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Biomedical subjects

A Ferrari

Publications and source records attributed to A Ferrari.

At least 73 records · Page 4Linked to original sources

[Percutaneous transhepatic sphincterotomy].

The authors describe the technique employed for percutaneous transhepatic sphincterotomy as performed on 3 patients with common bile duct (CBD) stones. In all patients, previous endoscopic attempt had failed for anatomical reasons (Billroth II gastric resection or partial gastric resection with Brown anastomosis), and the ampulla could not be correctly incannulated with the sphincterotome. In all patients endoscopy was useful to check the position of the diathermic loop inserted percutaneously. Complete and immediate success was obtained in all 3 cases. No major complications occurred during transhepatic treatment. To date, 1 recurrence has been observed, and the patient has been retreated with bilioplasty. All patients were followed after 5-6 months with US, plain X-rays of the abdomen and blood tests (gamma Gt, alkaline phosphatase, and bilirubinemia). The authors suggest that percutaneous transhepatic sphincterotomy be employed electively in patients with biliary tree diseases in case the endoscopic approach failes.

Aged

Colorectal adenomas containing invasive carcinoma. Pathologic assessment of lymph node metastatic potential.

Adenomas that contain early invasive carcinoma (ACIC) represent the earliest form of clinically relevant cancer of the colorectum in most patients. In order to assess the incidence of nodal metastases of ACIC, we studied 31 patients in whom the colon was resected after endoscopic polypectomy (EP) done from 1975 to 1987. We also reviewed the pathologic features reported in individual cases and in literature series of ACIC with lymph node metastases published from 1958 to 1986. The lymph node metastatic potential of ACIC is relatively high, ranging from an average value of 8.5% in the literature of to 16.1% in our own study, and is equivalent to the range of 10%-17% that occurs in colorectal carcinomas that invade the submucosa. When an ACIC is seen in an EP specimen in which the polypectomy margin is normal, the decision as to whether the patient should enter a follow-up protocol or have radical surgical resection is determined by the assessment of the probability of the occurrence of nodal metastases. According to several authors, certain histopathologic features make it possible to distinguish between an ACIC with a high-risk of nodal metastases versus those with a low-risk. The most relevant pathologic parameters include the state of the resection margins, the grade of the invasive carcinoma, and the presence or absence of vascular invasion. Of 351 cases of ACIC that were operated on, derived from 16 literature series, 45.6% were high-risk cases and 8.5% had lymph node metastases. In our group of high-risk ACIC that had surgical resection subsequently, the lymph node metastatic rate was 35.7%. Our results help to estimate the nodal metastatic potential of early colorectal carcinomas and stress the importance of adequate pathologic evaluation in order to assess metastatic risk in these patients accurately.

Adenoma

Characterization of a novel mouse reticular cell sarcoma M5076 subline resistant to cisplatin.

A novel murine tumor resistant to cis-diamminedichloroplatinum (cisplatin, DDP) was obtained (M5/DDP) after 22 passages in which mice bearing the ovarian reticular cell sarcoma M5076 (M5) were treated with DDP. Although DDP conserved some inhibitory activity on growth of M5/DDP, it was much less effective than on M5. Treatment with DDP did not prolong the survival time of mice with M5/DDP, whereas it markedly prolonged survival of M5-bearing mice. M5 and M5/DDP tumors shared many biological and biochemical features. They were similar histologically, they metastasized reproducibly to the liver and were poorly immunogenic. Their growth rates were comparable; their DNA index, percentage of cells in S phase and intra-cellular glutathione content were also similar. In both tumors, DDP caused an accumulation of cells in S late-G2-M within 24 hr after drug treatment. However, this was efficiently reversed in M5/DDP, whereas it worsened and persisted longer in M5. Cross-resistance was observed between DDP and its analogues carboplatin and iproplatin, but tetraplatin retained marginal activity on M5/DDP tumor. Several alkylating agents tested [L-phenyalanine mustard (L-PAM); cyclophosphamide (CTX); chlorambucil (CLB); 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and dacarbazine (DTIC)] were not totally cross-resistant to DDP, but showed greater activity on M5 than on M5/DDP. Other non-alkylating anti-neoplastic drugs showed a similar degree of activity on M5 and M5/DDP. 5-Aza-2'-deoxycytidine (Aza-d-Cyd) was very effective on both tumors, etoposide (VP-16) and cytosine arabinoside (Ara-C) had no activity and Adriamycin (ADR) was weakly effective.

Animals

Biological osteosynthesis in osteochondral lesions of the talus.

Osteochondral lesions of the dome of the talus whether medial or lateral are rare. Surgical treatment is required when there is a loose body, or when the lesion is symptomatic and resistant to nonsurgical treatment. Usually, the degenerated fragment is removed, followed by curettage and multiple perforations of the subchondral bed, but different methods may be used to reinsert the osteocartilaginous fragment. Having been satisfied with our first studies conducted both on animals and man, we began to reinsert the osteochondral fragment by using resorbable means of synthesis. The purpose of this study is to report our experiences with 3 such cases at a minimum follow-up of one year.

