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Biomedical subjects

F Orcalli

Publications and source records attributed to F Orcalli.

6 recordsLinked to original sources

Palliative treatment of carcinoma of the rectum by endoscopic injection of polidocanol.

Between January 1987 and December 1988, at the Surgical Department of Chiarenzi Hospital, five patients underwent endoscopic intratumoral injection of polidocanol for palliative treatment of inoperable carcinoma of the rectum. Histological evaluation was performed in all cases. The patients comprised two males and three females aged 78 to 88 years (mean 83.4). One of them refused surgery for recurrent rectal cancer, four consulted us with impending intestinal obstruction; three were inoperable due to local spread of the tumor and poor general condition, the other was in a poor general condition due to massive metastatic hepatic disease. In all the patients, we observed remission of the obstructive symptoms with no major complications; none of them has required a colostomy. The follow-up period has covered a period of two months to two years. The technique of injection is simple, inexpensive and, properly performed, safe. All these advantages make this type of palliative treatment for rectal cancer interesting, even when compared with laser treatment, urological resectoscope or electric snare resection, and electrocoagulation.

Adenocarcinoma

Continuous peritoneal dialysis in acute experimental pancreatitis in dogs. Effect of aprotinin in the dialysate medium.

In 27 beagle dogs, acute necrotizing pancreatitis was induced by retrograde injection of autologous bile and trypsin into the main pancreatic duct. Animals were randomly assigned to the following treatments: group 1--(9 dogs) aprotinin 600,000 KIU/d by i.v. route; group 2--(9 dogs) peritoneal dialysis for 6 d plus 500,000 KIU/L of aprotinin in the dialysate fluid; group 3--(9 dogs) peritoneal dialysis without aprotinin in the dialysate fluid. All dogs of the group 1 died within 16 h following the induction of pancreatitis and extensive necrotizing and hemorrhagic changes were seen in the pancreatic and peripancreatic areas. Six dogs of the group 2 survived and no necrotizing changes were observed 30 or 50 d after the induction of pancreatitis. Three dogs of the group 3 survived, but slight necrotizing lesions were found at the autopsy. The survival rate was higher in dogs with peritoneal lavage (p = 0.0129) or with peritoneal lavage plus aprotinin (p less than 0.0001) than in those receiving i.v. aprotinin, indicating that the latter treatment has no beneficiary effect on the course of acute pancreatitis.

Acute Disease

[Lipoid pulmonary granuloma in Parkinson's disease. Presentation of clinical case].

The authors describe one case of lipoid granuloma of the lung in a patient with PARKINSON'S disease. The cause of this pulmonary sequel is probably to be found in the alteration of the mechanism of deglutition, typical of PARKINSON'S disease, with aspiration bronchopneumonia and subsequent evolution to granuloma formation. In the case presented (a man of 64) the X-ray picture resembled the irregular mass opacities and bronchial amputations characteristically associated with cancer of the lung. As the actual anatomical extent of the process exceeded the limits indicated by radiological examination, the whole left lung was removed at surgery; histological studies, however, revealed the essentially benign nature of the lesion. The patient was discharged in due course of time as surgically cured. There was no major deterioration of his neurological status either at discharge time or at later rechecks.

Granuloma

[Cancer of the gastric stump (author's transl)].

On the evidence of 24 cases of cancer of the gastric stump the authors discuss the real incidence of this dread complication; they conclude that starting 8 years after primary surgery, all patients carrying a gastric stump must be regarded as high-risk subjects for malignancy; further, they recommend that pyloro-gastrectomy after Billroth (II) be considered for execution in young patients with all possible reluctance.

Gastrectomy

[Bronchogenic cyst of the lung and pulmonary tuberculosis. Presentation of a case].

The paper considers a clinical case of multiple bronchogenic cysts associated with a pneumonitic process of TB character, operated successfully by means of an upper right and middle bilobectomy. No similar case was found in literature. The malformations were of congenital origin, characterised histologically by a cavity, the walls of which contain elements proper to the bronchus: cartilage and ciliate columnar epithelium. The squamous metaplasia is rare, and the neoplastic transformation very rare. From the clinical point of view a distinction is made between asymptomatic cysts, in which the clinical picture is dominated by compressive phenomena affecting the surrounding structures, or sometimes by infection due to supervening bacterial, mycotic or--as in our case--tubercular contamination. The therapeutic indication is exclusively surgical, with methods of exeresis varying according to the extent and location of the morbid process.

Adult

[Postgastrectomy metabolic problems].

A synoptic pattern is drawn up to synthesize the morpho-functional alterations and metabolic disturbances arising from total gastrectomy, while a comparison is made with those arising from massive resections of the small intestine (so-called short intestine syndrome). Emphasis is placed on the desirability of rebuilding the gastric reservoir and maintaining duodenal continuity through interposition of a loop. Among the various available techniques, preference is given to the Mouchet-Camey method, which seems to respond better than others to expectations of the patient's good metabolic recovery.

Humans