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Biomedical subjects

G Sambataro

Publications and source records attributed to G Sambataro.

At least 19 recordsLinked to original sources
PubMed2005

Clinico-prognostic value of D-type cyclins and p27 in laryngeal cancer patients: a review.

Despite recent improvements in surgical and radiation therapy, failures still occur in patients with laryngeal squamous cell carcinomas, which may have a very different clinical outcome even when their clinical and histopathological characteristics are similar. The apparent inadequacy of "traditional" prognostic factors in predicting the clinical evolution of laryngeal squamous cell carcinomas has led to attempts to develop additional markers capable of distinguishing patients with a good prognosis from those who are more likely to relapse. A number of studies have demonstrated a relationship between tumourigenesis and alterations in the expression of cyclins, cyclin-dependent kinases and cyclin-dependent kinase inhibitors, but the data regarding laryngeal squamous cell carcinomas are somewhat conflicting. Herein a review is made of the published literature concerning the clinico-prognostic role of cyclin D1, D3 and p27, and personal data are described concerning laryngeal squamous cell carcinoma patients who underwent surgical resection at the ENT Department of the University of Milan. The results of our multivariate analyses demonstrated that cyclin D1, p27 and cyclin D3 overexpression are statistically significant predictors of disease-free survival (p = 0.0238, p = 0.0001 and p = 0.0217, respectively); the statistical correlation with overall survival was significant in the case of p27 (p = 0.0009) and cyclin D3 (p = 0.0189), and borderline in the case of cyclin D1 (p = 0.0622). In relation to cyclin D1/p27 coexpression, the patients with a cyclin D1-/p27+ phenotype showed the best prognosis, those with a cyclin D1/p27+ or cyclin D1-/p27- phenotype, an intermediate prognosis, and those with a cyclin D1+/p27- phenotype, the poorest prognosis (p = 0.0001 and p = 0.0001 for trend for disease-free survival; p = 0.0015 and p = 0.0008 for trend for overall survival). In the case of cyclin D1/cyclin D3 coexpression, the patients with cyclin D1+/cyclin D3+ tumours had the poorest overall survival, those with cyclin D1/cyclin D3+or cyclin D1+/cyclin D3- tumours showed intermediate course, and those with cyclin D1 /cyclin D3- tumours had the most favourable outcome (p = 0.0002). The findings of this review indicate that both types of cyclin D and p27 are involved in the genesis of laryngeal squamous cell carcinomas, and that immunohistochemical evaluations of biopsy samples may provide useful additional markers capable of identifying subgroups of patients with a poor prognosis who can be treated by means of more aggressive surgery, adjuvant radiotherapy and chemotherapy, as well as those requiring a closer and more prolonged follow-up. Finally, preliminary results suggest that the administration of new molecular therapies that exert their antitumoural activities by functionally subverting the pathways regulated by D-type cyclins and their cyclin-dependent kinase counterparts may represent a further therapeutic modality for patients with refractory head and neck squamous cell carcinomas [corrected]

Carcinoma, Squamous Cell↗
PubMed2004

Prognostic significance of P27 and cyclin D1 co-expression in laryngeal squamous cell carcinoma: possible target for novel therapeutic strategies.

Tumour cells are characterised by uncontrolled growth due to alterations in the genes that play a key role in cell repair systems and apoptosis: pro-mitotic oncogenes such as cyclin D1, and tumour suppressor genes such as p27. Recent studies have demonstrated that these genes are involved in different epithelial neoplasms and that their expression is generally associated with prognosis. The aim of this immunohistochemical study was to analyse the clinical relevance of cyclin D1/p27 co-expression in a homogeneous series of 132 laryngeal squamous cell carcinomas. Multivariate analysis showed that cyclin D1 and p27 were the only statistically significant predictors of disease-free and overall survival. In relation to the simultaneous expression of p27 protein and cyclin D1, the patients with a cyclin D1+/p27-phenotype had the poorest disease-free and overall survival rates. On the basis of these immunohistochemical results, it was possible to select a subgroup of patients with a high risk of recurrence and poor prognosis to undergo more extended surgical treatment and/or combination antitumoral therapeutic procedures.

Adult↗
PubMed2001

[Arytenoid subluxation. Experience with a new voice therapy].

The systematic use of video-fibro-endoscopy techniques has made it possible to precisely define an uncommon laryngeal pathology of traumatic origin: arytenoid subluxation. This pathology general arises after anesthesiological intubation and is characterized by a pathological anteromedial shift of one arytenoid resulting in cord immobility. The symptoms of this disorder are dysphonia similar to recurrent nerve palsy. Differential diagnosis is not always easy. The treatment of choice indicated in the literature is based on invasive approaches (reduction under direct laryngoscopy or, less frequently, even more aggressive surgery) while voice treatment plays a marginal role. The authors offer an overall picture of arytenoid subluxation in view of the anatomophysiological aspects of the crico-arytenoid articulation and describe a new approach to voice rehabilitation. While watching himself in the video-fibroscopy monitor (visual feedback), the patient performs a particular exercise enabling him to raise the larynx, lifting the arytenoids and causing hyperadduction and vibration of the arytenoid hood. After having learned the exercise the patient continues with regular speech therapy sessions and voice therapy at home. Periodically the patient undergoes video-endoscopy and phoniatric-speech therapy check-ups until vocal function and cord motility have been restored. This type of approach was applied in 4 patients, all of whom responded relatively quickly with reactivation of the articulation and recovery of the voice. The authors conclude that voice therapy can achieve full healing in patients with arytenoid subluxation and should be given priority over other forms of treatment. The excellent results are explained asserting that particular movement of the larynx can achieve a reduction in subluxation by rearranging the articulatory surface.