Adolescent

[Prevention of acute neonatal respiratory insufficiency. A method of conditioning the baboon lung during cesarean section].

Preterm baboons at 140 +/- 3 day gestation (term 182 +/- 7 days) have been subjected to lung conditioning, consisting of a series of prolonged inflations of the lungs at 35 cm H2O, followed by approximately 10 min of application of continuous positive airway pressure (CPAP) equal to 15-20 cm H2O, before umbilical cord interruption. The aim of this study was to evaluate, in a primate experimental model, the safety and efficacy in the prevention of neonatal RDS of a technique so far experimented on only in ovine models. Thoraco-pulmonary compliance exceeded the value of 0.2 ml (cm H2O)-1.kg-1 in only 1 animal out of 5 (20%), which didn't develop illness, versus 69% of positive results achieved with the same technique in lambs at 128-130 day gestation, an experimental model considered in the literature as equivalent to a 140 +/- 3 day gestation baboon as far as it concerns incidence and severity of RDS. The application of lung conditioning was easy and safe (as previously reported), but its effectiveness in a primate model is still to be defined.

Animals

[Outlook for the use of the colpocystoproctogram in the pre- and postoperative diagnosis of patients with urinary stress incontinence].

Colpocystoproctography is an X-ray investigation that uses radio-opaque material to highlight the bladder and urethra, vaginal canal and rectum. Twenty-five patients (7 suffering from SUI, 7 operated on for SUI and cured, 7 operated on for SUI with relapse, 4 suffering from prolapse without SUI) were submitted to this X-ray examination so as to determine mutual space relations within the pelvic viscera and the efficiency of their support mechanisms. The following parameters were examined: the anterior angle, the urethro-pelvic angle, the vagino-pelvic angle, the ano-rectal angle, the pubo-vesical distance and the position of the vesical neck with respect to the subpubic margin, in three different pictures recorded at rest, during voluntary contraction of the pelvic floor and in the contrary condition of increase in abdominal pressure. The purpose of the study is to see which data provide useful clinical indications in the pre- and post-operative stages in patients with SUI. The extreme variability of the data under dynamic conditions limits the usefulness of the X-rays taken with the pelvic floor at rest. It can be stated that the anterior angle (a.v. 30 degrees) expresses the anatomic condition of the vesical neck supports; the vagino-pelvic angle (a.v. 106 degrees) is an indicator of the support function of the vaginal walls with respect to the cervico-trigonal region, while good elevation on the neck of the bladder and its closeness to the posterior side of the pubic bone are necessary for complete cure. Colpocystoproctography may therefore represent an important diagnostic tool for assessing what operation is available today as the most suitable for correcting the anatomic defect.

Female

Dose-dependent pharmacokinetics of flavone acetic acid in mice.

The pharmacokinetics of the novel anticancer agent, flavone acetic acid (FAA) were investigated in Balb-c mice treated with i.v. doses of 100 mg/kg or 300 mg/kg, using an HPLC assay. The kinetics of disappearance from plasma was monoexponential and dose-dependent. After 100 mg/kg, the plasma peak level was 250 +/- 11 micrograms/ml, t1/2 was 0.5 h, and AUC was 309 micrograms/ml per h. After 300 mg/kg, the plasma peak level was 710 +/- 57 micrograms/ml, t1/2 was 2.1 h, and the area under the curve (AUC) 1771 micrograms/ml h. Mouse plasma protein binding of FAA was about 70%. As is the case with plasma, in all tissues analyzed, the FAA-AUC values were disproportinately greater after 300 mg/kg than after 100 mg/kg. The highest drug concentrations were found in the liver and small intestine; concentrations were intermediate in lung, heart, and spleen, and lowest in brain. Less than 5% of the FAA dose was eliminated as unchanged drug in the stool. Total excretion of FAA as unchanged drug in the urine collected up to 96 h after drug treatment corresponded to 75% and 60% of the i.v. doses of 100 and 300 mg/kg, respectively. A minor fraction of FAA dose, corresponding to 1% and 6% of the two doses, was eliminated in the urine as a FAA glucuronide or sulfate.

Animals

Large bowel adenomas containing carcinoma--a diagnostic and therapeutic approach.

Adenomas containing invasive carcinoma of the large bowel form the majority of early colorectal cancers. Conclusive histological diagnosis of early colorectal cancer depends on two conditions; first, the whole lesion must be examined and second the resection margin must border on healthy tissue. The presence of certain histopathological features makes it possible to distinguish between cases with high and low risk of having lymph node metastases. Sixty-six adenomas containing invasive carcinoma are reported. They comprised 3.15% of 2,095 adenomas removed by colonoscopic polypectomy during the same period. Five cases were lost to follow-up. Forty-nine patients considered to be at low risk of having lymph node metastases have been treated by endoscopic polypectomy only with a rigorous follow-up regime including CEA estimation, ultrasonography and total colonoscopy at regular intervals. In none have distant metastases been found on follow-up examinations at a mean duration of 3 years. Two of these cases have developed a metachronous colorectal carcinoma and 15 (30.5%) have metachronous adenomas. Two low risk patients with no tumour found in the operative specimen have undergone major surgical resection. Ten high risk cases have been referred for major surgery and lymph node metastases have been found in four (40%). The need for careful histological examination for lymphatic and veinous invasion is stressed by the presence of this finding in all four high risk patients with involved lymph nodes.

