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Biomedical subjects

F D'Angelo

Publications and source records attributed to F D'Angelo.

At least 37 records · Page 2Linked to original sources
PubMed1989

The role of CEA, TPA and CA 19-9 in the early detection of recurrent colorectal cancer.

Eighty-eight consecutive patients who underwent curative resection for colorectal cancer between 1983 and 1985 were studied prospectively to evaluate the roles of sequential CEA, TPA and CA 19-9 determinations and independent clinical examination in the early diagnosis of resectable recurrences. Twenty nine recurrences were detected between 8 and 38 months after primary surgery. CEA, TPA and CA 19-9 showed a sensitivity of 72%, 62% and 38%, and a specificity of 78%, 86% and 97%, respectively. Of eight recurrences in which CEA was not raised, five induced a rise in TPA and two a rise in CA 19-9. The rise in the serum concentration of one of the three markers was the first sign of relapse in 23 (79%) patients. Two second-look laparotomies based solely on a rise in serum markers were performed. In one case diffuse recurrent disease was found, and in the other a resectable solitary hepatic metastasis was found.

Aged↗
PubMed1984

Microsurgical approach to pancreatic duct occlusion in the pig by means of a prolamine solution.

Prolamine is an alcoholic solution of zein, with the property of polymerizing within 15 minutes in a humid medium. Such a substance has been injected in the pancreatic duct of 10 pigs with a microsurgical technique, causing complete occlusion. The prolamine gel produces a progressive fibrosclerosis of the exocrine pancreatic parenchyma, sparing the endocrine portion. The resulting pancreatic atrophy avoids the occurrence of inflammatory complications that often hamper surgery on such gland. The 10 pigs under study showed post-operative normal values of blood glucose and insulin, and a decrease in serum alpha-amylase levels. Complications occurred in only one case, and the microscopic pattern was similar in all cases. Microsurgical approach and use of prolamine are considered effective both in pancreatic transplantation and in chronic pancreatitis.

Animals↗
PubMedDate not supplied

Effective vascular endostapler techniques in hepatic resection.

The purpose of this report is to describe the technique of liver resection using an endovascular stapling device. A total of 31 patients underwent major hepatic resections with stapling techniques. The authors have used various approaches to portal structures and hepatic veins with the application of a vascular endostapler device. The specific techniques of different hepatectomies are described and illustrated. There were no deaths. A minor complication (biliary fistula) occurred in one patient, related to binary leak from parenchymal transection. No complications directly attributable to stapler ligations of portal pedicle or hepatic veins were observed. Stapling techniques can be helpful in major hepatic resection procedures. The vascular endostapler can significantly reduce both portal vein and hepatic vein closure time and may expedite the transection of the liver, eliminating the risk of slipped ligature following simple ligation.

Hepatectomy↗
PubMedDate not supplied

Whiplash injuries: clinical picture and diagnostic work-up.

The term "whiplash" commonly refers to symptoms and signs associated with a mechanical event such as a sudden acceleration and deceleration of the neck (due, in the majority of cases, to a road accident), instead of to the mechanism itself. The recent Quebec Classification of Whiplash Associated Disorders (WAD) contributed to define nosographically all the clinical manifestations usually grouped under the terms acute/post-traumatic and late "syndrome". In the late phase of WAD, neck pain and neck muscle contraction have been reported in all cases, together with headache in over 50%. "Headache stemming from the neck", despite numerous attempts to classify this entity (i.e. cervicogenic headache) according to the IASP classification (headache associated with neck disorders), is still a subject of debate. An adequate multiparametric procedure is required to study WAD, which takes into account: the patient's principal details; an exact reconstruction of the event; description and analysis of the signs and symptoms, with various complications and correlated dysfunctions; an objective neurological and neck-shoulder examination; and a battery of complementary instrumental tests which are described in this study. These investigations include evaluation of muscle tension (manual palpation, algometry, EMG recording), kinematic analysis of the cervical spine, neuropsychological and psychological evaluation, and evaluation of disability. In order to assess cervical spine mobility in WAD patients, a 3D kinematic analysis by means of the ELITE system and clinical evaluation were performed in our setting. Seventy patients with whiplash injury and 46 healthy volunteers were enrolled in the study. Patients were tested at the time of first consultation and again 6 months and 12 months later. Clinical evaluation of the range of motion was performed both in patients and in 41 healthy volunteers. Furthermore, patients diagnosed according to the WAD Classification as grade 2 (n = 68) or grade 3 (16) underwent a Quality of life (QoL) evaluation, measured using the short form (36-item) Health Survey (SF36) and the migraine-specific questionnaire (MSQ). According to our data, whiplash patients showed an impairment of cervical spine mobility, as well as a poor QoL, compared to a control group population, even though we observed a trend towards improvement over time in cervical ROM.

