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Biomedical subjects

P Puxeddu

Publications and source records attributed to P Puxeddu.

At least 19 recordsLinked to original sources
PubMed2005

Revision stapes surgery for recurrent transmissional hearing loss after stapedectomy and stapedotomy for otosclerosis.

A total of 20 stapedotomy and 24 stapedectomy cases were retrospectively reviewed to establish the causes of failure, and to evaluate hearing results after revision surgery. Our series included 23 male and 21 female patients. Mean age at revision time was 42 years, and the mean interval from primary surgery and revision stapes surgery was 27 months. The retrospective review of our data, revealed that the most common cause for revision surgery was a displaced prosthesis (47.7%). After revision surgery, the mean post-operative air-bone gap was 14.78 dB. A mean post-operative air-bone gap within 10 dB occurred in 24 patients (54.5%), in 14 patients (31.5%) this was between 11 and 20 dB, in 5 patients (11.5%) between 21 and 30 dB, and in one patient (2.5%) > 30 dB. There were no "dead ears" in this series. Our results compare to other reported series, and confirm that after revision stape surgery, an air-bone gap closure within 10 dB is difficult to obtain. In the present series, the use of the total ossicular replacement prosthesis resulted in the poorest functional hearing results.

Adolescent↗
PubMed2000

Endoscopic revision of failed external dacryocystorhinostomy.

Obstruction of the lacrimal pathways is a relatively frequent problem usually corrected by external dacryocystorhinostomy. Failure of the external approach may be due to an inadequate rhinostomy, excessive scar tissue production, anatomical anomalies or concomitant paranasal sinus infectious. The introduction of direct and angled endoscopes for paranasal sinus surgery and the refinement of endoscopic surgical procedures allows a complete intranasal exposure and surgical management of the lacrimal sac, even in cases of recurrent obstruction. The present work offers a retrospective review of the records of seven patients who underwent a revision endoscopic dacriocystorhinostomy (ENDCR) between January 1994 and June 1997 for failed external dacryocystorhinostomy. The preoperative evaluation of the patients, the surgical technique and the postoperative management are examined in detail. A permanent dacryocystorhinostomy was obtained in six patients. One patient underwent a successful bilateral procedure. One patient experienced a persistent stenosis. There were no complications related to the surgical procedure. In our experience the revision endoscopic dacryocystorhinostomy offered several advantages, including a complete exposure of those anatomical anomalies or inflammatory changes of the normal structures that commonly hinder conventional external surgery. Although a larger series will further elucidate the efficacy of this procedure in failed external dacryocystorhinostomy, we recommend considering revision ENDCR as an alternative to the external revision technique.

Adult↗
PubMed1998

Polymorphous low-grade adenocarcinoma of the parotid gland.

Polymorphous low-grade adenocarcinoma of the salivary glands is a well-defined clinico-pathological entity which occurs almost exclusively in the oral cavity. Only few reports have documented it in the parotid gland. The authors report an additional case of de novo polymorphous low-grade adenocarcinoma of the parotid and describe the histological and immunocytochemical features of the neoplasm. The current literature is also reviewed.

Adenocarcinoma↗
PubMed1995

Atypical "reversed" paroxysmal positioning nystagmus in benign paroxysmal positional vertigo.

An atypical paroxysmal positioning nystagmus (PPNy), "reversed" in its directional components, is a rare finding in patients suffering from benign paroxysmal positioning vertigo (BPPV). It poses problems of pathophysiogenetic interpretation, differential diagnosis with a CNS lesion and therapeutic strategy. Such a finding was observed in 7 patients (out of a total of 450 BPPV) and took on the typical PPNy pattern after repeated diagnostic manoeuvres. These aspects are incompatible with the "heavy cupula" mechanism (cupulolithiasis) and are better explained by the presence of "free endolymph aggregates" (canalolithiasis) within the posterior semicircular canal (p.s.c). Moreover, canalolithiasis would also permit a more convincing interpretation of all the clinical findings observed in typical p.s.c.-BPPV.

