[Experimental study of acute ischemia of the limbs. 3].
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Acute Disease↗
Biomedical subjects
A Bolognese
Publications and source records attributed to A Bolognese.
Surgical treatment of immune thrombocytopenic purpura.
The role of surgery in the treatment of immune thrombocytopenic purpura (ITP) is still discussed. The aim of this study was to verify our criteria of patient selection for splenectomy, to analyze the results of a protocol for the evaluation of the hemorrhagic risk, and to discuss long-term results of 70 patients with ITP who underwent surgical treatment from 1984 to 1990. All patients received steroid therapy. Sixty-two patients were given high doses of IgG (600 mg/kg/iv bolus) pre-operatively in order to obviate the need for intra-operative platelet transfusions. Forty-three patients showed a significant increase in the platelet count, 8 a moderate increase, while 11 patients did not respond. No operative mortality was observed, however postoperative minor complications occurred in 14 (20%) patients. Accessory spleens were found in 11 (15.7%) patients. Mean follow-up was 21 months. Response to splenectomy was considered as complete (platelets greater than 150,000 mm3 with no need for medical treatment) in 63 (90%) patients. No response was observed in 7 patients. In 2 of the non-responders postoperative indium-111 scan revealed accessory spleens and ITP remitted after accessory splenectomy. All non-responders were in the group of patients who did not respond to the pre-operative infusion of high dose IgG. It can be concluded that splenectomy is a safe and effective treatment for ITP and that response to pre-operative infusion of IgG may be considered as predictive for the outcome after splenectomy.
Adolescent↗
A study of sentinel node biopsy in T1 breast cancer treatment: experience of 48 cases.
Axillary clearance in breast cancer has been proven to be unnecessary in more than 50% of cases. Sentinel node biopsy (SNB) is a new technique that can be used to avoid unnecessary axillary clearance in breast cancer surgery. Our integrated team, consisting of surgeons, pathologists and nuclear medicine physicians, studied 48 cases of T1 breast cancer with lymphoscintigraphy-guided SNB. Before starting this study, the team performed 20 SNBs as a learning procedure. 500 microCi of 99mTc-nanocoll in 0.2 mL were injected around the lesion, under US or x-ray guidance if necessary. Static images in anterior, lateral and lateral oblique view collected at the end of a 20 min dynamic study were used to mark the SN on the skin. During surgery a gamma probe was used to guide SN resection, and node invasion was assessed with cytokeratin immunohistochemistry. In 14 patients tracer uptake was observed in a single node, in 30 patients in 2-4 nodes, whereas in four patients the nodes were scintigraphically missed. Surgical resection was possible in 42 nodes out of 54. All but two patients with negative immunohistochemistry for cancer cell clusters showed metastasis-free axillary nodes. All patients with positive SNBs (13) showed involved axilla. In four patients the lymphatic drainage was towards the intramammary chain; one node was juxtaclavicular and one node was intramammary in the upper outer quadrant. The overall sensitivity of the method was about 80%, the specificity about 90% with a diagnostic accuracy about 80%. SNB is a promising method for surgical decision-making regarding axillary clearance in breast cancer. Adequate training of an interdisciplinary team is needed in order to successfully perform SNB and assess SN invasion. Its unusual anatomic location can be encountered and technical care is necessary to correctly identify and remove them.
Axilla↗
Quantitative structure-activity relationships in a set of thiazolidin -4-ones acting as H1-histamine antagonists.
A series of 2-(3- and 4-substituted phenyl)-3-[3-(N, N-dimethyl-amino)propyl]-1,3-thiazolidin-4-ones acting as H1-antihistaminics was investigated with a combined Hansch-CoMFA approach. The substituents at the 3- and 4-positions of the phenyl ring have been described through steric, electronic and hydrophobic parameters and correlated with pA2 values. The obtained quantitative models suggest that affinity to the receptor is promoted by hydrophobic and small 4-substituents and by 3- and 4-substituents generating a positive electrostatic potential towards a complementary receptor region.
Animals↗
[Malignant biliary papillomatosis: a case report].
The aim of this study was to describe the clinico-pathological characteristics of malignant biliary papillomatosis and the diagnostic and therapeutic approach adopted in this case, which extended from the left hepatic biliary duct to the bifurcation of the 2nd and 3rd segments. The patient was studied with ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), CT scan and MRI cholangiography, which showed the morphological characteristics and the extent of the disease in the biliary tract. The malignancy of the disease was confirmed by preoperative cytological analysis of bile collected via a nasobiliary probe. The surgical treatment, preceded by intraoperative ultrasonography, consisted in a left hepatectomy, sparing the 1st segment, and a right intrahepatic jejunostomy. The final pathological analysis revealed a malignant biliary papillomatosis. Preoperative ERCP clearly documented the exact distribution of the biliary tract lesions and allowed both treatment of the cholestasis and diagnosis of the nature of the lesion through cytological analysis of the bile. Surgical treatment must be carried out and guided not only by the preoperative diagnosis, but also by perioperative ultrasonography. Finally, owing to the rarity of such cases and consequently our very limited knowledge of the disease, an intensive follow-up is recommended.
Bile Duct Neoplasms↗
[Bases and future perspectives of oncologic surgery in the integral treatment of advanced neoplasms].
