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Biomedical subjects

G Almadori

Publications and source records attributed to G Almadori.

At least 19 recordsLinked to original sources

Cathepsin D in primary squamous laryngeal tumors: correlation with clinico-pathological parameters and receptor status.

Using an immunoradiometric assay, Cathepsin D (Cath D) levels were measured in the cytosol of 23 normal and 39 neoplastic human laryngeal tissues. Scattered Cath D levels (from 2.2 to 17.8 pM/mg protein; median = 7.6) were found in normal mucosa specimens. Cath D concentrations range from 2.0 to 29.3 pM/mg protein (median = 8.5) in laryngeal tumors. When a comparison between Cath D levels in normal and neoplastic tissue specimens from the same patient was done, Cath D levels were significantly higher in laryngeal cancers than in their normal counterparts (P = 0.03). No correlation with clinico-pathological parameters and steroid hormone and epidermal growth factor receptor status was found. Further studies should investigate whether the production of Cath D by laryngeal tumors could have a clinical relevance for this neoplasia.

Adult

EGF receptor expression in primary laryngeal cancer: correlation with clinico-pathological features and prognostic significance.

Epidermal-growth-factor-receptor(EGFR) expression was evaluated in 103 primary laryngeal tumors and in 42 normal laryngeal tissue specimens. Significantly higher EGFR levels were found in cancer specimens than in normal mucosa (p = 0.0053). EGFR expression did not correlate with age, tumor localization, T classification, cervical-lymph-node involvement or type of surgery, whereas it was higher in poorly differentiated tumors (G3) than in well/moderately differentiated (G1-G2) tumors (p < 0.05). Follow-up data were available for 74 patients. When EGFR status and the most important clinico-pathological characteristics were submitted to univariate analysis, tumor localization, type of surgery and EGFR status were found to be significantly correlated with disease-free survival. The 24-month disease-free survival rate was 58% for EGFR+ cancer patients and 82% for EGFR- ones. With multivariate analysis, only EGFR status and tumor localization were identified as significant independent prognostic parameters. Data reported here suggest that high EGFR levels may identify a sub-set of laryngeal-cancer patients with a particularly unfavorable prognosis.

Adult

Plexiform neurofibroma of the cervical portion of the vagus nerve.

The authors describe a rare case of plexiform neurofibroma of the cervical portion of the vagus nerve, and discuss its aetiopathogenesis, clinical, histological and therapeutic features, emphasizing the difference from other benign tumours of the vagus nerve. The clinical characteristics of the mass, ultrasound tomography, CT scanning and digital subtraction angiography were useful in defining its extension and relationships with the surrounding structures. Surgery is the treatment of choice. After mentioning the most commonly employed surgical approaches, they emphasize the advantages of the lateral-cervical approach which allows a wide exposure of the possible sites of origin of the tumour and its complete removal. Finally they stress the need of an accurate histological and immunohistochemical examination in order to differentiate neurofibromas from neurilemmomas.

Adult

Functional study of the eustachian tube with sequential scintigraphy.

The authors investigated the tubal function by means of sequential scintigraphy in 16 patients affected by chronic otitis media and in 3 patients with posttraumatic perforation of the tympanic membrane. Evaluated parameters were: appearance time (AT), radioactivity peak time, rise time in the tympanic cavity, eustachian tube and rhinopharynx, and radioactivity percent values passed in the rhinopharynx. The tubal pressure-equilibrating function was determined by means of the manometer pump section of the impedance meter. A significant relationship between the pressure-equilibrating function and the tubal scintigraphy parameters has been detected. The variability of the AT in the tube and the almost constant time needed by the radioactive tracer to go through the tube and reach the rhinopharynx could indicate that a major role in the tympanic cavity drainage is played by the tympanic ostium and the surrounding mucosa.

Chronic Disease

Receptors for epidermal growth factor and steroid hormones in primary laryngeal tumors.

