Biomedical subjects

Carmine Alfano

Publications and source records attributed to Carmine Alfano.

13 recordsLinked to original sources

PubMed2006

Giant meta-typical carcinoma: an unusual tumor.

Meta-typical carcinoma (MTC) or basosquamous carcinoma is a remarkable malignancy with features of both basal and squamous cell carcinoma. It is typically located on the back and face, often with clinical features of basal cell carcinoma but tending to be more aggressive with enhanced prospects of lymph node or distant metastases. Our report describes a huge neglected MTC of the back of ten-year duration, a giant ulcero-vegetative tumor measuring 20 x 25 cm. Histologic examination of specimens from the margins and periphery revealed aspects of both basal and squamous cell carcinoma, while the ulcerated center showed sclerotic tissue without tumor. Radical excision and reconstruction by grafts were performed. No metastases were observed after two years. There are many controversies surrounding the histologic definition and biologic behavior of MTC, including its metastasizing potential. The MTC we describe exhibited benign biologic behavior. This may have been related to an intense inflammatory host response with elimination of neoplastic tissue and consequent local sclerosis evident in the central tumor-free portion. This central tumor regression is to our knowledge a unique finding in MTC.

Aged↗

PubMed2005

Low plasma coenzyme Q10 levels as an independent prognostic factor for melanoma progression.

BACKGROUND: Abnormally low plasma levels of coenzyme Q10 (CoQ10) have been found in patients with cancer of the breast, lung, or pancreas. OBJECTIVE: A prospective study of patients with melanoma was conducted to assess the usefulness of CoQ10 plasma levels in predicting the risk of metastasis and the duration of the metastasis-free interval. METHODS: Between January 1997 and August 2004, plasma CoQ10 levels were measured with high-performance liquid chromatography in 117 consecutive melanoma patients without clinical or instrumental evidence of metastasis according to American Joint Committee on Cancer criteria and in 125 matched volunteers without clinically suspect pigmented lesions. Patients taking CoQ10 or cholesterol-lowering medications and those with a diagnosis of diabetes mellitus were excluded from the study. Multiple statistical methods were used to evaluate differences between patients and control subjects and between patients who did (32.5%) and did not (67.5%) develop metastases during follow-up. RESULTS: CoQ10 levels were significantly lower in patients than in control subjects (t test: P < .0001) and in patients who developed metastases than in the metastasis-free subgroup (t test: P < .0001). Logistic regression analysis indicated that plasma CoQ10 levels were a significant predictor of metastasis (P = .0013). The odds ratio for metastatic disease in patients with CoQ10 levels that were less than 0.6 mg/L (the low-end value of the range measured in a normal population) was 7.9, and the metastasis-free interval was almost double in patients with CoQ10 levels 0.6 mg/L or higher (Kaplan-Meier analysis: P < .001). LIMITATIONS: A study with a larger sample, which is currently being recruited, and a longer follow-up will doubtlessly increase the statistical power and enable survival statistics to be obtained. CONCLUSIONS: Analysis of our findings suggests that baseline plasma CoQ10 levels are a powerful and independent prognostic factor that can be used to estimate the risk for melanoma progression.

Adult↗

PubMed2005

Prospective study on Trilucent soybean oil-filled breast prosthesis.

BACKGROUND: The use of Trilucent breast implants dates back to 1995. These implants were produced in an attempt to overcome the perceived shortcomings of other implants filled with saline and silicone gel. The filler material, which was derived from soybean oil, was said to be biodegradable and biocompatible. When this prosthesis was subsequently found to be prone to rapid aging and rupture of the silicone shell, the company that manufactured this implant decided to withdraw it from the market and offered to remove or replace all Trilucent prostheses. METHODS: The authors present a clinical study of the Trilucent implant in which 36 patients received a total of 63 implants and 33 patients had 58 implants removed. The authors also examined the implant shell of the removed prostheses to investigate the possible cause of silicone implant aging and rupture. RESULTS: Each of the implants removed was carefully inspected visually, and samples of the implant shell were analyzed by scanning electron microscopy. All the implants removed had a very bizarre appearance; they were variegated in color, with shades of yellow and brown, and were studded with whitish yellow nodules whose number grew in proportion to the time the prosthesis was implanted. Scanning electron microscopic analysis of the implant shell revealed a heterogeneous inner surface of the implant together with fissures and globoid deposits on the cut surface. CONCLUSIONS: The authors' findings on Trilucent implants are similar to those reported in previously published studies for other types of breast implants for the first 2 years after implantation, after which a progressive, rapid deterioration was observed.