Adult↗
PubMed1995

[The immunological assessment of a combined therapeutic approach (chemo- + radiotherapy +/- surgery) including immunotherapy in neoplasms of the head and neck area at an advanced stage].

Fourty-eight patients entered the study, 37 of whom were evaluable, who underwent a nonrandomized combined modality approach plus a randomized immunotherapy treatment assigning the patients to one of the three arms: 1) thymostimulin, 2) beta IFN, 3) thymostimulin + beta IFN. The patients enrollment started in May 1991 and was closed in February 1993: the final evaluation was in February 1994. An immunological evaluation was made for all patients enrolled. The immunological assessment confirms some previous reports, such as the defective proliferative response of PBMC, the high serum level and the low production in culture of soluble IL 2 receptor (s IL 2 R), the low serum level and the low production of IL 2, and moreover shows new data. It is noteworthy that the significant increases--especially for cytokines and s IL 2 R, except for IL 1 alpha which has decreased, both for serum levels and for culture production--are induced by treatment with beta IFN (or with thymostimulin + beta IFN), suggesting that beta IFn is the immunologically effective moiety.

Adult↗
PubMed1994

Neo-adjuvant chemotherapy +/- immunotherapy with s.c. IL 2 in advanced squamous cell carcinoma of the head and neck: a pilot study.

We carried out a pilot nonrandomized phase II study to compare the neo-adjuvant chemotherapic regimen with cisplatin, 5-FU and vinorelbine with the same combination plus s.c. IL 2 in advanced head and neck squamous cell carcinoma (HNSCC). The primary goals of the trial were to evaluate the feasibility and response rates of the two regimens. The study design consisted of a patient's assignment to either of the two following arms: Arm A: Cisplatin 80 mg/m2 i.v. on day 1; 5-FU 600 mg/m2 i.v. on days 2-5; and vinorelbine 20 mg/m2 i.v. on days 2 and 8, Arm B: the same chemotherapic regimen plus recombinant IL 2 (Proleukin, Eurocetus) 9 MIU s.c. daily from day 9 to 13 and from day 16 to 20 for every cycle. From March 1993 to November 1993 twenty three patients with Stage III-IV HNSCC were enrolled in the study. Patients could be evaluated for response to treatment if they had received at least 2 complete cycles of therapy. The overall response rate (ORR) was 63% in Arm A and 100% in Arm B. The differences for ORR and CR rates were statistically significant in favor of Arm B. The analysis for each of the three drugs included in the chemotherapy schedule shows that both the actually received average dose-intensity and the actually delivered average cumulative doses/patient were higher for Arm B (chemo-plus IL 2 therapy) (approximately 80% of programmed dose-intensity) than for Arm A (approximately 70% of programmed dose-intensity). Both the actually received average dose-intensity and the actually delivered average cumulative doses/patient for IL 2 were more than 80%. In both arms the most frequent side effects were myelosuppression, phlebitis and electrolyte disturbances. There were 2 toxic deaths, 1 in Arm A and 1 in Arm B, both for hematologic toxicity. Our "pilot" study suggests that the combination of cisplatin, 5-FU, vinorelbine plus IL 2 is a highly active, but rather toxic, neo-adjuvant treatment in advanced HNSCC with very high ORR and CR rates.

Aged↗
PubMed1992

[Controlled trial of thymostimulin treatment of patients with primary carcinoma of the larynx resected surgically. Immunological and clinical evaluation and therapeutic prospects].

