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G Cortesina

Publications and source records attributed to G Cortesina.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Tumors of the parapharyngeal space: case report of clear cell myoepithelioma of the parotid gland and review of literature].

The parapharyngeal space is a deep neck region and can be the site of a wide range of neoplasms, including primary benign or malignant tumors, metastatic tumors, neoplasms invading the parapharyngeal space from the adjacent regions and neoformations stemming from systemic processes. Tumors of the parapharyngeal space are, nevertheless, relatively rare and account for 0.5-0.8% of all head and neck tumors. Most are benign tumors originating in the deep lobe of the parotid gland and the minor salivary glands. The most frequent tumor is pleomorphic adenoma while myoepithelioma accounts for just 1% of all salivary gland tumors. The present case report involves a case of myoepithelioma of the deep parotid gland lobe, arising in the parapharyngeal space. Together with a review of the literature, considerations are presented on the clinical and radiological evaluation, differential diagnosis and treatment of these lesions.

Aged↗
PubMed1999

[Multi-center study of recurrent nasal sinus polyposis: prognostic factors and possibility of prophylaxis].

Today, surgery is the treatment of choice for nasal sinus polyposis. Nevertheless, although meticulous surgery does "per se" reduce the percentage of recurrences, there are cases where even the most painstaking removal of the entire pathology cannot prevent recurrence. Therefore recurrences do not appear linked to the type of surgery; rather onset appears linked to intrinsic, only partially recognizable factors responsible for the primary and secondary polypogenesis. In order to identify negative prognostic factors which might be implicated in recurrences, the present study extrapolated the data from forms on 181 patients who had undergone surgery for nasal sinus polyposis and subjected it to multivariance analysis. These patients were recruited during the course of a multicenter study with the participation of 12 ENT Centers in Piemont and Liguria. The recurrence rate was 13%. In analyzing unfavorable factors prognosticating recurrence, thirteen parameters were examined. Nine of these (age, sex, severe deviation of the septum causing restriction, severe turbinate hypertrophy, surgery or repeat surgery for recurrence, type of macro-micro endoscopic surgery, allergy to seasonal inhalants, allergy to perennial inhalants, mixed allergies) did not prove to have any significance in recurrences. The presence of bilateral involvement of the sinus system presented a negative trend as regards recurrences while involvement of more than one subsite (anterior ethmoid, posterior ethmoid, maxillary sinus, sphenoid), ASA and NSAID intolerance and abundant eosinophilic infiltration in the mucous chorion proved statistically significant (p < 0.05 for all three parameters) for recurrence. Post-operative topic prophylactic treatment with steroids (beclomethasone) or anti-H1 drugs (azelastin, HCl) did not appear to affect the onset of recurrence although it did have a positive effect on subjective symptoms.

Anti-Inflammatory Agents↗
PubMed1998

[Evaluation of various phonatory parameters in laryngectomized patients: comparison of esophageal and tracheo-esophageal prosthesis phonation].

Today there is increased need for an objective comparison between the various post-total laryngectomy phonatory rehabilitation techniques. This survey involves 20 patients who, after total laryngectomy, underwent rehabilitation using the esophageal voice (n = 10) or through the application of a secondary tracheal-esophageal prosthesis (n = 10). The multivariate analysis indicated that the only phonatory parameter which differed significantly between the two types of voice was the maximum phonation time (MPT) (p < 0.01). The MPT was markedly longer in patients with the tracheal-esophageal prosthesis. In patients with prosthesis, the Mann-Whitney test highlighted better figures for the following parameters: MPT (p = 0.0003), GP (maximum number of words that can be read in one breath) (p = 0.009), maximum intensity level (MIL) (p = 0.019), Shimmer (p = 0.008) and noise-to harmonics ratio (NHR) (p = 0.049). Furthermore, the Spearman test proved there is a relationship between MIL and GP, and between Pitch and Shimmer. Therefore, the tracheal-esophageal prosthesis seems to offer better phonatory energy and phonatory duration for every breath. However, these methods of objective inquiry need to be further developed so that comparison-among the different authors and among the different rehabilitation methods-can be made easier than it is now.

Aged↗
PubMed1997

Detection of MET oncogene/hepatocyte growth factor receptor in lymph node metastases from head and neck squamous cell carcinomas.

