Biomedical subjects
Publications and source records attributed to L Califano.
Swelling of the floor of the mouth is sometime difficult to diagnose clinically. Lithiasis and neoplasm are the most frequent causes of intraoral swelling. Also after plain radiology and computed tomography the diagnosis is often dubious. A case of swelling of the floor of the mouth due to an adenoid cystic carcinoma of the sublingual gland is reported.
A 44-yr-old woman with a long-standing history of painful mandibular swelling was hospitalized for the diagnostic evaluation of an osteolytic mandibular lesion in the premolar-canine area. Fine-needle aspiration biopsy (FNAB) was performed and cytologic smears were characterized by clusters, sheets, and rare isolated pleomorphic cells of the squamoid type, blocks of amorphous material encircled by fibroblasts, and occasional calcifications. A cytological diagnosis of Pindborg's tumor was made, which was confirmed by histopathological examination. Evaluation of DNA ploidy by semiautomated image cytometry produced an aneuploid histogram. The patient is free of residual neoplasm at a 12-mo post-operative interval. The cytological differential diagnosis of this rare odontogenic neoplasm is discussed briefly.
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OBJECTIVE: To observe the development of bone at different times during the period of mandibular lengthening by external distraction using Ilizarov's transosseous osteosynthesis technique. MATERIALS AND METHODS: Fifteen rabbits, 2 to 3 kg in weight, were used for this experiment. The left side of the mandible was exposed and a corticotomy was performed with a water-cooled drill. After 12 hours, distraction was started and continued 1 mm per day for 2 weeks. Plain radiography and three-phase bone scan scintigraphy were performed on the 1st, 7th, and 14th postoperative days. The mandibles were then either removed for immediate histologic evaluation or after 2, 5, or 8 weeks of postdistraction fixation. RESULTS: Elongation of up to 11 mm was achieved. Radiographic and scintigraphic evaluation suggested a residual inflammation on the 7th day and definite ossification on the 14th day. Histologic observations of the distraction site showed a gradual change from an amorphous matrix to a fibrous matrix and, finally, an osseous-like tissue. CONCLUSION: Bone lengthening by gradual distraction is commonly used in tubular bones. To achieve mandibular lengthening it is necessary to resolve many problems. Morphologic, radiographic, scintigraphic, and histologic observations confirm that mandibular lengthening by external distraction is possible, with the formation of new bone tissue.
During 1975-87, 105 patients with squamous cell carcinoma (SCC) of the lip were surgically treated. All patients underwent radical resection of the tumor. Only the patients with palpable lymph nodes had a simultaneous neck dissection. All patients were followed up for at least 5 years. Of the 80 patients without palpable lymph nodes, only three developed lymph-node metastasis. Of the 25 patients with palpable lymph nodes who underwent modified neck dissection, four had recurrence of lymph-node metastasis at a different level. The over-all 5-year survival rate was 97%. The survival rate for patients with lymph-node metastasis was 88%.
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We have demonstrated both in vivo and in vitro that Cyclosporin (CsA) treatment during psoriasis induced a regression of typical keratinocyte alterations and normalization of the basement membrane (BM). It is also known that the structure of BM implies cohesion between the networks formed by laminin and type IV collagen and that these components positively influence the cytomorphosis processes of keratinocytes. According to these results, we have evaluated, by immunohistochemical study, the behaviour of laminin and type IV collagen on psoriatic skin prior to the therapy and at the end of pharmacological treatment with CsA. This study was carried out on biopsies of involved skin taken from 12 patients with severe psoriasis and with PASI between 50 and 70. Our results can be summed up as follows: Untreated psoriasis: absence of laminin within BM; modest staining in basal keratinocytes; intense staining in suprabasal keratinocytes; discontinuous staining of Type IV collagen in the BM. After treatment: evident and continuous staining of laminin and Type IV collagen within the BM. The obtained results confirm the positive effect of immunomodulation determined by CsA in the regulation of the functional activity of cells implicated in BM component production. In conclusion, the authors discuss the pathogenesis of the disease.
BACKGROUND: Laryngeal cancer is the primary cause of death among patients with head and neck cancer in Argentina. Different prognostic factors have been incidentally dealt with in a number of articles, but there are few studies of prognostic variables, such as age, tobacco, and alcohol, using multifactorial analysis. METHODS: Between 1969-1987, 296 male patients with epidermoid carcinoma of the larynx treated at the Institute of Oncology "Angel H. Roffo" were studied regarding prognostic factors of survival. The effect of age, tobacco, alcohol, histologic grade, extent of primary tumor, and cord mobility on survival were assessed by means of the Cox proportional-hazards model. RESULTS: The univariate analysis showed that primary tumor extent, nodal involvement, stage, alcohol intake, previous tracheostomy, and cord mobility were statistically significant predictors of survival. Multivariate analysis disclosed only nodal involvement, alcohol intake, and cord mobility as statistically significant variables in regard to survivorship. With these variables, a hazard index was calculated for each patient, and four risk groups were formed. Five-year survival rates were as follows: Group A, 79%; B, 69%; C, 47%; and D, 14% (A versus C, P < 0.005; A versus D, P < 0.005). CONCLUSIONS: This study confirmed the prognostic impact of nodal involvement and also showed the importance of cord fixation and alcohol drinking as predictors of survival.
