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Biomedical subjects

G Baroni

Publications and source records attributed to G Baroni.

At least 19 recordsLinked to original sources

Prognostic value of P-glycoprotein and proliferative index in advanced low grade serous ovarian carcinomas.

The aim of this study was to test the prognostic value of p-glycoprotein expression and the proliferative index of tumor cells on the clinical response to chemotherapy, on the brief disease-free interval (< 12 months) and on cause-specific survival in advanced ovarian carcinoma. We evaluated 83 ovarian carcinoma patients homogeneous for stage, type and grade histological. Brief disease-free interval and cause-specific survival rates (Kaplan-Meier method) were compared using the log rank test. Multivariate analysis (Cox proportional hazards models) was used to determine the independent effect of each variable on prognosis. In the univariate analysis, P-glycoprotein expression (P < 0.0005) and proliferative index (P = 0.0003 and P = 0.0006) were independent predictors of survival and brief disease-free interval; residual disease was associated with survival (P = 0.021). In multivariate analysis (Cox proportional hazards models), P-glycoprotein expression (P = 0.001 and P = < 0.0005) and proliferative index (P = 0.081 and P = 0.041) were independent predictors of brief disease-free interval and survival. P-glycoprotein expression (P < 0.0005) and proliferative index (P = 0.008) were associated with clinical response to chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Self-marking of anatomical landmarks for on-orbit experimental motion analysis compared to expert direct-marking.

The on-orbit application of movement analysis methodology, on-board space stations, for studying the gravity role in motor functions, requires a careful adaptation of the currently adopted techniques in order to obtain reliable data. In those operative conditions, differently from common on-ground experimental activities, a non-specialist operator, an astronaut of the space station crew, is expected to self-administer the experimental protocol, particularly self-marking specific anatomical landmarks. The present paper proposes a movement analysis methodology, which fits the specific constraints of space activity and matches the objective of maximising reliability and minimising on-orbit time, and reports normative data about accuracy and precision of the self-marking of an extended set of anatomical landmarks. The same set of landmarks has been considered also for direct-marking performed by experts in motion analysis and their results have been compared to self-marking ones. The paper contents will support the design of future space experimental campaigns and is, in general, applicable to any on-ground scientific investigation, possibly increasing data reliability.

Adult↗

Multidrug resistance in ovarian cancer: comparing an immunocytochemical study and ATP-tumor chemosensitivity assay.

The aim of our study was to evaluate the possible prognostic and predictive significance of the expression of P-glycoprotein, a transmembrane transport protein related to multidrug resistance, in previously untreated patients with FIGO stage III ovarian cancer; to compare the results of immunocytochemical analysis of tissue sections of tumors to the in vitro chemosensitivity to cytotoxic drug of fresh samples of the same tumors; and to evaluate survival in women who underwent the same surgical treatment and the same adjuvant chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Optimisation of shape kernel and threshold in image-processing motion analysers.

The aim of the work is to optimise the image processing of a motion analyser. This is to improve accuracy, which is crucial for neurophysiological and rehabilitation applications. A new motion analyser, ELITE-S2, for installation on the International Space Station is described, with the focus on image processing. Important improvements are expected in the hardware of ELITE-S2 compared with ELITE and previous versions (ELITE-S and Kinelite). The core algorithm for marker recognition was based on the current ELITE version, using the cross-correlation technique. This technique was based on the matching of the expected marker shape, the so-called kernel, with image features. Optimisation of the kernel parameters was achieved using a genetic algorithm, taking into account noise rejection and accuracy. Optimisation was achieved by performing tests on six highly precise grids (with marker diameters ranging from 1.5 to 4 mm), representing all allowed marker image sizes, and on a noise image. The results of comparing the optimised kernels and the current ELITE version showed a great improvement in marker recognition accuracy, while noise rejection characteristics were preserved. An average increase in marker co-ordinate accuracy of +22% was achieved, corresponding to a mean accuracy of 0.11 pixel in comparison with 0.14 pixel, measured over all grids. An improvement of +37%, corresponding to an improvement from 0.22 pixel to 0.14 pixel, was observed over the grid with the biggest markers.

