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L Solmi

Publications and source records attributed to L Solmi.

15 recordsLinked to original sources
PubMed1991

Natural history of hepatic haemangiomas: clinical and ultrasound study.

Hepatic haemangiomas are the most common benign tumours of the liver and commonly present as incidental findings on sonographic examination of the abdomen. Since little is known of the natural course of these tumours, we performed a clinical and sonographic follow up of 123 haemangioma patients. Our prospective study investigated clinical and sonographic findings in 158 haemangiomas for periods of 12 to 60 months. Ninety nine haemangiomas measured less than 2 cm and had an echogenic pattern; 40 were between 2 cm and 5 cm with a mainly echogenic structure; 19 measured greater than 5 cm and showed a mixed echo pattern. At the first examination only eight patients, all with giant haemangiomas, presented symptoms which could be attributed to the tumour. During follow up only one haemangioma changed in shape and size. One patient who was symptom free at the first examination experienced right upper abdominal quadrant pain during follow up. No deterioration occurred in any of the patients with symptoms at the first examination, and all had a satisfactory quality of life. No complications arose during the follow up period. This study shows that in adults haemangiomas remain stable in size and echo patterns rarely change. Only haemangiomas greater than 5 cm may cause symptoms. Prolonged clinical and sonographic follow up of small and medium sized haemangiomas is not warranted.

Adult↗
PubMed1989

Comparison between the 21-gauge Urocut needle and the 21-gauge Surecut needle in echo-guided percutaneous biopsy of neoplastic liver lesions.

Fine cutting needles for histology are now widely used in echo-guided biopsies of various organs. In this study we compared the results obtained in the biopsy of neoplastic hepatic lesions using two different 21-gauge cutting needles: Trucut needle (Urocut) and a modified Menghini needle (Surecut). Eighty-five patients with primary or metastatic hepatic neoplasms were biopsied with a Urocut needle and a further 85 patients underwent biopsy with a Surecut needle. The two groups were comparable for size and nature of hepatic neoplasms. The Urocut needle provided a much higher percentage of diagnostic material than the Surecut needle (94.8% vs 70.5%) regardless of the primary or metastatic nature of the lesion or its size. The diagnostic accuracy was only identical for both needles (91.3% for Urocut vs 91.5% for Surecut) whenever the diagnostic material was compared in cases in which both types of needles had been used to take the biopsy specimens. There were no complications in either of the two groups studied. Given the smaller incidence of non-diagnostic biopsies with the Urocut needle, we consider that this needle should be preferred in echo-guided biopsies of neoplastic hepatic lesions.

Adult↗
PubMed1989

Intratumoral echo-guided injection of interleukin-2 and lymphokine-activated killer cells in hepatocellular carcinoma.

Interleukin-2 has proved to be effective for the intralesional treatment of tumors of the bladder. There are examples in literature of hepatocellular carcinoma (HCC) treatment with lymphokine-activated killer (LAK) cells infused in the hepatic artery. We decided to check the effects of echo-guided intralesional injection of these cells in this disease. We treated 5 patients with inoperable hepatocellular carcinoma, following cirrhosis; in 4 cases the mass had a diameter less than 3 cm (small HCC) while in the remaining case it measured 7 cm. Tumor size remained unchanged in 3 of the 4 small HCC, and increased only slightly in the other (over a period of 10 months). This would appear to indicate that treatment halted neoplasm growth or at least slowed it down. The echo pattern of the lesions changed, with a constant reduction in echogenicity. Finally, in multiple control biopsies, fibrosis, present in only one case before treatment, was found fairly constantly after treatment. There were no significant side effects, apart from slight water retention in one patient. On the basis of our preliminary results, we consider it worthwhile continuing this study to establish the most suitable IL-2 doses and analyze in more detail the modifications induced in the neoplasm.

Aged↗
PubMed1987

Small hepatocellular carcinoma: an Italian experience.

Recent reports have demonstrated the possibility of using ultrasound to detect hepatocellular carcinomas under 3 cm (small HCC). Our aim was to assess the incidence of small HCC in an Italian ultrasonographic series. Among 17,133 scans of unselected patients, we detected 85 HCC, 9 of which were under 3 cm. All patients had cirrhosis and 6 were HBsAg positive. An echo-guided biopsy was performed in all cases, and the diagnosis was always correct. We conclude that echographic follow-up is warranted in Italy for cases at risk for HCC such as HBsAg+ cirrhotics and patients with chronic aggressive HBsAg+ hepatitis older than 35, in agreement with the reports of Far Eastern authors.

Aged↗
PubMed1987

Echo-guided fine-needle biopsy of pancreatic masses.

Aim of this study was the evaluation of percutaneous echo-guided fine-needle biopsy in the diagnosis of focal lesions of the pancreas. In patients with masses of the pancreas 43 echo-guided fine-needle punctures have been performed. In 27 of the 30 cases of cancer, echo-guided puncture allowed aspiration of cells revealing malignancy. In the remaining three cases the histology was normal. Malignancy was not detected in the aspirate of any of the 13 cases of benign solid masses. In one of these patients we failed to obtain sufficient material for the purpose of diagnosis. The sensitivity of the method was 90%, the specificity 100%, and the diagnostic accuracy 92.8%. Positive and negative predictive values were 100 and 75%, respectively. No complications worthy of note occurred.

