PubMed Health⌕ Search

Biomedical subjects

E Tiso

Publications and source records attributed to E Tiso.

22 records · Page 2Linked to original sources

Reduced fibrinolytic potential in patients with arterial occlusive disease (AOD) in comparison with normal subjects.

When combining angioplasty and local lysis with urokinase (UK) in treatment of peripheral arterial occlusions we have observed marked differences in the individual patient's response irrespective of the age of the thrombus. The extensive arteriosclerotic changes revealed by angiography in some of these patients suggest a reduced fibrinolytic potential depending on the underlying disease. In the standard in vitro test system we measured the UK-dependent thrombolysis in blood samples from 10 normal controls at UK concentrations of 150, 200, and 300 IU/ml of whole blood. In comparison we determined the whole blood thrombolysis time (WBTT) of 10 patients with AOD using UK concentrations of 150, 200, and 300 IU/ml of whole blood. The mean WBTT values for normal controls obtained at UK concentrations of 150 IU/ml, 200 IU/ml, and 300 IU/ml, respectively, amounted to 9.5, 5.5, and 3.5 minutes, respectively, while in patients mean values of 20.7, 8.1, and 5.5 minutes, respectively, were found. Studies on plasma samples had shown that the lysis time could be shortened in a dose-dependent manner by addition of lys-plasminogen (LYS-PLASMINOGEN Steam Treated) and to some extent also glu-plasminogen. Since lys-plasminogen gave clearly superior results we tried to improve the lytic potential in terms of a shortening of the WBTT by adding different doses of lys-plasminogen (0.14-0.56 CU/ml whole blood) to each patient sample. Although the individual response varied, the addition of lys-plasminogen to the patient samples resulted in a clear dose-dependent improvement of pathologically prolonged lysis times.(ABSTRACT TRUNCATED AT 250 WORDS)

Antithrombin III↗

Spontaneous superior mesenteric vein thrombosis (SMVT) in primary protein S deficiency. A case report and review of the literature.

Superior mesenteric vein thrombosis (SMVT) is an uncommon but important clinical entity that can induce ischemia or infarction of the small and large bowel. It is rare and accounts for 5-15% of mesenteric vascular occlusions. Bowel infarction due to SMVT can present as an acute abdominal disease, requiring urgent laparotomy with resection of the intestinal segment affected. However, the clinical diagnosis of this event remains difficult and invariably requires specific imaging investigations in order to be able to treat the condition as soon as possible. SMVT without bowel infarction can present as persistent, non-specific abdominal pain and nausea with minimal clinical signs, affecting young individuals without any known predisposing disorder, where laparotomy is not an urgent indication. We report a case of a young adult man with SMVT due to a hypercoagulable state (protein S deficiency), in whom an early diagnosis and appropriate anticoagulant treatment prevented any further extension of the thrombotic process and limited the hemorrhagic infarction of the ileum, which simply required a segmental resection.

Adult↗

[Critical analysis of the new TNM staging (UICC, 1987) of cancer of the cervical esophagus in relation to therapeutic decisions].

66 consecutive patients with a tumor confined to the cervical esophagus underwent surgical resection. The comparison between clinical and pathological TNM stage showed a clinical understaging in 30 patients. 25 of the 56 patients who had undergone curative resection had lymph node metastases: positive mediastinal and abdominal nodes were found in 8 (32%) and 0 cases, respectively. The mean survival after curative resection of the 10 evaluable patients with metastatic periesophageal, recurrent and/or paratracheal nodes was 22.4 months; of the 6 evaluable patients with positive mediastinal nodes it was 10.3 months; and of the 5 patients with positive deep latero-cervical nodes it was 5.8 months. The 2-year actuarial survival after curative resection (in the 53 operative survivors) was as follows (according to pathologic TNM staging): Stage I (n = 3) 100%, Stage IIA (n = 17) 30%, Stage IIB (n = 3) 33%, and Stage III (n = 30) 22%. The exact location of neoplastic recurrence after curative resection was documented in 13 cases; it was in the neck in 8 cases (61%); both neck and at a distance in 3 cases (23%) and only at a distance in 2 (16%). The clinical TNM staging of cervical esophageal cancer was not in agreement with the pathological findings in nearly 50% of the cases and is, therefore, inaccurate and unreliable both for therapeutic decision-making and for prognostic evaluations. Endoscopic ultrasound, which was not used in most of the patients studied here, may improve the accuracy of clinical TNM staging. The N classification, which defines only the cervical nodes as regional nodes, appears to be arbitrary since the pathological staging showed metastatic mediastinal nodes in 32% of the N + cases, with a survival comparable to that of patients with metastatic nodes only in the neck. The prognostic value of pathological TNM staging was not confirmed in the present study since only Stage I patients had a significantly better prognosis than patients in the other stages. This may be due to the small number of patients considered or to lymph node understaging caused by the fact that most patients did not undergo mediastinal lymphadenectomy through a thoracotomy or a sternum splitting.

Esophageal Neoplasms↗

Preoperatory treatment with Triptorelin LA in hysteroscopic metroplastic.

Septate uterus is the intracavitary pathology which is most associated with infertility and/or preterm labor; therefore, it is primary indication for hysteroscopic metroplasty. By the introductio of the resectoscope in gynaecological endoscopy the surgical technique has been revolutioned. GnRHa therapy before surgery has showed some advantages related to surgical results, surgery time, intraoperative bleeding and endometrial detachment, and amount of fluids used for uterine cavity distention. The treatment before hysteroscopic metroplasty for partial septus has not influenced positive results, while for uterine septus that reached the inferior third of the cavity or moreover, it provided better condition for this procedure.

Female↗