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Biomedical subjects

E Fiori

Publications and source records attributed to E Fiori.

At least 37 records · Page 2Linked to original sources
PubMed2000

Diagnosis controversies for adrenal ganglioneuroma.

The authors report a case of adrenal ganglioneuroma which was incidentally diagnosed performing preoperative examination for a sigmoid carcinoma. The authors took this finding as a starting point to underline the rarity of this condition and its chance discovery, this being due to the rare presence of signs and symptoms and its frequent association with other synchronous neoplasms; all this makes differential diagnosis rather difficult.

Adrenal Gland Neoplasms↗
PubMed1999

[The usefulness and limits of echo-endoscopy in the clinical staging of esophageal cancer].

Endoscopic ultrasonography (EUS) is a diagnostic method of considerable value for the local staging of esophageal cancer, in particular for T and N evaluation. After an extensive review of the literature, the authors underline the possibility of using EUS to improve the treatment and prognosis of esophageal neoplasms based on the use of various stage-dependent therapeutic strategies. EUS is regarded as a gold-standard technique for esophageal cancer staging in order to select appropriate treatment options, but is currently hampered by the intrinsic difficulty and subjectivity of interpreting ultrasonographic images. In order to ensure safe and reliable data, EUS must be carried out by operators who have undergone suitable training at a specialised centre.

Carcinoma↗
PubMed1999

Small bowel schwannoma with diffuse subcutaneous lipomatosis. Case report and literature review.

A case of a small-bowel schwannoma with diffuse familiar lipomatosis is described. This case underlines the rarity of the neoplasm and its probably chance association with subcutaneous lipomatosis. The intestinal neoplasm was diagnosed preoperatively by upper gastrointestinal endoscopy and a small-bowel enema; computed tomography scan confirmed the intestinal lesion. Attention is focused on the morphological features of intestinal schwannomas and their biological behaviour.

Humans↗
PubMed1998

Endomorphin-1 and endomorphin-2 activate mu-opioid receptors in myenteric neurons of the guinea-pig small intestine.

The novel opioid tetrapeptides, endomorphin-1 and endomorphin-2, recently isolated from bovine and human brain bind with high affinity and selectivity to central mu-opioid receptors. In the digestive tract, a comprehensive pharmacological analysis of the receptors involved in endomorphin action has not been reported. In this study, we analyzed the effects of endomorphin-1 and endomorphin-2 on longitudinal muscle-myenteric plexus preparations (LMMPs) from the guinea-pig ileum. Both peptides (30 pM - 1 microM) inhibited (-log EC50 values: 8.61 and 8.59, respectively) the amplitude of electrically-induced twitch contractions in a concentration-dependent fashion, up to its abolition. Conversely, in unstimulated LMMPs, they failed to affect contractions to applied acetylcholine (100 nM). In stimulated LMMPs, the highly selective mu-opioid receptor antagonist, D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP), caused a concentration-dependent (30 nM-1 microM), parallel rightward shift of endomorphin-1 and endomorphin-2 inhibitory curves, without depression of their maximum. Following Schild analysis, calculated pA2 values were 7.81 and 7.85, respectively, with slopes not different from unity. Concentration-response curves to both peptides were not affected by 30 nM naltrindole (a selective delta-receptor antagonist) or 30 nM nor-binaltorphimine (a selective kappa-receptor antagonist). These results demonstrate that endomorphins selectively activate mu-opioid receptors located on excitatory myenteric plexus neurons, and that they act as full agonists.

Acetylcholine↗
PubMed1998

Fluoroquinolone-induced motor changes in the guinea-pig isolated ileum.