The authors investigated the presence of epidermal growth factor (EGF-R), estrogen (ER), progesterone (PR), and androgen (AR) receptors in 42 laryngeal squamous cell carcinomas and 20 normal laryngeal mucosa specimens. EGF-R were expressed in all tumor specimens analyzed, with significantly higher levels in tumor samples compared with normal mucosa (P less than 0.05). The immunohistochemical study demonstrated the presence of EGF-R in basal and parabasal cells of normal mucosa and in most of the cancer cells. There was no correlation between EGF-R and tumor localization or T classification. On the other hand, the authors did find an interesting correlation between EGF-R levels and grading, EGF-R levels being significantly higher in G3 than in G1-G2 tumors. Moreover, the three patients whose tumors expressed the highest EGF-R levels had disease recur within 8 months. Among tumor specimens, 9.5%, 35.7%, and 9.5% expressed very low but detectable ER, PR, and AR levels, respectively. No statistically significant difference was found between the levels of steroid receptors in the tumor and normal mucosa specimens, and neither was there any correlation of ER, PR, and AR with the pathologic findings. The authors' results suggest that the EGF-R system may play a role in regulating the growth of laryngeal cancer. Additional studies should demonstrate whether, as in other tumor types, EGF-R expression may have prognostic significance in human laryngeal cancer.

Adult

Marijuana smoking as a possible cause of tongue carcinoma in young patients.

A case of T1N0M0 carcinoma of the tongue in a male 23-year-old 'regular' marijuana smoker is described. Hemiglossectomy and complete bilateral neck dissection were carried out. No post-operative radiotherapy was given as the resection margins were histologically negative. The tumour recurred one year later in the left cervical region involving the mandible and surgery was again performed, but after three months, neck disease was still evident. The case described case implies the introduction of marijuana as a possible new risk factor in the development of oral cavity tumours. Resection of the primary lesion has to be as wide as possible even in T1 cases, due to the aggressive biological behaviour of such tumours in young subjects.

Adult

Auditory brainstem responses in the aged.

The auditory brainstem responses (ABR) in a group of 74 aged subjects (60-80 years), affected by presbycusis were evaluated for presence of a retrocochlear involvement. The comparison of results from subjects with presbycusis with those from normally-hearing elderly subjects, and young subjects, affected by a cochlear sloping hearing loss, revealed that the latency increase of ABR observed in presbycusis is mainly correlated to the audiometric shape of the hearing loss and not to age per se.

Acoustic Impedance Tests

40-Hz steady-state responses in newborns and in children.

The authors investigated the 40-Hz steady-state responses (SSR) in 32 full-term newborns and in 10 normal children (5-8 years old), using 500-Hz tone bursts. The 40-Hz SSR threshold is located at about 50 and 30 dB nHL in newborns and older children, respectively. The latencies of both P1 and N1 waves decreased significantly with age, while the amplitudes increased. No significant latency and amplitude intersex differences have been observed. Moreover, with age, the 40-Hz SSR became more stable, their test-retest replicability improved, and P1-N1 wave occurrence increased. The authors finally discuss the possible underlying mechanisms of these findings and conclude that the 40-Hz SSR are difficult to obtain and are scarcely reliable in defining the low-frequency threshold in newborns. The stability and reliability of the responses increase with age, and the electrophysiological and behavioral thresholds to low-frequency stimuli tend to overlap.

Audiometry, Evoked Response

Microbial flora of surface versus core tonsillar cultures in recurrent tonsillitis in children.

