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Biomedical subjects

G Panzironi

Publications and source records attributed to G Panzironi.

At least 19 recordsLinked to original sources

Adrenomedullin immunoreactivity tissue distribution in parathyroids of the patients with primary hyperparathyroidism.

Adrenomedullin (ADM) is a new potent vasorelaxant peptide identified originally in extracts of pheochromocytoma, and is widely distributed within the tissue. Although histopathological studies have demonstrated the presence of ADM-immunoreactivity (ir-ADM) in some human neuroendocrine tumors (such as insulinoma, pituitary adenoma, and gastrointestinal neuroendocrine tumors), data on the presence of ADM in normal and pathological parathyroid gland are not available. Plasma AM concentrations were recently reported to be elevated in patients with PHP (primary hyperparathyroidism). The aim of our study was to determine tissue distribution of ir-AM in 34 patients with PHP (27 female and 7 male, mean age 50 +/- 6 years) undergoing surgery. Six normal parathyroid samples incidentally found during thyroidectomy for neoplastic diseases and ten sections of human rectus abdominis muscle tissue were used as controls (C). Adenomatous parathyroids were found in 22 PHP and hyperplastic parathyroids in twelve PHP patients. Four hyperplastic parathyroids were found in three PHP patients and three parathyroids in 10 PHP patients. Eight parathyroids revealed a prevalent diffuse growth pattern and four showed a prevalent nodular growth pattern. Immunohistochemical ADM expression was seen in seven of twelve (58.3 %) hyperplastic parathyroids and in fourteen of twenty-two (66.6 %) adenomatous glands. Parathyroid chief cells showed strong cytoplasmatic staining, whereas oncocytic cells showed a faintly aspecific cytoplasmatic staining. Normal parathyroids were negative for ir-ADM. In conclusion, we found the presence of ADM in parathyroid chief cells of PHP patients using immunohistochemistry in our study.

Adenoma↗

[Radiological examination of the Lap-Band for the treatment of severe obesity].

The aim of this study is to determine the role of radiographic assessment in patient who underwent an adjustable laparoscopic (or laparotomic) banding for the treatment of morbid obesity, and to evaluate the different type of postoperative complications. Forty-three consecutive patients with morbid obesity were examined before and after surgical treatment with positioning of Lap-Band. In all patients radiological examination permitted to evaluate the bend position, the dimensions of the gastric pouch and of the stoma. In such cases it was possible to modify the stoma dimensions under fluoroscopy. 74.4% of patients obtained satisfactory weight loss without complications. In 16.2% of patients the treatment was unsatisfactory and the radiological examination demonstrated the presence and the type of complications. In 9.3% of patients the radiological exam was negative for complications but they didn't obtain satisfactory weight loss. Radiographic assessments are crucial in the management of weight loss and detection of postoperative complications in this surgical treatment.

Adult↗

Conservative surgical treatment for a giant thoracoabdominal benign teratoma.

The authors describe an adult patient with a giant, cystic teratoma (33 x 22 x 18 cm) involving the posterior mediastinum and retroperitoneum. A conservative surgical approach consisting of a partial endocystectomy plus injections of tetracycline into the residual cavity, was performed. Two months after surgery, a CT scan showed a 6 x 5 x 3 cm residual cyst. The authors believe that the excision of the inner surface of the cystic lesion and the intracystic administration of tetracycline, may successfully prevent the accumulation of fluid which is the main cause of the progressive enlargement of such benign cystic teratomas.

Humans↗

[Evaluation of the efficacy of image-guided drainage in the treatment of abdominal fluid collections].

In this paper the Authors report their experience in the diagnosis and management of abdominal fluid collections either primary or secondary to surgery. Sixty-eight patients with abdominal fluid collections were considered: in 28 cases an imaging guided percutaneous drainage was performed, while in 40 cases patients were treated with medical or surgical therapy. The Authors describe the different techniques, the approaches and the types of catheter used on the basis of the localization of the collections. The results show the efficacy of drainage procedures in 89% of the patients treated, without any major complication. Some considerations comparing patients treated with percutaneous drainage and patients who underwent different therapy as well as a review of the international literature are also reported. In conclusion the Authors affirm that percutaneous imaging guided drainage is the treatment of choice for abdominal fluid collections anatomically accessible, for the high effectiveness, good tolerability, low cost and minimal incidence of major complications.

