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E Ancona

Publications and source records attributed to E Ancona.

At least 73 records · Page 4Linked to original sources
PubMed1993

Transplantation of warm ischemia damaged kidneys: an experimental study in pigs.

This study evaluated renal function and histological and oxidative injury in transplanted kidneys harvested after prolonged warm ischemia in pigs. In 8 donor pigs, kidneys were perfused in situ 120 min after cardiac arrest. One of each pair of kidneys was used for histological and biochemical studies while the other was transplanted into a recipient undergoing bilateral nephrectomy. In 6 cases, renal function was satisfactory 14 days after transplantation. Histologically, a reversible acute tubular necrosis was observed with partial recovery at the 14th postoperative day. A moderate oxidation was revealed by decreased glutathione and increased malondialdehyde levels. In spite of this ischemic injury, these findings suggest that kidneys harvested after prolonged warm ischemia can still recover after transplantation, and that non-heart-beating donors may be considered as an alternative organ source for kidney transplantation.

Animals↗
PubMed1993

[The use of totally implantable systems (TIS) for long-term endovenous therapy].

The availability of a long-term central venous access for the management of neoplastic and chronic patients is extremely important in order to achieve an easy and safe infusion of chemotherapeutic drugs, blood components, and parenteral nutrition. The authors evaluated 26 adult patients (25 with malignant tumors and 1 with severe asthma) in whom implantable catheter systems were placed subcutaneously between February 1989 and March 1992. Catheters were inserted through the cephalic vein in 13 cases, the subclavia vein in 8 cases and jugular vein in 5 cases. The mean function time was 262 days in deceased patients and 155 in alive ones. There were no infective or thromboembolic complications. The authors, in agreement with the literature, confirm that TIS represent a safe and easy access for a long term i.v. therapy, with a very low complication rate. Furthermore, comfort of the patients is substantially improved and nursing care is greatly facilitated.

Adult↗
PubMed1992

Oesophagitis and pH of refluxate: an experimental and clinical study.

This experimental and clinical study examined the relationship between oesophageal damage and optimal pH of refluxate, and whether 24-h pH monitoring at optimal pH could discriminate the severity of oesophagitis. The rabbit oesophagus was perfused in vivo with pepsin and hydrochloric acid solutions of differing pH for 60 min. Maximal oesophageal damage coincided with peptic solutions at pH 1.5-2.5. Fifty-nine patients with proven gastro-oesophageal reflux disorders were tested for manometric features of the lower oesophageal sphincter (pressure, overall length and abdominal length) and oesophageal exposure to different pH levels. They were classified into four groups according to the endoscopically demonstrated severity of oesophagitis. Supine exposure at the optimal pH level for pepsin activity (pH 1.5-2.5) and overall sphincter length were found to discriminate the severity of oesophagitis reliably in 75 per cent of cases.

Adolescent↗
PubMed1992

Suicidal inactivation of human cytochrome P-450 by carbon tetrachloride and halothane in vitro.

A significant loss of human cytochrome P-450 was observed during the anaerobic incubation of NADPH-reduced human liver microsomes obtained from surgical samples, in presence of carbon tetrachloride or halothane. In order to prevent any interference in the classical spectrum of cytochrome P-450 with CO, the method of Johannesen & DePierre (1978) was modified to obtain cytochrome P-450 determination. The enzyme inactivation reaction showed pseudo-first order kinetics and was accompanied by destruction of the haem tetrapyrrolic structure, as indicated by a significant loss of its porphyrin fluorescence. Values of about 200 and 700 were calculated for the partition ratio between metabolic turnover of the substrate and enzyme inactivation during reductive incubation of one of these microsomal preparations with limiting concentrations of CCl4 and halothane, respectively. The results indicate that human liver cytochrome P-450 can be inactivated reductively in vitro by CCl4 and halothane reactive metabolites and suggest that a suicide type of mechanism, similar to that which was recently demonstrated to occur, for both substrates, with rat liver microsomes (Manno et al. 1988a & 1991), may also be involved in the inactivation of the human enzyme(s).

Animals↗
PubMed1992

Use of mini-invasive procedures in esophageal surgery.

The authors have applied the advantages of mini-invasive surgery to the treatment of esophageal diseases. The technical possibilities of esophageal dissection have been investigated in patients with cancer of the intrathoracic esophagus. The mini-invasive techniques have been applied in the clinical setting to perform the esophagectomy through a trans-hiatal approach or by means of thoracoscopy. Performing the esophagectomy through the trans-hiatal approach allows an accurate mediastinal dissection and lymphadenectomy of the paraesophageal nodes. Performing the esophagectomy by means of thoracoscopy requires division of the azygos vein. In our experience better to divide the esophagus high in the chest. At present, trans-hiatal esophagectomy with mini-invasive procedures seems to be the technique of choice. However, the approach based on thoracoscopy will gain popularity with the development of more sophisticated instruments. In selected cases, it could be advantageous to use both techniques.

Diverticulum, Esophageal↗
PubMed1991

[Esophageal manometry and pH-monitoring: cost-benefit analysis].

Functional tests of the esophagus have become increasingly popular over the last 10 years. Here we present a cost/benefit analysis model to evaluate the real contribution to diagnosis with reference to the cost of these tests. All of the patients referred to the digestive physiopathology laboratory at the Institute of Surgical Semiotics, from 1988 to 1990, were evaluated for gastroesophageal reflux disease (152 cases), dysphagia (27 cases) and chest pain (12 cases). The cost of each modified diagnosis was L. 508,250 in the first case, L. 315,772 in the second case and L. 262,446 in the third case. Additionally, concerning gastroesophageal reflux disease, the cost of medical therapy based on endoscopic diagnosis alone was compared to that of medical therapy guided by these functional tests. Hence it was demonstrated that it is economically advantageous to study functionally all of the symptomatic patients, except the cases of esophagitis, and patients with atypical symptoms or with mild symptoms and endoscopic esophagitis of the first degree. It is not worthwhile investigating patients with second, third or fourth degree esophagitis, regardless of the symptoms, and patients with typical severe symptoms and first degree esophagitis. These functional tests are economically practical in all cases in which morphologic alterations are either absent or minimal.