The effects of norfloxacin and enoxacin were examined on spontaneous motor activity in the guinea-pig isolated ileum. Micromolar concentrations of both compounds caused a biphasic response consisting of relaxation followed by transient contraction. Relaxation to norfloxacin, which was unaffected by phentolamine, propranolol and hyoscine (each at 1 microM), was partially sensitive to tetrodotoxin (1 microM). This indicates that the response is partly mediated by non-adrenergic non-cholinergic (NANC) inhibitory nerves, and partly related to a direct action on the smooth muscle. Apamin (0.1 microM) and suramin (300 microM) inhibited norfloxacin-induced relaxations to an extent similar to that of tetrodotoxin. Conversely, NG-nitro-L-arginine (300 microM) was ineffective. In the presence of theophylline (100 microM) and 3-isobutyl-1-methylxanthine (10 microM), norfloxacin caused relaxation less effective than when added alone. Based on this observation, the NANC component of the relaxation apparently depends on ATP release, whereas the direct component might be due, at least in part, to phosphodiesterase inhibition. Norfloxacin-induced contractions were neurogenic and cholinergic in nature. They were reduced by indomethacin or S-ketoprofen (both at 0.01-1 microM) and suramin (300 microM), suggesting involvement of local prostaglandin production probably induced by ATP release. Previous findings revealed that norfloxacin acted as a non-competitive antagonist at enteric GABAA receptors. In this study the same property was shared by enoxacin against the contractile response to 3-aminopropane sulphonic acid (3-APS), a GABAA receptor agonist. In conclusion, fluoroquinolones exert inhibitory and excitatory effects in the guinea-pig ileum. These are mediated by ATP, prostaglandin and acetylcholine release that might underlie, at least in part, the alterations of gastrointestinal motility observed after fluoroquinolone administration. Furthermore, isolated intestinal preparations might be useful to predict the GABAA-antagonist potential of this class of compounds.

Animals↗
PubMed1998

Endoscopy in the treatment of benign biliary strictures.

BACKGROUND/AIMS: Operative endoscopy is now the method of choice for treating numerous biliary tree diseases. In the treatment of benign strictures of the biliary tree, endoscopy serves as an alternative to surgical interventions. We evaluated the efficacy of endoscopic biliary stents in the treatment of benign biliary strictures. PATIENTS: Fifty-three consecutive patients with benign strictures of the biliary tree underwent endoscopic placement of one or more 10-12 Fr endoprostheses. Thirty-nine patients (73.6%) had iatrogenic strictures and 14 had inflammatory strictures (in 8 patients due to gallstones and in 6, chronic pancreatitis). Of the 53 patients, 20 (37.7%) had strictures classified as Bismuth type I, 23 (43.3%) Bismuth type II, 7 (13.2%) Bismuth type III and 3 (5.7%) Bismuth type IV. RESULTS: None of the patients died during the study period; three patients (5.6%) had immediate endoscopy-related complications treated conservatively. Late complications developed in 47.1% of the patients: 11.3% had cholangitis amenable to medical therapy, 5.6% had dislodged endoprostheses and 30.2% had obstructed endoprostheses. The reason why blocked stents accounted for most of the long-term complications in this series was that endoprostheses were not changed electively: they were changed only when clinical and laboratory signs indicated obstruction. Follow-up (6-84 months) in 42 of the 56 patients. 20 after stent removal, showed that 71.4% had an excellent outcome, 14.3% good results and 14.3% needed surgery. CONCLUSION: In benign biliary stricture endoscopic stenting is the first approach, providing definitive treatment or preparing patients for surgery.

Cholestasis↗
PubMed1997

A re-appraisal of the nature of the atropine-resistant contraction to electrical field stimulation in the human isolated detrusor muscle.

We investigated whether in human isolated detrusor strips the atropine-resistant contractile response to electrical field stimulation was mediated by ATP (or a related purine), as previously shown in the urinary bladder of other mammalian species. Electrical stimulation (1-50 Hz for 5 s at 1 min intervals, 0.1 ms pulse width, 60 V) elicited reproducible, frequency-dependent twitch contractions, which were markedly reduced by atropine (10 microM). Tetrodotoxin (TTX: 1 microM) inhibited contractile responses to a similar degree. When applied together, atropine and TTX caused an inhibition which was superimposable to that caused by either drug alone. The TTX-resistant contractions were totally unaffected by omega-conotoxin GVIA (omega-CTX: 0.1 microM). The atropine-resistant contractions were unaffected by the P2-purinoceptor antagonists suramin (300 microM) and PPADS (30 microM), at concentrations which virtually suppressed the contractile response induced by applied ATP (10 microM(-1) mM). As previously described, antagonism of the ATP-induced contractions by suramin (30, 100, 300 microM) and PPADS (3, 10, 30 microM) was insurmountable, with apparent 'pA2' values (calculated at the lowest antagonist concentrations) of 4.9 and 5.2, respectively. It is concluded that, under our experimental conditions, the non-cholinergic (atropine-resistant) component of the excitatory transmission in the human detrusor is not mediated by neural release of ATP, in spite of the presence of excitatory P2-purinoceptors on the effector cells. The TTX- and omega-CTX-resistant, non-cholinergic component might be related to the release of unknown transmitter(s) through a mechanism independent of both Na+- and N-type Ca2+-channels. More likely, the atropine-resistant component may reflect direct smooth muscle excitation since the human detrusor has a very short chronaxie (Sibley 1984).