The study aim was that of evaluate the effect of thymostimulin (Tp-1, Serono), either in vitro or in vivo, in patients with primary laryngeal carcinoma, treated only with surgery without any other complementary therapy. Nineteen patients have been studied: nine (mean age 62.5 years, range 48-70) have been treated with Tp-1 and ten patients (mean age 63.4 years, range 56-75) served as "controls". Tp-1 has been administered as follows: 60 mg/m2/daily i.m. days 1-15; 60 mg/m2 twice weekly i.m. days 16-30; 60 mg/m2 once weekly i.m. days 31-60. The treatment was stopped days 61-90. The same cycle was repeated until day 180. The treatment was stopped days 181-365. The following parameters have been assessed: clinical (at the protocol entry and after one year): Performance Status (PF, Karnofsky), local status, presence of relapses, incidence of chronic infections of the upper respiratory tract; immunological in vitro: 1) response to polyclonal mitogens, PHA, Con A and PWM, response to human recombinant Interleukin 2 (rIL 2) of PHA-prestimulated and non prestimulated peripheral blood lymphocytes. The immunological parameters also have been assessed at the protocol entry and after one year. Our results have shown that, in the group of patients treated with Tp-1, 5/9 patients (55.56%) exhibited a significant increase of the PHA response at the end of treatment as compared to pretreatment values, 3/9 (33.34%) showed a decrease and 1/9 (11.10%) an almost unchanged response. In the group of controls, 5/10 (50%) have shown a significant decrease of the response after one year, 3/10 (30%) an increase, 1/10 (10%) were unchanged and 1/10 (10%) exhibited a non univocal response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvants, Immunologic↗
PubMed1990

Survival analysis of 378 surgically treated cases of laryngeal carcinoma in south Sardinia.

The effect of various patient and tumor characteristics were evaluated in 378 laryngeal carcinomas treated only surgically between November 1974 and December 1987 at the Ear, Nose and Throat Clinic of Cagliari Medical University in South Sardinia. The overall three-year survival rate was 68%, the five-year survival rate was 61% (approximate 95% confidence interval (CI), 54-68%), and then a plateau seemed to emerge, with the ten-year survival rate being 51%. Tumor ulceration exerted a strong influence on survival: patients with ulcerated tumors had a twofold (95% CI, 1.4-2.9%) higher death rates. Conversely, the influence of tumor site and type of operation was not statistically significant in the multivariate analysis. A median delay in diagnosis of 4 months was found, with 30% of patients reporting an interval longer than 6 months between first symptoms and referral to a physician; overall, however, the influence of delay in diagnosis on survival rate was not significant. Dysphonia seemed to be the symptom less promptly recognized by the patient.

Adult↗
PubMed1990

Glucose-6-phosphate dehydrogenase (G6PD) activity in tumoral tissues of G6PD-deficient subjects affected by larynx carcinoma.

The activity of glucose-6-phosphate dehydrogenase (G6PD), the key enzyme of the hexose monophosphate (HMP) shunt pathway, was measured in both normal and tumoral larynx tissues from normal and G6PD deficient subjects. Significant increases of this enzymatic activity were found in tumoral tissues of both normal and G6PD deficient subjects, who were characterized by very low levels of G6PD activity in erythrocytes as well as in larynx tissue.

Aged↗
PubMed1990

Fine structure of excretory ducts of human salivary glands.

Excretory ducts of human major salivary glands are lined by an epithelium consisting of principal cells and by a discontinuous row of basal cells. The principal cells are tall and columnar with mitochondria, large lipofuscin granules and a central nucleus. Just beneath the plasmalemma bordering the lumen, their cytoplasm contains a number of small granules and vesicles similar to those observed in cells of striated ducts. Both in TEM and SEM, these cells also show large apical protrusions devoid of cytoplasmic organelles that may represent a kind of apocrine secretion. The cytoarchitecture of the principal cells seems to be at variance with that of cells of striated ducts. First, the cell body remains unique and does not split into major basal processes. Second, these cells usually lack the long laminated basal folds, housing vertically aligned mitochondria, that are typical of striated ducts. Instead, below the smooth area occupied by the junctional complexes, the lateral cell surfaces are completely covered by a great number of short irregular processes. These organelle-free folds are apparently involved in the mechanism of ion transport since, at their level, there is a strong reactivity for the transporting enzyme K(+)-pNPPase. The basal cells, which are small and cuboidal, have a dense and filamentous cytoplasm. Their functional role is still uncertain.

Adult↗
PubMed1988

A histochemical study of the main excretory duct of the human submandibular gland.