Adolescent↗
PubMed1991

[Esophageal manometry: methods of investigation and interpretation of results].

Standard manometry is still today the method of choice for investigating motor disorders of the esophagus. Fundamental elements in executing the test are suitable equipment, an execution technique following well established protocols and the adoption of univocal criteria for interpreting the results. In fact it is essential to use low compliance pneumo-hydraulic pumps and to perform the test in distinct steps to separately evaluate the features of the sphincter and the peristaltic activity of the esophageal body. Newly introduced technology (computerized analysis) authorizes an objective analysis of the tracing and the measurement of novel parameters, making it necessary however to re-evaluate the parameters of normalcy in the asymptomatic population. The manometric features of the lower esophageal sphincter, which define its competence (mean pressure at the point of respiratory inversion, abdominal length, total length), are probably better expressed by the mean pressure of the entire LES, by the area under the curve and by the Vector Volume. As far as motility of the esophageal body is concerned, computerized manometry provides for a more precise definition of the maximum amplitude of the esophageal contractions and an objective measure of their duration.

Esophagus↗
PubMed1991

Hiccups and related esophageal motor disorders.

The clinical course of a patient with pyrosis and intractable hiccups is presented. Hiccups persisted six years after an effective fundoplication had cured pyrosis, and the patient was eventually treated with baclofen. Esophageal function during and after hiccups was studied in detail by means of esophageal manometry and 24-hour-pH monitoring. The relationship between hiccups and gastro-esophageal reflux is discussed.

Amantadine↗
PubMed1991

[Relationship between nutritional and immunologic status in patients with esophageal cancer].

The nutritional and immunological status have been evaluated in 28 consecutive patients with esophageal cancer. Patients (21 male and 7 female), had a mean age of 61 years, ranging from 34 to 84 years. The tumor histological type was squamous in 25 patients. A melanoma, an oat cell carcinoma and a adenocarcinoma were observed in the remaining cases. The nutritional status was assessed by means of weight loss, triceps skinfold, midarm muscle circumference and serum levels of albumin and transferrin. On the basis of this data the patients were divided into two groups: A, 19 patients (68%), normal nourished group (or with a mild malnutrition) and B, 9 patients (32%) with a severe malnutrition. The immunological status was assessed by determining the lymphocyte absolute number (H-6000-Technicon), the T-Lymphocyte sub-populations (flow-cytometry with monoclonal antibodies--Ortho Diagnostic System) and the patient's response to intradermally placed recall antigens (Multitest Merieux). Significative immunological abnormalities were found only in malnourished patients, group B (p less than 0.05). Moreover a reduction of OKT4 helper (less than 30%) and the inversion of OKT4/OKT8 ratio (less than 0.9%) were also observed only in the malnourished group (p less than 0.01). Therefore, we conclude that acquired immunodeficiency, when present in patients with esophageal cancer, is due to the severe malnutrition rather than to the cancer itself.

Adult↗
PubMed1991

[Chronic idiopathic intestinal pseudo-obstruction].

The clinical course and the treatment of two patients with chronic idiopathic pseudo-obstruction are reported. Venting enterostomy to reduce the frequency of the occlusive symptoms and home parenteral nutrition to correct malnutrition have been employed, after the failure of aggressive medical treatment with prokinetic drugs. These measures improved symptoms of obstructions and allowed the reestablishment of oral alimentation. Therefore, according to medical literature, we suggest that patients with chronic idiopathic pseudo-obstruction can be safety managed for prolonged period with this treatment.

Adult↗
PubMed1989

Oesophageal motility and lower oesophageal sphincter competence in progressive systemic sclerosis and localized scleroderma.

Oesophageal motility and lower oesophageal sphincter (LOS) competence were investigated in 13 patients with progressive systemic sclerosis (PSS) and in 16 patients with localized scleroderma (LS) by means of oesophageal manometry and 24-h pH monitoring of the distal oesophagus. Results were compared with those of a control group consisting of asymptomatic volunteers. Marked abnormalities in oesophageal motility and in acid exposure in the distal oesophagus were observed in PSS patients only. The mean resting pressure of the LOS was 10.1 +/- 1.5 mmHg in PSS, 21.4 +/- 1.1 mmHg in LS, and 23.8 +/- 2.0 mmHg in asymptomatic controls. Overall sphincter length was 24.1 +/- 3.4 mm in PSS, 31.1 +/- 1.6 mm in LS, and 39.0 +/- 2.0 mm in the control group. Spincter abdominal length was 12.1 +/- 2 mm, 15.4 +/- 1 mm, and 25.0 +/- 1 mm, respectively. The amplitude and duration of oesophageal waves were markedly reduced at 5, 10, and 15 cm above the LOS in PSS patients, with only the upper part of their gullet being spared. An abnormal acid exposure in the distal oesophagus was observed in 84.6% of PSS patients, whereas only 18.2% (2 of 11) of pH-tested LS patients had an abnormal 24-h pH test. These data show that a marked oesophageal involvement is present only in the systemic form of scleroderma. Oesophageal tests may be useful for a circumstantial diagnosis whenever the diagnosis of PSS is uncertain; however, their use does not seem to be justified as routine in patients with LS.

Adult↗