Adenosine Triphosphate↗
PubMed1997

[Evaluation of the respiratory function by lung scintigraphy in patients candidates for pulmonary resection].

Sixty-one patients undergoing pulmonary resection were studied pre- and post-operatively by spirometry, arterial gas determination, and quantitative ventilation/perfusion lung scanning. Our results showed that ventilation and/or perfusional scintigraphic scanning is currently the most reliable method in identifying patients at risk for postoperative respiratory insufficiency. Specifically, this technique was successful in detecting pulmonary areas other than those to be resected presenting ventilation or perfusional abnormalities. Therefore, the technique is particularly useful in predicting residual pulmonary function.

Adult↗
PubMed1996

[Perforated diverticulitis of the colon: modalities of the surgical treatment].

A retrospective study was carried on 66 patients surgically treated for perforated diverticular colonic disease: 22 had acute phlegmon or pericolic abscess and underwent primary resection and anastomosis. Of the remaining 44 patients, who had multiple pericolic and/or pelvic abscesses, or generalized peritonitis, in 30 cases the Hartmann procedure was used, 6 underwent Mikulicz operation, while drainage with proximal colostomy was performed in 5 cases, and simple suture and drainage in the last 3 cases. Operative mortality was 18.2%. Mortality rate was higher in patients treated by colostomy and drainage. The Hartmann procedure and resection-anastomosis patients had a mortality rate of 23.3% and 4.4% respectively. No mortality was registered among patients treated with suture and drainage.

Colostomy↗
PubMed1996

[Leiomyosarcoma in jejunal diverticulum. A case report and review of the literature].

The Authors describe a case of double jejunal diverticulum, characterized by the presence of a leiomyosarcoma in one diverticulum and ectopic pancreatic mucosa in the other. The rarity of the occurrence of a leiomyosarcoma in the diverticular area is outlined; only few cases have been reported in Literature, excluding those originating, from Meckel's diverticulum. Barium X-rays of the small intestine allowed the neoplasia to be discovered, while an Echo-Color-Doppler examination suggested the histological type given the high vascularization typical of leiomyosarcomas.

Diverticulum↗
PubMed1996

Renal cell carcinoma in adolescents. A case report and review of the literature.

Renal cell carcinoma is rare in adolescents. Observation of a 16-year-old girl with a clear-cell carcinoma prompted us to review 372 published cases in adolescents. The tumor affects the sexes indifferently and has no side predominance. The incidence is higher in white races. The most frequent presenting sign is a palpable mass (52.7%). X-ray films typically show renal calcifications (25%). The most common histotype is the clear cell carcinoma (76.8%) and at diagnosis 59.5% of these tumors already extended beyond the kidney. The overall 5-year actuarial survival rate is 60.4%.

Adolescent↗
PubMed1996

[Update on deep thrombophlebitis and pulmonary thromboembolism].

Pulmonary thromboembolism, a frequent complication in deep vein thrombosis, is still a pathology with a high rate of mortality and morbidity. The authors underline that this pathology is particularly frequent after some types of surgery and in subjects with primary or secondary risk factors. The paper analysis the pathogenesis of deep-vein thrombosis and the physiopathology of pulmonary embolism. The authors then outline the current management in terms of the diagnosis, prophylaxis, and medical and surgical therapy of this pathology.

