[Contribution to the hepatic resection in the treatment of echinococcal cyst].
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Biomedical subjects
Publications and source records attributed to G Pesce.
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Seven hundred ninety-one consecutive patients with acute viral hepatitis, 17 of whom had liver failure, and 97 healthy volunteers were examined by ultrasound. No specific patterns were found in either the uncomplicated or the complicated forms. Only 19 subjects showed a typical "bright liver" pattern, which is correlated with significant vacuolar hepatocellular degeneration. The increased brightness and clear visualization of portal vein radicle walls, previously described in this disease, were detected in only 32.2% of the hepatitis patients but were also seen in 30.9% of the normal controls.
The TRH secretory responsiveness of the pancreatic islet cell clusters from newborn rat in organ culture was studied. Basal TRH secretion was stable over a 9-day period. The response to various secretagogues was tested on day 4. TRH secretion was stimulated by high potassium-induced depolarization and also through both cAMP and protein kinase-C dependent pathways. Like insulin, TRH release was stimulated by glucose and arginine and inhibited by somatostatin. These data suggest the existence of a common mechanism for TRH and insulin secretion by the pancreatic beta-cells.
The authors discuss Superior Thoracic Outlet Syndrome (STOS), which is characterized by aspecific symptomatology. However, some tests may be used to reveal the specificity of the disease. In the past, treatment was often followed by recurrence of the disease. In the last ten years, the Roos operation has been used with a high success rate.
INTRODUCTION: The aim of the study was to define the therapeutic approach used for obstructing colon cancer. PATIENTS AND METHODS: In the period 1990-2002 in the Emergency Surgery Department of the University of Naples Federico II, 81 patients underwent colon surgery for obstructing colon cancer (25 M, 57 F, age range: 55-88 years, mean: 72). Were performed subtotal colectomies, left or right hemicolectomies, sigmoid colectomies, anterior resections, temporary or permanent enterostomies. The authors put morbidity and mortality in touch with the type of surgical operation and with results of the literature. RESULTS: Mortality was 32%: 2.4% as a result of an anastomotic dehiscence; 4.9% for cardiovascular pathologies; 1.2% for sepsis; 23.4% for metastasis. Morbidity for anastomotic leakage was 4.9%: 2.4% after left emicolectomy and colo-colonic anastomosis; 1.2% after right emicolectomy and ileo-colonic anastomosis; 1.2% after defunctioning colostomy and left emicolectomy after 20 days. CONCLUSIONS: This experience suggests that a subtotal colectomy with primary anastomosis (one stage) can be performed more safely, by an experienced, skilled surgeon, in patients in good clinical conditions with acute obstruction of the colon. Healing remains a process depending more on the patient than on any aspect of the surgical technique. A defunctioning colostomy may be idealfor surgeons with little experience in colorectal surgery and in high risk patients with a very poor prognosis (unresectable lesions).
The present study was designed to demonstrate the role of homosexuality in transmission of HIV infection. The results, in cases showed by authors, suggest that the homosexuality is not significative for transmission in HIV infection. Whereas it is significative (56.52%) in transmission of syphilis. The study has demonstrated that homosexuals are not disposed very much to the use of sexual prevention.
In AIDS, immunitary system dysfunctions are manifold and regard both T and B-lymphocytes. The increased levels of circulating immune complexes (CIC) in HIV-Ab positive patients, immune complexes abnormalities, should be considered as an epiphenomenon of humoral immunity altered function; therefore, they are devoid of any diagnostic value.
The authors have evaluated the efficacy of Fluconazole (400 mg/iv/die for three days and after 200 mg/iv/die for 18 days) in three AIDS and SNC Cryptococcal infection patients. Two patients have shown healing of meningeal syndrome and negative isolation after 21 days of therapy; one patient, however, died because of Cytomegalovirus pneumonia. It is of note that early spinal puncture in AIDS patients with neurological symptoms enables an early diagnosis and immediate therapy. Fluconazole treatment has been well tolerated and immediately effective to resolve two of the cases observed; the oral prophylaxis with 100 mg/die of Fluconazole after 6 months has been effective to prevent the relapses of the disease.
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The authors report their experience of the endoscopic removal of 350 polyps of the colon. Vegetating lesions of doubtful endoscopic appearance and nature were excluded from this study. Indications regarding intestinal cleaning and the most appropriate pharmacological preparation are given on the basis of personal experience. No patient had to be hospitalised and the colon was fully explored in all cases; the cecum was reached in 85% of cases. The maximum limit of endoscopic removal was 5 cm due to the greater risk of complications and presence of cancer on polyps. A total of up to 8 polyps were removed in a single session in cases of multiple polyposis. From 1986 to 1992 350 polypectomies were performed in 177 patients, of which 301 were adenoma (85.9%) and 49 mixed (14.1%). Adenomas were 80.5% tubular, 13.6% tubulo-villous and 4.3% villous. Cancer was found on polyps in 5 cases (1.6%). 146 polyps were found in the rectum (41.8%), 84 in the sigma (24%), 76 in the descending (21.7%), 21 in the transverse (6%), and 23 in the right colon (6.5%). Patients were aged between 3 and 81 years, and the most frequently affected age bracket was between 40-70 years. Follow-up consisted in checks at 6, 12 and 24 months in cases of adenoma and quarterly checks during the first year in the event of carcinoma in situ. The decision to use a diathermic loop or hot biopsy was made in relation to lesion size, reserving the former for polyps with diameters of over 8 mm. All polyps under 5 cm were removed and subjected to histological tests. No cases of early or late complications were reported in the 350 polypectomies performed. The authors indicate the criteria of choice which led to surgical resection of the first instance. In the event of in situ carcinoma, endoscopic removal is considered sufficient provided that it is radical. The following must be evaluated in the case of invasive carcinoma: tumor size, the degree of differentiation, lymphatic or vascular invasion and generic or specific risk factors linked to the individual patient.