Aged

Immunohistochemical study of epithelial cell proliferation in hyperplastic polyps, adenomas, and adenocarcinomas of the large bowel.

A monoclonal antibody to bromodeoxyuridine was used in tissue specimens previously incubated with bromodeoxyuridine to show S-phase cells by immunohistochemical technique. Biopsy specimens of normal mucosa (n = 10), hyperplastic polyps (n = 10), adenomas with low-grade dysplasia (n = 20), adenomas with high-grade dysplasia (n = 10), and invasive adenocarcinomas (n = 10) of the large bowel were studied. Labeling index and cell proliferative patterns were analyzed. No statistically significant difference was found in labeling index between normal mucosa and hyperplastic polyps or between adenomas with high-grade dysplasia and adenocarcinomas. The labeling index was significantly lower in normal mucosa and in hyperplastic polyps than in adenomas and adenocarcinomas (p less than 0.001). The difference in labeling index between adenomas with high-grade dysplasia and low-grade dysplasia was also statistically significant (0.01 less than p less than 0.05). In normal mucosa and in hyperplastic polyps the proliferative zone was confined to the lower two-thirds of the crypt; no kinetic activity was found in the upper portions of the crypt or in surface epithelium. In adenomas the labeled cells were either present in the upper third or scattered along the whole axis of the crypt and in the surface epithelium. Labeling patterns in invasive carcinomas were similar to those observed in adenomas with high-grade dysplasia. The difference in proliferative patterns between hyperplastic polyps and adenomas supports a different significance of the two polypoid lesions in the histogenesis of large bowel cancer; our results confirm the subsequent steps of the adenoma-carcinoma sequence. Immunohistochemical labeling patterns observed with monoclonal antibody to bromodeoxyuridine in polypoid and cancer lesions of the large bowel are similar to those described by autoradiographic studies.

Adenocarcinoma

A morphometric study of liver cell dysplasia.

Thirty-seven cases of cirrhosis with large liver cell dysplasia (LLCD) were evaluated by morphometric analysis and the results compared with those in 11 cases of hepatitis B surface antigen (HBsAg)-positive cirrhosis, 12 cases of cirrhosis with nodules of active regeneration, 15 cases of hepatocellular carcinomas, and 15 cases of inactive cirrhosis. The nuclear-cytoplasmic, nucleolar-cytoplasmic, and nucleolar-nuclear ratios of LLCD were significantly higher than those observed in all other nonneoplastic groups. Whereas the nuclear-cytoplasmic and nucleolar-cytoplasmic ratios of hepatocellular carcinoma cells were significantly higher than those measured in dysplastic cells, the latter had a nucleolar-nuclear ratio similar to that of neoplastic cells. These results show that, in contrast to previously accepted criteria, the nuclear-cytoplasmic ratio of LLCD is increased and that some morphometric features of LLCD are consistent with its supposed premalignant nature. The usefulness of a morphometric analysis in evaluating any group of abnormal-appearing hepatocytes is stressed.

Biopsy

[Effect of the sympathetic activation and its inhibition on left ventricular mechanics in mitral prolapse. Echocardiographic study in 35 patients].

Mitral valve prolapse (MVP) is characterized by arrhythmias, atypical anginal chest pain and left ventricular (LV) wall motion abnormalities. The role of autonomic nervous system (ANS) as the origin of these disturbances is still debated. The aim of the study was to determine the possible interference between left ventricle (LV) mechanics and ANS. 35 consecutive patients with MVP (24 female, 11 male) (mean age 30 +/- 9 years), matched with a homogeneous control group, were examined by means of 2D-Echo during resting conditions and during sympathetic activation induced by passive orthostatism (90 degrees Tilting). At rest, no significant difference was found between the two groups regarding heart rate (HR), LV volume (LVV), ejection fraction (EF). Tilting produced a significant increase in HR (p less than 0.1) and LVV reduction (p less than .01) in both groups; on the other hand, EF did not change significantly. At 2D-Echo, LV abnormal wall motion at rest in 10/35 (29%) MVP, increasing to 17/35 (49%) was found during Tilting. This abnormality consisted in LV wall reduced systolic thickening and motion, localized in the antero-apical region in 11 patients (54%) and in the posterior wall in 6 patients (36%). Thirteen MVP patients with LV abnormal contraction patterns were re-examined after two weeks of beta-adrenergic blockade (200 mg Metoprolol orally per day). In all of them, LV abnormalities disappeared while LVV and EF remained unchanged. These data stress the role of the ANS in inducing LV abnormalities in patients with MVP.

Adolescent