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Biomedical subjects

I Morra

Publications and source records attributed to I Morra.

At least 19 recordsLinked to original sources
PubMed2003

Laparoscopic vs open hepatic resection: a comparative study.

BACKGROUND: Although the feasibility of minor laparoscopic liver resections (LLR) has been demonstrated, data comparing the open vs the laparoscopic approach to liver resection are lacking. METHODS: We compared 30 LLR with 30 open liver resections (OLR) in a pair-matched analysis. The indications for resection were malignant disease in 47% of the LLR and 83% of the OLR. The average size of the lesions was 42 mm for LLR and 41 mm for OLR. Five wedge resections, 12 segmentectomies, and 13 bisegmentectomies were performed in each group. RESULTS: The conversion rate for LLR was nil. The mean operative time was 148 min for LLR and 142 min for OLR. Mean blood loss was minimal in the LLR group (320 vs 479 ml; p < 0.05). Postoperative complications occurred in 6.6% of the patients in each group; there were no deaths. The mean postoperative hospital stay was shorter for LLR patients (6.4 vs 8.7 days; p < 0.05). In tumors, the resection margin was <1 cm in 43% of the LLR patients and 40% of the OLR patients ( p = NS). CONCLUSIONS: Minor LLR of the anterior segments has the same rates of mortality and morbidity as OLR. However, the laparoscopic approach reduces blood loss and postoperative hospital stay.

Adult↗
PubMed2000

CagA seropositivity and the severity of Helicobacter pylori infection in dyspeptic children.

AIM: To assess the incidence of cagA (cytotoxin-associated protein) and to evaluate its correlation with endoscopic-histologic findings and with eradication rate in a series of children affected by Helicobacter pylori (H. pylori) gastritis. METHODS: Fifty consecutive H. pylori gastritis children (27M; median age 10 y and 11 mo) were tested for IgG cagA protein (Western Blot technique). Pretreatment H. pylori infection was assessed on the grounds of endoscopic antral biopsy specimens by means of rapid urease test and histologic examination (Giemsa staining). All the children were treated with omeprazole (1 mg/kg/d), clarithromycin (15 mg/kg/d) and amoxycillin (50 mg/kg/d) for 2 wk. According to universally accepted clinical practice, outcome of treatment was assessed by 13C urea breath test at least 6 wk after the end of therapy. RESULTS: Thirty-five children (70%) were seropositive to cagA+ protein (median age 11 y and 1 mo). Endoscopic findings of cagA+ patients were similar to those of cagA- patients. In cagA seropositive patients the severity of histologic gastritis was higher (p < 0.05) and the granulocytic infiltration more marked (p < 0.01) than in seronegative ones. In cagA+ children, H. pylori eradication rate was significantly lower (p < 0.02). CONCLUSIONS: cagA testing may be of useful clinical interest because its positivity can imply a more severe gastritis and a lower susceptibility to eradication treatment.

Adolescent↗
PubMed1999

Treatment of simple renal cysts by percutaneous drainage with three repeated alcohol injection.

OBJECTIVES: This study sought to show the effectiveness and safety of three repeated alcohol injections for the treatment of simple large renal cysts. METHODS: From September 1991 to December 1997 we treated 72 renal cysts. The cyst was drained with an 8F mono J stent. Ninety-five percent sterile ethanol was injected into the cyst and left in place for 20 minutes. Two repeat alcohol injections were performed every 24 hours. After the third alcohol injection, the catheter was removed. To avoid pain in the last 39 patients, 20 mL of 2% lidocaine hydrochloride was injected into the cyst for 15 minutes before the alcohol injections. RESULTS: The follow-up period ranged from 8 to 83 months (mean 48). One patient underwent surgical intervention because of considerable bleeding in the cystic cavity that occurred after percutaneous drainage. In 1 patient in whom the cystic cavity communicated with the urinary tract, no alcohol injections were performed. After the repeated alcohol injections, the cystic cavity completely disappeared in 68 of the 70 treated cysts at first ultrasound examination. This result, observed at the first ultrasound control observation, remained unchanged during follow-up. CONCLUSIONS: In our experience, percutaneous drainage with three repeated alcohol injections offers a high rate of success without the cost and morbidity associated with other procedures, such as operation or laparoscopy.

Adult↗
PubMed1999

Transvaginal ultrasonography in the assessment of organic diseases of female urethra.