Algorithms↗

Voluntary head stabilisation in space during oscillatory trunk movements in the frontal plane performed before, during and after a prolonged period of weightlessness.

The ability to voluntarily stabilise the head in space exhibited by two subjects during lateral rhythmic oscillations of the trunk has been investigated before, during and after a prolonged period of microgravity (microG) exposure. In flight acquisitions were performed onboard the Core Module of the Russian Space Station MIR as part of the T4 "Human Posture in Microgravity" experiment of the 179-days ESA-RKA mission EUROMIR-95. Data collection and kinematic analysis were performed by means of a space-qualified version of the automatic motion analyser ELITE. Head stabilisation in space strategy was estimated by means of the head anchoring index and cross-correlation analysis. Results show that head orientation may be well stabilised about the roll axis both with and without the presence of visual information. This was true despite the expected reduction in vestibular efficiency and muscular proprioception occurring in-flight. In one subject, however, vision was found to improve head stabilisation in space post-flight, presumably to recover from the postural deficiency induced by the long-term microG exposure. Head stability during trunk movements was achieved with either over-compensatory (out-of-phase), under-compensatory (in-phase) or mixed movement strategies, as was attested by the analysis of cross-correlation functions between head and shoulder movements. In weightlessness, vision occlusion seemed to influence the choice of the strategies to be used as well as the reduction of movement variability. The feedforward nature of compensatory head movements suggests that head stabilisation could be based in weightlessness on the internal postural body scheme, supposed to be adapted to the weightless environment within 5 months of microG exposure.

Adaptation, Biological↗

Up-regulation of cyclooxygenase 2 gene expression correlates with tumor angiogenesis in human colorectal cancer.

BACKGROUND & AIMS: Recent studies have shown that cyclooxygenase (COX)-2 and its products, prostaglandins (PGs), may be involved in colorectal carcinogenesis. The aim of this study was to determine whether COX-2 expression and PGE(2) production correlate with microvessel density, vascular endothelial growth factor (VEGF) expression, and tumor metastasis in human colorectal cancer. METHODS: Tumor samples and adjacent normal mucosa were obtained from 31 surgical specimens. Immunohistochemical expression of COX-2, VEGF, and CD31 was analyzed on paraffin-embedded tissue sections. COX-2 and COX-1 proteins were determined by Western blot analysis. COX-2 and VEGF messenger RNA expressions were evaluated using Northern blot analysis. PGE(2) production was determined by specific radioimmunoassay. RESULTS: The immunohistochemical expressions of both COX-2 and VEGF were significantly correlated with microvessel density (P = 0.02 and P = 0.002, respectively). A significant correlation was found between COX-2 and VEGF expression (P = 0.004). Western analysis confirmed the up-regulation of COX-2 protein expression. COX-2 and VEGF genes were overexpressed in tumor specimens as compared with normal mucosa. PGE(2) levels were significantly higher in metastatic tumors than in nonmetastatic ones (P = 0.03). CONCLUSIONS: COX-2 is related to tumor angiogenesis in colorectal cancer. It is likely that VEGF is one of the most important mediators of the COX-2 angiogenic pathway.

Adenocarcinoma↗

Median raphe cyst of the penis: a report of two cases with immunohistochemical investigation.

