Biomedical subjects
Publications and source records attributed to D Piccinelli.
The authors report on the trans-sphincteric access to the rectum according to Mason's technique for the local excision of rectal tumors. On the basis of their experience, they confirm that this technique is easy to perform and that it is reliable as regards preservation of anal continence.
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The pulmonary metastatic locations due to colorectal cancer were considered, in not remote times, not worthy of surgical treatment. At present, according to our experience and some other Authors' one, the surgical removal of metachronal pulmonary metastases should be considered suitable to improve the period of life free from symptoms and the survival. The surgical treatment has improved the survival in the single or double pulmonary locations, whereas the monolaterality of multiple pulmonary lesions, in respect of the bilaterality, was not significantly bettered the prognosis (Hiroshi Takita, Francis Edgerton). The survival, moreover, seems to be affected by the interval free from illness and by the doubling time of the metastatic location. The surgical indication to the pulmonary metastasectomy is done on condition of the absence of any metastases in other organs. In our experience, out of 742 interventions with radical purposes for colorectal cancer, we documented 15 cases where lung appeared as the first and sole metastatic filter (many patients were lost for their non-cooperation in the follow-up). In 7 cases pulmonary resections were performed, in patients selected and free from secondary locations in other organs, with a satisfactory result. Casuistry and personal results are reported.
The authors describe the difficulties and possible complications of pregnancy in colonostomized women. In the neoplastic forms, generally appearing in advanced age, the knowledge of the basic disease discourages any possible attempt at pregnancy. In the chronic inflammatory diseases (ulcerous rectocolitis and Crohn's disease), typical of young age, pregnancy, if opportunely followed and programmed, can get an absolutely favourable course. The authors report their own experiences and some other authors' ones.
The authors maintain the opportunity of a mechanical and chemotherapeutical preparation of colon for the surgical operation, and illustrate the methods thereof. They report their clinical experience about the preoperative and peroperative cleaning, and confirm the importance of decompressive transversostomy as a protection of colorectal anastomoses.
The Authors study the statistics of the Verona Surgical Centre, concerning 5 cases of colovesical fistula. They support the two-time operation, that is, the colon resection with colo-colic anastomosis sheltered by a decompressive transversostomy and stitching of the vesical breach. They affirm the usefulness of the operation according to Hartmann in patients facing a greater operative risk.
The Authors describe 2 cases of anorectal melanoma, which underwent operation in the Surgical Clinic of Verona in the years 1981-83. They review the literature confirming the high malignancy of this neoplasm, the poor prognosis forecasting a demolishing surgical treatment only. They, at last, once again affirm the principle whereby the results of such surgery are proportional to the stage of evolution the neoplasm is caught in, and the difficulty to reach a precocious diagnosis is therefore one of the main reasons for the scanty remote results of such surgery.
The Authors, on the basis of the casuistry of the Verona Surgical Centre, concerning the interventions for Crohn's disease from 1973 up to 1983, and comparing the data of literature, study the problem of appendicectomy in Crohn's disease. They suggest the operation of appendicectomy both when there are signs of appendicopathy in course, joined to a pathology of the last ileum ansa, and in presence of apparently sound appendix and clear signs of ileum Crohn's disease. They think it opportune to avoid appendicectomy only in presence of clear signs of involvement of caecum by the morbid process.
Since 1-(m-chlorophenyl)piperazine (mCPP) is a metabolite of trazodone (TRZ) and etoperidone (ETO), two atypical antidepressants, a pharmacological study was undertaken to establish the possible contribution of mCPP to the effects of the parent compounds. Behavioral effects of mCPP in rats consist in head shakes and other signs of serotoninergic stimulation; subtoxic doses also produce clonic convulsions and prostration. TRZ and ETO produce sedation and signs of alpha-adrenergic blockade; subtoxic doses produce tremors, clonic convulsions and prostration. Peripheral effects of norepinephrine (NE) and serotonin (5-HT) in rats are potentiated by mCPP and inhibited by TRZ and ETO. 5-hydroxytriptophan (5-HTP)-induced head twitches in mice are inhibited by TRZ and ETO and unaffected by mCPP. At similar doses mCPP, TRZ and ETO inhibit some nociceptive responses in rats and mice.
The Authors face the problems involved in the colonic familial polyposis, with particular attention to the surgical treatment of subjects bearing neoplastic degeneration. They, moreover, report their clinical experience, and compare it with the experience of other centres.
The Authors show a case of rectal ampulla carcinoid, and review the literature thereabout. They suggest the removal through sphincter according to Mason, which technique, in their opinion, can ensure a satisfying radicalness when the diameter of carcinoid is shorter than 2 cm.
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The authors show their experience about the surgical treatment of colonic perforations in course of neoplastic disease. Their casuistry is compared with those of other centres.
The authors report their experience in the surgical treatment of the cancer of splenic flexure. The neoplasiae arising in such place are usually diagnosed in a more advanced phase than in the other colon segments. This results in a survival at a shorter interval.
1. Kassinin, a tachykinin dodecapeptide isolated from the skin of the African frog Kassina senegalensis was submitted to parallel bioassay with physalaemin, eledoisin and substance P, three major representatives of the tachykinin peptide family. Bioassay was carried out on blood pressure, salivary secretion and isolated or in situ smooth muscle preparations. 2. As expected, kassinin possessed the entire spectrum of biological activity peculiar to the tachykinins. However, among the examined tachykinins kassinin was the poorest stimulant of salivary secretion and the weakest hypotensive agent, while displaying very powerful stimulant effects on different smooth muscle preparations, especially on isolated preparations of urinary bladder. 3. Kassinin differed from the other tachykinins also for its more gradual and sustained action on several in situ and isolated preparations. The peptide most similar to kassinin in its spectrum of activity was eledoisin. 4. Emphasis is laid on the possibility to dissociate the effects of the tachykinins on different target systems through changes in the N-moiety of the tachykinin molecule.
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Personal experience of 135 operations on the left colon and the rectum, with simultaneous formation of decompressive transversotomy, is presented. According to the Authors, decompressive transversotomy is the sole method capable not of avoiding anastomotic dehiscences, but of ensuring that they do not become clinically manifest, and hence of reducing the mortality connected therewith. The doubts sometimes raised with regard to the method seem in the Authors' opinion to be linked to technical shortcomings in performance of the transversotomy itself.
The routine technique used by the Authors for performance of decompressive transversotomy in operations on the left colon and the rectum is described. The technique for extraperitoneal closure of the stoma is described in detail: the method is easy to perform and does not involve any noteworthy postoperative complications. Long-term follow-ups demonstrate that there are no functional disorders connected with adhesion of the organ to the abdominal wall.