Abdomen↗

[Preoperative diagnosis of thyroid nodule. Ultrasonography-guided fine-needle aspiration].

Nodular thyroid pathology weighs heavily for 4-5% of the general population, being the most common among the endocrinopathies. Because of this these diagnostic methods have gained more and more importance as FNA able to select already in the pre-operation phase the malignant nodules from the benign ones and to decide on the most suitable surgical intervention. In the period of time between January 1989 and June 1992 in the Institute of the III Surgical Clinic in Rome there have been performed 403 FNA. From the whole total we have extrapolated 221 patients. In this study we stressed how the FNA method has a sensibility of 80%, a specificity of 93% and afterwards an accurate diagnosis of 92%. Besides we have verified that sonography and radionuclide scanning have a truth worthiness respectively of 64% and 52%. The FNA in our opinion allows us to have in the pre-operation phase a much more accurate diagnosis as regards that obtained with only sonography and radionuclide scanning therefore the latter methods must be considered complementary to FNA.

Biopsy, Needle↗

[Ultrasonography and the kidney: a screening method?].

The Authors retrospectively analyzed 733 hepatic U.S. involving non symptomatic urologic patients. The study detected 23 renal cysts, 3 lithiasis (with associated hydronephrosis in two) and 3 kidney neoplasms. It is concluded that U.S. represents a reliable and useful screening method for renal carcinoma, therefore it should be routinely adopted.

Diagnosis, Differential↗

[Use of ultrasound-guided needle aspiration in the diagnosis and treatment of breast cysts].

The authors evaluated the advantages obtained utilizing FNAB with ultrasound in the needle aspiration of breast cysts. Echography can guide the aspiration up to its end in an effective and localized way. Cytologic examination of the cystic fluid confirmed the benign nature of the cyst. The association of needle aspiration and guided echography was related to a low number of relapses (19.8%). Among these relapses some risk factors have been found as well as a correlation between cystic fluid cytologic examination and relapses incidence has been determined.

Adolescent↗

Heterotaxia: radiological and surgical observations in a case of polysplenic syndrome.

We describe a case of asymptomatic polysplenic syndrome as suggested by ultrasonography, gastrointestinal series, computed tomography, magnetic resonance imaging scans and arteriography, and confirmed at surgery. Spleen malformation is frequently associated with heterotaxia and other malformations of the thoracic and abdominal organs, but no pathognomonic features can be detected in relation to this condition. In our patient, imaging studies revealed the presence of a polylobulated spleen in an atypical position below the liver, associated with malpositioning of the gastric fundus and gastro-oesophageal junction with interruption of the inferior vena cava, but no congenital heart disease. In conclusion, polysplenic syndrome is a rare clinical condition, occasionally found in asymptomatic adults. Radiological detection could be mistaken for mediastinal or abdominal pathological masses, and only a thorough study performed with several different radiological methods can determine the precise anatomy of the structures involved so as to be able to plan surgery where necessary.

Female↗

[The preoperative staging of rectal cancer with endorectal echography].

The authors stress the value of the routine use of endorectal US for the preoperative staging of rectal cancer. This method accurately demonstrates the exact level of the lesion, the degree of circumferential invasion, the depth of local involvement and the extent of eventual spread beyond the rectal wall, the invasion of the surrounding structures and the presence of enlarged perirectal lymph nodes. A hundred and forty-one patients with rectal carcinoma located 3-16 cm from the ano-cutaneous line were examined with endorectal US preoperatively; a comparison was made between US findings and pathological data, so that a correlation could be made between US (uT) and histologic (pT) findings. A radial probe and a 7-MHz transducer were employed. Our results show US accuracy to be 93.6% with only 4 cases of understaging and 5 of overstaging. A hundred and twenty-nine patients who had undergone major surgery were also studied to evaluate US accuracy in lymph node detection: in 110 cases the actual lymph node status was correctly demonstrated; US diagnostic accuracy was 85.3% with 16 false positives and 3 false negatives. The correct evaluation of the actual local tumor spread, as demonstrated by endoluminal US, allows the choice of the correct treatment, together with a personalized therapeutic schedule, to reduce the incidence of local recurrences and to save, whenever possible, sphincter functionality.

Adult↗