Penile median raphe cysts are uncommon benign lesions occurring predominantly in the ventral aspect of the glans penis of young men. We observed two cases: those of a 67-year-old patient and a 22-year-old patient. The epithelial lining of the cysts was composed of pluristratified small cells that focally showed rows of columnar cells above the inner surface as well as a monolayered mucinous columnar epithelium. A columnar cell lining predominated in the younger patient. The cytokeratin (CK) immunostaining pattern of the two cysts (CK7(+++), CK13(+++), CK20(-), CAM 5.2(+)) supports the interpretation of a columnar mucinous epithelium undergoing immature urothelial metaplasia. Carcinoembryonic antigen immunostaining positivity of the columnar cells is probably related to the dysembryogenetic cloacal nature of the cysts. Neuroendocrine differentiation of sparse cells interspersed in the pluristratified epithelium was documented by immunohistochemical staining for chromogranin and synaptophysin. Cilia were not identified in the columnar cells by light microscopy or by antidynein immunohistochemistry.

Adult↗

Static and dynamic postural control in long-term microgravity: evidence of a dual adaptation.

The adaptation of dynamic movement-posture coordination during forward trunk bending was investigated in long-term weightlessness. Three-dimensional movement analysis was carried out in two astronauts during a 4-mo microgravity exposure. The principal component analysis was applied to joint-angle kinematics for the assessment of angular synergies. The anteroposterior center of mass (CM) displacement accompanying trunk flexion was also quantified. The results reveal that subjects kept typically terrestrial strategies of movement-posture coordination. The temporary disruption of joint-angular synergies observed at subjects' first in-flight session was promptly recovered when repetitive sessions in flight were analyzed. The CM anteroposterior shift was consistently <3-4 cm, suggesting that subjects could dynamically control the CM position throughout the whole flight. This is in contrast to the observed profound microgravity-induced disruption of the quasi-static body orientation and initial CM positioning. Although this study was based on only two subjects, evidence is provided that static and dynamic postural control might be under two separate mechanisms, adapting with their specific time course to the constraints of microgravity.

Adaptation, Physiological↗

[Opto-electronic techniques and 3D body surface reconstruction for the control of patient positioning in the radiotherapy of breast cancer].

PURPOSE: In radiotherapy clinical practice, the currently existing gap between the high degree of accuracy in treatment planning and, the possibility of conforming the high-energy radiation beams on the one hand, and the uncertain set-up of each irradiation session on the other is a decisive factor for optimizing radiation treatment. Indeed there is wide experimental evidence that the current methods used for patient alignment and immobilization do not guarantee the necessary precision in delivering therapy with respect to the specifications of the treatment plan. The main reason for this is the lack of control systems that may be applied systematically to provide quantitative real-time feedback on the quality of patient repositioning and immobility during radiation emission. MATERIAL AND METHODS: Opto-electronic techniques and body surface registration methods were sygergisically used for the automatic three-dimensional verification and correction of patient position at the therapy unit. The method is based on radiotherapy applications of real-time opto-electronic human motion analysis using passive markers to control patient repositioning and to acquire and describe body surfaces in three dimensions. The quantitative detection of the localization error relies on the real-time detection of the position of an hybrid set of control points, namely physical passive markers and laser light markers, and their immediate comparison with a reference data set. The data set consists of the reference positions of the passive markers and a three-dimensional model of the body surface. The method was experimentally tested at the Radiotherapy Division of the European Institute of Oncology to control the repositioning of a phantom and of a volunteer, with reference to the clinical realignment procedure applied for breast cancer radiotherapy. RESULTS: The results confirm that the technique represents a valuable method to detect and automatically correct localization errors in the irradiation set-up. The use of the information provided by the laser markers allows one to reduce the potential inaccuracies in the manual relocation of the passive markers on the subject's skin and guarantees that position control is based on a redundant set of data describing the three-dimensional localization and configuration of the irradiated body surface portion. The experimental results show that the initial displacements of the controlled body area were systematically reduced to median values below 1 millimeter and 1.2 millimeters for the phantom and the volunteer, respectively. CONCLUSIONS: The synergistic use of opto-electronic technologies and stereophotogrammetric techniques associated to surface registration methods proved to provide an accurate description of the spatial transformation between the reference position and the actual position of the controlled body area. This allowed us to define an effective procedure to correct the patients position and recover the quality of the irradiation set-up, in agreement with the clinical requirements. The reported results confirm that the dynamic sensing of the body surface by opto-electronic technologies is a particularly promising technique that allows to systematically achieve swift and accurate patient alignment, thus ensuring that the treatment plan specifications are reproduced in the reality of each irradiation session.