The current investigation aimed to check the effectiveness of transvaginal ultrasonography in the diagnosis of organic urethral diseases, comparing its results with those of conventional examinations (physical examination, voiding cystourethrography, pelvic ultrasonography, cystourethroscopy). Transvaginal ultrasonography was performed in 560 female patients with recurrent cystitis, dysuria, or palpable masses and diagnosed the following urethral diseases: 25 diverticula, seven stenoses, three carcinomas, two leiomyomas of periurethral tissue, and one incomplete duplex urethra. In our study transvaginal ultrasonography proved to be the most reliable diagnostic tool among imaging methods used.

Diagnosis, Differential↗
PubMed1997

Rapid identification of Mycobacterium tuberculosis complex on urine samples by Gen-Probe amplification test.

The aim of the study was to evaluate the applicability to urine samples of the Amplified Mycobacterium tuberculosis Direct Detection Test (AMTD), which is currently used to identify this organism in respiratory specimens within a few hours. The study was performed on 95 patients, comprising 35 subjects with a high index of suspicion for active tuberculosis of the urinary tract and 60 subjects with evidence of non-mycobacterial disease. One urine specimen from each subject was examined by microscopy, culture and AMTD. AMTD was positive in 38 specimens and negative in 57. Assuming culture as the reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of AMTD were 100%, 91.93%, 86.84% and 100%, respectively. Reassessing the discrepancies between AMTD and culture by review of patients' charts, the sensitivity, specificity, positive predictive value and negative predictive value of AMTD were 100%, 93.44%, 89.47% and 100%. The results of the study as well as the characteristics of AMTD encourage its use for the rapid recognition of urinary tract tuberculosis, although its findings should be interpreted cautiously when the clinical picture is not consistent with an active tuberculosis.

Adult↗
PubMed1996

[Usefulness of transvaginal echography in the study of organic pathology of the female urethra].

The Authors describe their experience about the use of vaginal ultrasound in the diagnosis of some organic disease of the female urethra. The ultrasonography was performed with the 5 Mhz endocavitary probe and patients in lithotomy position and filled bladder. With this method has been possible value the urethral and peri-urethral echostructure and urethral calibre during micturition. the Authors visualized 20 urethral diverticula, 6 stenosis, 2 carcinomas and 1 leiomyoma. They show the great reliability of this investigation and argue that it may be present as a first instrumental approach in the clinical suspicion of an organic pathology of the female urethra.

Female↗
PubMed1996

[Transvaginal echography in the study of urinary stress incontinence].

Hypermobility of the bladder neck in response to increased intraabdominal pressure is one cause of stress urinary incontinence in women. Vaginal ultrasound (u.s.) is reliable and minimally invasive method for demonstrating bladder neck hypermobility. The Authors studied 50 women with S.U.I. and 40 with no history of S.U.I. measuring the distance from the bladder neck to the midline of the symphysis pubis (P.V.) and the angle between the BP line and the midline of the symphysis pubis (A.I.U.). The continent women were characterized by a median A.I.U. of 70 degrees and mean B.P. of 25.6 mm, at rest, a median A.I.U. of 80 degrees and a mean B.P. of 20 mm. at stress. The incontinent women were characterized by a median A.I.U. of 80 degrees and mean P.V. of 22.5 mm. at rest, and a median A.I.U. of 95 degrees and mean P.V. of 10 mm. at stress. There is a significant difference between the two groups. The Authors recommend the vaginal u.s. as reliable, practical, economical and patient accepted method to study the bladder neck mobility.

Female↗
PubMed1996

[Treatment of a solitary renal cyst using percutaneous drainage and repeat alcoholization].

The Authors report their results on the treatment of simple voluminous renal cyst with percutaneous drainage and three times repeated sclerosis with pure alcohol every 24 hours. After a mean follow-up of 28 months They report a 96% of success with only two recurrences. Since the fair results and low invasiveness of the method, the Authors propose the repeated alcoholization in the treatment of simple voluminous renal cysts.

Combined Modality Therapy↗
PubMed1996

[Echographic aspects of renal tuberculosis].

In this study the Authors examine the utility of the ultrasonographic investigation in the preoperative evaluation of 22 patients submitted to nephrectomy for tubercular lesions, comparing the informations obtained from this procedure with the histologic report. The renal ultrasonography execute with a Toshiba 3.5 Mhz probe, has been utilized to value morphology, volume, parenchymal echostructure and hydronephrosis. According to the Author's series, the ultrasonography has shown a 100% sensitivity permitting to well value the presence of parenchymal lesions and hydronephrosis. As regards the tubercular renal injuries the ultrasonography is non-specific because it does not allow to have pathognomonic images. The results obtained from the U.S. are overlapping to the Results Related from the literature for abdominal CT. The Authors argue that U.S., rapid and economical investigation is an efficient complement to the urography for an exhaustive preoperative evaluation of patients suffering from renal Tuberculosis.

