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Biomedical subjects

P Pisani

Publications and source records attributed to P Pisani.

At least 19 recordsLinked to original sources

Dietary habits, internal migration and social class in a sample of a northern Italian population.

The study of migrants has generated interesting hypotheses on the etiology of different types of cancer. In particular, it has been suggested that both colon and breast cancer could be related to living conditions, including diet, in the country of immigration. Considerable internal migration occurred in Italy in the sixties. We studied a random sample of 1,400 subjects living in the city of Torino and the province of Varese. They were interviewed with a detailed questionnaire about their dietary habits, and the consumption of several nutrients was considered according to the area of birth and social class. The hypothesis we tested was whether, after controlling for social class, there were different dietary habits among the migrants and the native population, and whether such differences could help in the formulation of etiologic hypotheses on cancer. We found that the intake of saturated fatty acids and cholesterol was lower among the migrants from the south, whereas they consumed higher levels of vegetables than people born in the north. The different intake of saturated fatty acids and cholesterol seemed to be attributable mainly to the consumption of butter, for which the south/north ratio was as low as 0.47 in men and 0.56 in women. Important gradients by social class were also suggested for several nutrients.

Adult

Argyrophilic nucleolar organizer region counts and proliferating cell nuclear antigen scores are two reliable indicators of survival in pharyngeal carcinoma.

The proliferative activity of pharyngeal carcinoma has been investigated by means of monoclonal antibody PC10 against proliferating cell nuclear antigen (PCNA/cyclin) and argyrophilic nucleolar organizer region (AgNOR) analysis in formalin-fixed, paraffin-embedded biopsies from 45 primary squamous and undifferentiated carcinomas, prior to therapy. The correlation between AgNOR counts and PCNA(PC10) scores was highly significant (r = 0.73; P < 0.0001) as determined by Pearson's correlation coefficient. Moreover, the univariate Kaplan-Meier survival analysis showed a significant correlation between 3- and 5-year survival rates and the mean AgNOR number per tumour cell (P = 0.0003) or the percentage of PCNA(PC10)-positive cells (P = 0.0001). Our results indicate that both AgNOR counts and PCNA(PC10) scores are reliable markers of the proliferative activity of pharyngeal carcinoma in small, routinely processed biopsies, in which they can allow simultaneous evaluation of the histology and tumour cell kinetics.

Adult

The European ST-T database: standard for evaluating systems for the analysis of ST-T changes in ambulatory electrocardiography.

The project for the development of the European ST-T annotated Database originated from a 'Concerted Action' on Ambulatory Monitoring, set up by the European Community in 1985. The goal was to prototype an ECG database for assessing the quality of ambulatory ECG monitoring (AECG) systems. After the 'concerted action', the development of the full database was coordinated by the Institute of Clinical Physiology of the National Research Council (CNR) in Pisa and the Thoraxcenter of Erasmus University in Rotterdam. Thirteen research groups from eight countries provided AECG tapes and annotated beat by beat the selected 2-channel records, each 2 h in duration. ST segment (ST) and T-wave (T) changes were identified and their onset, offset and peak beats annotated in addition to QRSs, beat types, rhythm and signal quality changes. In 1989, the European Society of Cardiology sponsored the remainder of the project. Recently the 90 records were completed and stored on CD-ROM. The records include 372 ST and 423 T changes. In cooperation with the Biomedical Engineering Centre of MIT (developers of the MIT-BIH arrhythmia database), the annotation scheme was revised to be consistent with both MIT-BIH and American Heart Association formats.

Algorithms

Validation of a method for the estimation of food portion size.

In the context of the planning phase of a large cohort study on dietary habits and cancer, we have developed a food frequency questionnaire on usual food intake, which includes a set of pictures to estimate the portion size of 23 different dishes. The validity of the estimation of portion size of recently consumed foods has been questioned by other researchers. To validate the use of pictures, we organized a field trial with 103 volunteers. They were invited to a dinner where standard Italian dishes were offered (total 17 foods); all of the portions they chose were recorded and weighed. The following day, we interviewed the volunteers on what they consumed during the dinner, and we compared the weight of the food actually eaten with the weight of the food represented in the pictures. The volunteers overestimated the portion size by more than 20% for six foods and underestimated the portion size by more than 20% for four foods. In addition, we found a tendency toward overestimation of portion size by those who ate smaller portions and underestimation, by those who ate larger portions ("flat slope syndrome").

Adult

Serum and urinary androgens and risk of breast cancer in postmenopausal women.