Biomechanical Phenomena↗
PubMedDate not supplied

Does extended lymphadenectomy influence prognosis of gastric carcinoma after curative resection?

BACKGROUND/AIMS: It is unclear whether gastric cancer prognosis is improved by extended lymph node dissection more than by lymph node dissection limited to the contiguous N1 perigastric lymph nodes. METHODOLOGY: Four hundred and thirty-eight patients treated by curative gastrectomy were evaluated. Outcomes of D1/D1.5 lymphadenectomy, limited lymph node dissection and of D2/D2.5 lymphadenectomy, extended lymph node dissection and histopathological prognostic factors as in the 1993 TNM staging classification supplement were analyzed. RESULTS: Estimated overall 5-year survival was 54.9%. Five-year survival was 58.4% in the limited lymph node dissection group and 54% in the extended lymph node dissection (P n.s.). Stage I 5-year survival was 59% after D2.5 lymph node dissection, 58% after D1.5 and 50% after D2 dissection (P n.s.). Stage II 5-year survival was 86% in D2.5 group and 56% in D1.5 group (P = 0.041). Stage IIIa survival was 61% in the D2.5 group and 22% in the D1.5 group (P = 0.001). Stage IIIb 5-year survival was 42% after D2.5 resection and 0% in D1.5 group (P = 0.001). In the pT3 group 5-year survival was 72% after D2.5 dissection and 33% after D2 dissection (P = 0.001). In the positive N1 lymph nodes group 5-year survival was better after extended lymph node dissection than after limited lymph node dissection. In pN2a patients 5-year survival was 57% after D2.5 resection and 0% after D2 resection (P < 0.001). In pN2b and pN2c patients extended lymph node dissection did not statistically improve survival. CONCLUSIONS: Even if no statistical differences were found in overall survival, prognosis was improved by extended lymph node dissection in stage II and III, particularly in T2 and T3 subgroups and in N1 and N2a subgroups. When large numbers of positive nodes were found, improved survival was dependent upon resection of extragastric nodes distal to the uppermost echelon of positive nodes.

Adenocarcinoma↗
PubMedDate not supplied

Complex fractures of the femur: treatment with a long gamma nail: short- and medium-term experience.

The introduction of the gamma nail and of the long gamma nail, associating the principle of intramedullary nailing and of the sliding screw-plate, has led to good results in the treatment of complex fractures such as per-sub-trochanteric fractures and associated fractures of the femoral neck-diaphysis. In this study, our experience with the long gamma nail (Long Gamma Nail Howmedica) is presented. Of the 43 patients treated between 1993 and 1998, 21 (49%) with a mean follow-up of 2.5 years (1-5 years) were reviewed. Clinical and a radiographic evaluations were obtained for each of the patients. This study showed that there was a high incidence of poor consolidation (dysmetria in 10 patients, torsion deficit in 7, consolidation in varus of the femoral neck in 1 patient) particularly in associated fractures of the femoral neck and diaphysis, accompanied, however, by good functional recovery (only 3 patients with modification in the angle of progression of the foot) and by the satisfaction of the patients questioned. Thus, indications for the use of this device in proximal fractures of the femur, particularly in elderly patients and in high-energy traumas, are demonstrated.

Adult↗
PubMedDate not supplied

Synchronous and metachronous retroperitoneal sarcomas: two case reports.