Algorithms↗

[Cystic dysplasia of the testis: report of a case and review of the literature].

Cystic dysplasia of the testis (CDT) is a rare, benign and congenital lesion causing scrotal mass in pediatric population that can mimic testicular cancer. This lesion consists of cystic dilation of the rete testis and it is frequently associated with renal or genitourinary tract anomalies as renal agenesis and multicystic dysplasia of the kidney. This frequent presentation suggests that testicular cystic dysplasia is associated with a defect of the metamesonephric system in particular with a defect in the connection between the efferent ducts derived from the mesonephros and the rete testis tubules derived from the gonadoblastoma. The role of ultrasound is of primary importance for clinical diagnosis and follow-up of untreated forms. The sonographic appearance of CDT consists of multiple cysts in the mediastinum testis. The cysts range in size from microscopic to several millimetres and may involve the whole testicular parenchyma or have a focal aspect. If the cysts are tiny, the ultrasound must be able to distinguish between CDT and testicular microlithiasis, a potential premalignant condition. Today it is possible thanks to high frequency 7.5 to 10 mHz probes. In the past orchiectomy has been considered as the treatment of the choice for CDT. Today, non operative management of CDT represents an effective alternative option in these patients and the primary benefit of this approach is the preservation of endocrine function and spermiogenic activity. However, the natural history of untreated CDT and its effect on normal testicular tissue are still unknown, therefore long-term follow-up is recommended.

Child, Preschool↗

Real-time opto-electronic verification of patient position in breast cancer radiotherapy.

OBJECTIVE: The clinical application of an opto-electronic system for real-time three-dimensional (3D) control of patient position in breast cancer radiotherapy is described. The specific features of the motion analysis technology (shape recognition of passive markers) are detailed, and the outcomes of its clinical use for quantitative position control and immobility verification of the thoracic irradiation field during breast cancer treatment are reported. MATERIALS AND METHODS: The position control system is based on the ELITEtrade mark opto-electronic motion analyzer, which provides in real time the 3D coordinates of a set of passive markers (plastic hemispheres 3 mm in diameter) previously placed on selected landmarks on the patient's skin. The system-dedicated hardware performs marker recognition by means of 2D correlation of shape with a predefined marker modeling mask. This feature ensures a high accuracy, even with small marker dimensions, and successful analysis in a noisy environment (due to room light, reflexes, etc.). The patient repositioning control was based on a comparison between the current positions of the markers and a corresponding reference configuration. The resulting marker displacements were graphically displayed in real time for immediate control. This information was not provided to the operator as a repositioning tool. Instead, the kinematic data was stored for subsequent off-line analysis aimed at quantifying the different factors contributing to patient mis-positioning (initial repositioning errors, patient's breathing, and random movements) when conventional means for patient alignment (laser centering) and immobilization (casting techniques) are used. RESULTS: Clinical application of the system revealed median 3D localization errors for the directly controlled anatomical landmarks of around 4.5 mm. This value is proposed to represent the intrinsic accuracy of conventional laser-centering techniques in breast cancer radiotherapy, including the effects of patient body deformations. When the positional inaccuracies introduced by patients' respiration were also considered, the extent of the resulting 3D mis-positioning of the control points increased to median values of up to 8 mm. CONCLUSIONS: The reported clinical trial confirms the significant role that real-time opto-electronic motion analysis based on passive markers can have in augmenting the accuracy of patient repositioning and immobility verification in the radiotherapy of a non-rigid body area while also accounting for physiological movements. Evaluation of the data collected during each irradiation session for five patients provided valuable information concerning the optimization of the efficacy of traditional methods for patient centering and immobilization.

