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Biomedical subjects

M Grosso

Publications and source records attributed to M Grosso.

At least 19 recordsLinked to original sources
PubMed1992

Cryopreserved allograft repair of aortic hypoplasia and interrupted aortic arch.

Mortality for interruption of the aortic arch approaches 100% within the first year of life if untreated. Prostaglandin E1 can stabilize the patient's condition in anticipation of surgical palliation, but total repair is required for long-term survival. Successful complete repair of type B interrupted aortic arch, hypoplasia of the left ventricular outflow tract, and ventricular septal defect was possible using a cryopreserved allograft in a child who previously had undergone unusual palliation.

Aorta, Thoracic↗
PubMed1992

[Liver transplantation: diagnostic imaging in the preoperative assessment].

The correct selection of patients for liver transplantation, which is essential for surgical success, requires thorough radiological evaluation. The authors present their experience on 94 pretransplant adult patients that underwent a total of 251 diagnostic exams (Doppler US, CT, angiography and cholangiography) and interventional radiology maneuvers (biopsy, chemoembolization, biliary drainage). Three sclerosing cholangitis, 3 Budd-Chiari syndromes and 20 hepatocellular carcinomas in cirrhotic patients were identified; venous collaterals were present in 62.7% of the cases, 12.8%, of which had important spontaneous porto-systemic shunts; 6 patients had portal thrombosis; 20 arterial variations were found. Interventional maneuvers were useful and free of complications. US, CT and angiographic findings of each patient were compared. Integrating informations from different exams allowed a significant increase in the accuracy of diagnostic conclusions. Thanks to interventional maneuvers 5 patients could be selected for transplantation (hepatic arterial lipiodolization stopped the growth of 4 hepatic neoplasms; 2 infected fluid collections were sterilized by percutaneous US-guided drainage and topic therapy.

Adult↗
PubMed1992

[Liver transplantation: role of the radiologic methods in the postoperative period].

Some complications of liver transplantation appear as aspecific clinical and blood test abnormalities; others--e.g., hepatic artery thrombosis in the immediate postoperative period and stenosis of the biliary anastomosis before T-tube removal--require early diagnosis. These considerations justify the need of frequent radiologic examination in both the complicated course and the follow-up. The authors report their experience in 59 adult patients submitted to liver transplantation for irreversible liver disease in advanced stage (49 with cirrhosis, 10 with HCC; 5 with cholestatic hepatopathy; 3 with fulminant hepatitis; 1 with Budd-Chiari syndrome; 1 with metastatic APUDoma). Two hundred and sixty-three radiological examinations were performed (Doppler US, CT, angiography and cholangiography) which showed numerous early and delayed complications: 13 of them were treated with interventional radiology maneuvers (US-or CT-guided percutaneous drainage of fluid collections, biliary drainage, bilioplasty, arterial transcatheter embolization). Our results demonstrate that diagnostic and operative radiology are essential for the success of liver transplantation; integrated imaging is particularly important in the diagnosis of complications, while interventional radiology techniques can be usefully employed in their treatment.

Adult↗
PubMed1992

[Percutaneous transjugular intrahepatic portosystemic shunt (TIPS). The preliminary experience and proposal of a new method].

A new interventional procedure employing metallic stents has been recently suggested to perform percutaneous portosystemic shunts in the treatment of variceal bleeding in portal hypertension; the technique is called TIPSS (transjugular intrahepatic portosystemic stent shunt). This percutaneous treatment presents several advantages over surgery: the shunt diameter can be calibrated according to the degree of portal hypertension; moreover, TIPSS can be performed in patients waiting for liver transplantation because it does not alter the vascular anatomy of liver. The original technique employed transhepatic portography. In this paper the authors report on their personal experience and present their series of 4 patients with portal hypertension and variceal bleeding, in whom TIPSS was performed utilizing noninvasive US guidance. Variceal bleeding was successfully treated in all patients and variceal distension was also obtained.

Adult↗
PubMed1992

[Percutaneous transcatheter embolization of deep visceral pseudoaneurysms].

The authors present their experience with the percutaneous embolization of 13 splanchnic aneurysms and pseudoaneurysms (2 pseudoaneurysms of gastroduodenal artery, 3 of the hepatic artery, 7 renal pseudoaneurysms, 1 aneurysm of the splenic artery). In 9 of 13 cases the lesions were iatrogenic. Embolizing devices and techniques are described. Percutaneous embolization was successful in 12 of 13 cases, and useless in 1 case of renal pseudoaneurysm. In the 12 successfully treated cases the lesions were still occluded in the follow-up period. Transcatheter percutaneous embolization is the elective treatment in splanchnic aneurysms and pseudoaneurysms; surgery must be performed only when embolization fails.

Adult↗
PubMed1991

Combined evaluation of total and functional liver plasma flows and intrahepatic shunting.

A diagnostic protocol was studied, designed to evaluate the main parameters of liver circulation in man. A water solution of D-sorbitol (S) and indocyanine green (ICG) was infused intravenously in six controls and nine cirrhotics. Steady-state renal and hepatic S clearances as well as hepatic ICG clearance were calculated. In controls the values (mean +/- SD) of the independent measurements of S and ICG hepatic clearance were 978 +/- 107 and 519 +/- 142 ml/min, respectively, while in cirrhotic patients they were 554 +/- 238 and 231 +/- 90 ml/min. Owing to the kinetic properties of S, its hepatic clearance may be regarded as a measure of functional liver plasma flow (FLPF). The total liver plasma flow (TLPF) values (mean +/- SD), calculated according to Fick's principle, were 1091 +/- 157 ml/min (S method) and 1033 +/- 153 ml/min (ICG method) in controls, and 1251 +/- 554 and 1284 +/- 677 ml/min in cirrhotics. In controls, FLPF was found to be very close to TLPF. In cirrhotic patients the difference between TLPF and FLPF (ranging from 169 to 2093 ml/min when measured by S method) was considered as an approximate estimate of intrahepatic shunting. The procedure is safe and simple and may add a new dimension to the investigation of hepatic circulation.