Adult↗

PubMed2005

Lubricant and razor debridement in partial thickness burn.

By aiming to relieve pain from removing blisters in partial thickness burn, we tested whether the application of a sterile lubricant (KY-Jelly) on blisters and the use of a sterile razor to remove their roof can reduce algesia in humans, compared to a conventional method. A prospective randomized controlled designed study was performed on 20 patients. A visual pain scale was used by patients to evaluate pain experienced.

Adult↗

PubMed2004

Mammary compliance: an objective measurement of capsular contracture.

Capsular contracture is the most unpredictable complication after mammary augmentation. It presents an uncertain evolution, and is one of the most difficulty complications to treat. Evaluation of this condition usually was relegated to the surgeon's judgment, but currently there are three methods for measuring capsular contracture: palpation, applanation tonometry, and measure of mammary compliance. A prospective study was conducted to evaluate the different methods for managing capsular contracture. Particular attention was paid to the measure mammary compliance with a new device: the Anton Paar Mammacompliance system. This study found a good match between clinical and objective measurements, and also between the measure of applanation tonometry and the measure of mammary compliance. The Anton Paar Mammacompliance system seems to be effective in eliminating the descriptive part and keeping to the measurements and objective data. It is easily reproducible in the various check ups. It permits objective assessment for the measure of capsular contracture.

Adult↗

PubMed2002

Transplantation of autologous cultivated conjunctival epithelium for the restoration of defects in the ocular surface.

Ocular surface disorders are often characterised by partial or complete loss of corneo-conjunctival epithelium, which causes dramatic functional and cosmetic problems. Depletion of stem cells and the scarcity of donor tissue available make large or bilateral defects challenging to reconstruct, and usually require the transplantation of heterotopic or allogeneic grafts. We investigated the feasibility of restoring severely damaged ocular surfaces with autologous cultivated conjunctival epithelium. Conjunctival cells were harvested from the healthy eyelid bed of four patients with oculopalpebral diseases. An epithelial sheet reproducing the original conjunctival epithelium was generated by serial cell culture. This was transplanted for the first time ever to our knowledge on to the ocular surface of the same patients. Take was excellent and the cultivated epithelium was stable, resulting in great improvement of patient's symptoms and cosmesis. Transplantation of cultivated conjunctival cells opens new perspectives in the treatment of severe ocular surface disorders.

Adult↗

PubMed2002

Basal cell carcinoma of the penis and scrotum with cutaneous metastases.

A 75-year-old man presented with a multicentric basal cell carcinoma (BCC) of the penis and scrotum with skin metastases. The lesion was large, affecting the whole shaft, the scrotum, and the public and inguinal areas. The patient was operated on and the defect covered with a split thickness skin graft. At six months follow-up, the patient was well, with no evidence of recurrence. This site is extremely rare (we know of 24 cases described) but seems to metastasis widely. Surgery is the best treatment option in these cases, and must be aggressive, considering the particular biological behaviour of BCC of the genital region.

Aged↗

PubMedDate not supplied

Changes over time in mammary compliance values after breast augmentation.

Capsular contracture is the most troublesome and distressing complication after breast augmentation for both the surgeon and patient. The etiology of capsular contracture remains unclear. Clinical treatment for this complication is based on the surgeon's evaluation, the condition of the breast, and a number of other factors. In a previous study, the authors investigated whether measurement of mammary compliance as a means of assessing capsular contracture was comparable with other methods described for the assessment of capsular contracture. The purpose of this study was to evaluate whether capsular contracture varies significantly over time. A prospective study was performed to measure mammary compliance in 60 female patients who received a total of 120 implants between 2000 and 2002. The implants used were anatomic prostheses filled with cohesive silicone gel and round double-lumen prostheses filled with silicone gel and saline solution. All the patients were followed up for at least 2 years. Statistical analysis of the data also was performed to assess significance. The results showed a general trend in mammary compliance values over time.

Adolescent↗

PubMedDate not supplied

Ultrastructural study of autologous cultivated conjunctival epithelium.