Adult↗
PubMed2001

Falls in the elderly: the development of a risk questionnaire and posturographic findings.

In elderly people, owing to a perturbation at several levels, including the motor, sensory and cognitive levels, a condition of dizziness and unsteadiness complicated by frequent falls often appears. In this article, we review the most recent information about clinical and instrumental tools available for preventing mobility-related accidents and report the results of a comparative study of postural control, carried out through tetraataxiometry (by Tetrax, Tel Aviv, Israel), in two samples of elderly women belonging to two different populations: 24 Italian women (11 reporting falls and 13 without falls) having a mean age of 73.1 years, and 37 Israeli women (12 with falls and 25 without falls) having a mean age of 72.5 years. The posturographic findings show that the falling subjects, to maintain postural control, are highly dependent on somatosensory inputs and have a weaker "systeme postural fin" (fine postural system), according to Gagey. They also show that an elderly subpopulation exists that, for unknown reasons, is immune to destabilization and falls.

Accidental Falls↗
PubMed2000

99mTc-sulfur colloid gastroesophageal scintigraphy with late lung imaging to evaluate patients with posterior laryngitis.

UNLABELLED: The aim of this study was to use gastroesophageal and pulmonary scintigraphy to evaluate the prevalence of gastroesophageal reflux and airway involvement among patients with posterior laryngitis. METHODS: The study included a total of 201 patients (131 females, 70 males; age range, 15-77 y; mean age +/- SD, 49 +/- 16 y). All patients had posterior laryngitis documented by laryngoscopy and symptoms such as a dry cough, painful swallowing, and hoarseness. A control population of 20 healthy volunteers (13 females, 7 males; age range, 19-74 y; mean age, 53 +/- 13 y) was also evaluated. After a 12-h fast, all subjects underwent gastroesophageal scintigraphy through administration of 300 mL orange juice labeled with 185 MBq 99mTc-sulfur colloid. After 18 h, planar anteroposterior thoracic images were acquired with the subjects supine. RESULTS: Sixty-seven percent of patients (134/201) had scans positive for gastroesophageal reflux; of these, 30 (22%) had distal reflux and 104 (78%) had proximal reflux. In addition, the scans of 31 patients were positive for proximal reflux-associated pulmonary uptake. The frequency, duration, and degree of reflux episodes were significantly greater in patients with proximal reflux than in patients with distal reflux (P < 0.001). The 67 patients in whom reflux was not detected had diseases or reflux-associated cofactors that could account for laryngeal symptoms. No statistically significant difference in symptoms or esophageal motility parameters could be identified among the patient groups, but patients with proximal reflux had significantly prolonged gastric emptying times compared with healthy volunteers. CONCLUSION: Most patients with posterior laryngitis had detectable proximal gastroesophageal reflux. Exposure of the proximal part of the esophagus to acid, by setting the stage for microaspiration of gastric material into the larynx, remains a major cause of damage to the laryngeal mucosa. Slowed gastric emptying may be a predisposing factor. Moreover, symptoms such as a dry cough, painful swallowing, or hoarseness may not be reliable predictors of the presence of gastroesophageal reflux or of associated airway involvement.

Case-Control Studies↗
PubMed1989

Comparative study of middle-latency responses and auditory brainstem responses in elderly subjects.

Auditory senescence is studied through an electrophysiological investigation of the brainstem, midbrain and thalamocortical tracts of auditory pathways. For this purpose, comparative electrophysiologic studies were carried out by recording middle-latency responses (MLR) and auditory brainstem responses (ABR) in elderly subjects in the 7th-8th and 9th decades of life and in a control group consisting of young subjects in the 3rd decade of life. All these subjects were free of otological, neurological, vascular and metabolic pathologic states. In elderly subjects, the statistical analysis of the results, especially of MLRs, showed a deterioration in the progression of information from the periphery to the center due to changes in morphology, increased latency, reduced amplitude and poorer reproducibility. Furthermore, a different behavior was noticed in females versus males. Indeed, the shorter latency of evoked potentials in the female control group was remarkably reduced in the elderly subjects. MLRs scan a wide tract of auditory pathways and give evident results even by adopting a juxtaliminal stimulation; therefore, they are a more complete and sensitive test than ABRs for the study of involutional processes.

Adult↗
PubMed1988

Xibornol: multiple dose pharmacokinetics and diffusion in lung, tonsillar tissue and laryngeal mucosa.