Surface and 'core' tonsillar specimens were collected from 60 children, between 2 and 14 years of age, suffering from recurrent tonsillitis, in order to establish the reliability of surface tonsillar swabbing technique and to define the most frequently involved aerobic and anaerobic microorganisms. From the qualitative point of view, the same mixed aerobic and anaerobic flora were obtained in both samples thus demonstrating the reliability of the surface swabbing technique. From the quantitative point of view, 187 microorganisms, 129 (69.2%) aerobes and 58 (30.8%) anaerobes were isolated from surface cultures while 184, 109 (59.2%) aerobes and 75 (40.8%) anaerobes from the core cultures, thus demonstrating a greater number of anaerobes in the core of the tonsil. The most common isolated aerobic microorganisms were the alpha- and beta-hemolytic Streptococci, the Neisseriae and the Staphylococcus aureus; the predominant anaerobic ones were the Fusobacterium nucleatum, the Bacteroides sp. and the Veillonella parvula. The isolated staphylococcus aureus and the bacteroides sp. were all beta-lactamase producers.

Adolescent

Auditory brainstem responses in noise-induced permanent hearing loss.

Fifty-four patients (108 ears) with presumed noise-induced hearing loss, were subjected to tonal and speech audiometry, impedance tests and measurements of auditory brainstem responses (ABR), in order to check for possible retrocochlear involvement. ABR data indicated that latency values of waves I, III and V, as well as III-I, V-III and V-I intervals fell within the normal range in all cases (M +/- 2 SD), even for fast repetition rates (51 stim/s). Poor waveform resolution of early components, particularly of wave I, was found in 12 ears (11.1%) and a total absence of evoked potentials not always related to the hearing loss, occurred in 5 ears (4.6%).

Acoustic Impedance Tests

Effects of sex on auditory brainstem responses in infancy and early childhood.

The effects of sex on I-III, III-V and I-V interwave intervals and I, III, V ABR waves latency values have been studied in 171 normal children born at term, 94 males and 77 females, aged between 2 and 720 days. The obtained data confirm that latency values decrease progressively with age, and show that there is a statistically significant difference in wave III and V latency values and in III-V and I-V intervals between males and females. Moreover, these differences seem to increase with age. The authors also discuss the possible underlying mechanisms and claim that even in infancy, sex-related variability should be taken into account.

Brain Stem

Radioisotopic method for nasal mucociliary function evaluation.

In 13 healthy young adults, nasal mucociliary transport velocity was measured by means of albumine microsphere labeled with Tc99m as a tracer. M + ISD of clearance velocity values and of the half time radioactivity (T1/2) resulted to be respectively 1.02 + 0.22 cm/min and 1.07 + 0.24 min. A significant correlation (P less than 0.05) between half time clearance (T1/2) values of the radioactive particles and the mucociliary velocity ones could be detected, making T1/2 a reliable and rapidly obtainable parameter for determining nasal mucociliary function. Advantages and disadvantages of the different techniques are discussed.

Adult

Influences of birthweight upon brainstem maturation as reflected by auditory brainstem response (ABR) evaluation.

The authors have studied auditory brainstem responses (ABR) in 49 preterm (Group A) and in 54 fullterm (Group B) newborns, classified according to the birthweight related to conceptional age, in order to verify the influences of this latter parameter upon ABR. In Group A newborns, 4 recording sessions were performed, while only 3 in Group B, to evaluate data obtained at the same extra-uterine age. The obtained data show that birthweight related to conceptional age seems to play a major role on the development of ABR, since no significant differences were detected between preterm and fullterm newborns, provided the birthweight was appropriate for conceptional age (ACA). On the contrary, small for conceptional age (SCA) newborns showed an abnormal ABR pattern at birth, which tended to normalize at the following recording sessions. The authors conclude that birthweight related to conceptional age represents an important factor in the development of auditory brainstem responses and that the audiological diagnosis has to be very cautious in SCA newborns, regardless if they are pre- or fullterm.

Birth Weight

Auditory brainstem and middle-latency responses in Bell's palsy.

Patients with acute peripheral facial palsy (Bell's palsy) were examined by auditory brainstem response (ABR) and middle-latency response (MLR) for signs of brainstem involvement. ABR data on 30 patients indicated that wave V latencies were abnormal by greater than 3 SD in only 2 patients, 1 of whom showed abnormality contralateral to the affected side. When the criterion for abnormality was reduced to 2 SD, wave V abnormality was found in only 3 of the 30 patients. All 14 patients tested by MLR showed normal responses. These findings suggest that on the basis of evoked potential measures, brainstem involvement may not be pathognomonic of Bell's palsy.