Serum levels of testosterone, dihydrotestosterone, androstenedione, dehydroepiandrosterone sulfate, and sex hormone-binding globulin and urinary levels of testosterone and androstanediol were compared in 75 women with breast carcinoma and 150 age-matched healthy controls. Odds ratios for quartiles of hormones, adjusted for known potential confounders, were computed using conditional logistic regression. Risk of breast cancer was positively associated with levels of all androgens in serum and urine but appeared stronger for testosterone (for trend, P = 0.03) and dehydroepiandrosterone sulfate (for trend, P = 0.06) in serum and for testosterone (for trend, P = 0.001) and androstanediol (for trend, P = 0.04) in urine. The adjusted odd ratios for high versus low quartiles were 2.7 (95% confidence interval, 1.1-6.5) for serum testosterone, 2.8 (1.1-7.4) for dehydroepiandrosterone sulfate, 4.7 (1.8-12.1) for urinary testosterone, and 3.4 (1.4-8.7) for urinary androstanediol. These observations suggest that endogenous androgenic hormones may play an important role in the epidemiology of postmenopausal breast cancer in women.

Age Factors

Laboratory evaluation during high-dose vitamin A administration: a randomized study on lung cancer patients after surgical resection.

The laboratory findings in patients receiving high-dose vitamin A as adjuvant treatment for stage I lung cancer are here reported. A group of 283 patients were randomized to either treatment with retinyl palmitate (300,000 IU daily for 12 months) or standard follow-up, and are now evaluable after a median observation period of 28 months. At regular intervals, all the patients underwent a physical examination, chest roentgenogram, blood chemistries, haematological assays, hepatic and renal function tests and determinations of serum triglycerides and cholesterol. Serum transaminase abnormalities were of similar magnitude in cases and controls, while gamma-glutamyltransferase levels were abnormally elevated in 69% of the treated patients compared to 39% of controls (mean values 149 vs 57 IU/l at 24 months, P less than 0.05). Serum triglyceride concentrations over 150 mg/dl were seen in 74% of treated patients compared to 43% of controls at 12 months, the average concentration was 283 mg/dl compared to 179 mg/dl (P less than 0.05). Cholesterol levels showed a modest, non-significant rise with time in both groups, and there was no other laboratory evidence of toxicity attributable to vitamin A. Serum retinol and retinol-binding protein, assessed on a limited sample of patients, were higher in the treatment arm (P less than 0.05) at 12 months. In our experience 300,000 IU/day of retinyl palmitate can be administered as a possible chemopreventive agent with reasonable safety for up to 2 years.

Aspartate Aminotransferases

Diagnostic accuracy of the double-contrast enema for colonic polyps in patients with or without diverticular disease.

The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The double-contrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.

Barium Sulfate

Repeated serum and urinary androgen measurements in premenopausal and postmenopausal women.

Intra-individual variability for serum and urinary hormones has been inadequately considered in previous studies. Therefore, in the planning phase of a prospective study of Hormones and Diet in the Etiology of Breast Cancer (ORDET study), androgen levels have been examined at two different times in 56 women (26 in premenopause and 30 in postmenopause). Hormonal measurements in serum showed a good level of agreement for both premenopause (pre) and postmenopause (post): androstenedione pre r = 0.70 (p less than 0.0001), post r = 0.77 (p less than 0.0001); testosterone pre r = 0.73 (p less than 0.0001), post log values r = 0.74 (p less than 0.0001). Dihydrotestosterone showed a good level for premenopause only: log values pre r = 0.82 (p less than 0.0001), post r = 0.41 (p less than 0.05). Agreement levels in urine were inferior to those of serum: testosterone pre r = 0.53 (p less than 0.05), post r = 0.41 (p less than 0.05); androstanediol log values r = 0.46 (p less than 0.001), post log values r = 0.57 (p less than 0.05). Correlation between the two measurements improves considering age, parity, time of blood collection and, for urine, the interval of sample collections.

Adult

Argyrophilic nucleolar organiser region counts and prognosis in pharyngeal carcinoma.

The prognostic significance of argyrophilic nucleolar organiser regions (AgNORs) has been evaluated in biopsy specimens from 61 primary squamous and undifferentiated carcinomas of the pharynx prior to therapy. The univariate Kaplan-Meyer survival analysis showed a significant correlation between 3- and 5-year survival rates and the mean AgNOR number per tumour cell (P less than 0.001). No significant correlation was found between prognosis and patients age and sex, tumour location, clinical stage, histologic grade, extent of lymphocytic infiltration, HMFG-2 positivity of tumour cells and UCHL1, LN2, MB2 positivity of infiltrating lymphocytes. There was no significant association between AgNOR counts and tumour histologic grade or clinical stage. Multivariate survival analysis showed that only two variables were significantly correlated with prognosis: AgNOR counts (P less than 0.001) and the extent of lymphocytic infiltration (P less than 0.027). Our results indicate the prognostic value of AgNOR counts and suggest the use of this method as a significant parameter in the pretherapeutic assessment of the aggressiveness of pharyngeal carcinomas.