The c-MET oncogene encodes the receptor for hepatocyte growth factor/scatter factor (HGF/SF), which is known to stimulate the invasive growth of epithelial cells cultured in vitro. The Met/HGF receptor is a heterodimeric transmembrane tyrosine kinase, which is a prototype for a new family of growth factor receptors. The c-MET oncogene is expressed in several types of epithelial tissue including keratinocytes and is over-expressed in a number of human carcinomas. Studies on various carcinoma cell lines have shown that over-expression and structural alteration of the receptor result in its activation and confer tumorigenesis. We have studied Met/HGF receptor expression in tissue specimens from 34 patients with head and neck squamous cell carcinomas (HNSCC) and in 17 regional lymph node metastases. Western blot analysis was employed, using monoclonal antibodies directed against either the intracellular or extracellular domain of the receptor. Each sample was compared to its normal counterpart. The receptor did not show any major structural alterations in HNSCC tissues, but its expression was increased from 2- to 50-fold in about 70% of tumors. Immunohistochemistry then showed that the same antibodies stained only a few cells in the basal layer of normal squamous epithelium but intensely marked tumor cells. In the lymph node metastases of Met-positive tumors, receptor expression was maintained and sometimes increased with respect to primary tumors. Immunohistochemical analysis of the metastatic lymph nodes showed that cells were negative in the normal lymphatic tissue and strongly stained in tumor cells. Over-expression of the Met/HGF receptor was found at all tumor stages but was more significant in those associated with enlarged or multiple (N2-N3) lymph node metastases. These data show that expression of the Met/HGF receptor may be involved in the progression of HNSCC towards a metastatic phenotype and may be a useful marker of head and neck tumor cell spread to regional lymph nodes.

Adult↗
PubMed1997

[The use of indwelling phonatory valve in the rehabilitation of laryngectomized patients: preliminary results in 30 patients].

The creation of a tracheo-esophageal fistula, and subsequent positioning of a voice button, has greatly improved the patients' ability to communicate and is the treatment of choice for many. The literature indicates that the success rate for this technique is in the 56-90% range. The present study presents the preliminary results obtained in a group of 30 laryngectomy patients for whom a Provox or Blom-Singer-Indwelling voice button were inserted at a later date. Of these 21 (70%) had undergone pre- or post-operative radiotherapy. On the average insertion of the voice button took place 36 months after the laryngectomy while it was approximately 40 months after radiotherapy. Patient selection was based on widely accepted criteria. In particular, the following factors were take into consideration: patient motivation, positive Taub test, dynamic features of the esophageal wall, video fluoroscopy evaluation. For the Provox voice button the patient was hospitalized for 24 hours while with the Blom-Singer-Indwelling device it was 72 hours. In addition, with the latter device, oral feeding was restored somewhat later although this depends on the difference in positioning. The results of the present study are in line with those presented by other authors. In particular, the immediate success rate was 83% while the long-term success rate reached 96%.

Adult↗
PubMed1997

[Chemotherapy of head and neck carcinomas].

In most cases head and neck tumors manifest themselves on a local-regional level giving rise to highly mutilating pathologies with psycho-social repercussions. Surgery and radiotherapy are effective treatments for limited neoplasms (stage I-II). On the other hand, after surgery and/or radiotherapy, the treatment of locally advanced tumors (stage III-IV) or local recurrences and/or distant metastases is still problematic. For this reason chemotherapy, initially used only as a palliative, is today associated with other treatments to achieve better results both in terms of survival and disease-free time spans. Hence chemotherapy must be considered part of any multimodal primary treatment for advanced squamous cell carcinoma of the head and neck. In fact, numerous clinical studies have clearly demonstrated that adjuvant or neoadjuvant chemotherapy has a highly relative affect on survival in locally advanced diseases and that the incidence of distant metastases is reduced. This is not, however, followed by a similar reduction in local recurrences which are often the cause of death in such patients. It would, on the other hand, appear that survival is improved with integrated radio-chemotherapy. Immunochemotherapy, which has not as yet provided significant clinical results in cases of advanced tumors and/or metastases, must still be evaluated in the treatment of locally limited neoplasms. Organ preservation, which proves feasible in the larynx, leads one to hope it can be applied in other head and neck sites. The future balance leans in favor of the multidisciplinary approach and multi-center studies must be performed so that an adequate number of cases can be gathered over a brief period. This will make it possible to answer those questions and, at times, illusions which accompany chemotherapy in the treatment of advanced head and neck tumors.

