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Biomedical subjects

F Meriggi

Publications and source records attributed to F Meriggi.

At least 55 records · Page 3Linked to original sources

Prostaglandin E1 (PGE1) gastric tissue levels in the rat after truncal vagotomy and/or pre-hepatic portal hypertension.

Three groups of female Wistar rats were considered to study the pathophysiologic changes induced by truncal vagotomy and/or prehepatic portal hypertension. The first group was subjected to transabdominal bilateral truncal vagotomy (T.V.) and Heinecke-Mikulicz pyloroplasty, the second group to main portal vein partial stenosis (P.P.S.), and the third one simultaneously to T.V. plus P.P.S. The rats were sacrificed and the stomach homogenized. The separation and simultaneous measurement of gastric prostaglandin E1 (PGE1) resulted from high performance liquid chromatography (H.P.L.C.). Mass spectrometry (M.S.) was used for identification of several gastric PGE1 samples in purified extracts. Control rats were also sacrificed and examined. With regard to PGE1 gastric contents, the following results are reported: 1.2405 +/- 0.1356 micrograms/g (control rats), 0.786 +/- 0.1296 micrograms/g (T.V. rats), 1.8495 +/- 0.3433 micrograms/g (P.P.S. rats), and 1.2754 +/- 0.1154 micrograms/g (T.V. + P.P.S. rats). The interpretation of results is made at the moment on a hypothetical basis.

Alprostadil↗

[Peritonitis encapsulans. Anatomo-clinical aspects. Case report].

Peritonitis encapsulans is a clinical interest on account of its rarity and the diagnostic difficulties caused by its aspecific symptomatology. A personal case is presented and its ambiguous clinical and instrumental picture is discussed. Diagnosis was finally obtained intraoperatively, after repeated episodes of mechanical ileus had made surgery mandatory.

Abscess↗

[Tumoral pathology of the jejunum. Apropos of 5 cases].

1654 cases of tumour of the digestive tube operated on in the Department of General Clinical Surgery and Surgical Therapy of the University of Pavia, during the period 2nd half 1964--1st half 1977, have been considered. Four primary tumours (1 leiomyoma, 2 adenocarcinomas, 1 reticulosarcoma) and one secondary tumour (metastases of retroperitoneal sarcoma) occurred in the jejunum and their pathology is examined from the etiopathogenetic and anatomoclinical viewpoints.

Adenocarcinoma↗

[Juxta-ampullar duodenal diverticula and bilio-pancreatic pathology. Considerations on 2 clinical cases].

75% of duodenal diverticula occur in the second or descending portion where, in 60% of cases, a juxta-Oddian site is involved. In about 10% of cases, juxta-Oddian forms may be responsible for symptoms due to their own effects or those induced in the biliary and pancreatic area. Two cases in female patients are presented and the subject is examined from all aspects in the light of 85 cases from the literature. Exact preoperative diagnosis is difficult. Radiological examination of the digestive tract and bile ducts, though by no means conclusive, is the only effective instrumental aid. When the symptoms are clear or indicative, surgery is necessary to prevent complications. In the two reported cases, an unevenful course and complete recovery were observed after diverticulectomy combined with papillosphincteroplasty.

Aged↗

Interactions between liver allografts and lymphocytotoxic alloantibodies in inbred rats.

Several clinical and experimental findings suggest that liver allografts are less sensitive than other organ allografts to lymphocytotoxic antibodies. In this experimental study in hypersensitized inbred rat recipients, rejection of liver allografts was delayed compared to that of heart allografts. Furthermore, there was a marked decrease in the level of cytotoxic antibodies after liver allografting but not after heart allografting in these animals. The decrease in the level of antibodies also occurred after donor-specific extracorporeal liver hemoperfusion in hypersensitized recipients. Whether the decrease was caused by a massive absorption of antibodies on the liver or related to excretion of major histocompatibility complex antigens in a soluble form remains to be demonstrated. These results support the hypothesis that the liver has a privileged position in regard to rejection and are consistent with clinical observations made following ABO incompatible or cross-match positive liver transplantations.

Animals↗

A phase II trial of ProMACE-CytaBOM in previously untreated non-Hodgkin's lymphoma of intermediate- or high-grade histology.