Adult

Occupation and cancer of the oral cavity or oropharynx in Turin, Italy.

In a population-based case-referent study, the occupational experience of 86 men with oral or oropharyngeal cancer and 373 referents was analyzed with respect to employment in 41 occupations and 40 industries, as well as to exposure to 16 chemicals, as estimated via a job-exposure matrix. Among the occupations and industries at higher risk were machinery operator (odds ratio [OR] 2.0; 95% confidence interval [95% CI] 1.0-4.0), plumber (OR 5.0, 95% CI 1.2-21.5), building industry (OR 2.5; 95% CI 1.3-4.5), textile industry (OR 2.5; 95% CI 0.6-4.6), and electricity production (OR 2.8; 95% CI 0.7-12.1). All the OR estimates were adjusted for age, education, area of birth, tobacco smoking, and alcohol consumption. An association between formaldehyde exposure and oral cancer was suggested (OR for any exposure 1.6, 95% CI 0.9-2.8; OR for probable or definite exposure 1.8, 95% CI 0.6-5.5). No other chemical included in the matrix showed any risk pattern. The evidence of an association between formaldehyde exposure and oral or oropharyngeal cancer is strengthened by the results of this study.

Case-Control Studies

[Anterior craniofacial resection in the treatment of malignant nasal-paranasal sinus tumors with intracranial extension].

Nasal and paranasal sinus tumors extending through the cribriform plate to the overlying dura of the frontal lobe can be successfully treated by anterior craniofacial resection. During the period from 1986 to 1990, 14 patients (11 males, 3 females, age 18-67) with nasal/paranasal tumors extended to the nasal basis underwent craniofacial resection. From a histological point of view these patients were classified as follows: --8 adenocarcinomas --2 squamous cell carcinomas --2 esthesioneuroblastomas --1 cylindroma --1 haemangiopericytoma. In 6 of the 14 patients post-operative complications were encountered, 3 being resolved. Radical surgery was realised in 12 cases; post-operative radiotherapy was performed in 7. No contraindications were found because of previous chemo- and/or radiotherapy, even if it had been performed as treatment. Four of the patients died because of recurrences between the 6th and 20th month after surgery; 5 patients (all adenocarcinoma subjects) are disease-free respectively 8, 16, 17, 22 and 24 months after surgery.

Adenocarcinoma

[Planning of a prospective study with a biological bank].

This present work aims to give a critical description of the organization and operative aspects of project ORDET (prospective study on diet and hormones in the aetiology of breast cancer). A number of problems which could arise when carrying-out a prospective study are described: they concern participant recruitment, laboratory organization, planning of a biological bank plus relative security checks in order to ensure full workability and personnel standardization in questionnaire administration and anthropometrical measurements. The methods adopted by ORDET, or at least some of them, could be useful for those engaged in the planning phase of a similarly designed project using a biological bank.

Adult

User-friendly image processing software tools: general purpose features and application to the correlation of PET-CT brain images.

An interactive software package, performing some useful general purpose image processing operations and being used as a tool for the problem of the anatomical correlation of PET brain images, is under development. The software is developed as a comprehensive tool with a graphic user-interface allowing the display of the processed images through the use of a variety of colormaps. The implemented routines perform a lot of processing operations on the images: a) Local image processing, i.e. smoothing and sharpening, contours extraction, interactive expansion, shrinking and thresholding of the gray scale, histogram equalization. b) ROI handling, i.e., ROI drawing and computing, transformation of an image to a ROI, ROI editing. c) Additional operators include frequency space image processing such as FFT.

Brain

[Prognostic factors after percutaneous transhepatic biliary drainage].

The authors reviewed the clinical charts and the radiographic files of 93 patients with obstructive jaundice--in 86 cases due to neoplasm--treated with PTBD. The test of differences from survival curves was used to identify the clinical parameters predictive of short survival after PTBD. The difference in survival curves was significant relative to serum indirect bilirubin (cut point: 7.6 mg%), to serum cholinesterase (cut point: 1290 mU/ml), to white blood cell counts (cut point: 8600/mm3), to blood urea nitrogen (BUN) levels (cut point: 60 mg%). Because of the marked negative prognostic value of high BUN levels, our data seem to indicate that PTBD should not be performed when severe renal insufficiency is present. Other parameters correlated with a short survival after PTBD were the histotype of metastasis (in comparison with the other ones), and large neoplastic volume (in comparison with a small and a medium ones). Through pre-PTBD radiological and laboratory data analysis, a group of patients can be selected in whom the procedure will increase neither well-being nor survival, as plotted against those patients who are likely to benefit from biliary drainage.