Adult↗
PubMed1997

[Identification of clinical, biological and prognostic factors in recurring squamous cell carcinoma of the head and neck].

Many studies have been performed to determine some prognostic factors for malignant head and neck tumors. Defining the clinical and biological features would enable one to predict the progression of the disease and plan treatment. The aim of the present study has been to identify what host and neoplasm characteristics provide prognostic indication of possible recurrences. A group of 380 patients with squamous cell carcinoma of the head and neck was studied. The neoplasm was located in the following sites: 257 larynx-hypopharynx, 69 oropharynx, 54 oral cavity. At the present time 309 of these subjects are still alive and disease free while 71 have had recurrences. Analyses were performed on various variables regarding the patient, neoplasm and histology. Multivariante analysis of these prognostic factors was performed using the PLR-BMDP program. The time of recurrence in the primary tumor site and at the lymph node level was evaluated using the Kaplan-Meier method. Of the 28 variables analyzed 16 had no effect on the probability of recurrence. Two variables reduced the risk of recurrence: age over 61 years (p < 0.05) and primarily intra and peritumoral lymphocyte infiltration (p = 0.06). Of the data regarding the patient, age lower than 61 years and presence of associated internal pathologies (i.e. bronchial pneumonia and hepatitis) appeared to significantly facilitate the appearance of recurrence. The characteristics of the neoplasm which appear to effect recurrences are: tumor site (hypopharynx), presence of lymph node metastases, morphological elements of tissue spread (vascular invasion, plasmocyte infiltration), capsular breakdown, positive margins and post-operative infection. In conclusion, it can be asserted that technical development of multifactorial analysis has made it possible to identify important prognostic factors and quantify their impact on the evolution of a neoplasm.

Adult↗
PubMed1997

[Adhesion molecules in squamous cell carcinoma of the larynx: possible indication of prognosis].

Thirty patients with laryngeal tumors were divided into two groups on the basis of whether clinical and pathological features indicated good or bad prognosis. Samples of each tumor group were selected and examined by immunohistochemistry using mAbs, raised against integrin chains (beta 1, beta 4, alpha 2, alpha 3, alpha 6) and their ligands laminin 1 and 5, collagen type IV, two fibronectin isoforms (ED-A and ED-B) and two isoforms of tenascin known to be associated with neoplasm. Controls were provided by samples of tumor-free laryngeal mucosa removed during the surgical procedure. The normal topographical integrin pattern and the continuity of the basement membrane components was altered in both groups but the extent of these changes was significantly greater in those tumors with poor prognosis. Therefore, the groups could easily and reliably be distinguished by simply observing their immunohistochemical features. It is suggested that performing immunohistochemical analysis on biopsies may aid in early diagnosis as well as in adopting the proper therapeutic strategy to follow for these tumors. The above molecules may become one of the diagnostic tools available for head and neck surgical pathologists.

Adult↗
PubMed1996

Treatment of oral cavity and oropharynx squamous cell carcinoma with perilymphatic interleukin-2: clinical and pathologic correlations.

We describe the correlations between the clinical and histologic findings in an initial series of 60 patients with T2-4, N0-3, M0 squamous cell carcinoma (SCC) of the oral cavity or oropharynx enrolled in a randomized trial set up to evaluate whether the disease-free interval and survival are extended when perilymphatic injections of recombinant interleukin-2 (rIL-2) are combined with routine surgery and radiotherapy. Twenty-nine patients were operated on only (controls). The other 31 received two daily injections of 2,500 U rIL-2, one near the mastoid process on the same side as the tumor and the other under the chin, for 10 days before surgery, and further injections on the nonoperated-on side on a monthly basis for 1 year starting 4 weeks after surgery (or radiotherapy, where necessary) in an effort to upregulate the immune system and delay recurrence. Their surgical specimens displayed a significantly greater inflammatory reaction, larger areas of necrosis, and more intense sclerosis. The inflammatory tumor infiltration consisted of eosinophils, plasma cells, and CD25+ and human leukocyte antigen (HLA)-DR+ lymphocytes. However, no correlations were apparent with regard to the intensity of necrosis, eosinophil infiltration, and the number of DR+ cells and the clinical outcome. By contrast, the correlation between CD25+ cells and a significantly longer disease-free survival suggests that induction of T-cell reactivity, and perhaps specific immunity, is the only important aspect of rIL-2-induced antitumor reactivity.