BACKGROUND: Retroperitoneal sarcomas represent less than 1% of all diagnosed human neoplasias. They are generally malignant and can infiltrate retroperitoneal structures. The value of chemotherapy and radiotherapy are difficult to evaluate and the dominating factor in the outcome is the ability to resect the tumor. A few patients develop distant metastases. Recurrence of sarcoma at the operative site and on peritoneal surfaces is a prominent cause of morbidity and mortality. CASE REPORTS: Here we report two patients who underwent surgery for retroperitoneal sarcoma. In each of them at least two primary retroperitoneal tumors were diagnosed. The neoplasms were histologically different, thus they cannot be considered local recurrence but rather primary tumors. CONCLUSION: This is the first report underlying the synchronous or metachronous presence of different histological subtypes in this neoplastic pathology. In explanation of the occurrence of satellite tumors and multiple primary tumors, a virus-associated etiology or polyclonality of the tumor or pluripotentiality of tumor stem cells should be considered.

Aged↗
PubMedDate not supplied

On the presence and ultrastructure of valves in the lymphatic vessels of the canine ovary.

The origin and course of the intraovarian lymphatic vessels were examined by means of histologic studies of the gonads of pubertal female dogs. The small vessels that were present in the cortex near the follicles and corpora lutea flowed into an anastomotic network located at the margins of the medulla. Vessels of larger caliber were found to originate from the medulla and to reach the hilum by an approximately rectilinear pathway. In concordance with their previous findings in other species, the authors identified numerous semilunar valves in the lymphatic vessels of the cortex. Their ultrastructure is described.

Animals↗
PubMedDate not supplied

Angiolymphoid hyperplasia with eosinophilia: a rare artery lesion.

BACKGROUND: Angiolymphoid hyperplasia with eosinophilia (AHE) is a rare skin condition of unknown aetiology. The lesion seems neoplastic in nature, or at least an abnormal vasoproliferative reaction. CASE REPORT: A 40-year-old man presented with an 18-month history of erythematous papula over the right temporal area without a history of trauma. The patient reported a history of Hodgkin lymphoma at the age of 20, treated by radiochemotherapy. A subcutaneous nodule was found on the superior branch of the right temporal artery. An echocolordoppler revealed a normal temporal artery flow with pariental thickness. An excisional biopsy was performed and the patient remained asymptomatic at 24 months. The histological diagnosis was angiolymphoid hyperplasia with eosinophilia of the temporal artery. CONCLUSION: More appropriate studies are necessary to assess whether AHE is a manifestation of an unknown immunological disorder. If a correlation could be found between an altered immunological system and AHE, an intensive follow-up could be applied to patients. We report this case to encourage further studies to highlight potential challenges in the diagnosis and management of variants of vascular processes, such as AHE.

Adult↗
PubMedDate not supplied

Management and survival of patients affected with obstructive colorectal cancer.

Between 1978 and 1984 a consecutive series of 571 patients with colorectal cancer were admitted to the First Department of Surgery of the University of Rome. Patients were divided into a group of 82 patients affected with obstructive cancer and a control group of 489 patients with non-obstructive tumors. In the obstructed group there was a significantly higher incidence of lesions localized in the left colon. Depending on the advancement of lesions a significantly higher incidence of Dukes D tumor, nodal involvement, hepatic metastases and peritoneal dissemination and a significantly lower incidence of Dukes A tumors, were found in the obstructed patients. No significant differences were found in the two groups according to age distribution, duration of symptoms and degree of differentiation of neoplasms. The mortality and morbidity rate were 9.7% and 12.2% respectively in the obstructed patients, and 3.5% and 8.3% respectively in the non-obstructed patients. The rate of complications was greater in the two groups when serum albumin values were under 3 g/l, being 40% vs. 3.3 and 20% vs. 5.2% in obstructed and nonobstructed groups respectively. When Hb levels were under 10 g/l the incidence of complications was 16.7% and 14.4% for the two groups, while when it was higher than 10 mg% the morbidity rate was 8.7% and 6.3% in obstructed and non-obstructed patients respectively. The execution of surgical treatment within 24 hours was related to a morbidity and mortality rate of 50% and 22.2% in obstructed patients, and 40% and 20% in the non-obstructed group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