Biomedical subjects

F Fanfani

Publications and source records attributed to F Fanfani.

41 records · Page 3Linked to original sources

PubMedDate not supplied

Endometrial cancer: magnetic resonance imaging.

Carcinoma of the endometrium is the most common invasive gynecologic malignancy of the female genital tract. Clinically, patients with endometrial carcinoma present with abnormal uterine bleeding. The role of magnetic resonance imaging (MRI) in endometrial carcinoma is disease staging and treatment planning. MRI has been shown to be the most valuable imaging mod-ality in this task, compared with endovaginal ultrasound and computed tomography, because of its intrinsic contrast resolution and multiplanar capability. MRI protocol includes axial T1-weighted images; axial, sagittal, and coronal T2-weighted images; and dynamic gadolinium-enhanced T1-weighted imaging. MR examination is usually performed in the supine position with a phased array multicoil using a four-coil configuration. Endometrial carcinoma is isointense with the normal endometrium and myometrium on noncontrast T1-weighted images and has a variable appearance on T2-weighted images demonstrating heterogeneous signal intensity. The appearance of noninvasive endometrial carcinoma on MRI is characterized by a normal or thickened endometrium, with an intact junctional zone and a sharp tumor-myometrium interface. Invasive endometrial carcinoma is characterized disruption or irregularity of the junctional zone by intermediate signal intensity mass on T2-weighted images. Invasion of the cervical stroma is diagnosed when the low signal intensity cervical stroma is disrupted by the higher signal intensity endometrial carcinoma. MRI in endometrial carcinoma performs better than other imaging modalities in disease staging and treatment planning. Further, the accuracy and the cost of MRI are equivalent to those of surgical staging.

Endometrial Neoplasms↗

PubMedDate not supplied

[Treatment of scaphoid waist fractures by shape memory staples. Retrospective evaluation on 60 cases].

OBJECTIVES: In carpal scaphoid fractures, treatment with screws is considered the gold standard: ostheosynthesis with mini-staples is not the usual choice of treatment. The authors report a study on fractures of the middle third of the scaphoid treated by mini shape memory staples, in order to test the quality of reduction and ostheosynthesis, functional results, time of union and complications. MATERIALS AND METHODS: A retrospective analysis of 60 patients, with average age 39 years old and follow-up 36 months, was performed. Evaluation criteria were: the grade of pain, flexion-extension and pronation-supination wrist range, hand grip strength, radiographic consolidation of fractures and lateral intrascaphoid angle of flexion as described by Amadio. RESULTS: Pain was absent in 86% of the cases, the average flexion-extension range achieved was 107 degrees and the average pronation-supination range 171 degrees. Hand grip strength values achieved were comparable to those of the controlateral wrist in 85% of cases. Radiographic consolidation of the fracture was achieved in all patients within three months of surgery and the average value of the lateral intrascaphoid angle of flexion was 37 degrees. No cases of algodystrophy were observed. CONCLUSIONS: Our results show the safety and the practicality of ostheosynthesis with mini shape memory staples in fresh unstable fractures of the middle third of the scaphoid. Stable fixation, continuous compressive force on fragments and the ability to allow early active movement, are the main advantages.

Adolescent↗

PubMedDate not supplied

Minilaparotomy for type II and III radical hysterectomy: technique, feasibility, and complications.

The objective was to assess the feasibility, the operative and postoperative outcome, and complications in the use of minilaparotomy for type II and III radical hysterectomy (RH) and pelvic lymphadenectomy (PLN) in early-stage cervical/endometrial cancer. A pilot study on 91 consecutive patients submitted to type II and III RH and PLN for early-stage cervical/endometrial cancer was performed between March 2002 and May 2003 in the Division of Gynecologic Oncology (UCSC, Rome). Thirty-two of 91 cases (35.2%) were eligible for minilaparotomy. The mean operative time was 156.7 min, whereas the mean intraoperative estimate of blood loss was 303.7 ml. A mean number of 32.7 pelvic lymph nodes and 6.2 common iliac nodes were removed. Ileus and removal of bladder catheter were on mean postoperative day 2.4 and 3.4, respectively. The mean number of postoperative days spent in the hospital was 3.7. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy and Pfannenstiel incision, showing substantially comparable results. Minilaparotomy is acceptable for selected patients undergoing radical abdominal hysterectomy (RAH) and PLN and does not compromise the adequacy of the procedure. It can be considered as an alternative to the classic midline vertical incision or even to the Pfannenstiel incisions and laparoscopy.

Adult↗

PubMedDate not supplied

Severe prolonged gastroparesis after cytoreductive surgery in an advanced ovarian cancer patient.

Number and type of complications after ovarian cancer surgery can vary greatly according to both the patient's characteristics, and the extension and type of surgery. Current literature lacks in mentioning specific gastrointestinal side effects, which could be evidenced during the early postoperative course of patients submitted to major gynecological oncologic surgery. A severe gastroparesis prolonged for 2 months after cytoreductive surgery in an advanced ovarian cancer patient was successfully treated with conservative multidrug therapy. Gastroparesis has to be enumerated as a rare but possible event after major gynecological oncologic surgery. A conservative management involving decompressive nasogastric tube, nutritional support, antiemetic drugs, prokinetic drugs is suggested, while surgical therapy is only recommended in a very small subset of unmanageable patients.

Cystadenocarcinoma, Serous↗

PubMedDate not supplied

[Sandwich-graft myringoplasty: the authors' personal technic and results].

The authors describe the anatomic and functional results obtained with a sandwich myringoplasty technique (MPL) employing an endaural approach. The suggested technique is a modified sandwich MPL by endaural approach with a reduced Shambaugh incision, a systematic profiling of the canal wall bulge and separation of the meatal and tympano-meatal flaps that are maintained pedunculated. The temporal fascia is inserted between the fibrous layer of the tympanic remnant and a single pedunculated tympano-meatal cutaneous flap replaced in the original location. The authors present 72 cases operated between January 1987 and December 1989 for perforations involving up to three quadrants. In 93.1% of the cases a complete and lasting resolution of the perforation was obtained. Of the 5 failures, 4 presented a perforation smaller than the original one. An average (250, 500, 1000 Hz) functional recovery of 14.1 dB was observed compared to an average pre-operatory gap of 21.6 dB. In 25% of the cases, average recovery was greater than 25 dB and in 5 patients a slight worsening with an average difference of -3.3 dB was observed. On the whole, in 41 patients a residual post-operatory gap of only 10 dB was achieved. The anatomical results obtained with the MPL presented are similar to those found in the literature describing the classical overlay technique. However, the cases reported do not present those inconveniences associated to the latter technique (lateralization of the graft and blunting). The anatomic and functional results obtained with the technique discussed are on the whole superior to those described with the underlay and the classical overlay techniques. The Authors believe that this is mainly due to the absence of the gelfoam in the middle ear and to the double contention and vascularization of the temporal fascia graft. By means of the profiling of the canal wall the endaural approach permits a good view of the operating field. Furthermore, it is less traumatic and more acceptable to the patient than the postauricular one that has to be limited to the MPL where there are clinical indications for the exploration of antrum. The personal technique here presented implies, however, a certain presence of epithelial pearls. Their localization is nevertheless facilitated by the absence of blunting, thickening and lateralization of the graft. This allows for an early and easy removal on an out-patient basis. Other inconveniences of the technique are the length of the procedure and a more difficult control of the ossicular chain.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