Breast Neoplasms↗

Real-time three-dimensional motion analysis for patient positioning verification.

BACKGROUND AND PURPOSE: This paper describes the technology and methods involved in a system for automatically checking the position of patients at radiotherapy units. This is proposed for improving the accuracy in the irradiation geometrical set-up, which is a crucial factor in radiotherapy quality control. MATERIALS AND METHODS: The system is based on real-time opto-electronics and close-range photogrammetry and detects multiple passive markers placed on selected patient skin landmarks. Patient alignment and position monitoring is carried out by comparing the current three-dimensional positions of the markers with those of an initial reference position acquired during the simulation procedure and/or the first irradiation session. The system was used to measure the accuracy of conventional laser centering techniques for patient repositioning. Inaccuracies due to breathing and random movements were also taken into account. Professional technicians were asked to reposition three volunteer subjects carefully using a traditional laser centering procedure. RESULTS: The results revealed significant repositioning errors even in highly controlled conditions, affecting particularly body areas relatively far from the skin reference points used for laser alignment. CONCLUSIONS: The outcome of the experimental application of this technology confirms its potential as a tool for patient repositioning and automatic detection of any errors caused by breathing or other unpredictable movements. The real-time feedback on the patient's position given by the system provides operators with appropriate visual indices and allows them to take suitable countermeasures in case of significant failures. In addition, the use of the system output for automatic position control is envisaged.

Artifacts↗

Quantitative analysis of neutral body posture in prolonged microgravity.

The experiment was performed during a 6-month space flight and focused on the quantitative three-dimensional description of the Neutral Body Posture (NBP) and of subjects' spine anthropometry in Erect Posture (EP). The NBP joint angles' configuration is described along the long-term microgravity exposure and compared with respect to previous in-flight collected data. Observed spinal length modification during EP in-flight is related to on-ground investigations focused on circadian anthropometrical fluctuations. The flattening of the spinal lumbar lordosis and thoracic kyphosis is also described. Even though only two subjects were studied, this analysis points out the maturity of the opto-electronic technology for the quantitative analysis of posture in microgravity and confirms the need of enriching the anthropometrical database of human postures in weightlessness for the design optimization of permanently inhabited space modules.

Adult↗

Cutaneous ciliated cyst: a case report with immunohistochemical evidence for dynein in ciliated cells.

Cutaneous ciliated cysts (CCCs) are rare benign lesions predominantly occurring in the lower limbs of young women. We observed such a lesion in the perineal region of a 12-year-old girl. The histogenetic interpretation of CCCs is controversial. The similarity of the epithelial lining of the cyst to the salpingeal epithelium supports the hypothesis of a Müllerian heterotopia. Strong dynein positivity observed immunohistochemically in the apical portion of CCC lining cells suggests the integrity of the ciliary apparatus. There was a marked similarity between a CCC and normal salpingeal epithelium in the mode of staining for dynein, whereas the dynein reactivity of bronchial epithelial cells showed larger cytoplasmic aggregates of positive material in proximity to the nucleus. No immunohistochemical staining for estrogen or progesterone receptors was identified in our observation, although this finding could have supported the Müllerian histogenetic hypothesis. To the best of our knowledge, this is the first time that antidynein immunohistochemistry has been applied to paraffin-embedded samples from human surgical pathology.

Child↗

Epstein-Barr virus infection and P53 expression in HIV-related oral large B cell lymphoma.

