[Pupillary dynamics to monochromatic lights].
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Adaptation, Ocular↗
Biomedical subjects
G Morone
Publications and source records attributed to G Morone.
[Study of the pupillary reflectivity to light and to darkness in relation to the pneumoencephalographic examination].
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Adult↗
[Electrophysiologic study of the influence of pH on the local anesthetic effect in the cornea].
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Anesthetics, Local↗
Radioguided surgery for gastrinoma: a case report.
AIMS AND BACKGROUND: Gastrinomas are the most common neuroendocrine tumors of the duodenopancreatic region. Surgical resection is the primary type of radical treatment. METHODS AND STUDY DESIGN: At the Institute of General, Gastrointestinal and Breast Surgery we treated a patient with a duodenal gastrinoma that was diagnosed and localized by means of selective celiac-mesenteric angiography and labelled octreotide scintigraphy. Surgery was performed using a radioguided technique; in this way we easily detected the small tumor and discovered another tracer-uptaking lesion that turned out to be a metastatic lymph node. RESULTS: Surgical resection is the ideal treatment for sporadic gastrinoma: it improves quality of life, prolongs survival, and reduces the incidence of metastases, with a modest percentage of complications and practically zero mortality. Meanwhile, medical treatment is being reevaluated, particularly in the case of metastatic disease or polyendocrine MEN1 syndrome. A fundamental aspect in the management of gastrinomas is tumor localization. Endoscopic ultrasonography and labeled octreotide scintigraphy (Ostreoscan) proved to be more effective than the usual imaging modalities. Intraoperative ultrasonography gastroscopy for duodenal transillumination and repeated measurement of blood gastrin levels should be performed intraoperatively in the surgical treatment of gastrinomas. CONCLUSIONS: The clinical application of radioguided surgery for tracer-uptaking endocrine tumors is still controversial. In our case the decision to use this method was influenced by the fear that the patient's obesity and the effects of previous surgery could hamper the identification of the small tumor.
Aged↗
[Aspects of the complications after restorative proctocolectomy in the treatment of ulcerative colitis. Review of the literature and personal experience].
PURPOSE: Analysis of complications and causes of failure after stapled restorative proctocolectomy with ileal J pouchanal anastomosis in patients with ulcerative colitis is presented. PATIENTS AND METHODS: The procedure was performed in 28 patients, 19 males (68%) and 9 females (32%); diverting ileostomy was always performed. RESULTS: There was no perioperative mortality. The overall morbidity rate was 31%. Six patients (21%) had pelvic abscess, 2 (7%) pelvic hematoma, 4 patients (14%) presented ileo-anal anastomotic stricture, 1 patient (3.6%) had pouch-vaginal fistula, three patients (11%) presented intestinal obstruction and 7 (25%) pouchitis. Reoperation was necessary in patients with small bowel obstruction and with pouch-vaginal fistula. Septic complications and pouchitis were resolved with medical treatment. Stenosis of the anastomosis required anal dilation. No patient underwent pouch excision for pouch failure. CONCLUSION: The main significant complications of ileal pouch-anal anastomosis for ulcerative colitis were pelvic sepsis, intestinal obstruction and pouchitis. Our results suggest that the use of stapling technique is safer and has fewer early septic complications and sepsis-related pouch removals. Success in ileo-anal construction increases with experience. The selection of patients with exclusion of Crohn disease, a correct surgical timing, a carefully technique, a delayed ileostomy closure and a low pre and postoperative regimen of steroids are important factors of success.
Adult↗
[Aneurysms of the visceral arteries: report of 5 cases].
Visceral artery aneurysms are uncommon and usually result from atherosclerosis, periarteritis nodosa and fibromuscular dysplasia. Hepatic artery aneurysms were detected in two patient, splenic artery aneurysms in three. In four patients rupture occurred. In the two patients with hepatic artery aneurysm hemobilia from arterial rupture into the common bile duct and intraperitoneal bleeding in lesser sac was assessed. Ruptured aneurysms of the splenic artery with free intraperitoneal bleeding occurred in two patients, one patient had an asymptomatic splenic artery aneurysm. In four patients the diagnosis was made by contrast-TC and/or celiac and mesenteric angiography. In four patients excision of the aneurysm was successfully performed. One patient with ruptured hepatic artery aneurysm and in which resection and revascularization was made died.
Adult↗
[Clinical and functional results after restorative proctocolectomy with ileal J reservoir in the treatment of ulcerative colitis].