Adolescent

Auditory brain-stem (ABRs) and middle latency auditory responses (MLRs) in the prognosis of severely head-injured patients.

Auditory brain-stem responses (ABRs) were studied in 66 subjects with severe head trauma. Middle latency responses (MLRs) were also recorded in 22 of them. Patients were carefully selected to avoid conditions such as pre-existing or acute deafness, hypothermia or ethanol intoxication. In order to evaluate the usefulness of potentials in predicting recovery, patients were classified according to the Glasgow Coma Scale (GCS). ABR tracings were classified into 5 groups and MLR into 2 groups. The recovery was good in the presence of a type 1 ABR, poor in the presence of types 3, 4 and 5. Concerning type 2 ABR, the outcome is related to the MLR type, and to the presence of an electrophysiological improvement within the first 3 months following trauma. The reliability of ABR and MLR in predicting the outcome of severe head injury appears to be greater than other usually considered clinical and instrumental data (age, GCS, CT scan, EEG).

Adolescent

Mucociliary function and nasal resistance evaluation before and after adenoidectomy.

Thirty-four children with clinically and radiologically confirmed adenoid hypertrophy underwent otoscopy, impedance tests, active anterior rhinomanometry and nasal mucociliary clearance evaluation before and 6 months after adenoidectomy. Mucociliary clearance velocity increased significantly while binasal resistances decreased after surgery. The authors conclude that mucociliary evaluation and objective measurements of nasal resistances should be added to impedance tests as indicators to adenoidectomy.

Adenoidectomy

Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis.

Nasal secretions, maxillary sinus aspirates and specimens of the maxillary sinus mucosa were collected in 44 patients aged between 25 and 60 affected by mono- or bilateral chronic maxillary sinusitis, in order to establish the best sampling technique for microbiological purposes, the most frequently involved bacteria and the physiopathological mechanism underlying chronic maxillary disease. The sinusal mucosa resulted to be the most reliable sample as it reduces contamination and microbial variability. Anaerobic bacteria were isolated in nasal swab (15.6%), in maxillary sinus aspirates (30.4%) and in maxillary sinus mucosa (36.4%) of maxillary sinusitis patients. In controls anaerobic bacteria were isolated only in one nasal swab (2.3%), while they could not be isolated in maxillary sinus aspirates and in maxillary sinus mucosa. The presence of anaerobic bacteria in chronic maxillary sinusitis patients and their absence in controls seem to confirm that anaerobic microorganisms represent the main pathogenetic agents of chronic maxillary sinusitis. The possible physiopathological mechanisms underlying chronic maxillary sinus disease are finally discussed.

Adolescent

Auditory brainstem responses in the full-term newborn: changes in the first 58 hours of life.

The authors have studied auditory brainstem responses (ABR) in 33 full-term newborns at 0-9, 10-30, 31-58 h, in order to evaluate changes in the first hours after birth, particularly in relation to different repetition rates and recording procedures. The data obtained show that the characteristic newborn 3-peak tracing is observed in almost all the cases at the third recording session while, at the first, wave I is absent in two-thirds of the cases. The most reliable waves at birth are waves III, V and N II, which is often present even when other vertex-positive peaks are absent. Latency values of the considered peaks tend to decrease in a statistically significant way and this decrease is almost complete at the second recording session (30 h), while V-I interval values decrease, especially when the 9 stimuli/s repetition is employed. Stimulus repetition rate affects ABR replicability and synchronization, but it hardly influences latency values. Contralaterally recorded potentials are often absent at birth and become evident 58 h later. The authors conclude that the maturational processes probably affect both peripheral and central auditory structures in the first hours after birth. In this period, increasing repetition rates seem to have a greater effect on wave replicability than on latency values.

Brain Stem