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Biomedical subjects

G C Anselmetti

Publications and source records attributed to G C Anselmetti.

18 recordsLinked to original sources

Complicated jejunal diverticulosis: report of a case.

The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. Endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60-70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.

Aged

Giant sigmoid diverticulum.

The case of a giant diverticulum of the sigmoid colon in a 74 year-old woman is reported. The diverticulum had perforated into the urinary bladder and required a 3-phase operation with resection of the sigmoid colon and urinary bladder. Giant diverticulum is considered a rare complication of diverticulosis. Generally, it is a pseudo-diverticulum that grows due to a valve mechanism working in the neck of the diverticulum. The differential diagnosis lies mainly between intestinal duplication and pneumatosis cystoides. Surgical therapy yields favorable results.

Aged

[Percutaneous transjugular intrahepatic portosystemic shunt (TIPS). The preliminary experience and proposal of a new method].

A new interventional procedure employing metallic stents has been recently suggested to perform percutaneous portosystemic shunts in the treatment of variceal bleeding in portal hypertension; the technique is called TIPSS (transjugular intrahepatic portosystemic stent shunt). This percutaneous treatment presents several advantages over surgery: the shunt diameter can be calibrated according to the degree of portal hypertension; moreover, TIPSS can be performed in patients waiting for liver transplantation because it does not alter the vascular anatomy of liver. The original technique employed transhepatic portography. In this paper the authors report on their personal experience and present their series of 4 patients with portal hypertension and variceal bleeding, in whom TIPSS was performed utilizing noninvasive US guidance. Variceal bleeding was successfully treated in all patients and variceal distension was also obtained.

Adult

[Percutaneous transcatheter embolization of deep visceral pseudoaneurysms].

The authors present their experience with the percutaneous embolization of 13 splanchnic aneurysms and pseudoaneurysms (2 pseudoaneurysms of gastroduodenal artery, 3 of the hepatic artery, 7 renal pseudoaneurysms, 1 aneurysm of the splenic artery). In 9 of 13 cases the lesions were iatrogenic. Embolizing devices and techniques are described. Percutaneous embolization was successful in 12 of 13 cases, and useless in 1 case of renal pseudoaneurysm. In the 12 successfully treated cases the lesions were still occluded in the follow-up period. Transcatheter percutaneous embolization is the elective treatment in splanchnic aneurysms and pseudoaneurysms; surgery must be performed only when embolization fails.

Adult

[Emergencies in the surgery of colonic neoplasms. A review of the literature and the authors' cases].

The paper reports the personal experience of the 2nd Division of General Surgery of the Martini Hospital in Turin and compares it to the results of the most recently published studies. Of 123 patients who underwent emergency surgery, 101 were suffering from tumors of the colon complicated by intestinal occlusion and 22 by perforation. Only right hemicolectomy was performed in cases of perforation or resection with ileostomy and colic mucous fistula was used for neoplasms located in the right colon; Hartmann's operation or dual ostomy was performed in the event of neoplasms in the left colon. Surgical treatment of occlusive tumors of the left colon is still the subject of continued debate. The elective surgical technique is an amblée resection using colo-colic anastomosis with a protective ostomy. This is followed by Hartmann's operation, whereas decompressive colostomy should only be used in patients who are admitted to hospital in generally precarious conditions.

Aged

The innervation of human teeth and gingival epithelium as revealed by means of an antiserum for protein gene product 9.5 (PGP 9.5).

The innervation of human teeth and oral mucosa has been studied in the past by different methods, none of which offered a clear description of the precise morphology of nerve fibers and terminals and of nerve organization as a whole. Recently, interesting findings have been obtained by means of immunohistochemical investigations for neurofilaments and S-100 proteins. A new brain-specific molecule, protein gene product 9.5 (PGP 9.5), has been used for the first time in the present research to investigate the distribution of nerves in human oral mucosa and decalcified teeth, about which there is a paucity of information. The data provided in this study, confirming previous work in other species, may be of value for understanding the anatomy of human oral innervation. In the oral mucosa, the antiserum labels nerve fibers, corpuscles, and neuroendocrine (Merkel) cells. In sections of decalcified teeth, numerous PGP 9.5 positive fibers are demonstrated in the pulp and in the inner 100 microns of dentin. The novel nerve tissue protein used, PGP 9.5, thus appears to be a reliable marker for studies of nerve fibers in human tissues and not to be affected by decalcification procedures. It could then be used for investigations on the innervation of normal and pathological calcified human tissues.

Dentin

Sexual differentiation and hormonal control of the sexually dimorphic medial preoptic nucleus in the quail.

We recently identified a sexually dimorphic nucleus in the preoptic region of the Japanese quail, the medial preoptic nucleus (POM), which is significantly larger in males than in females. In the present study, we investigated the hormonal control of this morphological neuroanatomical difference and the possible relationships between the sexual dimorphism in POM volume and in copulatory behavior. Treatments which are known to affect sexual behavior were thus applied to different groups of birds and the POM volume was then measured. In one experiment, male and female quails were either gonadectomized, gonadectomized and treated with testosterone or left intact. The larger size of the POM in males was confirmed and treatments significantly affected the nucleus size which was decreased by gonadectomy and restored by testosterone treatment in both sexes to a level similar to that seen in intact males. In two other experiments, eggs were injected with estradiol benzoate on day 9 of incubation and the POM volume was measured in adulthood either in intact birds or in gonadectomized birds receiving a replacement therapy with testosterone. Despite the fact that estradiol benzoate treatment completely suppressed copulatory behavior, it did not affect the volume of the POM or slightly increased it. These data thus show that the POM volume is controlled by testosterone levels in adulthood and could thus be an interesting model for the study of the effects of steroids on the brain.