Humans↗
PubMed1995

[Electrohydraulic intracorporeal lithotripsy in the treatment of "difficult" calculi of the common bile duct. Report of a caseload].

The Authors report their experience in 38 cases (January 1990-Septembre 1994) of "difficult" gallstone disease of the main bile duct treated with electrohydraulic intracorporeal lithotripsy. Nineteen patients were affected with giant stones of the biliary tree, 6 with multiple stones of the main bile duct, 13 with stones of one or both hepatic ducts. The approach to the biliary tree was peroral transpapillary in 16 patients and transhepatic in the remaining 22. Twenty-five patients were previously submitted to surgery of the biliary tree (13 hepaticojejunostomy, 8 choledochoduodenostony, 4 papillostomy), while 5 had required a cholecystectomy, and 6 a gastroresection according to Billroth II. In 80% of the cases two lithotripsy sessions were enough to achieve the complete clearing of the bile duct. There was no mortality and morbidity was 5.3%. Total clearing was obtained in 97.4% of the cases. 6-48 months after treatment 37 patients still do not show clinical, laboratory or echographic signs of gallstone stasis or disease relapse.

Adult↗
PubMed1994

The usefulness of biliary drainage for restoring liver function in obstructive jaundice.

In eighty patients with obstructive jaundice treated with percutaneous or endoscopic drainage, the results of biochemical liver-function tests (serum bilirubin, transaminase, gamma-glutamyl transferase, alkaline phosphatase, and albumin) were analyzed to evaluate the return of liver function after biliary decompression. Before decompression all the patients had increased serum concentrations of all the liver-function indicators measured. Conjugated bilirubin normalized within 7 days in 67.5% of the patients and within 14 days in 94.5%. The other serum responses normalized as follows: glutamic oxaloacetic transaminase (7 days in 45%, 14 days in 100%); glutamic pyruvic transaminase (7 days in 46.2%, 14 days in 100%); gamma-glutamyl transferase (7 days in 56.2%, 14 days in 89.1%); alkaline phosphatase (7 days in 52.5%, 14 days in 90.4%); and albumin (7 days in 100%, 14 days in 90.4%). The low mortality and morbidity rates in this series of patients with obstructive jaundice: 0% and 7% after endoscopic and 2.1% and 10.4% after percutaneous drainage suggest that biliary drainage has a valuable place in the preparation of jaundiced patients for surgery and in some cases provides a definitive intervention.

Adult↗
PubMed1994

[Current trends in the treatment of giant nonparasitic cysts of the liver].

The authors report 10 cases of giant non-parasitic congenital cysts of the liver (7.7-25 cm in size). All the patients were symptomatic; preoperative ultrasonography was diagnostic in all cases allowing to discover the cyst. Six patients underwent partial resection of the cyst (in one of these a cystojejunostomy was performed), while atypical hepatic resection was performed in two cases, enucleation in one and left lobectomy in another case. No evidence of malignant degeneration was found in the histologic study of the specimens. No mortality nor morbidity were registered. All patients were followed up for 1-20 years and no recurrences were found. The authors point out that partial resection of the cyst is a safe operation with good immediate and long-term results.

Adolescent↗
PubMed1994

Esophagocardiomyotomy with Dor gastroplasty in the treatment of esophageal achalasia.

Thirteen patients affected by achalasia of the esophagus, undergoing esophagocardiomyotomy with Dor gastroplasty, are reported. No postoperative deaths or complications occurred. Overall long-term results were satisfactory: excellent or good in 92.3% of cases, fair in 7.7%. Manometry after esophagocardiomyotomy as compared to preoperative assessment showed a decreased resting pressure in the esophageal body, in all patients in whom it was elevated, and the appearance of some peristaltic waves in 23.1% of them (3 patients). As for lower esophageal sphincter, some relaxation after deglutition was observed in one patient. The 24h pH monitoring showed signs of gastroesophageal reflux only in one patient. Based on the obtained results which compare well with those of the literature, the authors be believe that the procedure represents an effective treatment of esophageal achalasia.

Adolescent↗