Humans↗
PubMed1994

[Hydrogen breath test in celiac disease: relationship to histological changes in jejunal mucosa].

Hydrogen concentration in expired breath depends on the fraction of ingested carbohydrates unabsorbed by the small intestinal mucosa which reach the large intestine and are fermented by the colonic flora. The aim of this study is to assess whether in coeliac children breath hydrogen excretion reflects the histological changes in the jejunal mucosa. Hydrogen breath test was performed on 40 children (15 males 25 females) divided into three groups. Group I (controls): 9 children with symptoms suggestive of coeliac disease who, after the appropriate workup, were found to suffer from other gastrointestinal disorders and had abnormal jejunal mucosa. Group II: 14 children who had been diagnosed as coeliacs according to the ESPGAN criteria, were kept on a gluten free diet for a minimum of 6 months and had a normal jejunal mucosa. Group III: 17 coeliac children who ate small quantities of gluten or were on a normal diet. At histology, 10 of them showed a total and 7 a partial atrophy of the jejunal mucosa. Breath hydrogen levels were measured both at baseline and after ingestion of a 2% sorbitol solution in water, at 30 minute intervals for four hours. The peak hydrogen level and the total surface area under the hydrogen excretion curve were also assessed. Coeliac children on a gluten containing diet excrete significantly more H2 than controls or coeliacs on a gluten free diet. Patients with more severe histological lesions had higher peak H2 levels and greater total excretion areas. In coeliac children, sorbitol breath H2 test represents a simple noninvasive technique to detect impaired jejunal function and it should have an important role as a screening test and in assessing dietary compliance.

Adolescent↗
PubMed1994

[Treatment of voluminous renal cysts with drainage and repeated percutaneous administration of alcohol. Our experience].

The Authors report their experience on the treatment of simple voluminous renal cysts with an echo-guided puncture followed by a sclerosis, that is repeated thrice, with an endocavitary injection of pure alcohol. Since the fair results (94% of success) that were obtained after a mean follow-up of 16 months, the low invasivity of the method and the benignity of the disease, should propose the method itself as the first approach for the treatment of voluminous but not complicated renal cysts.

Combined Modality Therapy↗
PubMed1993

Endoscopic and histologic findings in the upper gastrointestinal tract of children with coeliac disease.

Frequency of mucosal damage to the esophagus, stomach, and duodenum was investigated in 176 children with coeliac disease (CD) during 230 upper GI endoscopies performed to obtain duodenal biopsy specimens and was compared with findings in 230 age-matched children who underwent endoscopy for upper GI complaints without CD (non-CD patients). To evaluate a possible association with gluten ingestion, we then compared frequency of mucosal damage in patients on a gluten-containing diet and those on a gluten-free Diet (GFD). In children with CD, frequency of esophageal damage seen at endoscopy and of peptic esophagitis shown by histology were significantly lower than in non-CD patients (p < 0.01) due to the very low frequency of mucosal damage in CD children on GFD; however, frequency of columnar metaplasia was significantly higher (p < 0.05). At endoscopy, CD children had a significantly lower frequency of gastric abnormalities, but histology showed a higher prevalence of superficial chronic gastritis (SCG; p < 0.01). SCG was associated with gluten ingestion, since its frequency in CD children on GFD was similar to the frequency in non-CD patients. At endoscopy, frequency of duodenal mucosal damage was similar in CD and non-CD patients. In addition to villous atrophy, histology showed a significantly higher frequency of duodenitis in CD children on a gluten-containing diet (p < 0.001 vs. non-CD patients; p < 0.05 vs. CD children on GFD). Our findings show that the mucosa of the whole upper GI tract can be damaged in CD patients and that the prevalence of some changes is higher with a gluten-containing diet.

Adolescent↗
PubMed1989

Campylobacter pylori gastritis: long term results of treatment with amoxycillin.

To evaluate the efficacy of amoxycillin in eradicating Campylobacter pylori, endoscopic biopsy specimens were taken from the antral mucosa of 40 children with gastritis before, immediately after, and (in 30 patients) three months after treatment. Immediately after treatment 34 patients (85%) no longer had the organism in the mucosa, and the gastritis had healed in 23 (58%). Three months later the infection had recurred in 22 of 30 patients (73%), and the gastritis had relapsed in all of them. Significantly more children in whom C pylori recurred had family histories of peptic ulcer disease. The results suggest that amoxycillin alone is ineffective in the long term treatment of C pylori gastritis.

