Jejunal perforation for biliary stent dislocation.
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Aged, 80 and over↗
Biomedical subjects
Antonio Licata
Publications and source records attributed to Antonio Licata.
Bilateral Morgagni-Larrey hernia: a rare cause of intestinal occlusion.
Morgagni-Larrey hernia is a rare pathologic finding, representing approximately 3% to 5% of diaphragmatic hernias. Its bilateral presentation is an absolute rarity, and its description is based only on isolated case reports. Two different theories exist about its origin: congenital vs acquired. Morgagni-Larrey hernia is asymptomatic in most cases, but it can also manifest with abdominal or thoracic symptoms. Diagnosis is based on findings from conventional radiography and computed tomography. The only treatment is closure of the herniary pass, even if the patient is asymptomatic. We describe this case because of the absolute rarity of bilateral localization in Morgagni-Larrey hernia and because of its subocclusive symptoms.
Aged↗
Nonproteic antioxidant status in plasma of subjects with colon cancer.
Reactive oxygen species (ROS) could be important causative agents of a number of human diseases, including cancer. Thus, antioxidants, which control the oxidative stress state, represent a major line of defense regulating overall health. Human plasma contains many different nonenzymatic antioxidants. Because of their number, it is difficult to measure each of these different antioxidants separately. In addition, the antioxidant status in human plasma is dynamic and may be affected by many factors. Thus, the relationship between nonenzymatic antioxidant capacity of plasma and levels of well-known markers of oxidative stress (oxidized proteins, lipid hydroperoxides, decreases in thiol groups) better reflects health status. The present study considers antioxidant capacity and oxidative stress in human plasma of patients with colon cancer or precancerous lesions, as well as before and after surgical removal of tumors and/or chemo/radiation therapy. Healthy blood donors were used as controls. Colon cancer patients demonstrated a significant decrease in nonproteic antioxidant status and in total thiol groups with respect to healthy controls, whereas oxidized proteins and lipid hydroperoxide levels were significantly increased. In patients with precancerous lesions, the only unmodified parameter was the thiol group level. After surgery, the levels of oxidized proteins, lipid hydroperoxides, and total thiol groups were restored to those seen in healthy subjects, whereas nonproteic antioxidant capacity remained unmodified from that determined before surgery. Conversely, chemo/radiation therapy increased both nonproteic antioxidant capacity and levels of oxidized proteins and lipid hydroperoxides and significantly decreased total thiol groups. These results further support the hypothesis that oxidative stress correlates to the risk of some forms of cancer, not only in the initial stages but also during progression.
Adult↗
Thermic ablation with RF of liver metastases from colorectal cancer.
Aim of this study was to evaluate the role of radiofrequency ablation in the treatment of the hepatic metastasis of colorectal cancer. From November 1997 to July 2002 49 radiofrequency ablations have been performed in 19 patients (11 male and 8 female; mean age 65 years: range 50-78 years). The disease-free period was between 5 and 32 months. Nodules had a diameter <3 cm in 4 cases while in 3 cases a single lesion was present. One patient had a single lesion after 2 courses of intravenous systemic chemotherapy which had a reduced greater lesion (from 6 to 3 cm) while a 2 cm lesion had disappeared. In the remaining 12 patients the mean number of lesions is 3 (range 1-13) with a diameter between 3 and 12 cm. The radiofrequency ablation has been performed during laparotomy and vascular exclusion through clampage of the liver hilum in 4 cases and percutaneously under ultrasound guide in the remaining 15 cases. All patients underwent follow up by computed tomography, CEA level and ultrasound every 3 months. One patient only has completed a 4 year follow up and is alive without local recurrence but with a cerebral metastasis. The other 18 patients have a 32 months follow up with a survival of 50% (9 on 18). In conclusion in our experience the radiofrequency ablation is a valid alternative method in the treatment of the hepatic metastasis of colorectal cancer.
Aged↗
Lymphoma of the cecum: a case report.