Adult↗
PubMed1990

Patterns of dyspepsia in patients with no clinical evidence of organic diseases.

We studied 2000 dyspeptic patients with no obvious signs of organic disease at their first examination, in order to (1) verify how many diagnoses of idiopathic dyspepsia had really been made after exhaustive diagnostic procedures and (2) evaluate the diagnostic power of the symptoms in distinguishing organic from idiopathic dyspepsia. This latter was considered only when no structural abnormalities were found. In all the other cases, a distinction was made between "related" and "associated" organic dyspepsia according to whether or not there was a certain relationship between the abnormalities and the dyspeptic symptoms. The patients were referred to us as follows: (1) spontaneously, (2) sent by physicians collaborating with us, (3) referred to our open access endoscopic service. The results show the frequency of idiopathic dyspepsia was 26%, whereas associated structural abnormalities were present in 45.4%. Obvious organic causes of dyspepsia were seen in 28.6% (24% benign and 4.6% malignant diseases). When considered separately, no symptom alone allows a correct diagnosis. The simultaneous evaluation of the symptoms with linear discriminant analysis distinguishes between idiopathic and organic dyspeptic patients in about 70% of the cases. A higher discrimination percentage in about 70% of the cases. A higher discrimination percentage could probably be obtained using a wider range of clinical parameters and/or a more complex statistical analysis of the interrelationships which exist between the clinical symptoms and the final diagnosis.

Adolescent↗
PubMed1990

Trophic response and morphological changes in pancreas of caerulein treated rats: dose and time dependent effects.

The present study was performed to determine the effect of the duration of chronic caerulein administration given at different doses, on the rat pancreas. Four groups of rats, one treated with 0.9% NaCl (control) and the others with caerulein 2, 5 and 10 micrograms/Kg twice a day i.p. were used. After a treatment period of 15, 30 and 60 days, 6 rats from each group were anesthetized, the pancreas was removed, and growth and composition of pancreatic tissue were determined. Small samples were taken for histological examination. Caerulein induced pancreatic hyperplasia and hypertrophy. The dose of caerulein used and the length of the treatment did not significantly modify the trophic effect. Focal perivascular and periductular lymphomonocytic infiltrates associated with cellular abnormalities were seen at 30 and 60 days. The results suggest that 1) the trophic effect of caerulein is not dose-and-time dependent and 2) morphological abnormalities can appear during long term treatment with CCK analogous.

Amylases↗
PubMed1990

[Percutaneous unblocking of porto-systemic shunts. Personal experience with 11 cases].

The authors report their personal experience in percutaneous treatment of portosystemic shunt occlusion and stenosis. Eleven patients with portosystemic shunt stenosis or occlusion were percutaneously treated. Seven patients were treated with PTA alone; in 2 cases, with recurrent variceal bleeding, percutaneous variceal embolization was associated with PTA. Four patients were treated with local fibrinolytic infusion through the catheter inserted into the thrombus; in 3 cases this treatment was followed by PTA. In all 11 patients recanalization was possible, no complications arose. Six patients died in the following 15 months, none due to rebleeding; in 5 patients of this group the shunt was patent at autopsy. In one patient autopsy was not performed but the shunt was functioning at the last duplex US control. Of 5 patients still alive in the follow-up period (2-25 months) the shunt was patent in 3 and occluded in 2.

Adult↗
PubMed1990

Immunohistochemical localization of filaggrin in benign and malignant lesions of the human oral mucosa.

Filaggrin is a protein normally present in the granular and horny layer of stratified squamous epithelia. We studied the presence of this protein in 83 benign lesions and in 73 cases of malignant epithelial tumours of the oral cavity and investigated its possible role as an immunohistochemical marker. The immunohistochemical technique was based on the P.A.P. method. The results in benign lesions show a distribution of filaggrin similar to that observed in the normal mucosa. By contrast, an irregular distribution of filaggrin is observed in areas of leukoplakia with parakeratosis and in papillomas. In malignant lesions the expression of this protein is closely related to the degree of differentiation of the cellular elements, being positive in more differentiated and negative in anaplastic areas. Therefore in some types of benign lesions filaggrin testifies an alteration of the normal process of keratinization. Filaggrin is more significant in malignant lesions in which its presence if any permits an evaluation of the degree of differentiation of the tumour.

Carcinoma, Squamous Cell↗
PubMed1989

Percutaneous treatment (including pseudocystogastrostomy) of 74 pancreatic pseudocysts.

Percutaneous treatment of 74 pancreatic pseudocysts was performed in 70 patients. Initially, single-step fine-needle aspiration was used and had a 71% (15 of 21 patients) recurrence rate. Better results were obtained with prolonged extragastric or transgastric external drainage, performed in 43 patients (46 pseudocysts). Two patients in this series (4.7%) required urgent surgery: one for gastric wall hematoma and the other for intracystic hemorrhage. Three patients (7.0%) were lost to follow-up. The recurrence rate in the remaining 38 patients (41 pseudocysts) was 23.7% (nine of 38 patients). Since 1986, seven patients have been treated with percutaneous pseudocystogastrostomy (one also underwent external drainage and is thus included in the previous series, too) after placement of a transgastric drainage catheter, with no recurrence (follow-up, 2-26 months). It is concluded that transgastric drainage should be performed whenever the anatomic situation is favorable and that a pseudocystogastric stent should be placed in these patients whenever secretions are still abundant after 7-10 days.

Drainage↗