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Biomedical subjects

M De Fazio

Publications and source records attributed to M De Fazio.

15 recordsLinked to original sources
PubMed2007

Tissue factor and vascular endothelial growth factor expression in colorectal cancer: relation with cancer recurrence.

OBJECTIVE: This study was undertaken to quantify tissue factor (TF) and vascular endothelial growth factor (VEGF) in colorectal cancer and to evaluate their possible relationship with recurrence. METHOD: TF and VEGF were measured by enzyme-linked immunosorbent assay in surgical tumour specimens and normal mucosa from 50 consecutive patients with colorectal cancer who were followed up for 3 years for the assessment of disease recurrence. RESULTS: TF and VEGF antigens were detected in all tumour samples. VEGF, but not TF, was much higher in tumour than in normal mucosa (P < 0.0001), as also confirmed by measurement of specific mRNAs. There was a strong correlation between TF and VEGF antigens (P < 0.0005) in tumour tissue but not in normal mucosa. Neither protein was related to tumour stage, grade or size. Local or distant recurrence was statistically related to pTNM stage. High VEGF, but not TF, levels in tumour extracts were associated with an increased risk of recurrence both by univariate (RR, 4.00, 95% CI: 1.45-11.0) and multivariate analyses (RR, 3.65, 95% CI: 1.33-10.0). CONCLUSION: These findings suggest that VEGF content in colorectal cancer is an independent risk factor for tumour recurrence and might help select patients who might benefit from adjuvant therapy.

Colorectal Neoplasms↗
PubMed2002

Metastatic malignant melanoma of the gallbladder: a case report and review of the literature.

Both primary and metastatic melanoma of the gallbladder are rare. Involvement of the gallbladder occurs in about 15% of all gastrointestinal metastatic localizations in post-mortem case records. It is often difficult to differentiate primary from metastatic lesions on the basis of clinical, radiological and histopathological features. Melanoma involving the biliary tree seldom causes relevant symptoms during life, and this is why cases reported in the literature are few and those documented in living patients even fewer. We report a case of a young woman with a metastatic gallbladder melanoma who presented with a long and vague clinical history of symptoms that mimicked chronic cholecystitis with epigastric right hypochondrial pain without instrumental evidence of disease until the development of acute cholecystitis. We report this case to emphasize the need for awareness of the possibility of gallbladder involvement in the melanoma patient and to underline the necessity of meticulous investigation of unclear lesions of the gallbladder and biliary tree in patients with a past history of malignant melanoma. The clinical presentation, diagnosis, histopathology, prognosis and treatment of primary and metastatic melanoma of the gallbladder are also discussed and reviewed.

Adult↗
PubMed2002

[Papillary carcinoma of the thyroglossal duct cyst: a case report].

The thyroglossal duct cyst is the most common anomaly in thyroid development. To date, approximately 250 cases have been reported, the majority being papillary thyroid carcinomas. In most cases the diagnosis is established only after excision of a clinically benign thyroglossal duct cyst. Controversies exist in relation to a rational and effective therapeutic approach. A further case of thyroglossal duct papillary carcinoma affecting a 52 years-old man is presented to highlight the clinicopathological features of this condition. FNAC resulted false negative. Surgery consisted in a Sistrunk procedure, followed by total thyroidectomy and central lymphectomy after definitive histological diagnosis. In view of the prolonged course of papillary carcinoma, long-term follow-up is mandatory.

Carcinoma, Papillary↗
PubMed2001

Long-term effects of stapled haemorrhoidectomy on internal anal function and sensitivity.