Non-Hodgkin lymphomas present a wider systemic diffusion than Hodgkin lymphomas. Superficial and internal nodes, the tracheobronchial tree, and the digestive tract are almost always affected. The gastrointestinal tract is affected in 50% of the cases; the stomach is the first organ, followed by the small intestine and large intestine. The colon is affected in only approximately 0.4% of cases. The clinical picture of our patient showed abdominal pain, palpable mass, and anemia. Colonoscopy showed a tumor in the cecum (diameter, approximately 10 cm) and the biopsy indicated lymphoma. Through computed tomography, bone marrow biopsy, and measurement of beta2-microglobulin, complete staging was obtained. Right hemicolectomy was immediately performed because the large tumor could determine intestinal occlusion. Definitive diagnosis was non-Hodgkin lymphoma, type mucosa-associated lymphatic tissue B cells with a low grade of malignancy. After surgery the patient underwent six courses of chemotherapy according to the CHOP scheme (750 mg/m2 cyclophosphamide, 1.4 mg/m2 vincristine, 50 mg/m2 adriamicin, and 80 mg prednisone). Two years after surgery the patient shows no sign of the disease.
Antineoplastic Combined Chemotherapy Protocols↗
Gastric cancer: prognostic significance of the Goseki histological classification.
The aim of this study was to evaluate the prognostic significance of the Goseki factor in patients undergoing potentially curative resection for gastric cancer. From 1989 to 1999 202 patients with gastric cancer came in for observation to the Ist Surgical Clinic of Catania University. For the purposes of this study we examined 86 patients with a 5-year follow-up, from whom it was possible to obtain samples which were mounted in paraffin blocks and stained (haematoxylin-eosin and PAS-Alcian blue). The 5-year survival rates of patients with Goseki I and II tumours with good tubular differentiation were 90% and 30% as compared with 42% and 32% in patients with tumours that showed poor tubular differentiation (Goseki III and IV). In contrast, the 5-year survival rates in patients with mucin-poor tumours (Goseki I and III) were 90% and 42%, as against 30% and 32% in patients with mucin-rich tumours (P < 0.05). Our conclusion is that of the two components of the Goseki system, i.e. tubular differentiation and intracellular mucus, mucus production was found to be the more important determinant of clinical outcome. Mucus production has a greater impact on survival than the degree of tubular differentiation and is independent of it.
Adolescent↗
Hydatid disease in a very unusual location: the adrenal gland. A case report.
Hydatid cysts are most often located in the liver and lungs (55-90%), while their location in the adrenal gland is very rare (0.5%). We observed a patient with a hydatid cyst in the adrenal gland, the diagnosis of which was incidental during ultrasonography and computed tomography. The experience acquired in Sicily where hydatid disease is endemic makes serological tests unnecessary, also because they often require a lengthy waiting period and are expensive. The patient had undergone surgery for the treatment of hepatic hydatid cysts. The adrenal localization may be explained as a consequence of secondary dissemination via the blood stream. The cyst developed inside the gland and caused atrophy of the glandular tissue. The surgical treatment called for adrenalectomy as the adrenal gland was entirely occupied by the cyst.
Adrenal Gland Diseases↗
Portal vein thrombosis. A multifactorial clinical entity.
Portal vein thrombosis usually appears in the course of acute abdominal septic complications or after splenectomy, though in 50% of cases no aetiological factors can be identified. In our department we recently treated two patients affected by portal vein thrombosis, the first after splenectomy for haematological disease, and the second after sigmoid diverticulitis. When portal vein thrombosis occurs after splenectomy for haematological reasons, the increased viscosity of the blood due to thrombocytosis is the main factor regarded as being the cause. In the first case, acute abdominal pain appeared 15 days after splenectomy and the diagnosis was suspected and confirmed by Doppler ultrasonography. The clinical course in the second case was less typical, because, although the sigmoid diverticular disease was known, the symptomatology presented with high fever but no clear subjective or objective abdominal picture. The diagnosis was achieved by computed tomography. The clinical picture may vary greatly but usually abdominal pain, fever and intestinal ischaemia are present. Nowadays the diagnosis has improved as a result of the extensive use of Doppler ultrasonography and computed tomography. Fibrinolytic therapy and acetylsalicylic acid are the treatment of choice and in our experience the clinical picture tends to clear up rapidly. When the patient presents a number of risk factors, prophylaxis of portal vein thrombosis should be planned.
