Biomedical subjects
Publications and source records attributed to M Bononi.
The rarity of primary non-Hodgkin lymphomas of the parotid gland triggers this report on a case treated and now in the fourth year of follow-up, which offers the opportunity for a review of the literature on the subject. The paper also describes the criteria for accurate classification, the diagnostic tools available and the problems of differential diagnosis. Treatment protocols and survival are also considered.
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The authors underline the importance of correct screening in the female population in order to achieve as early a diagnosis as possibly of malignant breast tumours. In view of the high frequency of this neoplasia, as well as the encouraging results of numerous tested diagnostic protocols in terms of their positive influence on the progress of this disease, the authors prepared a screening protocol within a breast pathology service, and report the results achieved during the course of about seven years. Out of a total of 5000 patients aged between 30 and 90 years old, a total of 261 cases were diagnosed with pathologies requiring surgery with a 57.9% incidence of carcinoma, among which, in compliance with reports in the literature, a net predominance was found of initial stage tumours with diameter of less than 2 cm (58.3%).
Staplers have introduced and continue to introduce benefits above all in terms of anastomotic procedures used in digestive tract surgery. A prime sector od application is rectal cancer in that mechanical anastomosis allows low rectal resections to be performed, thus reducing the number of abdominoperineal amputations, without negatively affecting the oncological radicality of exeresis. The authors review the cases operated by the 1st Chair of Surgical Pathology at "La Sapienza" Rome University during the period 1984-1993 when rectal anastomoses were systematically performed using mechanical staplers. On the basis of their personal experience and in line with the data reported in the literature, although there may be anastomotic complications, such ad dehiscence ad stenosis, it is possible to affirm that the use of staplers has led to benefits which, if evaluated as a whole, fully justify their cost which is still quite considerable.
The authors make a wide-ranging review of the literature, examine the epidemiological aspect of fail chest and underline the importance of its correct anatomopathological classification for a more qualified physiopathologist, diagnostic and therapeutic approach. They make a historical excursion on volet's treatment and underline the complementarity of surgical and resuscitation therapies.
The authors base their study on a retrospective evaluation of a personal series of patients and on a review of the literature on this topic. They focus their attention on surgical problems relating to the type of treatment of non-toxic multinodular goitre. On the basis of the data obtained, they underline that in this pathology total thyroidectomy is the most appropriate form of surgery and does not entail a higher morbidity in relation to more conservative resection.
A prototype for the performance of mechanical thromboendarterectomy was constructed following various experimental designs and applications. The study was carried out on 25 aortobifemoral segments presenting typical obliterating arteriosclerotic lesions. The equipment consists of a flexible probe whose distal end was represented by a screened helical cutter and whose proximal end by an inlet and washing chamber. At the centre of these chambers and of the probe, a steel tube sets the cutter rotating at an adjustable speed. Good recanalisation was achieved in all vasal segments treated without damaging the vessel's wall. Although encouraging, results thus far are preliminary and require verification.
Total parenteral nutrition is now a broadly used method whose efficacy is confirmed, even if it is still not free from risk of complications. The Authors report their own clinical experience on 130 cases in the period 1981-1988. Complications were registered in 4.6% of the observed cases. They underline the problems relating to this subject.
The authors report two cases of chylous ascites recently observed. After a wide review of the literature, they point out the rarity of this disease and its particular therapeutic aspects.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The histological and diagnostic features of a thymoma case observed recently have been investigated in the present study. Comparing the case under investigation with the literature, the Authors conclude that the proper surgical approach is that indicated by Jaretsky. By means of a longitudinal sternotomy associated with minimal cervical incision, the whole mediastinal cellular tissue together with that of the thyroid inferior poles is easily removed. Moreover oncological and myastenic recurrences have a very low incidence in cases surgically treated with this procedure.
It is widly accepted that Fine Needle Aspiration Biopsy (FNAB) is the main test to distinguish benign from malignant thyroid lesions. Nevertheless, this technique presents some limits such as the possibility of false-negative or inadequate samples and it is unable to cytologically discriminate among adenomathosus goiter, follicular adenoma and well-differentiated follicular carcinoma. The aim of this study was to evaluate the possibility of restricting these limitations using Core Needle biopsy (CN) technique. Therefore we selected for CN, 40 out of 136 patients who underwent FNAB during a one year period; among these patients only 32 agreed a to this technique. Forty-two out of 136 patients underwent surgery; 29 of them were subjected to both biopsies. Sixteen of the diagnostic microbiopsies have been histologically confirmed. We had no discordant cases between cytological and microhistological diagnosis, except for one case which appeared cytologically colloid goiter, microhistologically follicular neoplasm and histologically follicular adenoma. In this case it was not possible to microhistologically discriminate benign from malign follicular lesion. In our experience not all patients accepted CN biopsy as well as FNAB and, moreover, this technique showed no advantage over FNAB diagnosis. On this base we think that actually FNAB should be the main procedure in the diagnosis of the thyroid lesions. It is easily performed, accepted by the patients and has a low cost-benefit ratio. If the sample is not diagnostic it can be easily repeated and false-negative cases could be discovered thanks to an adequate clinical and ultrasonographical follow-up of the patients.
The problems concerning surgical goiter treatment are discussed, particularly the morbidity of total thyroidectomy and possible injury to recurrent nerves in comparison to the partial resection of the gland. We discuss our case material and review the literature. We conclude that total thyroidectomy seems to be the most effective surgical procedure with lower morbidity than subtotal thyroidectomy.