BACKGROUND: Head and neck non-Hodgkin's lymphomas in HIV positive patients are highly related with Epstein-Barr virus (EBV) infection. In general, viral agents can alter p53 protein levels by enhancing degradation of cellular p53 or by increasing its half-life by viral protein-p53 interaction. Moreover, it has been reported that modifications of p53 gene can modulate tumor cells' response to radio- and chemotherapy. METHODS: To assess a possible role of EBV infection, p53 protein deregulation, and p53 gene alterations in exons 5 to 8, we have studied six cases of HIV-related primary oral large B-cell lymphoma. We used in situ hybridization (ISH) for EBV-DNA and EBV-encoded nuclear RNA-1 (EBER-1), immunohistochemistry (IHC) for EBV latent membrane protein -1 (LMP-1) and p53 proteins expression, and single strand conformational polymorphism (SSCP) analysis to screen p53 gene mutations in exons 5 to 8. RESULTS: The EBV-DNA was present in all specimens, according to conventional DNA-ISH. No evidence for EBER-1 was found by ISH. The presence of EBV-DNA was correlated with the LMP-1 expression in all but one case. Moreover, p53 protein expression was negative in three cases and strongly positive in the others. However, mutational analysis of p53 gene in exons 5-8 showed no alteration. CONCLUSIONS: Our data may suggest that both EBV infection and LMP-1 expression may cause p53 loss of function even in the absence of p53 gene mutations, as assessed by SSCP. We speculate that the presence of EBV-infection and p53 protein deregulation may be responsible for radio- and chemotherapy resistance, by influencing apoptosis of cancer cells.

Adult↗

Long-term adaptation of postural control in microgravity.

Orbital microgravity represents a unique environment, which allows the isolation of variables assumed to be involved in the mechanism of body positioning in space. In this context, the alignment of the trunk axis along allocentric references and the positioning of the body center of mass inside the supporting base compete for the role of the primary-controlled variable when assuming erect posture. This paper reports the quantitative evaluation of the postural strategies exhibited by two subjects with feet fixed to the floor of the space module along a 4-month period of exposure to microgravity. With respect to previous findings in parabolic flights and short term space missions, the analysis focused on long-term process of sensorimotor adaptation to weightlessness. Results show that while trunk-axis orientation is preserved and used as a stable postural frame of reference, the positioning of the body center of mass appears to be significantly biased backward and turns out to be involved in a long-term process of adaptation throughout the entire flight towards the re-emergence of a typically terrestrial postural regulation compatible with equilibrium.

Adult↗

Methodological and technological implications of quantitative human movement analysis in long term space flights.

In the frame of the 179-days EUROMIR '95 space mission, two in-flight experiments foresaw the analysis of three-dimensional human movements in microgravity. For this aim, a space qualified opto-electronic motion analyser based on passive markers was installed onboard the MIR Space Station. The paper describes the experimental procedures designed in order to face technical and operational limitations imposed by the critical environment of the orbital module. The reliability of the performed analysis is discussed, focusing two related aspects: accuracy in three-dimensional marker localisation and data comparability among different experimental sessions. The effect of the critical experimental set-up and of TV cameras optical distortions is evaluated on in-flight acquired data, by performing an analysis on Euclidean distance conservation on rigid bodies. An optimisation method for the recovering of a unique reference frame throughout the whole mission is described. Results highlight the potentiality that opto-electronics and close-range photogrammetry have for automatic motion analysis onboard orbital modules. The discussion of the obtained results provides general suggestions for the implementation of experimental human movement analysis in critical environments, based on the suitable trade-off between external constraints and achievable analysis reliability.

Algorithms↗

Validation protocol of models for centre of mass estimation.

The estimation of the body centre-of-mass (COM) position requires the modelling of the human body as a system of rigid segments and the measurement of the position of related external anatomical landmarks. Many models for COM position estimation have been proposed with different levels of complexity and, in some cases, specific protocols have been used for model accuracy evaluation. In this paper, we propose a general method for the quantitative assessment of any COM model in relation to a determined set of movements. It consists of an experimental protocol and of a set of comparative indices, which quantify the congruence among the estimated kinematic variables and their expected values. The general applicability of the method is specifically addressed to models' comparison, aiming to support the user in the process of choice and validation of the most suitable model for her/his purposes. In this frame, the results of the analytical comparison among two kinematic models with different levels of complexity are reported.

Algorithms↗