Animals

A sexually dimorphic nucleus in the quail preoptic area.

The cytoarchitectural analysis of the preoptic-anterior hypothalamic region of the Japanese quail reveals a sexual dimorphism in the total volume of the medial preoptic nucleus (significantly larger in males than in females). Different nuclei of the region (dorsal preopticus, suprachiasmaticus) do not show any statistically significant difference. The sex-related difference is more consistent comparing the distribution of dark volume. This last is due to a larger number of cells containing high amount of Nissl's substance in male than in female. Present findings represent the first example of sexual dimorphism in the avian hypothalamus.

Animals

[The transcatheter recanalization of occluded portosystemic shunts].

UNLABELLED: The authors present their personal experience in percutaneous treatment of portosystemic shunt occlusion and stenosis by percutaneous transluminal angioplasty (PTA) and fibrinolytic local infusion. Twelve patients with portosystemic shunt stenosis or occlusion were percutaneously treated. In 8 patients only PTA was performed, 4 were treated with local fibrinolytic infusion, in 3 of the latter cases this treatment was followed by PTA. In all 12 patients recanalization was successful and non complications arose. Six patients died in the following 15 months, none due to rebleeding. In 5 of these patients the shunt was patent at post-mortem examination. In the 6 patients still alive in the follow-up period (2 to 25 months, mean 14.5 months) the shunt was patent in 4 and occluded in 2. IN CONCLUSION: percutaneous treatment with PTA or fibrinolytic local infusion is preferable in non-functioning portosystemic shunt; further surgery is always extremely risky in such patients.

Adult

[Quantitative computerized tomography in the study of osteoporosis. Our experience].

In the diagnosis of osteoporosis there are, today, several techniques for investigating bone mineral density. In this work the authors evaluate the sensitivity of Computed Tomography in the diagnosis of this metabolic disease, because of the built-in competence of this method in determining the density of the anatomical tissues. In a randomised study the Authors performed Single Energy Quantitative Computed Tomography (SEQCT) in estimating the bone mineral density of lumbar vertebrae in 44 female patients. The data obtained were correlated, using the Student "t" test, to the measurements acquired, in the same group of patients, employing Dual Energy X-ray Absorptiometry (DEXA), 27 patients, and Total Body DEXA, 17 patients. Results revealed a good correlation between SEQCT and DEXA (R = 0.89) and statistical significance (p < 0.001). On the contrary there is not a good correlation (R = 0.58) if SEQCT is compared to Total Body DEXA. According to our experience Quantitative Computed Tomography is useful in diagnosis osteoporosis and it should be performed in all post-menopausal patients. This method, which has a high level of precision, is cheap and easily adaptable to every Computed Tomography. Because of the high X-ray dose rate, only DEXA should be performed in monitoring patients undergoing therapy.

Absorptiometry, Photon

[Hemobilia following biliary drainage: percutaneous treatment with arterial embolization and biliary fibrinolysis].

The Authors report a case of haemobilia following the performance of biliary drainage. Angiography of the celiac tripod and superior mesenteric artery was carried out in order to evidence the lesion and to perform, during the same session, embolization of the leaking vessel by means of fibrin sponge particles (Spongostan). Subsequent cholangiographic controls demonstrated the presence of bile ducts clots then treated by loco-regional infusion of urokinase. On the basis of the Authors' personal experience, the combination of loco-regional biliary fibrinolytic treatment and embolisation leads to the resolution of the cause of hematobilia and of retention jaundice.

Aged

[Computerized tomography with lipiodol in hepatocarcinoma. Assessment of its diagnostic accuracy with anatomo-pathological control].

PURPOSE: To assess the diagnostic accuracy and predictive value of Lipiodol CT for hepatocellular carcinoma (HCC) before liver transplantation (OLT). MATERIAL AND METHODS: Seventy-eight cirrhotic patients awaiting OLT underwent Lipiodol CT to demonstrate the presence and extent of possible HCC. Radiologically, focal uptake areas with dense, homogeneous or "mosaic" iodized oil uptake were considered to be neoplastic nodules. All patients underwent OLT within 4 months of Lipiodol CT. Pathologic examination of the explanted livers was performed using the standard technique and, if necessary, with additional slices. Pathologic findings were compared with radiologic results to calculate the diagnostic accuracy and predictive value of Lipiodol CT in relation to both patients and lesions. RESULTS: Lipiodol CT depicted 61 focal areas of iodized oil uptake in 48 patients; pathologic examinations detected 57 HCC lesions in 42 patients (diameter .8 cm, mean 2.2 cm); agreement with radiologic diagnosis was found in 35 patients only. Patient by patient, Lipiodol CT had 83.3% sensitivity, 63.8% specificity, 74.3% diagnostic accuracy, 72.9% positive predictive value (PPV), and 76.6% negative predictive value. Lesion by lesion, Lipiodol CT showed overall sensitivity and PPV of 75.4-70.5%, 74-69.8% for "small" HCCs (diameter < or = 3 cm), and 72.9-71.1% for nodules < or = 2 cm in size. Eighteen uptake areas in 13 patients were diagnosed as HCC by Lipiodol CT but the finding was not confirmed at histology: 4 were hemangiomas and 14 corresponded to cirrhotic tissue without neoplastic foci. CONCLUSIONS: Our study, as the few others comparing radiologic results and pathologic findings of whole explanted liver, demonstrates that Lipiodol CT has relatively low diagnostic accuracy; particularly, specificity and PPV were limited by possible false positives, with HCC overstaging and mistakes in the indications/contraindications for OLT.

Adult