Adult↗
Polyamines levels in colorectal cancer: new markers?
BACKGROUND/AIMS: The aim of this study is to evaluate free polyamine and acetyl derivate levels in colorectal cancer, precancerous lesions and a control group in order to investigate if there are different concentrations between neoplastic and non-neoplastic lesions. METHODOLOGY: For this study, in the Department of Surgical Sciences of Catania University we observed 62 patients affected by colorectal cancer, 32 affected by precancerous lesions and 20 used as the control group. In each patient we performed an endoscopic biopsy on the lesion, one 5 cm to the lesion and one 10 cm to the lesion. In each biopsy were detected polyamines concentrations. RESULTS: We found a significant increment of free and acetylated polyamines levels in neoplastic patients in comparison with non-neoplastic. Polyamines levels are increased at the site of cancer in comparison of adjacent colonic mucosa. In addition polyamines levels are increased in normal colon mucosa from cancer patients compared with the mucosa of control patients. CONCLUSIONS: Significant increment of polyamines levels at the site of cancer in comparison of non-neoplastic mucosa and adjacent colonic mucosa give them the possibility to occupy an important role in early detection of colon cancer by acting like oncological markers.
Adult↗
Ancient schwannoma of the facial nerve: a case report.
Ancient schwannomas are rare benign tumours, deriving from neural crest cells. Schwannomas of the head and neck are frequently misdiagnosed and preoperative investigations are often fruitless. We report a very rare case of a patient with a schwannoma of the seventh nerve. T.A., a 43-year-old male, was referred to our department in September 2003 with a 6-month history of a gradually enlarging asymptomatic right neck mass. Ultrasonography of the parotid gland demonstrated the presence of a nodule, with irregular borders, measuring about 2.90 x 2.00 x 1.70 cm. During surgery we found a mass apparently spreading from the parotid gland and therefore we decided to resect the mass together with the gland. The histological examination yielded a diagnosis of ancient schwannoma. Schwannomas are very rare and approximately 25-30% of all reported cases occur in the head and neck, mostly in the eighth nerve, while involvement of the seventh nerve is extremely rare.
Adult↗
Mediastinal ganglioneuroma: a rare and often asymptomatic tumour. A case report.
Ganglioneuroma is a very rare tumour characterised by a slow evolution and arising from cells originating in the neural crest. This type of tumour occurs most commonly in the posterior mediastinum and is considered malignant in childhood and benign thereafter. It grows very slowly and can usually grow to a substantial size without giving rise to an evident clinical picture. We report the case of an 18-year-old asymptomatic patient, who had undergone a medical examination in a military hospital where a chest X-ray revealed a roundish mass in the right lung displacing the trachea to the left. Computed tomography showed that the mass was located in the posterior mediastinum. Surgical resection was performed. The tumour was encapsulated and adhered tightly to the pleura of the costovertebral angle. Histological examination revealed a ganglio-neuroma composed of Schwann cells and mature ganglion cells without any neuroblastomatous elements. This case of a mediastinal ganglioneuroma in a young male patient is a typical example of this rare pathological entity. The totally asymptomatic clinical picture could be explained by the very slow growth of this type of tumour which can displace the surrounding anatomical structures without infiltration.
Adolescent↗
Totally implantable venous access ports: a clinical trial comparing percutaneous versus surgical technique.
Totally implantable venous access ports are valuable instruments for long-term intravenous treatment of patients with cancer, but implantation and use of these devices may be associated with complications. The aim of our study was to compare two implantation techniques in order to establish which one is better for the patient and the surgeon as regards morbidity, surgical time, tolerability, and costs. A prospective study was conducted on a series of 99 patients undergoing implantation of totally implantable venous access ports with surgical cut-down or percutaneous access from January 2000 to June 2004 at the Department of Surgical Sciences, Organ Transplantation and Advanced Technologies. Our experience shows that there are no statistically significant differences between these two techniques in terms of associated morbidity, technical failure, operative time and patient acceptance.
Aged↗