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Biomedical subjects

G Polli

Publications and source records attributed to G Polli.

17 recordsLinked to original sources

Beneficial effects of intranasal applications of capsaicin in patients with vasomotor rhinitis.

Capsaicin, a nonenamide derived from Capsicum plants, has proven useful in patients with vasomotor rhinitis. In the present study, we studied the effects of 15 micrograms capsaicin suspended in 100 microliters solution in patients with known vasomotor rhinitis. Drug was given 3 times/day for 3 days to each patient by means of a spray delivered to the nasal mucosa. Acute effects induced by the drug included painful sensation and secretion of nasal fluid but were no longer observed at the last capsaicin application. Patients recorded their symptoms over a 1-month period. The mean symptom score involving nasal obstruction and nasal secretion was markedly reduced by capsaicin treatment. We advance the hypothesis that the beneficial effect of drug treatment may be due to its specific action on the peripheral endings of primary sensory neurons leading to their functional blockade. Further randomized, double-blind, placebo-controlled trial is now needed.

Administration, Intranasal

Scanning electron microscopic study of nasopharyngeal carcinoma.

The study has been carried out on biopsies taken from four patients affected by squamous cell carcinoma and four patients affected by undifferentiated carcinoma of nasopharyngeal type (UCNT). Three healthy volunteers have served as controls. All the specimens have been studied by SEM. The neoplastic conditions cause obvious alterations both in the mucosal surface and in the morphology of the cellular apex.

Aged

[Comparison of the results of surgery and radiotherapy in 175 cases of T2 glottic carcinoma: 116 operated and 59 irradiated cases].

The results were analyzed of 175 patients with glottic squamous cell carcinomas who were treated with curative purposes (1970-1986). One hundred and sixteen of them underwent surgery at the Otolaryngology Department of the University of Florence, and 59 were treated by radiation therapy at the Florence University and Hospital Departments of Radiotherapy. In the surgical series 78 cases were treated with radical surgery and 38 with conservative surgery. All patients were staged according to TNM system (UICC 1978) as T2. Overall 10-year local control rates were 74% for the surgical series and 69% for the cases treated by radiation therapy. After salvage therapy 10-year survival rates were 83% and 76%, respectively. The analysis of the results showed no statistically significant difference. In the group treated by radical surgery 80% local control was observed, versus 66% in the cases treated with conservative surgery. 10-year survival rate was higher in the latter group (89% versus 81%) because of better results of salvage therapy: 7 of 10 recurrences were salvaged with the second treatment. Several prognostic factors were evaluated, i.e., T extent, anterior commissure involvement, subglottic invasion, vocal cord mobility impairment, and ventricular involvement. Anterior commissure involvement was the main factor affecting outcome in the surgical series: in the presence of this factor, 64% 10-year local control was observed versus 85% in the patients without commissure involvement. This factor proved more important in the patients treated with conservative surgery (10-year control: 42% versus 88%) than in those undergoing radical surgery (78% versus 85%). Anterior commissure involvement and the number of involved subsites were found to worsen prognosis in the series treated by radiation therapy: cases with anterior commissure involvement had 59% 10-year local control versus 83%. The cases with a deeper spread had 60% local control versus 75%. Vocal cord mobility impairment was a less important prognostic factor in both series. Our results suggest radiation therapy as a valuable method in the treatment of the small T2 laryngeal cancers which are not suitable for conservative surgery.

Carcinoma, Squamous Cell

[Scanning electronic microscopy study of nasopharyngeal carcinoma].

The nasopharyngeal carcinoma is a greatly interesting model of study. Its morphology has been studied in 8 patients affected by squamous cells carcinoma (4 cases) and by undifferentiated carcinoma (4 cases). By means of a fibre-optic pharyngoscope equipped with mechanical biopsy forceps, biopsies have been taken and subsequently studied by scanning electron microscopy (SEM). Squamous cells carcinoma is characterized by large, flattened elements, generally equipped with a network of microridges. Irregular microvilli or smooth apices have been observed too. Desquamating elements often accumulated in waves or vortices, as far as little cornified structures have been described. Undifferentiated carcinoma shows a great morpho-structural disorder. In a rugged surface, it is possible to observe element highly varying for size and shape. The apical plasmalemma is characterized by pleomorphic microvilli, while it must be emphasized the presence of little pseudopod-like extrusions of some cellular apices. Ciliated elements have been observed too, whose apical specializations are distorted or irregularly disposed. Necrotic zones are particularly frequent, in which bacteria or mycetes proliferate. The role of SEM in the study of this tumour is emphasized, because of the close relation between epithelial patterns and natural history of nasopharyngeal carcinoma.

Aged

Total parotidectomy--a routine treatment for parotid gland swellings?