BACKGROUND AND OBJECTIVE: This report is one of the first in the literature on the attempted cultivation and clinical application of human conjunctival epithelium. The authors investigated the possibility of restoring severely damaged ocular surface with autologous cultivated conjunctival epithelium. PATIENTS AND METHODS: The conjunctival cells needed for the experiment were harvested from six patients with oculopalpebral diseases. Confluent epithelial sheets were developed from each biopsy specimen. The new epithelium was then implanted on the patients' or donors' eye surface. RESULTS: The histologic examination showed a pluristratified squamous non-keratinized epithelium lying on a basement membrane and with a lamina propria of well-vascularized connective tissue. Normal ultrastructural characteristics were evident on electron microscopy. CONCLUSION: The cultivation of autologous conjunctival cells may be a good option for rapid and safe repair of large single or bilateral conjunctival defects, as an alternative to heterotopic or allogenic grafts.

Biopsy↗

PubMedDate not supplied

Q-switched alexandrite laser-assisted treatment of melasma: 2-year follow-up monitoring.

Melasma is a common disorder of hyperpigmentation involving sun exposed face and neck areas. Three clinical patterns of melasma are recognized: the centrofacial, the malar, and the mandibular ones. Several factors have been implicated in the pathogenesis of this disorder including pregnancy, oral contraceptive therapy, sun exposure, genetic factors, cosmetics, and race. This condition is most frequently observed in women and affects all racial groups; however, it is commonly found in darker-complexioned individuals (skin types IV through VI) and in Asian women who live and work under strong sunlight exposure for long periods. Melasma is very difficult to treat and often resistant to therapy. Treatment of melasma includes various hypopigmenting agents, chemical peeling, and laser surgery with unsatisfactory results. We report 3 cases of facial melasma successfully treated with a Q-switched Alexandrite laser.

Adult↗

PubMedDate not supplied

Extrarenal malignant rhabdoid tumour of the heel--a case report.

Malignant rhabdoid tumour is a rare soft-tissue neoplasm that occurs in children and young adults. Cases have involved numerous extrarenal sites, including the thymus, liver, paravertebral region, central nervous system, heart, prostate, pelvis, chest wall, extremities, as well as soft tissues. Given their highly aggressive nature, early diagnosis of rhabdoid tumours is essential; indeed, survival times after initial presentation are typically in the range of months rather than years. The low incidence of rhabdoid tumours and confusion between this type of tumour and other tumours has precluded the collection of adequate data on its clinical presentation and there is no specific therapeutic protocol. Owing to the rarity of this condition and the difficulties encountered in its diagnosis and treatment, we report the case of a malignant tumour with rhabdoid-like features in the foot that confirms the local aggressiveness and the high metastatic potential of this type of tumour.

Adult↗

PubMedDate not supplied

Combined mucormycosis and Aspergillosis of the rhinocerebral region.

BACKGROUND: Opportunistic fungal infections are rare, life-threatening conditions and are a major cause of morbidity and mortality in immunocompromised hosts. Our experience in the management of a case of combined mucormycosis and aspergillosis of the rhinocerebral region is presented. PATIENTS AND METHODS: The infection developed a few weeks after tooth extraction, massively involving facial structures. After diagnosis, the patient underwent prolonged combined systemic antifungal treatment. Once the local and general conditions had stabilized, an extensive surgical debridement was performed, followed by reconstruction with a pedicled myocutaneous flap. RESULTS: This approach was curative with patient survival after 16 months. CONCLUSION: Early diagnosis, early anti-fungal treatment and early stabilization of the patients' general condition are fundamental for patient survival. Surgery is necessary for fungal eradication, but must be performed according to the above conditions. Pedicled muscle flaps are considered the first reconstruction choice because of their excellent blood perfusion and resistance to fungal invasion.

Amphotericin B↗

PubMedDate not supplied

[Obesity and plastic surgery].

The number of the bariatric surgical procedures to obtain a body weight loss is increasing, and will be higher in the years to come. The plastic surgeons are witnessing in parallel a meaningful growth of requests for surgical procedures to obtain a reshaping of body profiles after the procedures of bariatric surgery The surgical techniques of bariplastic surgery can be divided in three main groups: (1) Dermolipectomies (associated or not with lipoplastics). (2) Mammaplasties (with or without prosthetic implant). (3) Combined techniques (torsectomies). To correctly treat the morbid obese patients the multidisciplinary collaboration of a medical equip is of paramount importance. Bariplastic surgery after massive loss of weight has grown safe and efficacious if made on selected patients and in the hands of wide experienced surgeons.

Abdominal Wall↗