PURPOSE: Restorative proctocolectomy is the procedure of choice in the treatment of ulcerative colitis. The operation is successful in removing all diseased mucosa while preserving a normal bowel function and a good quality of life for the patient. In this article are presented the clinical and functional results obtained in 28 patients, 19 males (68%) and 9 females (32%) after stapled restorative proctocolectomy with ileal J pouch-anal anastomosis. RESULTS: There were no perioperative deaths. The overall morbidity rate was 31%. Six patients (21%) presented pelvic abscess; 2 (7%) pelvic hematoma, 4 patients (14%) ileo-anal anastomotic stricture, 1 patient (3.6%) pouch-vagina fistula, three patients (11%) intestinal obstruction and 7 (25%) pouchitis. All patients were able to evacuate their pouches spontaneously. The mean bowel movements were 6-9/24 hours at the first postoperative month and 3-5/24 hours at the sixth month. Infrequent nocturnal seepage occurred in 6 patients (21%). Stool consistency returned to normal within 3-6 months. The mean pouch capacity was 210 cc. The mean resting pressure was diminished in 11 patients (39%), the men and maximal squeeze pressures were improved in 9 (32%); the ileo-rectal-anal inhibitory reflex was normal in 5 patients (18%), not defined in 12 (43%). Impotence or impaired bladder function was not present. CONCLUSION: The use of staplers in the surgical technique of restorative proctocolectomy with J shaped ileo-anal pouch is associated with low morbidity and better long-term results. The procedure requires a good selection of patients, a correct surgical timing, a very carefully technique and a low pre and postoperative treatment with steroids.
Adult↗
[Surgical treatment of pulmonary metastases of sarcoma].
Lungs are the most common target of metastases from osteogenic and soft tissue sarcomas. Metastases can be successfully treated by surgery. Only a few patients with non treated pulmonary metastases from sarcomas are alive after 5 years. In fact, without surgery the 1-year mortality is 50%. The number of metastases, the site in one or both lungs, the disease-free period and the tumoral doubling time have important prognostic significance. The authors report two interesting cases successfully treated with surgical therapy.
Breast Neoplasms↗
[Surgical treatment of pulmonary metastases in colorectal carcinoma].
After surgical exeresis of pulmonary metastases from colorectal carcinoma the 5-year survival rate is 30% vs 5% in non treated patients. Postoperative survival is longer for patients with a primary rectal cancer. Single pulmonary metastatic lesions, negative ilar and mediastinal lymph nodes, and Dukes' stages A and B are favourable prognostic criteria. The authors review literature's data and report and analyze their clinical observations.
Adenocarcinoma↗
[Surgical treatment of pulmonary metastases of primary neoplasms of the urogenital tract].
The authors review the literature data concerning the surgical therapy of pulmonary metastases from genital and urinary tumours. In both cases a combined chemo-surgical treatment is able to increase longterm survival. Some personal cases successfully treated are reported. The case is reported also of a young girl operated on for pulmonary metastases from a Wilms tumour. Successively, a heart transplantation was performed. She is alive and well.
Adolescent↗
[An update of Bassini's operation for the treatment of inguinal hernia].
Although the Bassini hernioplasty has been criticized, particularly by North American surgeons because of a high incidence of recurrence, among the techniques used for inguinal hernia repair, the Bassini method, in authors' opinion, is still the best if correctly performed. In fact, the transversalis fascia division is fundamental to obtain a better mobilization of the triple layer (transversalis fascia, transversus abdominis, internal oblique) which can approach the inguinal ligament without tension. Hernia repair is achieved by suturing this layer to the pubic tubercle and inguinal ligament with separated stitches.
Fasciotomy↗
[Surgical treatment of pulmonary metastasis from breast carcinoma. Personal contribution and considerations on the experience in the literature].
Considering a series of twelve patients operated on at the General Surgical Clinic of the University of Pavia, the authors discuss the results of surgical therapy of pulmonary metastases from breast cancer. According to literature data their results are not so good with a 5-year survival rate of 11%. Nevertheless, selected series of patients have been reported with a 5-year survival rate of 43% after pulmonary resection. So, by a careful selection of the indications the possibility of a surgical treatment would not be eliminated. After breast cancer exeresis it is certain that surgery is the best treatment for a solitary pulmonary nodule when there is some doubt about the diagnosis of primary or secondary lung cancer.
Breast Neoplasms↗
[Primary and secondary pulmonary tumors associated with head and neck carcinoma].
The authors analyze personal and literature results in surgery of primary and secondary lung cancer associated with head and neck malignancies. Eighteen patients with primary lung cancer associated with head and neck cancer were compared with six patients affected by pulmonary metastases from head and neck cancer. In the first group the 3-year postoperative survival rate was 60.5%, in the second group 33%. Differential diagnosis between primary and metastatic lung tumours may be easy when multiple pulmonary nodes are present. When only one pulmonary node is present, diagnosis is more difficult. Thoracotomy is necessary to perform the correct diagnosis and the best postoperative medical treatment.
Carcinoma↗
[The surgery of lung metastases of melanoma].
Melanoma is considered one of the most lethal cancers and surgical therapy of its pulmonary metastases is rarely indicated. The only hope for a successful surgical treatment of secondaries from melanoma is a radical resection. Considering the very frequent multiorgan involvement of melanoma metastases, surgery is usually possible in less than 5% of cases. Nevertheless, in selected cases without lymph nodal involvement a 5-year survival rate of 31% has been reported. In any way, it must be remembered that about 10% of lung tumours thought to be metastases are primary cancers. In this occurrence surgery could be a rescuing solution. So, a pulmonary resection is always imperative when some diagnostic doubt exists.
Humans↗