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Biomedical subjects

A Puglionisi

Publications and source records attributed to A Puglionisi.

At least 19 recordsLinked to original sources
PubMed1986

Venous involvement by follicular carcinoma of the thyroid gland.

Involvement of the great veins by thyroid neoplasms is a rare event: to date 9 cases have been reported and only 2 of them have been surgically treated. The authors describe a case of follicular thyroid carcinoma involving the proximal tract of the left innominate vein at its confluence with the superior vena cava: a neoplastic bud was protruding into the lumen, but the endothelial lining appeared to be perfectly preserved. Full radicality was obtained by a major vascular procedure.

Adenocarcinoma↗
PubMed1985

Clinical staging of rectal cancer. Results of a prospective continuing study.

78 patients with rectal adenocarcinoma were studied with a diagnostic protocol in order to obtain a TNM clinical stage in the preoperative period. Each patient underwent digital rectal examination, proctoscopy, double contrast barium enema, pelvic CT scan, liver ultrasound and chest x-ray. The degree of infiltration of the rectal wall by the tumor and the presence or absence of node and liver metastases were evaluated. After resection all specimens were studied by a pathologist who defined the pathologic stage. Data obtained by each diagnostic procedure were compared with the pathologic data. For each method, accuracy, specificity and sensitivity were evaluated. Each method showed an equivalent accuracy (100%) to detect infiltration of the muscularis of the rectum. Data were less accurate in identifying extraparietal tumor invasion. Accuracy was 79% for rectal examination, 74% for double contrast barium enema and 72% for pelvic CT scan. In the evaluation of lymph-node involvement, accuracy was 77%, specificity 74% and sensitivity 80%. Liver metastases were detected with 94% accuracy, 97% specificity and 50% sensitivity.

Barium Sulfate↗
PubMed1985

[Leiomyosarcoma of the inferior vena cava].

Leiomyosarcoma is a rare tumor of soft tissues. The inferior vena cava is affected infrequently, a literature review showing only 66 cases reported previously, 29 of these patients undergoing radical surgery. The case described was diagnosed during operation for gallstones, and the lesion was excised radically using an original technique. Experience of this case and opinions of various authors who have treated similar cases suggest that the factors determining choice of therapy are: the caval segment involved, an effective collateral circulation, longitudinal or circumferential extension of the affected vascular wall, the presence or absence of neoplastic or hepatic thromboses.

Adult↗
PubMed1984

[Cavoauricular thrombectomy under extracorporeal circulation and right superior lobectomy for paraneoplastic thrombosis in a case of lung cancer].

A patient with superior vena cava thrombosis from cancer of the right lung is described. The particular interest of this case resides in: The numerical scantiness of cases reported in the literature: 12 cases reviewed; The exceptional nature of the etiopathogenic mechanism: paraneoplastic thrombosis; and the more precise problems relating to the indication, technique and tactics with respect to surgery.

Adenocarcinoma↗
PubMed1984

Effectiveness of intraoperative L.E.S. pressure measurement during Nissen-Rossetti fundoplication.

A study was made to evaluate the effectiveness of Lower Esophageal Sphincter Pressure (L.E.S.P.) measurement during Nissen antireflux procedure. Thirty-five patients affected by reflux esophagitis were submitted preoperatively to X-ray examination, endoscopy and esophageal biopsy, intraluminal esophageal manometry and 24 hour pH monitoring of the distal esophagus. Intraoperative measurement of L.E.S.P. was performed before and after Nissen fundoplication. In 30 patients a follow-up (average 32 months after surgery) was performed by clinical, radiographic and pH (24 hour monitoring) evaluation. Complete relieve of symptoms was obtained in patients showing a L.E.S.P. between 25 and 30 mm Hg after fundoplication. Symptoms of "post-fundoplication syndrome" were observed in two subjects with a L.E.S.P. more than 30 mm Hg. On the other hand, one patient with sphincteric pressure of less than 25 mm Hg suffered from postoperative recurrence of gastroesophageal reflux. The effectiveness of intraoperative L.E.S.P. measurement to verify the adequacy of Nissen fundoplication is emphasized. It is also postulated that good results can be obtained when surgical repair is associated with a range of intraoperative sphincteric pressure between 25 and 30 mm Hg.

Adult↗
PubMed1984

[Left inferior vena cava and aneurysm of the abdominal aorta].

A case of isolated left-sided inferior vena cava, without situs inversus, in a patient with abdominal aortic aneurysm is reported. On the basis of a review of literature, the authors recall the incidence and the embryology of this anomaly, and analyze its surgical implications, with particular reference to abdominal aortic surgery.

Aorta, Abdominal↗
PubMed1983

Post-gravidic Budd-Chiari syndrome treated by mesocaval H-graft shunt.

A new case of Budd-Chiari syndrome following pregnancy is reported. The patient, shortly after her second normal delivery, showed clinical evidence of hepatic venous outflow impairment. The diagnosis of Budd-Chiari syndrome was supported by angiographic studies, computed tomography, liver scanning and histology. Because of the poor results reported in the literature following medical treatment, portosystemic shunting was considered. At laparotomy, due to the huge caudate lobe hypertrophy, a mesocaval H-graft shunt was performed, using a 10 mm woven Impraflex graft. The patient is well, with normal liver function tests, 24 months following the procedure.

Adult↗
PubMed1983

Rupture of multiple hepatic adenoma and oral contraceptive use: a case report.

A 38-year-old woman was seen with a hemoperitoneum caused by rupture of a hepatic adenoma of the right lobe. The patient had been taking oral contraceptives for ten years, but discontinued their use three years previously. During the postoperative course a second adenoma of the contralateral lobe, not diagnosed at the first operation, ruptured. The relationship between oral contraceptive use and hepatic cell adenoma is briefly reviewed.

Adenoma↗
PubMed1980

[Hepaticoportal arteriovenous fistula: a case report, discussion of physiopathological and clinical problems, and review of the published literature (author's transl)].

A patient developed an arteriovenous aneurysm between the gastroduodenal and middle colon arteries and the main mesentericoportal vein, following gastroduodenal resection. This case is described, and patients with arteriovenous fistulae in the portal region reported in the published literature (179 cases) are reviewed. Etiological, pathological, and clinical aspects in relation to surgical treatment and according to the type and location of the lesion, are also discussed. Emphasis is placed on a study of physiopathological problems, and the effects provoked by these fistulae on portal vein hemodynamics, arterial hemodynamic function, and on the general circulation are analyzed in greater detail.

Arteriovenous Fistula↗