In ten patients with severe chronic bronchitis and in a further 23 with planned resection of lung, tonsils or larynx, 500 mg doses, single or multiple, of xibornol (6-isobronyl-3, 4-xylenol) were administered for an antibacterial effect. The pharmacokinetics and diffusion of the drug in the tissues were studied. A high diffusion and distribution value of xibornol was observed, with levels in the tissues constantly higher than that in the serum. The concentrations reached within the respiratory tract were adequate for their antibacterial effect.

Administration, Oral↗
PubMed1987

Guidelines for pharyngostome closure.

The reconstructive procedure for pharyngostome closure includes single-stage restoration in three steps: lining, intermediate layer, and covering. The lining repair is the key factor to the successful outcome of the operation. Three clinical situations may be distinguished. First, the mucosa is sufficient to restore a new gullet. In this case, it is widely undermined and sutured along the midline without any tension. Second, the mucosa is only partially sufficient. The same procedure as above is adopted to close the lower two-thirds of the pharyngostome, while an advancement flap is outlined from the base of the tongue to restore the upper third. Third, the mucosa is not sufficient. A musculocutaneous flap solves the problem. Reconstruction of the intermediate layer involves rotation of one (or both) sternomastoid muscle(s), if present. The possibilities for coverage include a submandibular flap, a thoracoacromial flap, and/or musculocutaneous flaps. By following these guidelines, the authors have successfully closed 37 pharyngostomes.

Female↗
PubMed1986

Human pharmacokinetics and distribution in various tissues of ceftriaxone.

Multiple-dose pharmacokinetics of ceftriaxone were investigated in 7 patients with bronchopneumonia using an intramuscular regimen of 1 g given every 24 h for 7 days. Serum, sputum, and urine samples were collected serially following the first dose (day 1) and last dose (day 7). Mean peak serum concentrations of ceftriaxone occurred at 2 h on both days and were 67.8 and 75.1 micrograms/ml, respectively, on day 1 and day 7. Ceftriaxone had a half-life of 6.9 h on day 1 and 7.4 h on day 7. The half-life of ceftriaxone in sputum was 5.9 and 6.6 h, respectively, on days 1 and 7. Approximately 50% of the dose of ceftriaxone was recovered in the urine within 24 h on day 1, 60% on day 7. Tissue distribution of ceftriaxone was determined in 103 patients following intramuscular administration of a single 1-gram dose at different times up to 24 h prior to surgery. High concentrations of ceftriaxone were found in lung, tonsil, middle ear mucosa, and nasal mucosa, and therapeutic levels of ceftriaxone persisted for 24 h after administration.

Ceftriaxone↗
PubMed1984

Reconstruction of the hypopharynx following extensive loss of mucosa.

Mucosal loss of the hypopharynx, following pharyngostome or wide resection of carcinoma, poses problems for repair. The authors emphasize a reconstructive procedure based on the use of three elements combined together in various ways: residual strip of mucosa of the posterior pharyngeal wall, a musculomucosal pedicled flap obtained from the base of the tongue, a pectoralis major musculocutaneous flap. Thus any defect of the hypopharynx can be repaired in one stage. The safety of the procedure is well tested with good clinical results and lack of complications.

Adult↗
PubMed1979

The evolution of the vestibular apparatus according to the age of the infant.

In 56 full-tem A.G.A. infants and in 27 infants of a minimal age of 15 days with a neurological "risk" (full-term small for gestational age, S.G.A.), the nystagmic response to vestibular stimulation (rotatory and torsion swing test) was examined. A delay in the appearance of a response to the labyrinthic stimulus and a persistence of the prevalence of the slow phase of the nystagmus appeared clearly higher in the "risk" infants. The statistical difference of the response between the two groups was highly significant. This allowed us to conclude that the vestibular test appears to the one of the most useful in evaluating the sensorial maturation of S.G.A. infants.

Electronystagmography↗
PubMed1979

Our experience with pharyngoesophageal reconstruction.

Our experience with 11 cases of cervical esophageal reconstruction following excision of the hypopharynx and conservative neck dissection is reported. For the reconstructive procedure, we utilized a full-thickness skin graft from the penis according to Kaplan and Markowicz in 2 cases and a deltopectoral flap according to Bakamjian in 9. Critical evaluation of the clinical follow-up has led us to prefer the second method. It seems, in fact, to be the solution of choice in this kind of surgery, for the deltopectoral flap offers a generous source of viable skin due to its good blood supply.

Aged↗
PubMed1979

Use of submandibular flap to close pharyngostomes and other defects of lower anterior neck region.

We describe the use of a suprahyoid flap for reconstruction in the lower anterior neck. It has been most useful for immediately closing pharyngostomes and for resurfacing defects from the excision of squamous cell carcinoma of the larynx or other neoplasms involving the skin. This flap provides a good deal of viable tissue, it can easily be rotated without a delay procedure, and the donor area is closed by direct suture. We present our experience with 22 cases.

Adult↗