Stefano Pelucchi

The impact of hearing loss on the quality of life of elderly adults

Hearing loss is the most common sensory deficit in the elderly, and it is becoming a severe social and health problem. Especially in the elderly, hearing loss can impair the exchange of information, thus significantly impacting everyday life, causing loneliness, isolation, dependence, and frustration, as well as communication disorders. Due to the aging of the population in the developed world, presbycusis is a growing problem that has been reported to reduce quality of life (QoL). Progression of presbycusis cannot be remediated; therefore, optimal management of this condition not only requires early recognition and rehabilitation, but it also should include an evaluation of QoL status and its assessment.

CD44 as prognostic factor in oral and oropharyngeal squamous cell carcinoma.

This retrospective case control study was conducted to assess the prognostic value of some patient-, tumor-, treatment-related variables, and to correlate markers of primary tumor with survival and cervical metastases. Twenty-five patients with histologically proven squamous cell carcinoma of the oral cavity and oropharynx were analyzed. Patients were never treated before and had a minimum follow-up review of 45 months.Results show that T-stage is the most important clinical prognostic parameter. Regarding immunohistochemical markers (Ki67 and CD44), only CD44 seems to be significantly correlated with prognosis but this value showed a multicollinear effect with N upon survival. Decreased expression of CD44 correlates with a decreased survival, although increased CD44 expression was consistent with a longer survival. Therefore, it was assessed that a loss of cell adhesion, related to decreased expression of CD44, may be determinant of survival in these patients.

A comparison between TNM and TANIS stage grouping for predicting prognosis of oral and oropharyngeal cancer

PURPOSE The 1987 TNM classification system modified some T and N definition but it did not change stage grouping. Consequently it has not improved the prognostic validity of the advanced stage groups. In 1993, a new stage grouping was purposed, TANIS, that seems to have a higher correlation with survival. In this report, the TNM classification and TANIS system were compared to evaluate this prognostic ability. PATIENTS AND METHODS Data from 164 patients affected by primary cancers of oropharynx or oral cavity were analyzed by means of Kaplan-Meier and Cox regression analysis. RESULTS The crude survival rate at 5 years was 43.9%. Both systems showed a significant correlation with the survival rate by means of Cox regression analysis. TANIS subcategories were correlated to the mortality rate in the stage IV patients. TANIS resulted a better predictor of mortality when compared with TNM. CONCLUSION The TANIS system was able to separate the TNM stage IV patients into prognostic groups, yielding more information with respect to TNM for such a category of patients. When a comparison between TNM and TANIS was performed, it was observed that TANIS had a higher correlation with survival rate, whereas TNM did not add any information in defining the survival function.

Hibernoma of the Neck

A hibernoma is a rare, benign, soft-tissue tumor composed of cells similar to those of brown adipose tissue. Only nine cases in the cervical area have been reported. Typically, hibernomas are asymptomatic and slow growing. Adequate treatment consists of complete excision. We describe an additional case of neck hibernoma and review the literature to clarify a pathologic condition rarely included in the differential diagnosis of cervical masses.

Unresectable primary tumor of head and neck: does neck dissection combined with chemoradiotherapy improve survival?

A study regarding patients with primary and previously untreated advanced histologically proven squamous cell carcinoma of the head and neck was performed to compare two treatment modalities: neck dissection followed by chemoradiotherapy (Group I) versus chemoradiotherapy alone (Group II). Fifty-four patients were randomly chosen to receive Group I or II treatment. Our results demonstrate that Group I treatment has a higher and statistically significant disease-specific survival rate. We suggest that an association of neck dissection plus chemoradiotherapy can be useful in the event of unresectable advanced carcinomas.

