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Biomedical subjects

G Ettorre

Publications and source records attributed to G Ettorre.

At least 19 recordsLinked to original sources
PubMed2003

Perilymphatic gusher in stapedectomy: demonstration of a fistula of internal auditory canal.

Gusher is a very rare phenomenon, generally associated with congenital stapes fixation or otosclerosis in adult age, that may present during stapedectomy. A sudden perilymph flow occurs following platinotomy, due to congenital malformation (abnormally wide cochlear aqueduct or internal auditory canal fistula), that causes an abnormal connection between subarachnoid and perilymphatic spaces. This report deals with a case of bilateral gusher, occurring during stapedectomy, caused by an osseous fistula between bottom of internal auditory canal and the osseous labyrinth later observed at computed tomography scan. The usefulness of a radiologic examination is stressed for a correct therapeutic approach in the even contralateral ear stapedectomy.

Cochlea↗
PubMed2003

A combined approach of neoadjuvant chemotherapy and surgery for colorectal liver metastases.

Hepatic metastases represent one of major clinical problems in patients affected by solid tumours because liver is the first site of metastatic disease after lymph nodes, (1, 2). The most common origins among adults are from colon and rectum cancer followed by pancreas (adenocarcinoma or neuroendocrine), lung and breast (3-7). It is estimated that in 15-20% of patients affected by adenocarcinoma of colon-rectum liver metastases are present at the time of diagnosis (8-11), while in 40% of cases they will develop during the follow-up (10, 11). Liver metastases are the first determinant for survival (1, 3, 12-17), and both hepatic and extrahepatic involvement have a statistical significant impact on it (3, 14, 18-21). Prognosis of patients affected by untreated disease is very poor, being 5 to 14 months with rare 2-year survivors and a 5-year survival rate of 0% (10, 21-24). In half of all patients affected by colorectal cancer and undergoing to a radical surgery, disease will fail in the liver (8, 25-28); among patients dying for colorectal cancer, 60-70% have a liver involvement (9, 29), and in 20-25% liver is the only site of recurrence and death results from liver failure (3, 29-31). In Autoptic studies those rates increased up to 83% and 38% respectively (1, 10, 17, 32).

Adenocarcinoma↗
PubMed2003

Personal experience on treatment of colorectal liver metastases: a multidisciplinary approach.

UNLABELLED: Diagnosed colorectal cancer patients presents liver metastases at presentation in 25% of cases, an another 25% of patients will develop hepatic recurrence during follow-up period. Natural history of disease in untreated patients is sad without long term survivors. The only chance of curative treatment is surgical resection. Aim of this study was to evaluate recurrence and survival in the multimodal approach of colorectal liver metastases patients. MATERIALS: From 1990 to 2003, 212 colorectal cancer liver metastases patients were observed at the "Regina Elena" cancer institute of Rome, the 48.8% of cases were synchronous. Of 185 patients with minimum follow-up of 12 months, 80 were surgically resected, while 105 were not. Major resection was possible in 45.3% of cases and 66.1% of them were radicals. Tweny were treated by surgery alone, 65% were resected after i.v. chemotherapy, in the last 10% resection followed HAI chemotherapy. Of non resected patients, in the 36.2% i.v. chemotherapy was administered, 26.1% were submitted to HAI chemotherapy, in 18.9% others treatments were carried out and 18.8 were untreated. RESULTS: Operative mortality was contained to 2.5%. The hepatic recurrence was observed in 50.5% of cases while extrahepatic was in the 13.6%. In the resected cases the 5-yr. Overall survival was 38.8%, the disease-free survival decreased to 14.7% with a median time to progression of 15 months. The liver recurrence-free survival was 31.3%. Really bad prognopsis was observed in the non resected patients with none survived at 5 years and 3-yr overall survival of 18.7%. CONCLUSION: In selected patients the multimodality approach to treatment of hepatic metastases showed satisfactory results in terms of local and distal control of disease. Long term survivors were observed in the our experience.

Adenocarcinoma↗
PubMed1992

Acute systemic and splanchnic haemodynamic effects of L-carnitine in patients with cirrhosis.

L-carnitine (L-C) is a naturally occurring substance in mammalian tissues that has recently been proposed as a therapeutic agent in hepatic encephalopathy and liver steatosis. L-C also produces some acute, non-metabolic, haemodynamic effects that have not previously been studied in patients with cirrhosis. Therefore, the authors evaluated the acute effect of i.v. administration of L-C (30 mg/kg) on systemic and splanchnic haemodynamics in ten patients (L-C group) with chronic liver disease (Child-Pugh's class A: 4, B: 3, C: 3 patients) and a control group composed of ten patients with similar clinical characteristics (Child-Pugh's class A: 5, B: 2, C: 3 patients) who received placebo. Heart rate, cardiac index and pulmonary arterial pressure (measured by right heart catheterization) decreased slightly but significantly in the L-C group and the changes observed in stroke volume were highly correlated to the Pugh's score. Moreover, the hepatic venous pressure gradient (measured by hepatic vein catheterization) decreased significantly in the L-C group, whereas no changes occurred in the placebo group. The overall response to L-C was contradictory to that previously observed in animals and humans with normal liver function, and the extent seemed to depend on the severity of liver disease. The effect of the drug on cardiac index, heart rate and hepatic venous gradient could possibly be beneficial for patients with hyperdynamic circulatory condition and portal hypertension.

Adult↗
PubMed1990

Takayasu's arteritis: a case report and discussion of differences in eastern and western cases.