The results of 25 years of quasi-routine total parotidectomy performance are shown. At the Department of Otolaryngology of the University of Florence, 582 patients were treated as follows: on 527 occasions by total parotidectomy with facial nerve preservation; 24 occasions by lateral lobectomy; 27 occasions by total parotidectomy with removal of the whole facial nerve; four times by enucleo-resection of the disease. Benign tumours were 378; primary and metastatic malignant tumours--100; non tumoral lesions--104. The benign tumours follow-up showed three recurrences only (two pleomorphic adenomas--one of them proved to be an adenoid-cystic carcinoma, and one monomorphic adenoma, which also proved to be an adenoid-cystic carcinoma), respectively 6, 6 and 8 years later. The malignant tumours were also treated by total parotidectomy with adequate management both of the facial nerve and the neck lymph nodes. The results thoroughly justify the nerve preservation, when preserved.

Facial Nerve

Study of the nasopharynx in man by scanning electron microscopy.

To date only few and often disagreeing studies about human nasopharynx are available. The present research has the purpose to give a contribution to the knowledge of nasopharyngeal epithelium using S.E.M. The study was carried out on biopsies taken from 20 healthy volunteers. The surface of nasopharynx is covered by ciliated cells, microvilli provided cells and goblet cells. Areas covered with squamous epithelium and presumably transitional epithelium were observed. The possibility that ciliated cells become microvilli provided cells is discussed.

Adolescent

Reconstructive laryngectomy.

Reconstructive laryngectomy, the aim of which is to leave the patient without a tracheostoma, thus preserving the normal pneumophonic function relative to vocal articulation, is a link between the various techniques suggested for conservative laryngeal surgery and classic total laryngectomy. The aim of this technique is to restore continuity to the airways, so that the patient is able to breathe naturally and subsequently can speak without having to resort to the use of esophageal voice.

Cricoid Cartilage

Conservation surgery for cancer of the larynx in the elderly.

The postoperative course was evaluated for 458 consecutive patients, all over the age of 56 years, who had undergone laryngeal conservation surgery in the last 10 years. One hundred seventy-one patients aged 66 and over made up the "elderly" group and 287 patients, aged between 56 and 65 years formed the control group. It was confirmed that cordectomy and frontolateral laryngectomy are feasible even in elderly patients. Bronchopneumonia is the most frequent and serious complication after supraglottic laryngectomy. Therefore this operation should be performed in the elderly patient only after a thorough evaluation of cardiac and respiratory function. Prophylactic neck dissection should not be done for N0 necks and the second therapeutic neck dissection in N2 cancers should be staged 6 or more weeks later. Hemilaryngopharyngectomy and subtotal reconstructive laryngectomy with cricohyoidpexis are not advisable in elderly patients.

Age Factors

Five-year results of 1000 patients operated on for cancer of the larynx.

The five-year results of 1000 consecutive cases of cancer of the larynx operated on at the Clinic of Otolaryngology of the University of Florence are presented. The treatment was cordectomy for T1a glottic cancers and total laryngectomy for the other cases. The five year cure rate is 66.5% of the 606 supraglottic cancers, 76.9% of the 294 glottic cancers and 54% of the 100 subglottic cancers. These crude survival rates consider the 7.6% of patients who died from non-tumoral causes and the 1.1% of untraced patients.

Evaluation Studies as Topic

[Otitis media in the child. Follow-up study and control of 104 cases].

The authors report a case-study on 104 children admitted for many reasons to the I Department of Pediatrics of the A. Meyer Hospital in the period 1979-81. During their hospitalization, otitis media was diagnosed in all these cases. The children later underwent two check-ups including otorhinolaryngologic and tympanometric tests and in some cases an audiometric examination. A correlation between otitis media and enlarged adenoids was noticed and the results of the present case-study are compared with other international publications, following the short bibliography.

Adenoidectomy

The human nasal mucous membrane during chronic inflammation, before and after muco-active therapy: a study using scanning electron microscopy.

Chronic inflammation seems to induce alterations in nasal mucosa morphology. The type and extent of these alterations seem to be directly correlated with the duration of the inflammation. This study was carried out to ascertain whether the administration of muco-active drugs could modify these alterations by inducing their total or partial regression. Ten healthy control subjects, and thirty patients affected with chronic rhinopharyngitis, at various levels of severity, were studied. All the forty subjects underwent biopsy of the posterior region of the medium turbinate. The bioptic samples were examined using Scanning Electron Microscopy (SEM). Patients with phlogosis underwent treatment which consisted of a single day administration of carbocysteine-sobrerol (1125 mg carbocysteine and 180 mg sobrerol day 20 days). This group underwent biopsy again and the fragments obtained were studied using the same method. Chronic inflammation, in the nasal epithelium, causes progressive degenerative phenomena, which are related to the duration and to the severity of the pathology. The response of the nasal mucosa principally results in damage to the muco- ciliary unit, loss of cilia and consistent modifications in the mucous secretion. In cases of persistent inflammation, the nasal epithelium becomes squamous. The therapy employed was able to alter the morphological signs of degeneration in the less severe cases, and to improve the overall pattern of the most severe and irreversible pathologies.

Adult