PubMed Health⌕ Search

Biomedical subjects

C Grandi

Publications and source records attributed to C Grandi.

53 records · Page 3Linked to original sources
PubMedDate not supplied

Analysis of prognostic factors and proposal of a new classification for nasopharyngeal cancer.

A retrospective analysis was performed on 410 patients with nasopharyngeal carcinoma of squamous or undifferentiated histotype. All patients were classified according to the classification of the American Joint Committee for Cancer Staging and End-Results Reporting (AJC) and to that of the International Union Against Cancer (UICC, Geneva, 1978). The following prognostic factors were investigated by means of a Weibull multiple regression model: sex, age, histology, primary tumor extent, and nodal metastasis extent. With the exception of sex, all factors significantly influenced survival. With regards to nodal extent, only the level of the involved nodes was a significant variable. Both AJC and UICC classifications, when applied to the entire series of patients, appeared to be unsatisfactory. The authors propose an alternative classification based on a prognostic scoring system directly derived from the Weibull model.

Female↗
PubMedDate not supplied

Salvage surgery of cervical recurrences after neck dissection or radiotherapy.

A series of 113 patients operated on in the period 1980-1989 for a neck recurrence from a head and neck cancer was studied. All patients had no other evidence of disease. The male/female ratio was 93/20, and the median age was 58 years (range 28-87). Previous treatment consisted of surgery (SG) +/- radiotherapy (RT) in 81 patients (SG group) and only RT in 32 (RT group): 59 cases presented a relapse in the treated neck and 54 in the contralateral side. All but one contralateral recurrences were in the SG group. Ten patients were lost to follow-up. The observed 5-year survival rate of the whole series was 29.2% (95% confidence interval, 0%-38%). Considering patients with ipsilateral recurrences, the 5-year disease-free survival rate was 38.7% (95% c.i., 28.7%-48.7%) and 27% (95% c.i., 18%-36%) for the SG and the RT group, respectively. The 5-year disease-free survival rate after SG for contralateral recurrences was 38.8% (95% c.i., 23.8%-53.8%). Dimension and mobility of the neck nodes were the only demonstrable prognostic factors.

Adult↗
PubMedDate not supplied

Surgery versus combined therapies for cancer of the anterior floor of the mouth.

We report the results of treatment in a consecutive series of 75 patients operated on at the Istituto Nazionale Tumori of Milan, from January 1965 to December 1979, for cancer of the anterior floor of the mouth. Most of the tumors were advanced: 39 were treated with simple resection, and 36 underwent combined treatment, consisting of surgery associated with either chemotherapy or surgery. Three- and five-year observed survival rates of the whole series were good (41% and 25%, respectively), considering the tumor stage of these patients, but the determined survival rates were particularly high (56% and 46%, respectively). No real advantage was found in the use of multiple planned sequential therapies over surgery alone, and deaths from intercurrent diseases seemed to be more frequent in the patients who underwent combined therapies. We conclude that for patients in poor general condition, such as those with carcinomas of the anterior floor of the mouth, aggressive and complex treatments should be considered with caution in controlled clinical trials.

Carcinoma↗
PubMedDate not supplied

Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications.

A series of 618 patients with neck dissections were performed in 455 consecutively admitted patients with head and neck carcinomas at the Istituto Nazionale Tumori, Milan, from 1976 to 1978. Clinical and pathologic node factors were considered in an effort to correlate lymph node involvement with prognosis. Actuarial survival decreased with the increase in the size of nodes, although no significant difference was found for all categories and the prognosis was poor when nodes were greater than 5 cm and/or hypomobile (33%, 5-year survival). The presence of histologically proven neck metastases significantly reduces the 5-year survival, and the presence of distant metastases correlates directly with the pathologic staging of neck nodes.

Actuarial Analysis↗
PubMedDate not supplied

Retrospective comparison of conservative and radical neck dissection in laryngeal cancer.

A retrospective comparison of radical and conservative technique for neck dissection in cancer of the larynx was made, starting from analysis of 98 patients operated on with the conservative procedure (128 cervical neck fields at risk of recurrence) at the Istituto Nazionale Tumori of Milan. Furthermore, a series of 162 patients was selected from more than 500 radical neck dissections performed in the past to set up a series as comparable as possible as far as several parameters were concerned. No significant difference was found between radical and conservative neck dissection with regard to the incidence of recurrences in the operative field, either considering the whole series (2.5% versus 1.6%), or cases with histologically proven metastases (9.4% versus 4.5%). Conservative neck dissection seems as safe as radical neck dissection, at least within the limits set in the present study for the indication of the former procedure, ie, nonsuspect nodes or metastatic mobile nodes not greater than 2.5 cm.

Humans↗
PubMedDate not supplied

Treatment of cancer of the base of the tongue and glosso-epiglottic region: a multicenter Italian survey. GLOCC Group. Gruppo di Lavoro in Oncologia Cervico Cefalica.