Adult↗
PubMed1996

Significance of adhesion molecules as biological prognostic factor in locally advanced laryngeal squamous cell carcinomas.

Thirty laryngeal carcinomas were studied immunohistochemically in order to evaluate whether the expression and different distribution of adhesion molecules influence the clinical features and progression of the tumors. On the basis of clinical and pathological variables, two different groups were established: one with good and the other with poor prognosis. The patients were included in one of the two groups on the basis of prognostic factors previously studied by multivariate analysis (the validity of this choice was confirmed by the NED survival curves of the two groups). Different integrins, type I and V laminin and type IV collagen were evaluated by means of monoclonal antibodies in the tumoral specimens and in normal mucosa. Univariate statistical analysis was performed to evaluate differences between the two groups. The degree of expression and pattern of distribution were different in tumor compared with normal mucosa and significant differences were found between the good- and worst-prognosis tumors.

Antibodies, Monoclonal↗
PubMed1996

Are recurrent and chronic tonsillitis different entities? An immunological study with specific markers of inflammatory stages.

It seems that there are clinical differences between tonsillitis in children and adults. In order to verify whether such a supposed clinical subdivision be true, tonsillar mononuclear cells from 20 children operated on for recurrent tonsillitis caused by a common flora and 20 adult patients with an indication for surgery for chronic tonsillitis were studied by means of monoclonal antibodies (MoAbs) specific for the antigens associated with each stage of the inflammatory response. BMA 4D10 and BMA 27E10 MoAbs were used as markers for the early stages, BMA RM 3/1 for the intermediate stage. BMA 25 F 9 for the late stage, and BMA G 16/1 for the chronic stage. The results indicate that chronic tonsillitis in the adult should be considered as such (higher expression of antigens associated with the chronic stages (p = 0.039), low and even lower expression of those associated with the intermediate and acute stages, respectively), whereas tonsillitis in children could perhaps be more correctly regarded as an expression of recurrent inflammation (higher expression of antigens associated with the acute stages (p = 0.022)). Results are presented and discussed.

Adolescent↗
PubMed1995

Integrin expression in head and neck cancers.

Neoplastic transformation results in rearrangement of the cell membrane with a breakdown of the regular expression of adhesion molecules such as integrins. A relationship may exist between the intensity of this alteration, and the form it takes, and a tumour's ability to metastatise. We studied this possibility by investigating the epithelial integrin expression of 35 head and neck squamous cell carcinomas. Two types of positivity were observed: one associated with tumours with a better prognostic index, the other with those characterized by greater malignancy.

Carcinoma, Squamous Cell↗
PubMed1995

Is transposed skin transformed in major head and neck mucosal reconstruction?

We used histological and histochemical methods to investigate the possible changes with time in skin transposed into the oropharynx and oral cavity of patients whose surgical wounds were reconstructed with the classic pectoralis major flap. We found histological evidence that skin morphology was maintained (keratinization with reduced, but the desquamating layer, hair follicles, sweat and sebaceous glands were identifiable), and noted an intense inflammatory reaction in the dermis. Histochemical studies confirmed the progressive flattening of the basal interdigitations between the epithelium and dermis, and the gradual reconstruction of the basement membrane. Although skin-mucosa continuity developed fairly quickly without scar reactions, the two epithelia maintained their original patterns of keratin production, i.e., their textural peculiarities. We propose an original method for the transposition of muscular flaps implanted with autologous culture of keratinocytes, an approach developed in an attempt to ensure more satisfactory rehabilitation of the removed mucosal structures.

Carcinoma↗
PubMed1995

[The problem of recurrence of rhino-sinusal polyposis: pilot trial with locally administered azelastine HCL in the prevention of relapses].