Bile Duct Neoplasms

Diurnal variation of testosterone and estradiol: a source of bias in comparative studies on breast cancer.

In this paper we present a study of the diurnal variation of testosterone (T) and estradiol (E2) in women, carried out as part of the design of a prospective study on the hormonal and nutritional etiology of breast cancer. Blood samples were obtained 5 times on the same day, in the morning and early afternoon, from 23 women aged between 25 and 63 yr. Twelve were sampled within the first days following daylight-saving time (SUMTI) introduction. In postmenopause, T mean values decreased from 08:00 h to 15:00 h and the effect of blood drawing time was statistically significant (p less than 0.01), with no significant effects of SUMTI. For E2 mean values, no significant effect was found for either blood drawing time or SUMTI. In premenopause, T mean values decreased from morning to afternoon (p less than 0.01), while no effect of SUMTI was found. A significant decrease was observed for E2 during the day (p less than 0.01), with no significant influence of SUMTI. These results indicate that diurnal variation of T and E2 are such, that one must not neglect the possible effects of timing procedures on hormonal measurements, when hormonal hypotheses are tested in comparative studies on cancer etiology.

Adult

Renal carcinoma metastasis to the parotid gland.

Metastatic tumours in major salivary glands are uncommon with a higher incidence of primary sites from the head and neck. The lungs and breast are the common primary sites, while metastases from the kidney are very rarely found. The authors describe a case of renal clear-cell carcinoma with metastasis to the parotid gland. The incidence of a metastasis in the parotid gland from a primary renal carcinoma, even if rare, should not be overlooked in making a correct differential diagnosis with acinic cell carcinoma and monomorphic clear cell adenoma.

Adenocarcinoma

[Post-radiotherapy complications in malignant tumors of the nasopharynx. Analysis of 141 cases].

This study was aimed at retrospectively analyzing the incidence and severity of the complications occurred in 141 patients affected with nasopharyngeal carcinomas treated with exclusive radiotherapy from 1960 to 1986. The acute complications were analyzed (85/141 grade II-III mucositis which generally came to a complete remission) which occurred during and immediately after radiation treatment. The late damage was then studied which occurred in 74/141 patients (52.5%) and which may worsen patients' quality of life. Finally, the incidence and severity of damage were correlated with some parameters: sex, age, performance status, risk factors (tabagism, alcoholism, diabetes), stage, total dose, fractionation, and processing techniques for treatment planning.

Adolescent

Radiation dose and breast cancer risk in patients treated for cancer of the cervix.

The relationship between breast cancer and radiation treatment for cervical cancer was evaluated in an international study of 953 women who subsequently developed breast cancer and 1,806 matched controls. Radiation doses to the breast (average 0.31 Gy) and ovaries (average 32 Gy) were reconstructed for exposed subjects on the basis of their original radiotherapy records. Overall, 88% of the breast cancer cases and 89% of the controls received radiation treatment [relative risk (RR) = 0.88; 95% confidence interval (CI) = 0.7-1.2]. Among women with intact ovaries (561 cases, 1,037 controls), radiotherapy was linked to a significant 35% reduction in breast cancer risk, attributable in all likelihood to the cessation of ovarian function. Ovarian doses of 6 Gy were sufficient to reduce breast cancer risk but larger doses did not reduce risk further. This saturation-type response is probably due to the killing of a critical number of ovarian cells. Cervical cancer patients without ovaries (145 cases, 284 controls) were analyzed separately because such women are at especially low natural risk for breast cancer development. In theory, any effect of low-dose breast exposure, received incidentally during treatment for cervical cancer, should be more readily detectable. Among women without ovaries, there was a slight increase in breast cancer risk (RR = 1.07; 95% CI = 0.6-2.0), and a suggestion of a dose response with the RR being 1.0, 0.7, 1.5 and 3.1 for breast doses of 0, 0.01-0.24, 0.25-0.49 and 0.50+ Gy, respectively. However, this trend of increasing RR was not statistically significant. If low-dose radiation increases the risk of breast cancer among women over age 40 years, it appears that the risk is much lower than would be predicted from studies of younger women exposed to higher doses.

Adult