BACKGROUND: The current treatment options for cancer of the base of the tongue and glosso-epiglottic region are surgery, radiotherapy, or a combination of both modalities. Comparisons between different modalities are not common in the literature, and a real standard of treatment has not yet been established. The purpose of our study was to evaluate the results of treatment in a large series of patients from 18 Italian institutions in relation to the main treatment adopted. METHODS: The present study is a retrospective survey. The series was divided into a combined surgery group and a radiotherapy group. The Kaplan-Meier method and the log-rank test were used for survival calculations and comparisons. RESULTS: Eight hundred patients were registered (25.7% stage III and 62% stage IV), 336 in the surgery and 372 in the radiotherapy group. Conventional fractionation was adopted in almost all cases. The five-year overall and disease free survival of the whole series was 32% and 38%, respectively. Survival was slightly better for patients with tumors of the glosso-epiglottic region than for those with a tumor of the base of the tongue. Five-year disease-free survival was 55% for patients treated with surgery +/- radiochemotherapy and 26% for those submitted to radiotherapy alone or in combination with chemotherapy. As far as the total dose and the treatment duration were concerned, only 26% of the patients of the radiotherapy group met the established criteria of adequacy, but in patients with adequate radiation the control rate was better only for small tumors (T1-T2). CONCLUSIONS: The results in patients treated with surgery +/- postoperative radiotherapy were similar to or better than those reported in the best series in the literature. By contrast, the survival rate of irradiated patients was lower than those reported by other centers.

Adult↗
PubMedDate not supplied

The diagnostic usefulness of electron microscopy investigation of orbital embryonal rhabdomyosarcomas.

The ultrastructural study of three malignant orbital tumors, only one of which was correctly diagnosed as embryonal rhabdomyosarcoma upon histologic examination, is reported. In all 3 cases electron microscopic investigation revealed the presence of rhabdomyoblasts. These are easily recognizable in one case in which the diagnosis was made on the basis of the optical microscopic study. The other two cases needed further tests to evince rhabdomyoblasts. The importance of an ultrastructural study for a histogenetic characterization of this kind of tumor is emphasized. As far as embryonal rhabdomyosarcomas are concerned the electron microscopic study is possible, and it gives useful results even when material fixed with routine histologic methods (formalin, Bouin's solution) are used.

Child↗
PubMedDate not supplied

[Delphi study in the identification of research need in occupational medicine in Italy].

The aim of the study was to identify the research priorities and strategies in Occupational Safety and Health (OSH) in Italy with a high degree of consensus. Based on the Delphi technique, a two-phase questionnaire was sent to experts at Universities, Local Health Units (ASLs) and Trade Unions. In the first phase, experts were requested to indicate three research topics in the OSH sector. A total of 27 topics for both universities and ASLs and 18 topics for Trade Unions were identified. In the second phase, experts were requested to assign a score from one (low relevance) to five (high relevance) to each topic previously identified. On the basis of a mean score reported for each topic, two ranked lists of priorities, one referred to universities and ASLs the other referred to Trade Unions, were formulated. The highest priority identified by universities and ASLs was occupational carcinogenesis, followed by quality in occupational medicine. Workers' information, education and participation was also identified with a high degree of priority. For Trade Unions, occupational cancers as well as training, information, participation and prevention awareness had the highest priority. Trade Unions also identify small-industries and occupational accidents as topics with high priority for research development. This study allowed a high degree of consensus to be reached regarding the research priorities in the OSH sector in Italy. Differences in the topics identified, or regarding the mean score of topics commonly identified, were related to the origin of the expert recruited to this study (University, ASLs or Trade Unions) and, for universities and ASLs, to the geographical area. In the authors' opinion, the full transfer of existing scientific data to occupational health practice and the harmonization of the priorities identified by this investigation are crucial if the research needs in the OSH sector in Italy are to be met.

Delphi Technique↗
PubMedDate not supplied

[The bystander effect: potential impact on risk assessment of carcinogen agents].

A growing experimental evidence indicates that ionizing radiation is able to determine relevant biological effects, included SCE and micronuclei induction, gene mutations, ROS production and gene expression modification, in cells not directly hit by radiation. Such a phenomenon, known as bystander effect, has been described for different types of radiation (alpha, gamma, X and beta) and cells and it is relevant at low doses (also few mGy). It is likely to be mediated by either diffusible factors released by irradiated cells or the passage of mediators through gap junctions; in many cases it seems to be persistent over time. Until now, the bystander effect has been primarily described in vitro for ionizing radiation. A crucial outcome of future research deals with the existence and quantification of this effect in relation to chemical agents displaying genotoxic and carcinogenic potential.

Bystander Effect↗
PubMedDate not supplied

[Bystander effect: critical review and implications for risk assessment in radioprotection].