Adolescent↗
PubMed1987

Production of monoclonal antibodies for the immunohistochemical detection of gastric carcinomas.

About 700 antibody-secreting hybrids were obtained by fusion of lymphocytes, (harvested from mice hyperimmunized with the human gastric carcinoma line KATO III) and P3-X63-Ag8-653 myeloma cells. Antibody specificity was screened in ELISA performed on glutaraldehyde-fixed cultured cells and on paraffin-embedded tissue sections stained with the method of avidin-biotin-peroxidase. When tested in ELISA, the monoclonal antibody produced by the hybrid clone BD-5 was found to bind only to the cell line used as immunogen, among the many neoplastic or normal human cell lines tested. When assayed on paraffin sections with the avidin-biotin-peroxidase method, the BD-5 monoclonal antibody stained gastric carcinomas, but not the normal mucosa. Pancreatic carcinomas were also stained, while the corresponding normal gland was not. The antibody strongly stained the normal colonic and small intestinal mucosa. Among the other normal or neoplastic tissues tested, a weak reactivity was observed only with some epithelial cells of the salivary glands and with some carcinoma cells of the uterus and of the lung. It is concluded that the BD-5 antibody reacts with an epitope normally present on intestinal mucosa, which, following neoplastic transformation, is ectopically expressed also on gastric and pancreatic carcinomas. This monoclonal could represent a useful reagent for histopathological diagnosis.

Antibodies, Monoclonal↗
PubMed1986

The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast.

Immunological markers improve specificity and accuracy of cell detection, therefore it is important to evaluate their usefulness in improving standard histological procedures. This study investigates whether immunocytochemical techniques increase the accuracy of detection, in axillary lymph nodes, of metastatic cells from infiltrating breast lobular carcinoma (ILC). Fifty cases of ILC reported to be node-negative were selected. New serial sections were cut from a total of 767 lymph nodes, stained with H&E and tested in immunoperoxidase (ABC procedure) with a conventional anti-Epithelial Membrane Antigen (EMA) serum, with a monoclonal raised against human milk fat globule membranes (HMFG-2) and with a monoclonal against 54 kd keratin. Metastases were detected immunocytochemically in 12 cases (24%); in five of these cases metastatic cells were also visible in serial H&E sections. Monoclonals offered no evident advantage over anti-EMA conventional antiserum. Immunocytochemical positivity alone is not sufficient evidence for metastatic invasion since macrophages occasionally appear EMA- and HMFG-2-positive (probably because of secondary incorporation of the antigen), and so an improvement in the accuracy of breast cancer metastatic cell detection in axillary lymph nodes requires a combined histo-immunological approach.

Antibodies, Monoclonal↗
PubMed1985

CAR-3, a monoclonal antibody-defined antigen expressed on human carcinomas.

Several monoclonal antibodies were raised against the human epidermoid carcinoma line A 431. The antibody produced by clone AR-3, when tested in enzyme-linked immunosorbent assay, was found to react with the cell line used as immunogen, the human gastric carcinoma line KATO III, the colon carcinoma line HT29, and the ovarian carcinoma line SW626. This monoclonal antibody was found unreactive when tested on human peripheral blood leukocytes or on a number of normal or neoplastic cell lines. The antibody precipitated a high-molecular-weight glycosylated component. When tested on paraffin sections by the avidin:biotin: peroxidase method, the AR-3 antibody stained pancreatic (6:7), gastric (11:14), ovarian (5:6), colon (4:8), endometrial (4:6), and cervical (4:7) carcinomas. A small minority of carcinomas of other organs was also stained. Sarcomas, lymphomas, and other tumors of nonepithelial origin were constantly negative. Staining of some normal epithelial cells was also observed. Among the fetal tissue tested, the antibody reacted with pancreatic ducts and the small intestine. The antibody recognized metastatic carcinoma cells in peritoneal effusions. On the basis of its tissue distribution, the antigenic determinant defined by the AR-3 monoclonal antibody was called CAR-3. The monoclonal AR-3 did not cross-react with partially purified preparations of carcinoembryonic antigen, gastrointestinal carcinoma antigen, or the human milk fat globule antigen. The AR-3 MAb appear, thus, to broaden the number of available reagents for histopathological diagnosis of carcinomas.

Animals↗