BACKGROUND: Stapled haemorrhoidectomy is gaining wide acceptance but there is still some concern about the risk of injury to the internal anal sphincter (IAS). IAS function and morphology, and anal canal sensitivity were studied prospectively in patients undergoing this operation. METHODS: Twenty patients (11 women; mean age 43 years) with stage III haemorrhoids entered the study. All underwent preoperative anorectal manometry, rectoanal inhibitory reflex (RAIR) testing and three-dimensional transanal ultrasonography. A test of anal sensation was administered to evaluate ability to discriminate between air and warm water. All the investigations were repeated 6 months after the operation. RESULTS: The mean(s.d.) maximal resting pressure was 87(30) mmHg before surgery and 81(20) mmHg afterwards (P not significant). The maximal squeeze pressure did not change after operation (178(43) versus 174(60) mmHg). The RAIR showed the same features in 19 of 20 patients before and 18 of 20 after operation. Three-dimensional ultrasonography demonstrated no changes in the width of the IAS (mean(s.d.) 2.1(4) mm before and 2.1(3) mm after surgery). The ability of the anal mucosa to discriminate air from warm water improved in five patients. Continence scores did not differ significantly after 6 months. CONCLUSION: Stapled haemorrhoidectomy does not affect the function and morphology of the IAS in the long term. The sensitivity of the anal canal can improve in patients with preoperative sensory impairment.

Adult↗
PubMed2001

Biliary tract papillomatosis.

Papillomatosis of the biliary tract is characterised by multicentric papillary lesions of intra and extrahepatic biliary epithelium. It's a rare benign neoplasm of the biliary tract that causes obstructive jaundice with a high rate of malignant transformation. We described a case of papillomatosis of the biliary tract in a woman of 75-years-old, who came to our observation with jaundice, pruritus and fever. The surgical treatment consisted of cholecystectomy, choledochotomy and positioning a definitive T-Tube. We described our experience and the evolution of this disease.

Aged↗
PubMed2000

[NMR cholangiography in the diagnostic algorithm of candidates to video laparocholecystectomy].

BACKGROUND: High resolution magnetic resonance cholangiopancreatography (MRCP) is a non invasive imaging modality for depicting the pancreatobiliary tree. It can demonstrate dilation, stenosis and intraductal filling defects of both the biliary and the pancreatic duct. The imaging quality of high resolution MRCP is excellent. MRCP appears to be more effective and less invasive than endoscopic retrograde cholangiopancreatography (ERCP) to evaluate many pancreatic and biliary diseases as choledocholithiasis, malignant obstruction, incomplete or failed ERCP, postsurgical alterations of the biliary tract (as biliary-enteric anastomoses), sclerosing cholangitis, chronic pancreatitis, and congenital anomalies of the biliary and pancreatic duct. METHODS: MRCP was performed in 21 non selected patients with suspected choledocholithiasis and demonstrated the presence of stones in the biliary tract in 5 of them. In these 5 patients sequential endoscopic-laparoscopic treatment was performed and confirmed in all cases the presence of stones in the biliary tree. Laparoscopic cholecystectomy (VLC) and transcystic cholangiography was attempted in the restant 16 patients. RESULTS: Laparoscopic transcystic cholangiography confirmed in all cases the response of MRCP. CONCLUSIONS: MRCP has the potential to replace ERCP in the management of patients candidate to VLC with suspected choledocholithiasis.

Algorithms↗
PubMed1999

Hypogonadotropic hypogonadism in obese women after biliopancreatic diversion.

OBJECTIVE: To evaluate a particular form of weight-related amenorrhea occurring in severely obese patients after biliopancreatic diversion, a surgical procedure designed to cause weight loss. DESIGN: Prospective, open, controlled clinical trial. SETTING: Department of Gynecology and Obstetrics, University of Naples "Federico II", Naples, Italy. The surgical procedures were performed in various hospitals in the Naples metropolitan area. PATIENT(S): Eight severely obese women (mean [+/-SD] age, 26.9+/-5.3 years) who underwent biliopancreatic diversion (group A) and eight healthy women of normal weight (mean [+/-SD] age, 25.8+/-5.6 years) (group B). INTERVENTION(S): Biliopancreatic diversion, hormonal evaluation, and LH pulsatility evaluation. MAIN OUTCOME MEASURE(S): Weight parameters, hormone levels, and LH pulsatility amplitude and frequency before surgery and at the onset of amenorrhea after surgery, and the response of LH pulsatility to the infusion of naloxone at the onset of amenorrhea. RESULT(S): All patients lost weight after surgery and became amenorrheic after 3 months, when they had lost 25% of their basal weight but were still obese. The hormonal picture at that time was one of hypothalamic amenorrhea with significantly reduced LH pulsatility frequency and amplitude. The alterations in LH pulsatility were not modified by naloxone infusion. CONCLUSION(S): Obese patients who undergo dramatic weight loss may be affected by hypothalamic amenorrhea when still obese. Endogenous opioid activity does not play a significant role in this kind of hypogonadotropic hypogonadism.