Adenocarcinoma↗
PubMed1985

Indications for laparoscopy before and after the introduction of ultrasonography.

We compared the outcome of laparoscopy performed from 1973 to 1974, prior to the introduction of routine ultrasound diagnostics, with that of examinations during the period 1980-1981 when ultrasound had become a well-established technique in the diagnosis of hepatic lesions. Our data reveal statistically significant changes in the use of laparoscopy in the diagnosis of cholestasis and tumors of the hepatic parenchyma. Laparoscopy now has fewer indications in the study of the jaundiced patient with suspected extrahepatic cholestasis which is easily identified at ultrasound. Given the high sensitivity and specificity of ultrasonography in detecting metastases, laparoscopy has become a secondary examination. However, there has been an increase in the use of laparoscopy to identify benign hepatic lesions, particularly hemangiomas.

Biliary Tract Diseases↗
PubMed1985

Triletide and ranitidine for the management of chronic duodenal ulcer: a controlled clinical investigation.

Twenty out-patients with active, chronic duodenal ulcer were treated over a period of 6 weeks with either 0.6 g ranitidine per day or 2 g triletide per day, a new synthetic tripeptide shown to be effective in healing ulcers by increasing the mucosal defence mechanisms. Efficacy was assessed by scoring the intensity of day and night pain before, after 2 and after 6 weeks of treatment, and by endoscopy before and after. Tolerance was assessed by routine laboratory tests, physical examination and a survey of any accessory symptoms. Both drugs significantly relieved pain almost at the same rate and to the same extent, whereas endoscopy showed a not significantly greater improvement in the ranitidine group. It was found, however, that the patients in the triletide group had, on average, a significantly greater intensity of intractable factors on entry than those in the ranitidine group (+75%; p less than 0.02). After stratifying the intractability factor intensity, the 5 patients in the triletide sub-group comparable with those in the ranitidine group exhibited exactly the same behavior on pain relief and a very similar one on endoscopy findings (2 healed, 2 improved and 1 unchanged, compared with 7 healed and 3 improved, respectively). The sub-group with greater severity also showed improvements, both symptomatic and endoscopic, but to a lesser extent, indicating the need for prolonged treatment. Tolerance was good with both drugs. Two patients on triletide reported adverse effects; 1 of increased intensity of previous constipation and the other 1 of mild headache and dizziness, but these could not be related definitely to treatment.

Adult↗
PubMedDate not supplied

Comparison between echo-guided fine-needle aspiration cytology and microhistology in diagnosing pancreatic masses.

Echo-guided fine-needle aspiration biopsy of pancreatic masses is a well-established diagnostic procedure. However, there is no consensus as to the superiority of cytology or microhistology. We compared the results of cytology and microhistology in 50 consecutive patients who underwent fine-needle aspiration biopsy for pancreatic masses. Aspirates were positive for malignant disease in 42 patients; the other eight had chronic focal pancreatitis. In the 42 cases of cancer, cytology provided conclusive results in 40 (95.2%); sampling was inadequate in two. Microhistology proved accurate in 30 cases (71.4%); insufficient tissue was obtained in 12, giving a statistically significant difference in favor of cytology (P < 0.01). In the eight patients with benign disease both techniques ruled out malignancy; in five microhistology gave further indications confirming suspected chronic pancreatitis (fibrosis, lymphocyte and histiocyte-cell infiltrate). Our results show that cytology is the method of choice in diagnosing pancreatic carcinoma. Microhistology can be a useful adjunct in patients with suspected chronic pancreatitis.

Adult↗
PubMedDate not supplied

Cancer of the gastric stump in Italy, 1979-1986.

Sixteen thousand fiberoptic endoscopies were reviewed. Gastric stump cancer was found in 24 patients of 368 who had had gastric resection for benign peptic disease. A direct relation between the percentage of patients with cancer of the gastric stump and the postsurgical interval was observed. Patients with partial gastrectomy who are 15 to 20 years postoperative should have an endoscopy irrespective of presence or lack of symptoms. Multiple biopsies should be taken in view of the multicentric growth pattern of early carcinoma.

Aged↗
PubMedDate not supplied

Laparoscopy compared with ultrasonography in the diagnosis of hepatocellular carcinoma.

In recent years, various newer imaging procedures have superseded laparoscopy in the detection of many diseases. The role of laparoscopy in the diagnosis of hepatocellular carcinoma is still subject to debate. To assess the value of laparoscopy compared with that of ultrasonography, we compared data obtained from a series of 54 patients with hepatocellular carcinoma, all of whom had both procedures performed at nearly the same time. In our study, ultrasonography proved superior to laparoscopy in detecting the presence and extent of the hepatocellular carcinoma. Supplemental findings attributable to laparoscopy did not alter management, whereas additional information obtained by ultrasonography often did influence the choice of treatment. We conclude that ultrasonography is the primary diagnostic method of choice in the assessment of hepatocellular carcinoma and that laparoscopy should be reserved for only selected cases.

Adult↗