Recurrent nasal polyposis is one of the most common unsolved problem in clinical rhinology. In the last few years a great number of histopathological, immunohistochemical and immunological studies on nasal polyps have been carried out by several Authors. Notwithstanding this, the aetiology of these formations still remains unknown. Many data suggest that the presence of polyps is the result of various inflammatory, allergic and pseudo-allergic processes which finally lead to the formation of the oedema constitutive of the polyp itself. In the present report a preliminary trial was carried out in order to evaluate the possibility of preventing recurrences by means of a locally administered anti-H1 receptors drug (Azelastine HCl). In the reported first phase of the study 10 allergic patients with bilateral polyposis were evaluated. Attention was given to the anti-edemigen activity of the drug, as well as to its influence on the local production of Secretory IgA, 7SIgA and albumines. Data are presented and discussed.

Albumins↗
PubMed1994

Temporary regression of recurrent squamous cell carcinoma of the head and neck is achieved with a low but not with a high dose of recombinant interleukin 2 injected perilymphatically.

The efficacy of ten daily injections of 500 or 500,000 U of recombinant interleukin 2 (IL-2) day-1 given 1.5 cm from the insertion of the sternocleidomastoid muscle on the mastoid was evaluated in 31 patients with recurrent head and neck squamous cell carcinoma. No toxic effects were noted. One complete response (CR) and three partial responses (PRs) were observed in the 16 patients who received 500 U of IL-2, whereas the higher dose was not effective. The CR was recorded in one of the seven patients with a oropharyngeal recurrence. Partial responses were obtained in 1/5 patients with hypopharyngeal recurrences, in 1/5 patients with oral cavity recurrences and 1/7 patients with laryngeal recurrences. The duration of the responses was 3-5 months and additional courses of ten injections of IL-2 had no further effect.

Carcinoma, Squamous Cell↗
PubMed1994

[Loco-regional treatment with low and high doses of interleukin-2 of head and neck squamous cell carcinoma recurrences].

The present study reports the effects of repeated administration of two different doses of recombinant (r) Interleukin-2 (IL-2) around tumor-draining lymph nodes in 22 patients with recurrent squamous cell carcinoma of the head and neck (HNSCC). Each patient was randomly assigned a dose of 500 or 500,000 IU/r-IL-2/day. Inoculation was made at a depth of 15 mm in the anterior margin of the sternocleidomastoid muscle at 15 mm from its insertion into the mastoid. The injections were made on the same side as the recurrent tumor when draining lymph nodes were still present and contralaterally when only contralateral lymph nodes were present. The 10 daily injection were followed by an interval without treatment until day 40. A further three courses of 10 injections were made at thirty-day intervals in the absence of a CR. There was no toxicity. One complete response (CR) and 2 partial responses (PR) were observed in the 11 patients who received 500 U of IL-2, whereas the higher dose was not effective. The CR was recorded in the 4 patients with an oropharyngeal recurrence. One PR was obtained in the 4 patients with hypopharyngeal recurrences and one in 3 with oral cavity recurrences. Clinical responses were nearly always preceded by improvement of the functional impairment caused by tumour infiltrations of the upper respiratory-digestive organs. The responses lasted 3-5 months and additional courses of 10 injections of IL-2 had no further effects.

Adolescent↗
PubMed1993

Mucosal immunity in allergic rhinitis.

Secretory IgA (SIgA) is the main agent protecting the mucosal districts against both infectious microorganisms and inert foreign macromolecules. A lack of secretory immunity has previously been described in patients with allergic rhinitis, but it is a controversial finding. The discrepant results of SIgA levels found in allergy may partially be due to methodological problems. Sixty patients with previously demonstrated allergic rhinitis, treated or not with specific desensitization therapy and free from clinical manifestation of rhinitis were studied. Normal volunteers and patients with selective 11S IgA deficit, without allergic pathology, were investigated as controls. The titration of SIgA in nasal secretions, performed by an original immunoisoelectro-focusing method, showed significantly decreased values in allergic patients. An evaluation of the IgE level in nasal secretion was performed by ELISA. Low rates of IgE were also found in the intercritic period.

Adolescent↗