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Biomedical subjects

A A Tempia-Caliera

Publications and source records attributed to A A Tempia-Caliera.

5 recordsLinked to original sources

[Visceral surgery].

Visceral surgery has benefited from several significant therapeutical improvements in 2005. They involve more specifically endocrine surgery, obesity, ovarian cancer, rectocele and cystic pancreatic neoplasia. Minimal invasive surgery is increasingly used, for example in endocrine conditions and obesity treatment. New techniques also emerge, such as electrical gastric stimulation for obesity or Stapled Trans Anal Rectal Resection (STARR) for anterior rectocele. Accurate diagnosis criteria allow better management of cystic pancreatic neoplasia, especially to choose the best treatment of this condition.

Bariatric Surgery↗

[Surgery].

The evolution of visceral surgery is characterized by defining with ever increasing precision the real role of new techniques. Hernia repair, abdominal compartment syndrome, pancreatic and colorectal cancers, as well as haemorrhoids, confirm this reality. Although laparoscopy has clear indications in hernia repairs, many still prefer open approach. The abdominal compartment syndrome, now better understood thanks to laparoscopy, is increasingly important in intensive care. The role of laparoscopy for pancreatic and colorectal cancers is still limited. The development of minimally invasive techniques has led to a reduced morbidity of surgery for haemorrhoids and better results. The economic impact of new technologies must remain a primary concern.

Compartment Syndromes↗

Mesenteric inflammatory veno-occlusive disease: a rare cause of intestinal ischemia. The first description of recurrent disease.

BACKGROUND: Mesenteric inflammatory veno-occlusive disease (MIVOD) is a rare cause of intestinal ischemia of unknown etiology. Histologically, MIVOD is characterized by extended thrombophlebitis and fibrous organized thrombosis of multiple veins. The arteries are by definition not involved. Management includes surgery in all cases described. Recurrence has not been described until now. METHODS: We describe the case of a 64-year-old woman operated with the suspicion of intestinal ischemia. Clinical and histopathological characteristics are reported. RESULTS: The patient underwent a right hemicolectomy and segmental resection of the terminal ileum 15 months later for a recurrence. The histological examination of the resected specimen confirmed the diagnosis of MIVOD and a recurrence thereof. CONCLUSION: MIVOD is a rare cause of colonic ischemia. Recurrence of the disease, which is described here for the first time, is unusual after surgical resection.

Colitis, Ischemic↗

Differential expression of metastasis-associated genes in papilla of vater and pancreatic cancer correlates with disease stage.

PURPOSE: Papilla of Vater cancer has a much better prognosis than pancreatic cancer. It is not known whether this is the result of differences in the tumor biology of the two malignancies. Because metastasis formation is a critical step in tumor progression and a negative prognostic factor, we compared the expression of nm23-H1 and KAI1, two metastasis-suppressing genes, in papilla of Vater cancer and pancreatic cancer. PATIENTS AND METHODS: Analysis was performed in nine normal human papilla of Vater samples, 27 papilla of Vater cancers, 16 normal pancreatic samples, and 29 pancreatic cancers. Expression of nm23-H1 and KAI1 was analyzed by Northern blot analysis and in situ hybridization. In addition, immunohistochemistry was performed to localize the respective proteins. RESULTS: There was no difference in nm23-H1 and KAI1 mRNA expression levels in normal versus cancerous papilla of Vater samples. In contrast, nm23-H1 and KAI1 RNA expression was upregulated in early tumor stages of pancreatic cancer and reduced in advanced tumor stages. When expression of nm23-H1 and KAI1 RNA was analyzed by use of in situ hybridization, normal epithelial cells of the papilla of Vater exhibited mRNA staining intensity similar to that of papilla of Vater cancer cells. Similar levels of nm23-H1 and KAI1 immunoreactivity also were observed in these samples. In contrast, early stage pancreatic cancer samples exhibited stronger nm23-H1 and KAI1 immunoreactivity than normal controls. Furthermore, early pancreatic cancer stages exhibited higher KAI1 and nm23-H1 immunostaining than advanced tumor stages. CONCLUSION: Differences in the expression patterns of the two tumor suppressor genes nm23-H1 and KAI1 may contribute to the different prognoses of papilla of Vater cancer and pancreatic cancer. Our findings support the hypothesis that biologic differences rather than earlier diagnosis influence the different outcomes of these two tumor entities.

Adolescent↗

Duodenum-preserving pancreatic head resection: future standard operation in chronic pancreatitis.

As the incidence of chronic pancreatitis (CP) has risen in most industrialized countries due to increasing alcohol intake, operative therapy has gained importance, and various new operative procedures have been introduced in the past two or three decades. With pancreatic duct drainage operations, pain relief is frequently not satisfactory in long-term follow-up. Pathological studies in combination with modern molecular biology investigations, suggests that the pancreatic head is the "pacemaker" of the disease in most CP patients. Therefore, surgical procedures which aim to remove pancreatic head-related CP complications are needed in most patients. The Whipple operation, which was originally developed to treat malignancies in the pancreatic head region, follows oncological criteria and can therefore be considered surgical overtreatment in the majority of CP patients. As an alternative, the duodenum-preserving pancreatic head resection (DPPHR) was introduced by Hans Beger in 1972 to preserve the stomach, the extrahepatic bile duct and the duodenum. DPPHR is an organ-preserving surgical procedure which provides satisfactory long-term results with regard to mortality, morbidity, pain relief, weight gain and social and professional rehabilitation. Among the operations currently available, DPPHR is the best choice for a new standard operation in patients with pancreatic head-related complications.

Chronic Disease↗