinical outcome, followed by International Federation of Gynecology and Obstetrics stage, whereas grade of differentiation yielded no independent prognostic information. CONCLUSIONS: The flow cytometric deoxyribonucleic acid index is an important independent prognosticator, and its determination should be included in the standard management of endometrial cancer.

Actuarial Analysis↗
PubMed1993

Changes in transcutaneous oxygen partial pressure as an index of response to inhaled methacholine in asthmatic patients.

Bronchoconstriction and hypoxemia have been reported to occur during airway challenges, but the correlation between changes in forced expiratory volume in 1 s (FEV1) and transcutaneous oxygen partial pressure (tcPO2) during methacholine provocation tests has not yet been established (to our knowledge). In 15 symptom-free atopic asthmatic patients and 5 normal subjects, variations in tcPO2 and FEV1 were simultaneously measured during inhalation of doubling methacholine concentrations; the drug concentrations causing a 20 percent decrease in control FEV1 and tcPO2 (PC20FEV1 and PC20tcPO2, respectively) were subsequently calculated. In patients, geometric mean PC20FEV1 and PC20TcPO2 were 1.31 (range, 0.16 to 5.19) and 1.26 (range, 0.29 to 5.82) mg/ml, respectively. In addition, in six patients, methacholine-induced fall in tcPO2 was accompanied by similar changes in arterial PO2. Methacholine inhalation caused no change in tcPO2 or FEV1 in normal subjects. The independent effects of deep breath tests and bronchoconstriction on PC20tcPO2 were studied in five patients challenged on two separate occasions, with and without FEV1 assessment; in these patients, PC20tcPO2 were similar on both the study days. The results indicate that, in asthmatic patients, methacholine-induced bronchoconstriction causes parallel decreases in FEV1 and tcPO2. The tcPO2 monitoring may serve as a tool in the assessment of airway hyperreactivity when active patient's cooperation is scarce.

Administration, Inhalation↗
PubMed1989

High-dose aprotinin: hemostatic effects in open heart operations.

Two groups of patients were prospectively studied to evaluate the hemostatic effects of high-dose aprotinin in open heart operations. Group A patients (n = 22) received aprotinin during the entire surgical procedure. Group B patients (n = 12) served as controls. The groups were homogeneous for base variables and for cardiopulmonary bypass duration. Postoperative bleeding was lower in group A (mean, 486 mL) than in group B (830 mL) (p less than 0.01). The need for banked blood decreased by approximately half in the aprotinin patients (mean: group A, 213 mL; group B, 409 mL). Hemoglobin levels were similar in the two groups (postoperative day 7: group A, 11.29 g/100 mL; group B, 11.26 g/100 mL; NS). Platelet count decreased at the end of operation in both groups (99,000 and 95,000/mL, respectively; NS) and then increased beyond baseline levels before discharge. No complications were observed that could be attributed to aprotinin. In conclusion, we believe that the use of high-dose aprotinin is safe and effective. It decreases blood loss and reduces the need for banked blood in cardiac operations, particularly in select groups of patients (eg, those undergoing reoperation, Jehovah's Witnesses, those with renal failure).

Adult↗
PubMed1989

Influence of inspiratory flow rate on the bronchial response to ultrasonic mist of distilled water in asthmatic patients.

In an attempt to evaluate the influence of inspiratory flow rate on the sensitivity of the bronchial challenge with ultrasonic mist of distilled water (UMDW), we studied 8 symptom-free asthmatic patients who inhaled 60 liters of UMDW at a flow rate of either 0.35 or 1.2 1/s on two separate occasions. Tidal volume and the total duration of the respiratory cycle were kept constant during all inhalation tests. The bronchial response was assessed in terms of percent changes of baseline airway conductance. The results demonstrate that the mean bronchial response after 0.35 1/s UMDW inhalation was significantly greater than after 1.2 1/s inhalation of comparable doses of UMDW. Furthermore, 3 patients who developed a significant bronchoconstriction after 0.35 1/s UMDW inhalation showed only a mild, not significant bronchial response when the mist was inhaled at 1.2 1/s. We conclude that the sensitivity of the UMDW challenge is increased if the agent is inhaled during slow, tidal breathing.

Adult↗
PubMed1987

[Determination of bone density of the macerated human radius. Comparison of diverse densitometry methods: computerized axial tomography and single photon ray densitometry].

Bone mineral content (BMC) assays are widely used in clinical practice. The most common techniques in vivo are computed axial tomography (CT) and single photon ray densitometry (SPA). The two techniques were compared in studies of macerated bone (16 macerated radii of both sexes). The BMC was measured first by SPA that provides information on both the trabecular and the cortical bone tissue. CT densitometry was then performed on the cortical bone in the same sites at the SPA. Bone sections were then taken and the area of the depth of the cortical bone calculated on their radiographic images using a semiautomatic image analyser. The results show that data obtained by SPA correlate better with the CT data (r1 = 0.861) than with the figures for the area of the thickness of the cortical bone (r2 = 0.786). This suggests that the BMC of the radius as measured by SPA may depend more on the density than the thickness of the cortical bone.

Aged↗
PubMed1984

[Renal volume and human somatic type].

The abdominal C. T. of 128 patients (45 women and 83 men) aged more than 25, without any history of renal disease, have been analyzed by an evaluation computer. By the measure of the areas of kidney in each C. T. scan, the volume of the whole organ has been calculated. In men the volume resulted to be cm3 167 +/- 84,6 (M. +/- S.D.) for the right kidney and cm3 170 +/- 58 for the left one. In women it was cm3 142 +/- 54,9 for the right kidney and cm3 156 +/- 54,5 for the left one. The volumes of the organs collected into 3 classes according to their dimension, have been compared to the 3 somatic types of the subjects (Mega, Medium, Micro) obtained following the Brian & coll. method. Using a test for a monotonic trend for two ordered variables, no significant association has been demonstrated between the volume of the kidney and the human somatic type.

Adult↗
PubMed1983

Glucose-6-phosphate dehydrogenase activity and estrogen receptors in human breast cancer.

Both estradiol receptors and glucose-6-phosphate dehydrogenase activity (G6PDH) were measured on the same tissue sample from 143 patients who had undergone mastectomy for primary breast cancer. G6PDH activity in the estrogen receptor positive group (ER+) was higher than in the negative one (ER-). Moreover, the distribution of the enzymatic values in the ER+ group appeared to derive from two partially overlapped distributions. The authors suggest that only those ER+ tumors which show elevated G6PDH activity contain functional receptors. The determination of G6PDH activity at the time of mastectomy is proposed as an additional test in selecting those patients who would be likely to benefit from endocrine therapy.

Breast Neoplasms↗