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Biomedical subjects

A M Napolitano

Publications and source records attributed to A M Napolitano.

At least 19 recordsLinked to original sources
PubMed2003

[Clinical study of metastasis of thyroid differentiated carcinoma].

The Authors report 5 cases of distant metastases of well-differentiated thyroid carcinoma over a number of 114 patients operated for thyroid neoplasm (4.3%). In 101 pts was total thyrodectomy performed, in 13 pts underwent istmo lobectomy. Distant metastases were verified in 3 patients with follicular and in 2 patients with papillary carcinoma. In 2 cases the metastases were in lungs, in 2 cases are the bone, and in one patient in lungs and bones. In 3 patients istmolobectomy had been performed at first operation. All the patients were treated with radioiodine. Three patients were alive after 3, 5 e 10 years from the diagnosis of metastases, 2 of them are presently disease free.

Carcinoma↗
PubMed2002

[Reoperations in thyroid surgery].

The Authors examine etiology, incidence and hazards related to reoperation in thyroid surgery either for benign either for malignant pathology. The Authors present, then, 26 secondary operations performed in the Unit of Surgical Pathology of the Department of Surgical Sciences Chieti University: 15 for benign, 11 for malignant pathology. In the cases of thyroid malignant pathology, in 2 patients (operated in different hospitals) there was a parenchimatous recurrence, in 2 patients a lymphnodal recurrence. In all the patients a total thyroidectomy was performed, in one patient associated with lymphadenectomy. In the patients with lymphadenomatous recurrence a functional laterocervical lymphadenectomy was performed.

Follow-Up Studies↗
PubMed1998

Glutathione-related antioxidant defenses in human atherosclerotic plaques.

BACKGROUND: Oxidative stress, resulting from an antioxidant/prooxidant imbalance, seems to be crucial in atherogenesis. Recent evidence has emerged, however, of a surprisingly high content of low-molecular-weight antioxidants in human atherosclerotic plaques, although other antioxidant systems have not been investigated in these lesions. METHODS AND RESULTS: We studied glutathione-related antioxidant defenses (which play a key role in tissue antioxidant protection) in carotid atherosclerotic plaques of 13 patients subjected to endarterectomy and in normal internal mammary arteries of 13 patients undergoing coronary artery bypass surgery. Selenium-dependent glutathione peroxidase activity was undetectable in the plaques of 7 patients; the other 6 patients with plaques showed a mean enzymatic activity approximately 3.5-fold lower than that of mammary arteries. Glutathione reductase activity was also markedly lower in the plaques than in the arteries. Glutathione transferase instead had comparable activity in the two tissues. Remarkably, 5 of the 7 patients with an undetectable selenium-dependent glutathione peroxidase activity but none of the 6 with a detectable one were characterized by multivascular atherosclerotic involvement (3 patients) or stenosis of the contralateral carotid artery (2 patients). CONCLUSIONS: A weak glutathione-related enzymatic antioxidant shield is present in human atherosclerotic lesions. Although the cause of this phenomenon remains to be determined, the present data suggest that a specific antioxidant/prooxidant imbalance operative in the vascular wall may be involved in atherogenic processes in humans.

Antioxidants↗
PubMed1998

[Acute thrombosis of the infrarenal aorta].

The Authors report three cases of patients operated for acute thrombotic aortic occlusion. All the three patients were treated with an aortic transabdominal approach, thromboendarteriectomy and aorto-femoral by-pass. In two patients the result was satisfying, one with a late and partial recovery of the motility of the inferior limbs. One patient died for heart failure in eighth postoperative day. The Authors believe that this unsatisfying result was caused by delay in the surgical treatment (almost 30 hours).

Acute Disease↗
PubMed1997

[Unusual pathology of the spleen].

The Authors report 7 cases of unusual spleen pathology represented by 2 real cysts, 1 pseudocyst, 1 hydatid cyst, 2 abscesses, 1 splenic artery aneurysm. Pathophysiological hypotheses are examined, and clinical and diagnostic considerations are stressed, evaluating particularly anatomo-histologic characteristics and the differential diagnosis through non invasive imaging techniques. All patients were subjected to splenectomy via laparotomy, except for the case of real cyst where an inferior hemisplenectomy was performed. In the case of splenic artery aneurysm, an urgent aneurysmectomy was required together with splenectomy, considering the young age of the patient (29 years old), and the type of aneurysm presenting in a double rupture phase. Reoperation was necessary in only one patient to drain an hematic abscess. After a 9 year follow up all the patients are well.

Abscess↗
PubMed1997

[Personal experience in the treatment of carcinoma of the head of the pancreas].

The Authors report 195 cases of carcinoma of the head of the pancreas observed in the period 1983-1995. Only 94 (48%) of these patients were operated: in 32 cases an exploratory laparotomy was performed, while in 36 a bilio-digestive bypass, associated in 2 patients with a gastro-jejunal bypass was assured. In 26 patients a resection was performed: in 12 a Whipple procedure, in 6 a total duodenopancreatectomy, in 8 a pylorus preserving procedure (Traverso-Longmire). The mean survival was 2 months after laparotomy, 6 months after bilio-digestive bypass, 20 months after Whipple procedure, 20 months after total duodenopancreatectomy, 23 months after a pylorus preserving procedure (Traverso-Longmire). The Authors believe that the Whipple procedure is the treatment of choice for the carcinoma of the head of the pancreas. Only in cases of suspected multifocality or when there is a severe nodal involvement it is advisable to perform a total duodenopancreatectomy.