A single-blind, randomized, parallel-group study was conducted to compare the efficacy and safety of dirithromycin with miocamycin in the treatment of streptococcal pharyngitis/tonsillitis caused by Group A streptococci. The study population consisted of 60 patients: 30 were randomized to receive 500 mg dirithromycin od and 30 to receive 600 mg miocamycin bd. All 30 dirithromycin-treated patients were eligible for efficacy analysis. A favourable clinical response was observed in 100% of these patients at the post-therapy visit. In the miocamycin-treated group, 28 of 30 (93.3%) patients were eligible for efficacy analysis; a favourable clinical response was observed in 100%. Bacteriological cure of evaluable dirithromycin- and miocamycin-treated patients was 96.7% and 92.9%, respectively. No statistically significant post-therapy differences in clinical or bacteriological response rates were noted between the two groups. Adverse event analysis showed no significant differences between treatment groups. There were no serious adverse events during the study. Two miocamycin-treated patients were prematurely withdrawn from the study due to adverse events (diarrhoea). Analysis of clinical laboratory data revealed no statistically significant differences between the treatment groups that were considered to be drug related. The results of this study suggest that dirithromycin has comparable safety and efficacy to miocamycin in the treatment of streptococcal pharyngitis/tonsillitis infections caused by Group A streptococci.
Recent work reports the usefulness of radionuclides in the study of hepatic hemangiomas. In particular, 99Tcm-red blood cell (RBC) scintigraphy is useful to evaluate the vascularization and to plan the therapy. The aim of this paper is to confirm the usefulness of 99Tcm-RBC scans in the detection and follow-up of maxillofacial hemangiomas. Results using this technique in a selected group of patients with maxillofacial hemangiomas are reported.
Calcifying odontogenic epithelial tumor is a rare affection, representing only 1% of all odontogenic tumors. Histology shows polyedral epithelial cells, organised in layers, strands or nests or, more rarely present as individual cells. The cell nuclei are polymorphic and hyperchromatic with projecting nucleoli. An amorphous substance presenting specific immunohistochemical characteristics surrounds the cellular elements. It appears to be related to amyloid and is also considered to be the product of degeneration of the cell basal lamina and/or the product similar to the dentine or cement of the tumor cells. Surgical treatment varies from simple enucleation to more or less partial resection of the affected bone.
Parotid lesions are often not easily classified. Important information is gathered by conventional and instrumental investigation. But these data are often insufficient to make a correct diagnosis. The authors have compared these techniques. In particular, they have evaluated their accuracy in identification of site and histology. 60 patients with parotid tumours underwent the same instrumental diagnostic techniques (echography, sialography, computed tomography and fine needle aspiration biopsy). In regard to the identification of the site, the highest percentage was achieved by computed tomography (98%). Echotomography has shown an accuracy of 83%, and sialography 87%. Fine needle aspiration biopsy has allowed the definition of the histiotype in 98% of cases. Computed tomography, echotomography and sialography have not allowed the definition of histiotype in malignant tumours, but in the case of benign tumours computed tomography has permitted a diagnosis in 29 cases (57% of benign tumours). Echotomography and sialography in 25 (49%) and 26 cases (51%), respectively.
Authors report their experience in enteral nutrition (E.N.) on maxillo-facial surgery. From 1987 to 1989, 24 patients were subjected to enteral alimentation in the Department of Maxillo-Facial Surgery of the 2nd School of Medicine of "Federico II" University of Naples (Italy). 50% of patients suffered from head and neck tumours, and 50% suffered from traumatic lesions. Before treatment, patients' nutritional conditions were evaluated by anamnesis, azotic balance, hydroelectrolytic balance, anthropometric, bioumoral, and immunologic parameters. Basal energy expenditure was calculated through Harris-Benedict formula. Patients were checked every week, and E.N. allowed a rapid and adequate caloric increase.
The problem of surgical fixing for incisional hernia is still far from a final solution. Over the past few years, prostheses have been used in addition to traditional plastic surgery. The aim of this experimental study was to assess the efficacy of traditional techniques in comparison to modern methods using prostheses. For this purpose, two original experimental models were designed to assess parietal resistance. Ninety-six Wistar rats were subdivided into 4 group: 1) control; 2) "waistcoat" plastic surgery; 3) plastic surgery using a vicryl prosthesis. With the exception of rats in group 1, a lozenge-shaped section of abdominal wall was removed from all other rats and, subsequently, the wall was repaired using the above-mentioned methods. Rats were killed after 30-60-120-180 days and the abdominal walls were subjected to traction and pressure using specially designed experimental models. For the first 30 days, the walls with dacron and vicryl prostheses behaved in a similar way, and showed a greater resistance than the other two groups; but after day 120, the resistance of dacron prostheses was considerably greater than that of the other groups studied. In conclusion, plastic surgery based on the use of nonreabsorbable prostheses is now more efficacious than traditional plastic surgery in the surgical treatment of incision hernia.
The authors report their clinical experience with topical treatment of seborrheic acne with a 5% spironolactone cream in 20 patients, 11 males and 9 females aged 12 to 28 years (average 20.5). Treatment duration, about one month. Treatment proved remarkably effective in that it brought about complete regression of acne in 30%, improvement in 65% of the patients. The drug was always well tolerated, side effects were never observed.
Three cases of Mibelli's angiokeratoma, observed in patients of 11, 15 and 27 years old respectively, are described. The pathological examination either with routine or with immunohistochemical methods for the VII factor suggests, together with other reports, that the superficial vascular dilatation could be the conseguence of a prolonged peripheral vasoparalysis.
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