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Disease Progression↗
[Physiopathological bases and the role of oncologic surgery in the formation of general surgeon].
Surgical oncology can currently be definite "bio-surgery" in as more frequently uses in pre-, intra and postoperative phase biological substances what growth factors, cytokines, anti-adhesion and neoangiogenesis inhibiting molecules with a potential reduction of the local recurrences and improvement of survival rates. The increasing and continuous development of the genic therapy, cellular therapies, immunotherapy, chemotherapy and radiotherapy in the cancer treatment, "force" surgeon to interrogate himself on the role of the radical surgery through the "advanced" tumors of the digestive tract. Surgery alone, continuous to be in terms of recovery, the most effective treatment against tumor, (62% of the recoveries), also if its combination with other therapies improve the results especially in the advanced tumors. Chemotherapy has had positive results in the treatment of solid tumors, sometimes like adjuvant or neoadjuvant treatment to a radical surgery, improving the survival rates. Surgical oncology of "tomorrow" must be necessarily a quality surgery performed from a surgeon possessing some necessary requisite: technical ability, specific base-formation on physiopathologic knowledge in constant evolution, standardization ability of surgical techniques and therapeutic protocols. Such requisite will allow surgeon reach the main goal of surgical oncology what the local control of tumor, reduction of local recurrences, offer an good enough quality of life getting all the possible information on the local development of tumor and on the ways of diffusion. All these elements will be necessary for formulate a reliable prognostic judgment, more and more requested from the patients.
General Surgery↗
[Prognostic factors and results of surgical treatment of pelvic recurrence of rectal cancer].
From 1990 to 2003 have been admitted 105 patients with pelvic recurrence from rectal cancer. Fifty-nine patients have been selected and 25 patients underwent surgery. We evaluate the prognostic factors and the 3 years disease-free survival. The 60% of the patients after R0 resection and the 20% of the patients who underwent R1-R2 resection are alive. The evaluation of the prognostic factors allows early diagnosis of recurrence with a better long time survival.
Female↗
[Molecular epidemiologic analysis of the levels of metalloproteases and cyclooxygenase-2 in colorectal cancer].
The aim of this work is the investigation of the level of expression of the vascular endothelial growth factor (VEGF) and metalloproteases (such as Cox-2) in the colon rectal cancer. The final goal is the correlation with liver metastases. Molecular biology approaches will be adopted: in particular: RT-PCR, quantitative real time PCR with fluorescent probes, immunolocalizations and Western blotting This is a proposal of research. The work is under development and results and conclusions cannot be at the moment anticipated. However, in recent publication we found human polyomavirus DNA sequences in colorectal tumors.
Colorectal Neoplasms↗
Anti-inflammatory drug incorporation into polymeric nano-hybrids for local controlled release.
In this paper we present the formulation, preparation and characterization of new polymeric composite materials containing a nano-hybrid to be used for the controlled molecular delivery of an anti-inflammatory molecule, Diclofenac. The nano-hybrid consists of a layer of double hydroxide of an Mg-Al hydrotalcite type, in which we replaced the chloride anions present in the host galleries with Diclofenac anions by a simple ion-exchange reaction. Different amounts of the hybrid material were incorporated in polycaprolactone and processed as films of 0.15 mm thickness. The composite materials were analyzed by X-ray diffractometry, thermogravimetry and for their mechanical properties, and showed properties even better than those for the pristine polymer. The release process of the anti-inflammatory molecules was very interesting and promising for tuneable drug delivery. It consists of two stages: a first stage, very rapid as a burst in which a small fraction of the drug is released, and of a second stage that is much slower, extending for longer and longer periods. The parameters influencing the drug release were individuated and discussed.
Anti-Inflammatory Agents, Non-Steroidal↗
[Surgery of lymphoma].
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Duodenal Neoplasms↗
[Melanosis of the colon. Considerations on 101 cases].
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Adult↗
[Role of surgery in the treatment of primary gastric lymphoma].
Recently the role of surgery in the LGP treatment is reviewed. 30 cases of LGP are reported; GT was in 9 cases performed, GST in 21 cases. All the patients were included in a therapeutical protocol as chemo and/or radio-therapy as adjuvant treatment. Two patients treated with GT died; the medial survival ranged was 30.5 months for the patients in stadium Ie, 52 months for the patients in stadium IIe and 15 months for the patients in stadium IV. The central role of surgery for treatment of this lesion is underlined; finally the role of adjuvant therapy is emphasized in the improvement of long-term survival.
Adult↗
p53 immunostaining in differential diagnosis of pleural mesothelial proliferations.
We evaluated tissues for the overexpression of p53 protein in 35 malignant mesotheliomas and 20 reactive pleural hyperplasias, obtained from open biopsies or pleurectomies. Of the 35 neoplasms investigated, 30 (85.7%) displayed positive nuclear staining for p53. No staining was seen in any specimens of hyperplasia. We found no significant statistical difference in p53 expression when we compared p53 overexpression in the different histological subtypes of mesotheliomas. Moreover, p53 overexpression did not correlate in a statistical manner with survival. We conclude that p53 overexpression is a frequent feature of pleural mesothelioma and is useful for routine differentiating between malignant and non-neoplastic mesothelial alterations. The reason for p53 overexpression in mesothelioma, however, remains to be determined.
Adult↗