Biliopancreatic Diversion↗
PubMed1996

[Skeletization of the inferior mesenteric artery in colorectal surgery. Current considerations].

Anastomotic dehiscence after colon resection is the most frequent complication in colon surgery and the main cause of post-operative death. In the light of anatomical peculiarities of the blood supply to the rectum, it would appear that in atherosclerotic patients with impairment of hypogastric arteries (80% in authors' series out of 200 atherosclerotic subjects) inferior mesenteric artery ligature, determining vascularization of the rectal ampulla by the distal vessels alone, results in an insufficient supply in case of colo-rectal anastomosis. A series of 15 cases of cancer of the left and sigmoid colon, treated with left hemicolectomy, preservation and peeling of the inferior mesenteric artery, is reported. In the follow-up ranging from 6 months to 5 years, no anastomotic dehiscence was observed and only one case (7.5%) presented hepatic recurrence after two years. The other patients are all alive and disease free.

Aged↗
PubMed1995

Carotid bifurcation stenosis: a comparative study between MR angiography and duplex scanning with respect to digital subtraction angiography.

PURPOSE: This study compared sensitivity, specificity and diagnostic accuracy of Echoduplex and Magnetic Resonance Angiography (MRA) in the evaluation of carotid bifurcation stenosis. MATERIAL AND METHODS: Twenty-five patients with clinical signs suggestive for cerebrovascular insufficiency (CVI) were studied with Duplex scan, MRA and Digital Subtraction angiography (DSA). Gold standard was the angiographic examination. RESULTS: on equal value of sensitivity (80.5%), MRA showed 96% specificity versus 81% of Duplex scan, 89.4% diagnostic accuracy versus 80.9% for Duplex scan. As for stenosis over 31%, the value of sensitivity did not change i.e., 80.5%; MRA showed 100% specificity versus 97.1% for Duplex, 91.2% diagnostic accuracy versus 89.1% respectively. These values compared by the test for categorial analysis and correspondence analysis (p < 0.05) did not indicate any statistically significant difference. DISCUSSION: on the basis of our experience and as shown by current literature [2, 12] we can state that both MR-angiography and Duplex scan fail in quantifying correctly carotid stenosis with consequent over- and underestimation [3, 4]. However, they can be considered effective diagnostic procedures in a screening program [12, 16]; they are accurate, safe and accepted by the population. CONCLUSIONS: on the basis of the cost in planning the screening of a population at risk for CVI, Duplex scanning is still to be considered the elective procedure.

Adult↗
PubMed1994

Antiproliferative effect of desferrioxamine on vascular smooth muscle cells in vitro and in vivo.

Vascular smooth muscle cell (VSMC) growth is a primary component of accelerated and spontaneous atherosclerosis. Previous studies have shown that iron may be involved in the control of enzymatic activities that modulate DNA synthesis in human cells. In this study the effects of the iron chelator desferrioxamine on in vitro and in vivo VSMC proliferation were tested. Rat VSMCs in culture and a rabbit model of carotid artery balloon injury were used. Desferrioxamine showed a significant inhibitory effect on [3H]thymidine incorporation in cell cultures that was antagonized by iron supplementation. Desferrioxamine also provided effective preventive myointimal VSMC proliferation as assessed by bromodeoxyuridine labeling and morphometric analysis of endoluminal stenosis. These experiments suggested that iron may be involved in the control of VSMC proliferation and that desferrioxamine may have a role in preventing VSMC growth and myointimal proliferative lesions.

Animals↗
PubMed1992

Role of oral cholecystography, real-time ultrasound, and CT in evaluation of gallstones and gallbladder function.

The capacity of oral cholecystography (OCG), real-time ultrasound (RUS), and computed tomography (CT) to detect gallstones and to analyze their size, number, and composition was tested preoperatively in 37 patients undergoing elective cholecystectomy. Gallbladder response to a standard meal was also evaluated by OCG and RUS. Gallstones were analyzed chemically for calcium, cholesterol, and bilirubin content. The results show that RUS is the most valuable test for detecting gallstones and is similar to OCG in measuring their size and number, whereas CT underestimates the stone size. Gallbladder function in terms of contractibility can be evaluated by RUS and OCG, but RUS provides useful information even if the gallbladder is not opacified at OCG. CT is more accurate than OCG in detecting the presence of calcium, and CT attenuation numbers are positively correlated with calcium content of the stone (r = 0.87, p less than 0.01).

Cholecystography↗
PubMed1990

[Carcinoma of the male breast. Our experience].

A case series of 5 male patients afflicted with breast carcinoma is reported. The Authors describe symptomatology, diagnostic iter, principles of surgical treatment and results. Underlined is the wider surgical demolition in male breast cancer in comparison with females, even if natural history and biological conduct are comparable. This is because in male breast carcinoma the local and remote infiltration is more rapid than female for the less development of breast gland. Finally, indications for radiochemotherapy are comparable to female breast cancer.

Adult↗
PubMed1986

[Prognostic factors in gastric carcinoma].

A personal experiment conducted on 80 gastric carcinoma patients requiring radical surgery at the Special Surgical Pathology Institute is reported. The aim of the study was to identify and assess the factors capable of influencing prognosis e.g. sex, age, TNM, type of operation, symptoms etc and to make a comparison with data from the international literature.

Adult↗