Sex hormone receptor levels in laryngeal carcinoma: a comparison between protein and RNA evaluations

The larynx is a secondary sex organ, and the hormone dependence of laryngeal carcinomas is considered an interesting matter of speculation. However, while tumors of other secondary sex organs, including the prostate, breast, and endometrium, have been recognized as hormone-dependent cancers, the laryngeal carcinomas are still subject to controversy. In this study, samples from 15 laryngeal carcinomas obtained at the time of surgery were assayed for specific estrogen alpha, progesterone, and androgen receptor expression, both at mRNA and protein levels. Detectable levels of specific estrogen and progesterone receptors, 53.3 and 73.3%, respectively, were found in the tumors. This positive detection by immunohistochemical analysis was higher in tumors than in normal mucosa adjacent to the tumor areas and was correlated with the absence of metastatic lymph nodes. No androgen receptor protein was detected in any sample analyzed, even if quantitative RT-PCR revealed high mRNA levels specific for this receptor. A strict correspondence between protein and mRNA hormone receptor levels was not found. This is in agreement with the transcriptional and protein synthesis mechanisms, and it is also compatible with the complex larynx tumorigenesis.

Schwannoma of the parapharyngeal space.

A schwannoma (or neurilemmoma) of the parapharyngeal space is a rare tumor in the head and neck region arising from the sheath of cranial nerves and/or the sympathetic chain. In the early stages of growth, there is usually a lack of symptoms because of the anatomical localization and slow growth of the tumor. The large dimension of the mass at presentation makes it difficult to perform a functional surgery, and in many cases the operation worsens the nerve status. The choice of surgical approach is of paramount importance in both preserving nerve function and achieving vascular control. The authors report a case and discuss the English literature.

Akt, protein kinase C, and mitogen-activated protein kinase phosphorylation status in head and neck squamous cell carcinoma

To detect epigenetic changes in head and neck squamous cell carcinoma (HNSCC) and between metastatic and nonmetastatic tumors, we performed a systematic phosphorylation screening on different protein kinases.

Site-dependent survival in cancer of the oral cavity.

&NA; A series of 100 patients affected by primary squamous cell carcinoma of the oral cavity treated at the Ear, Nose, and Throat Clinic of Ferrara from January 1980 to December 1989 was considered in this retrospective study. Data set was classified according to Union Internationale Contre le Cancer staging system. Results showed a crude survival rate at 5 years of 54%. Tumor site of origin and N, adjusted for sex and age of patients were the most important prognostic variables for survival rate. T stage and therapy did not achieve a significant value in the correlation with survival rate when used as covariates in multivariate analysis. The present study demonstrates that survival decreases the closer the tumor origin is to the inner sites of the mouth and in relation to N status. In cases with these characteristics, multimodality treatment protocols are useful in improving survival.

Pro-chondrogenic effect of miR-221 and slug depletion in human MSCs.

In this study we have inhibited the expression of two negative regulators of chondrogenesis, Slug transcription factor (TF) and the small non-coding single stranded RNA microRNA-221 (miR-221), in human mesenchymal stem cells (MSCs). Our aim was test a new approach to guide the cells toward a chondrocyte – like phenotype, without the employment of differentiating agents, in the prospect of their clinical applications for cell-based cartilage tissue engineering. We have characterized these manipulated cells by gene expression analysis at the RNA and protein levels. We demonstrated that decreased miR-221 or Slug induced an increase of chondrogenic markers, including collagen type II (Col2A1), and the positive chondrogenic TFs Sox9 and TRPS1. Slug and TRPS1 are not direct targets of miR-221 since their expression was not affected by miR-221 content. Further, we showed by gene expression and Chromatin Immunoprecipitation analyses that i. miR-221 is positively regulated by Slug in hMSCs, where Slug and miR-221 high levels hamper cell differentiation, and ii. TRPS1 contributes to maintaining low levels of miR-221, both in hMSCs committed toward chondrogenesis by Slug depletion and in chondrocytes, where the low levels of miR-221 and Slug allow a chondrogenic phenotype.Taken together, our data may be relevant both to understand yet unknown miRNA – TF regulatory loops in cartilage biology and to establish new strategies based on a siRNA approach for cartilage tissue engineering.