The possibility of a different clinical expression of Takayasu arteritis (TA) in different geographic areas has been discussed in previous reports. However, many aspects of this problem still remain unclear. A very atypical case of TA concerning the early onset and the unusually slow progress of the disease is reported. Referring to anatomicopathological, clinical, and therapeutic prognostic criteria reported in literature from oriental countries, many discrepancies appear evident. This is consistent with the hypothesis of two different clinical varieties of TA and suggests that, both in its prepulseless stage and after its actual recognition, this disease could show a less malignant progress in western countries.

Arteries↗
PubMed1984

Diagnosis of aneurysm of the thoracic aorta. Comparison between two non invasive techniques: two-dimensional echocardiography and computed tomography.

In order to assess the respective values of two-dimensional echocardiography (2D echo) and computed tomography (CT) in the evaluation of aneurysms of the thoracic aorta, 14 patients with angiographically proven aneurysms of the thoracic aorta (three of which were dissecting aneurysms) were studied. The entire thoracic aorta was visualized in 10/14 patients by 2D Echo and in all patients by CT. An intimal flap was recognized by 2D echo in each case with a dissection whereas such a recognition was never possible with CT. CT identified calcification of the wall of an huge aneurysm of the ascending aorta in one case and a thrombotic stratification in the lumen of the descending thoracic aorta in another case; both abnormalities were missed by echocardiography probably because of inappropriate gain setting. In conclusion, 2D Echo and CT are both useful in the evaluation of aneurysms of the thoracic aorta; 2D echo appears to be superior in the recognition of an intimal flap due to dissection whereas CT allows a better recognition of the configuration, extension and tissue modifications of the aneurysm.

Adult↗
PubMed1982

Differences between the concentrations of antiepileptic drugs in normal and pathological human brain.

The concentrations of antiepileptic drugs in histologically normal and pathological brain tissues were investigated in 6 patients submitted to surgery. No significant difference for phenobarbital and phenytoin was found between normal and scar tissue, whereas there was a trend to concentration in tumour tissue (meningioma and glioma) of phenobarbital, phenytoin and carbamazepine. Alteration in the vascular supply and pathological changes at cellular and subcellular levels could be responsible for the differences in the distribution of the drugs. The possible clinical relevance of the preferential concentration of the drugs in tumour tissue is discussed.

Adolescent↗
PubMed1980

Stereo-EEG and surgery in partial epilepsy with temporo-parieto-occipital foci.

Six cases of partial epilepsy operated on for lesions at the temporo-parieto-occipital junction are presented. Three cases had signs of enlargement of one lateral ventricle at the temporo-parieto-occipital carrefour, three had a lateral homonymous hemianopsia and all showed lateralizing interictal EEG abnormalities. The manifold features of the seizures could not be related to the involvement of one or more definite cortical areas. Since clinical, radiological, scalp EEG investigations provided no sufficient data to map the epileptogenic lesion to be excised, stereo-EEG studies with chronic depth electrodes were performed. Besides permitting the exact delimitation of the epileptogenic lesion, depth EEG gave the clue for interpreting physiopathological mechanisms underlying the electroclinical seizures in each case.

Adolescent↗
PubMed1980

Late results of stereotactic radiofrequency lesions in epilepsy.

Thirty-five patients with partial complex seizures and two patients with generalized epilepsy were treated by stereotactic radiofrequency lesions. Follow-up from 2 to 13 years was available in 30 patients. The stereotactic targets in patients with partial complex seizures were: a) Amygdala; b) Ammon's horns; c) parahippocampal gyrus; d) Fornix. Depending on scalp EEG and depth electrode studies, each patient had one or more target coagulated, unilaterally or bilaterally. In the 2 cases of generalized epilepsy, bilateral Forel field lesions were performed. Late surgical results are discussed in relation to the depth EEG studies and the number and site of stereotactic lesions.

Adolescent↗
PubMed1978

Chronic depth electrodes study of one case of bitemporal epilepsy due to glial tumour. Some physiopathological considerations.

The authors describe a seventeen-years-old girl suffering from partial seizures with complex symptomatology. The neuroradiological studies demonstrated a slow-growing glial tumour seated deeply in the right temporo-occipital region. Scalp EEG demonstrated a bilateral asynchronous temporal focus without definite lateralization. Chronic depth electrodes recording allowed identification of a primary epileptogenic area in the right rhinencephalic structures. Radiofrequency lesions performed in the right amygdala and anterior third of right Ammon's horn abolished the seizures at ten months follow up.

Adolescent↗
PubMed1977

Tumours of the fifth cranial nerve.

Tumours of the fifth cranial nerve are very rare, comprising only 0.2% of all intracranial neoplasms. The authors critically review the literature, and report on 12 personal cases of trigeminal tumours (nine neurinomas, one meningioma, one epidermoid, one osteochondroma). General pathology, symptoms, and signs are analyzed, and compared with cases from the literature. Because of their insidious onset and slow "illogical" progression of misleading symptoms, trigeminal tumours often prove to be a diagnostic challenge. As a consequence they usually reach a large size before causing sufficient symptoms to lead the patient to a neurosurgical clinic. The diagnosis is therefore likely to be made by radiological investigations. The typical radiological feature (on plain skull films, pneumoencephalography, and angiography) are described, and differential diagnosis is discussed. All the patients in the present series were operated on. Surgical procedures and postoperative results are discussed.

Adolescent↗