A growing experimental evidence indicates that ionizing radiation is able to determine relevant biological effects, including reduction in cell survival, cytogenetic alterations, gene mutations, induction of apoptosis and gene expression modification, in cells not directly hit by radiation. Such a phenomenon, known as bystander effect, has been described for radiation of different quality (alpha, gamma, X, beta radiation, heavier ions) and for different types of cells; it is relevant at low doses (even few mGy) and in many cases it seems to be persistent over time. Bystander effect is surely mediated by soluble factors released by irradiated cells into the extracellular environment and/or by the passage of mediators through gap junctions. The search of the effect in vivo, the setting up of models of risk assessment at low doses of ionizing radiation accounting for the bystander effect and the identification and quantification of this effect in relation to chemical agents displaying genotoxic and carcinogenic potential are primary research goals.

Animals↗
PubMedDate not supplied

[Use of the comet test in occupational medicine and industrial toxicology: considerations and prospects].

The comet test (Single Cell Gel Electrophoresis or SCGE) is an easy to perform, rapid and highly sensitive genotoxicity assay; it requires small amounts of biological substrate and is applicable in vivo and in vitro to a wide variety of cells and tissues. Modified versions of the comet test able to detect oxidative damage or the effects of agents inducing DNA-DNA or DNA-protein crosslinks are available. Similarly to other genotoxicity assays, the comet test is not predictive far individual cancer risk. Limitations and critical features presently linked to comet test applications, with particular regard to the biomonitoring of individuals exposed to genotoxic agents, include: lack of sensitivity with respect to aneugens (agents inducing numerical chromosomal aberrations), possible underestimation of genotoxic potency of agents with mixed action mechanisms, sensitivity depending on the genotoxic agent itself, dependence an biological substrate with regard to the influence of cytotoxicity on the assay results, influence of age, tobacco smoke, alcohol and drug consumption, diet, kinetics of DNA adducts and DNA repair mechanisms. Consequently, a routine use of the comet test in biological monitoring of individuals that are occupationally and environmentally exposed to genotoxic agents is submitted to its validation by multicentric studies on large population samples with different exposure patterns, with a suitable characterisation of the role played by the above mentioned factors. Human studies should also be increasingly focused on the direct cellular targets of exposure to genotoxicants (e.g. epithelial cells of oral cavity and airways).

Age Factors↗
PubMedDate not supplied

General stability of thermophilic enzymes: studies on 6-phosphogluconate dehydrogenase from Bacillus stearothermophilus and yeast.

The thermophilic enzyme 6-phosphogluconate dehydrogenase (6-phospho-D-gluconate:NADP oxidoreductase, decarboxylating, EC 1.1.1.44) from Bacillus stearothermophilus was much more resistant to inactivation under different conditions of temperature, pH, guanidine-hydrochloride, and organic solvents (dioxane, dimethylformamide, acetone) than its mesophilic counterpart from yeast. In addition, the thermophilic enzyme largely withstands proteolysis with trypsin, chymotrypsin, and elastase when compared with the yeast enzyme. It is proposed that thermophilic enzymes are not only thermostable, but also generally more stable to most common protein denaturants than their mesophilic counterparts. Because of their remarkable stability, enzymes isolated from thermophilic microorganisms may be ideally suited for technological applications.

Geobacillus stearothermophilus↗
PubMedDate not supplied

[Health risks from infrared emissions from radiant tube heaters in the workplace].

With the exception of domestic rooms, Overhead Radiant Tube Heaters (ORTH) are an effective system for indoor heating (e.g. warehouses, factories, garage workshops, shipyards, greenhouses, schools hall etc.). The growing number of units installed is due to several advantages, such as uniform heating, absence of air movements, energy saving, versatility and safety. Indoor heating is obtained by an infrared emission, which is produced by the circulation of combustion exhaust gases within tubes and is collected by a set of reflecting surfaces located around the tubes. In the present communication, the attention is driven on the characteristics of ORTH infrared emissions, with reference to potential health risks for the exposed people (especially people working within areas heated by this system). A reason for this is represented by the existence of a specific italian regulation (Circolare N. 1322/4134-28.01.1992, Direzione Generale della Protezione Civile-Ministero dell'Interno). Following the last one, ORTH surface temperatures resulting in a spectral emission which includes wavelengths less than 3 microns have to be considered, in the case of ORTHs with thermal power greater than 34.89 kW, as hazardous for exposed people. Although the ORTHs emission spectrum partially covers the near infrared region (0.8-1.4 microns) at 400 degrees Celsius and may adversely affect the retained tissue a gross evaluation of the near infrared energetic flux, weightened on the surface unit, allows to exclude this risk. On the opposite, the results of the same evaluation carried out in the medium and far infrared spectral region at 200 degrees-400 degrees Celsius (the normal temperature range for ORTHs) do not allow to preliminary exclude a thermal risk for eye structures such as lens, near the tube surface at least. In every case, a burn hazard for both corneal tissue and skin is excluded. With the aim to carry out a detailed set of radiometric estimates, some preliminary considerations are furnished concerning the risk assessment for the eye, with reference to the following parameters: emission spectrum, energetic flux, workstation, presence of reflecting surfaces, potential interferences, exposure duration, angle between the incident radiation on eye surface and the optic axis. ACGIH 1992/93 for infrared radiation TLVs are followed as reference standard.

Environmental Exposure↗