Between November 1985 and June 1989 the aggressive combination chemotherapy programme ProMACE-CytaBOM was used at a community-based hospital as primary treatment for non-Hodgkin's lymphoma (NHL) of intermediate or high-grade histology in Ann-Arbor stages IB-IV. The 53 patients entering the study represented 90 per cent of all consecutive eligible patients with NHL diagnosed during the time period considered. Their median age was 54 years and median observation time was 36 months. Of 50 patients evaluable for response, 35 (70 per cent) achieved complete remission (CR), seven (14 per cent) partial remission, and five (10 per cent) were refractory. Treatment was given on an outpatient basis. Actually delivered drug doses ranged from 88 per cent to 97 per cent of the theoretical doses. Life-threatening toxicity was experienced by four patients. Treatment was stopped in three cases (6 per cent) because of toxicity and there was one treatment-related death. Actuarial 2-year disease-free survival of patients in CR was 73 per cent. Overall actuarial 3-year survival and disease-free survival were 67 per cent and 51 per cent respectively. High LDH level was a significant adverse prognostic factor both for achievement of CR (P less than 0.005) and for survival (P less than 0.0002). Age was of no prognostic importance. We conclude that ProMACE-CytaBOM is an effective, easy to administer and well-tolerated regimen for patients with aggressive NHL.

Antineoplastic Combined Chemotherapy Protocols↗

Primary carcinoid tumor of the ovary: report of an unusual case.

Carcinoid tumors are endocrine malignancies that are often associated with a characteristic syndrome, the malignant carcinoid syndrome, which is most common in patients with small bowel tumors and liver metastases. In the rare instances when the syndrome is present without liver metastases the primary tumor is usually localized to the bronchus or ovary and secretes hormones directly into the systemic circulation. About two thirds of patients with carcinoid syndrome have evidence of carcinoid heart disease. We report on a case of a primary ovarian carcinoid tumor with an unusual clinical presentation.

Aged↗

Mitomycin-C and lonidamine as second-line therapy for colorectal cancer: a phase II study.

AIMS AND BACKGROUND: Recent preclinical data have suggested that lonidamine may potentiate the acitivity of mitomycin C in human colon cancer cell lines LoVo and HT29. STUDY DESIGN: A phase II study was carried out in 14 patients with advanced colorectal cancer pretreated with fluorouracil and folinic acid. Treatment consisted of lonidamine, 600 mg po, followed after 2 h by mitomycin, 20 mg/m2 by iv bolus, followed by lonidamine, 150 mg tio for 5 days; the cycle was repeated every 6 weeks. RESULTS: No objective response was seen. Three patients had stable disease; the median survival for the whole group was 4 months. Although hematologic toxicity was negligible, lonidamine-related side effects were moderate to severe in most patients and mainly represented by myalgia and gastric pain. DISCUSSION: Despite a sound preclinical rationale, this schedule of lonidamine and mitomycin C was ineffective and toxic in patients with advanced colorectal cancer. More experimental data about lonidamine are needed in order to design more effective regimens based on the combination of this interesting drug with other anticancer agents.

Adult↗

[Neoplastic obstruction of the vena cava inferior in general surgery].

Patients with primary or secondary tumoral occlusion of the inferior vena cava are difficult to be managed with safety and success. Nevertheless, their survival may be prolonged by an aggressive surgical approach according to the technical advances of liver transplantation. In fact, it is possible to perform a tumoral exeresis including the inferior vena cava by a total vascular exclusion of the liver (HVE) and a pump-driven veno-venous bypass (ECC). The Authors report the management of 8 patients with inferior caval tumoral involvement (8 M, 1 F, mean age 63.7 yrs). Vascular occlusion was caused by caval leiomyosarcoma (n 1), renal cell carcinoma (n 3), hepatocellular carcinoma (n 1), liver metastases (2 colorectal, 1 renal). Five patients (62.5%) underwent surgical treatment (2 laparotomy, 2 wide nephrectomy with partial caval wall resection in HVE, 1 ex vivo liver resection with caval venoplasty in HVE and ECC). Operative mortality was 40%. Three patients underwent medical treatment (radio-chemotherapy, chemoembolization). Total survival rate was 75% at 3 months, 50% at 6 months, and 25% at 24 months. Two patients (25%) are still alive at 3 months from the diagnosis and at 36 months from the operation.

