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L A Marzano

Publications and source records attributed to L A Marzano.

At least 19 recordsLinked to original sources

[Video-assisted appendectomy].

BACKGROUND: The acceptability of the classic laparoscopic technique in the treatment of acute appendicitis is slow, probably due to the higher costs of this method compared to the cheaper, efficacious, safe and rapid discharge associated with traditional surgery. METHODS: In order to combine the advantages of the laparoscopic technique with those of traditional surgery, we performed a retrospective study of the safety, efficacy, rapid discharge with return to normal working activities, and the costs in 70 patients referred to our attention with a diagnosis of acute appendicitis and who underwent one trocar appendectomy. This technique consists of positioning a single trocar in an umbilical site and using a 10 mm telecamera with a 5 mm operating canal. Having visualised the appendix and freed it from any synechiae, the distal end is grasped and it is removed through the umbilical trocar. Appendectomy is performed outside using a technique that is similar to traditional surgery. The diagnosis of acute appendicitis was made on the basis of clinical data (pain, leucocytosis, fever, possible resistance in the right iliac fossa).

Adolescent↗

Serum withdrawal-induced apoptosis in thyroid cells is caused by loss of fibronectin-integrin interaction.

In some cell types, including a fetal thyroid cell line, denial of adhesion to extracellular matrix induces a type of apoptosis called anoikis. Serum withdrawal in dog and transformed rat thyroid cells also induces programmed cell death. Because serum can stimulate cells to produce some components of the extracellular matrix, it was of interest to determine the role of the matrix in the apoptosis induced by serum withdrawal in normal human thyroid cells in primary culture. The present report demonstrates that thyroid cells selectively produce and deposit insoluble fibronectin (FN) only when stimulated by serum. Adhesion in the presence of serum is dependent upon integrin-FN interaction. Serum withdrawal determines a degradation of the insoluble FN deposited and a detachment of the cells from the plates. In these conditions, cells undergo anoikis, demonstrated by DNA fragmentation and annexin V staining. Apoptosis was prevented by exogenous FN immobilized onto the plates. These results indicate that serum withdrawal induces apoptosis in human thyroid cells, determining FN degradation and loss of cell-matrix adhesion.

Annexin A5↗

Expression of integrins of the beta1 family in thyroid cells from patients with Graves' disease in vivo and in vitro.

The expression of the beta1 family of integrins was determined in thyroid follicular cells from patients with Graves' disease (GD). Integrin expression was quantitated by flow fluorocytometry of single cell suspensions with antibodies against the common beta1 chain and the alpha1-alpha6 subunits. Results indicated that also in thyroid glands of GD, as previously observed in nodular goiters, two follicular cell populations with different patterns of beta1 integrin expression coexist (VLAalpha3beta1 and VLAalpha1,3,5,6beta1). The VLAalpha1,3,5,6beta1 thyrocyte population in GD was more abundant than in nodular goiters, ranging from 40 to 70% of the total follicular cells and the overall expression of the beta1 integrins was a two-fold higher. In thyrocytes from patients with GD cultured in vitro, alpha3 and alpha2 expression was regulated by cell-to-cell contact as previously described in normal thyroid cells, while the expression of alpha1, alpha5 and alpha6 was quickly lost during the culture. Our data suggest that the integrin profile of the VLAalpha1,3,5,6beta1 thyrocyte population in GD is induced by micro-environmental conditions rather than being the expression of a constitutive phenotype.

Cells, Cultured↗

Surgical management and follow-up of medullary thyroid carcinoma.

Between 1977 and 1990 we operated on 33 patients with medullary thyroid carcinoma. We performed total thyroidectomy in 31 patients and central node dissection and/or lateral modified node dissection in 21 patients (63.3%). Two patients underwent radiotherapy after subtotal resection and tracheostomy. No perioperative death occurred. Twenty-five patients were followed (mean follow-up, 63.8 months) and 8 others were unavailable for follow-up. Three patients (1 with multiple endocrine neoplasia type IIB, 2 sporadic with distant metastases) died of their disease at 12, 18 and 36 months after initial operation. Of the remaining 22 patients, 4 with stage II disease were normocalcitoninemic even with pentagastrin stimulation, following total thyroidectomy and bilateral modified neck dissection and central node dissection. Eighteen other patients continued to have elevated calcitonin levels postoperatively. Only 10 patients with known cervical metastatic disease were reoperated upon. We performed extensive node dissection in all. In addition we resected recurrent tumor from the thyroid bed in 4 patients. Despite these extensive reoperations no patient became normocalcitoninemic. At the completion of the study (December 1991), 22 of the 25 patients followed were alive: 4 patients with normal calcitonin levels, baseline and after pentagastrin stimulation, and 18 with persistent mildly elevated calcitonin levels but no other evidence of disease. Our experience supports a very aggressive surgical approach at the time of the first operation for patients with medullary thyroid carcinoma. A lesser operation usually resulted in residual medullary thyroid carcinoma in the neck. We demonstrate the difficulty of achieving a cure by reoperation once the tumor becomes demonstrable by localization studies.

Adolescent↗

[Medullary carcinoma of the thyroid gland].

The Authors, after introducing the epidemiology and physiopathology of medullary thyroid carcinoma, compare the most recent diagnostic methods and therapeutic strategies. They highlight recent progress in genetics, in diagnosis and therapy and in the role of labelled radiopharmaceuticals in diagnosis, post-operative therapy and follow-up.

3-Iodobenzylguanidine↗

[GH and surgery].

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Energy Metabolism↗

Choledochal cysts in adults: a case report.

We examined a case of choledochal cyst in an adult having congenital dilatation of the bile duct classified, according to Todani's, as type I and treated by excision with hepatic-jejunostomy Roux-en Y. This procedure is recommended as the best treatment for eliminating pancreatitis by pancreaticobiliary disconnection and thus for reducing the risk of malignancy.

Adult↗