The duct was reacted histochemically to identify glycoproteins and several enzymic activities. Neutral mucosubstances were detected in the entire cytoplasm of the principal cells, and acid glycoproteins were identified only in a thin apical zone corresponding to the glycocalyx. Lysosomal enzymes were demonstrated as cytoplasmic granules, whereas endogenous peroxidase was diffusely distributed throughout the entire cytoplasm of the epithelial cells. 17 beta- and 3 beta-hydroxysteroid dehydrogenases and prostaglandin-synthetase reactivity were intense in all epithelial cells.

Adult↗
PubMed1987

[Collateral effects of 9-alpha-fluor-prednisolone acetate and kanamycin, administered by nasal spray. Clinical experience and experimental data].

Iatrogenic pathology due to treatment with steroid drugs used by systemic route is well known. On the contrary iatrogenic pathology due to topical use of these drugs is rarely reported. Two cases of abuse of 9-alpha- fluor-prednisolone and kanamycin administered by endonasal route are reported. The same treatment has been carried out in patients and rabbits. Clinical and bio-humoral data in patients and anatomo-pathological findings in rabbits are reported. The risks, sometimes underestimated, of an overdose of corticosteroid and antibiotic drugs used by endonasal route are pointed out.

Administration, Inhalation↗
PubMed1987

Ciliated cells in the main excretory duct of the submandibular gland in obstructive sialadenitis: a SEM and TEM study.

The epithelium of the main excretory duct of the submandibular gland in five cases of obstructive sialadenitis was studied by TEM and SEM. In three cases we found a considerable increase in goblet and ciliated cells. As well as normal cilia, different kinds of ciliary anomalies, especially compound cilia, were noticed. Images of centriole formation and of ciliogenesis, both normal and abnormal, were also observed. Several hypotheses concerning the mode of formation of the compound cilia are discussed.

Adult↗
PubMed1986

Histological and ultrastructural findings on mucocele of maxillary sinus.

The authors describe a rare case of mucocele of maxillary sinus and, on the basis of the histological and namely of the ultrastructural findings, they maintain that the mucocele has in all probability a multiple pathogenesis being dependent not only on the inflammatory processes, but also on other local predisposing factors and namely the active participation of the mucosa in the formation of the cavity of mucocele.

Adult↗
PubMed1984

Cytochemical localization of ouabain-sensitive, K+ -dependent p-nitrophenylphosphatase and Ca++-stimulated adenosine triphosphatase activities in human parotid and submandibular glands.

K+ -dependent p-nitrophenylphosphatase (pNPPase) and Ca++ -stimulated adenosine triphosphatase (ATPase) activities were studied in human parotid and submandibular glands using cytochemical methods at the ultrastructural level. In both glands, only the striated-duct epithelium showed K+ -pNPPase reaction product, thereby indicating the localization of Na+, K+ -ATPase. The precipitate was concentrated on the deep invaginations of the basolateral plasma membranes, in close association with their cytoplasmic surface. Ca++ -ATPase activity was also found on the basolateral plasma membranes, but two striking differences from the K+ -pNPPase distribution were observed: firstly, Ca++ -ATPase appeared in both acinar and ductal cells, and secondly, it was localized on the outer side of the plasma membranes.

4-Nitrophenylphosphatase↗
PubMed1983

Human ceruminous glands: a histochemical study.

Human ceruminous glands were treated for the histochemical demonstration of glycoproteins and of several enzymatic activities. Neutral mucopolysaccharides were detected in the cytoplasm and pigment granules of the epithelial cells, and acid glycoproteins were recognized only in a thin apical zone corresponding to the glycocalyx. Lysosomal enzymes were demonstrated within cytoplasmic granules, while peroxidase, G6PD and 6PGD showed a diffuse reactivity through the entire cytoplasm of the secretory cells. Age and sex-related differences were observed with respect to 17 beta-HSD and the 3 beta-HSD, whose reactivity appeared more intense in the young and in the female than in the old and in the male glands. Finally, all the ceruminous cells showed a strong prostaglandin synthetase reactivity.

Adolescent↗