Aged↗

[Surgical resection of hepatic hilar tumors].

Hepatic hilar cancer has an extremely poor prognosis and resection for cure is a realistic possibility in only 15-20% of patients. Tumours confined strictly to the biliary confluence can often be excised locally without resorting to hepatic resection (Bismuth's type I, II). Tumours extending beyond the second order bifurcation (Bismuth's type III) require hepatic resection. In the period 1996-1998 ten patients with hilar cancer (adenocarcinoma) underwent curative resection at our Institution. There were 9 men and 1 women with a mean age of 61.7 years (range 49-76 yrs). One neoplastic lesion was Bismuth's type I, five type II, four type III. The mean preoperative bilirubin level was 20 mg% and the mean duration of jaundice was 4 weeks. Four patients had skeletonization resection of the tumour and extrahepatic bile ducts, clearing all lymphocellular and other tissue from the hepatic pedicle and coeliac axis. Bilioenteric continuity was reestablished by a Roux-en-Y jejunal loop with separate biliary duct anastomoses. Six patients required also hepatic resection to adequately remove the tumour (1 right hepatectomy, 2 right lobectomy, 2 left hepatectomy, 1 segmentectomy III). Three patients had liver metastases. One patient had involvement of the left arterial and portal branch. The postoperative staging was 2 stage II, 1 stage III, 7 stage IV. In 5 patients hepatic lymph nodes (N1) were involved. In no patient the tumour was found at the margin of resection. The median estimated blood loss for hepatic resection was 1,000 ml and for skeletonization 500 ml. Intraoperative mortality was 0%. Operative mortality was 20%. Three patients had a complicated postoperative course (1 cerebral TIA, 1 multiorgan failure, 1 ictus cerebri). All patients died. The mean postoperative survival was 7.4 months. Four patients (N1+) died of local tumour recurrence at 8, 11, 6, and 8 months. In our experience resective procedures can achieve a longer survival and a better quality of life. The operative mortality may be kept to a minimum by adequate selection of patients and technical expertise.

Aged↗

[Hepatic cystadenoma: a case report].

Hepatic cystadenoma is a rare tumor arising from the biliary system. Although ultrasound and CT scan show peculiar features, diagnosis is not easy preoperatively. Because of the unreliable natural history of cystadenoma, total excision of the neoplasm by hepatic resection seems to be the treatment of choice. A case of benign cystadenoma treated by minor liver resection is reported.

Adult↗

Delaying rejection in discordant heart xenografts in the rat: efficacy of cyclosporin, prostaglandin I2 and exchange transfusion.

If effective modes of prevention of hyperacute rejection were available, the problem of the absence of enough suitable donors could be solved by the use of organ xenografts. Organ xenograft rejection is principally mediated by preformed antibodies which are responsible for the hyperacute pattern of rejection. We decided therefore to study various methods of prevention of rejection in the guinea pig to Lewis rat combination (donor-recipient discordant species) in which hyperacute rejection is particularly intense. Three series of experiments were performed. In the first series immunosuppression of the recipient was induced using an oral solution of cyclosporin A. In the second series antiplatelet-aggregation therapy was administered to the recipient, using intravenous prostacyclin (PGI2). In the third series antibody depletion of the recipient was attempted using exchange transfusion with or without prostacyclin perfusion. The most significant (p less than 0.01) prolongation of graft survival time was observed when combining exchange transfusion (8 ml) and PGI2 infusion (620 ng/kg/min). This observation suggests that, if antibody depletion in the recipient is the primary goal, measures aiming at reducing the consequences of the antigen-antibody reaction are also necessary to improve the results of organ xenografting.

Animals↗

[Rejection of discordant xenografts of the liver and heart].

Comparative study of the rejection of 26 heart and liver xenografts in strain discordant combination (guinea pig/rat lewis) allows the authors to establish the liver's weakest sensibility to natural xenoantibodies, the modesty of histological signs on liver xenograft rejection, and these lost's more longer survival. The results are compared to those obtained with 26 heart and liver isografts.

Animals↗