Adult↗
PubMed1994

[Treatment of pancreatic stump after duodenopancreatectomy. Our experience].

The authors describe the experience gained during the four-year period 1988-1991 regarding the treatment of the pancreatic stump after DCP independently of the base pathology. The techniques used and conceptual evolution which led us to leave the pancreatic anastomosis are shown here; likewise the morbid physiology induced by this technique with all this variation is here tested. The positive results obtained support the method and encourage further developments.

Anastomosis, Surgical↗
PubMed1993

[Solitary presacral echinococcal cysts].

A rare case of a solitary hydatid cyst located in the pelvis, which was responsible for neural pain due to the compression of the left ischiatic nerve is described. Diagnostic and pathogenic problems related to the localization of hydatic cysts without liver and lung involvement are discussed.

Adult↗
PubMed1991

[Splenic trauma. Conservative treatment].

The spleen performs a wide range of important life functional at an hematological, immunological and hormonal level. The frequency of immediate and late complications following splenectomy suggest that the most conservative treatment possible must be adopted in cases of splenic trauma. The paper reports 180 cases observed during the period from January 1982 to August 1987. Conservative treatment was used to treat 92 patients. The real advantages of this methods are reviewed in relation to the stability of clinical conditions, the absence of associated abdominal lesions, and the availability of diagnostic equipment and intensive therapy units.

Emergencies↗
PubMedDate not supplied

[Immunologic functions after laparoscopic cholecystectomy].

Trauma and surgical procedures can induce immune depression, related to the prevalent impairment of cell-mediated immunity, which may predispose to infections. The early recovery following laparoscopic cholecystectomy without infectious complications seems to be related to a lesser degree of surgical trauma and to only minimal impairment of immune functions. The present study was conducted in 20 patients with symptomatic gallstone disease, all undergoing laparoscopic cholecystectomy. Blood samples taken before operation and at 3 and 6 days postoperatively were tested for lymphocyte subsets (CD4+, CD8+, CD19+, CD57+), blood chemistry parameters (IgG, IgA, IgM, CH-50, C3, C4) and haemochrome. A group of 10 normal volunteers, matched for age and sex, were also examined twice at an interval of 48 h. Student's "t"-test was used for statistical comparisons. The findings showed only minimal changes in immune functions after operation (slight increase in CD57+ cells, and very slight decreases in IgM and C4 factor) and a slow reduction of serum haemoglobin levels as compared with preoperative values. All parameters returned to baseline levels within 6 days of the operation. This study demonstrates that laparoscopic cholecystectomy does not significantly affect immune functions, suggesting that immunity is preserved in the postoperative period.

Adult↗
PubMedDate not supplied

[Anatomical hepatic resection using radiofrequency thermoablation in the treatment of primary or secondary liver tumors].

Radiofrequency thermoablation (RFA) in performing parenchymal liver section has been tested. Eleven patients with primary cancer or colorectal cancer metastasis underwent anatomical major liver resection after vascular control. Parenchymal section was performed by knife after coagulative necrosis. No deaths, clinical or technical complications or blood losses occurred. Such technique is feasible and effective.

Adult↗
PubMedDate not supplied

Communicating oesophageal duplication: a case report.

Duplications of the oesophagus are rare congenital abnormalities and rarely communicate with the oesophageal lumen. They are commonly associated with other congenital malformations, such as spinal deformities, congenital heart disease, vertebral anomalies, malrotation of the bowel, Meckel's diverticulum. During a percutaneous endoscopic gastrostomy, performed because of a neurological dysphagia, the endoscopy revealed a very rare case of a 26-year old man affected by Klippel-Trenaunay syndrome, with an asymptomatic oesophageal duplication that communicated proximally and distally.

Abnormalities, Multiple↗