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Biomedical subjects

M Montorsi

Publications and source records attributed to M Montorsi.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Frequency of surgical wound infections in patients treated with a barrier procedure. Multicentric study].

In 3088 patients submitted to various surgical procedures an open clinical trial was carried out to evaluate the rare of surgical wound infections (SWI). All of them were treated, before and after surgery, with a foam emulsion (Bioshield) considered, from a theoretical point of view, to be able decrease the bacterial contamination of the surgical wounds. The SWI rate was really low (congruent to 2.3%) and a favorable role played by Bioshield cannot be excluded, both minimizing the skin lesions of the surgeon's hands and reducing wound contamination by exogenous flora.

Adolescent↗
PubMed1992

Clinical utility of the serum CA 19-9 test for diagnosing pancreatic carcinoma in symptomatic patients: a prospective study.

The diagnostic accuracy of the serum CA 19-9 determination was prospectively evaluated in patients selected for the presence of signs or symptoms highly suggestive for pancreatic cancer. Of 110 patients included in the study, 54 had a final diagnosis of pancreatic adenocarcinoma (49% prevalence). CA 19-9 values were higher than 40 U/ml in 45 patients with pancreatic carcinoma and in 18 of the 56 patients with other final diagnosis (sensitivity, 0.83; specificity, 0.68; positive predictive value [PPV], 0.71; negative predictive value [NPV], 0.81). The serum CA 19-9 determination was not capable of shortening the diagnostic workup of patients with strong clinical suspicion of pancreatic cancer since adequate imaging of the pancreas was required to confirm or exclude the diagnosis. However, values above 120 U/ml were strongly suggestive for pancreatic carcinoma in the overall population (PPV, 0.85) and they were diagnostic (PPV, 1.0) in the anicteric portion. Combined with pancreatic imaging, the CA 19-9 was an excellent confirmatory test; a normal value in a patient with negative imaging ruled out pancreatic carcinoma as the cause of symptoms (NPV, 1.0), whereas a pathological result in the presence of positive or equivocal pancreatic radiology was highly suggestive for the presence of the disease (PPV, 0.93).

Adenocarcinoma↗
PubMed1992

Newest human herpesvirus (HHV-6) in the Guillain-Barré syndrome and other neurological diseases.

To investigate the presence of human herpesvirus-6 (HHV-6) in patients affected by Guillain-Barré syndrome (GBS) and by other neurological diseases (OND), we examined by indirect immunofluorescence analysis (IFA) the sera and cerebrospinal fluid (CSF) from 28 GBS and 63 OND. Moreover, we tested 150 blood donors (BD) to appreciate the diffusion of HHV-6 infection in the Italian adult healthy population. We found a significantly higher titre of antibody to HHV-6 in the GBS patients compared with OND and BD, although the pathogenicity of the virus is not known.

Adult↗
PubMed1992

[Clinical use of a new compression surgical stapler in surgery of the large intestine].

The clinical experience with the use in colorectal surgery of a new compression anastomotic device developed by the Authors is reported. From May 1986 through June 1990, 95 patients underwent large bowel anastomosis using this device. Operations performed included 51 left hemicolectomies or anterior resections of the sigmoid and rectum, 23 left colon resections, 19 right hemicolectomies, and two total colectomies. Twenty-nine anastomoses were performed below the pelvic peritoneal reflection and 18.5% of them resulted less than 4 cms from the anal verge while 20% were located between 4.5 and 8 cms. Five (5.2%) intraoperative diverting colostomies were needed. The rings were evacuated postoperatively after a mean of 10.9 days with none or very little discomfort. Operative mortality was 1.0% (one patient died of myocardial infarction). Anastomotic complications included five (5.2%) clinical and four (4.2%) subclinical leakages. No haemorrhages or stenoses were observed. This initial clinical experience shows the anastomotic device is reliable and justifies further experimentation.

Adenocarcinoma↗
PubMed1991

Effects of intraperitoneal chemotherapy on anastomotic healing in the rat.

The effect of perioperative intraperitoneal (ip) (2 mg/kg) vs intravenous (iv) (1.5 mg/kg) mitomycin-C on healing of intestinal anastomoses was studied in rats after jejunal section and anastomosis. When the animals were killed 7 days after surgery 52.8% in the ip group had an anastomotic leak (41.2% causing death of the animals), compared to 20% in the iv group and none in the control group. Mean anastomotic bursting pressure was 156 mm Hg in the ip group, 178 mm Hg in the iv group, and 203 mm Hg in controls (P less than 0.01). Hydroxyproline content of the intestinal segment containing the anastomosis was 2.26 micrograms/mg in the ip group, 3.49 in the iv, and 4.91 in controls (ip vs controls, P less than 0.01). Histological examination of the anastomoses in rats given ip mitomycin showed significantly "slower" anastomotic healing than in iv rats and controls. Electron microscopy showed that the mean diameter of collagen fibers was significantly smaller (P less than 0.05) in ip rats (34 nm) than iv (51 nm) and controls (79 nm). An intraoperative bolus of mitomycin thus significantly impaired the healing of a jejunal anastomosis in the rat, more so after ip than iv injection. Thus in clinical practice ip adjuvant chemotherapy after surgery should perhaps be delayed until wound repair has reached an advanced stage.

Anastomosis, Surgical↗
PubMed1991

[Mebendazole in the therapy of hydatidosis].

The effectiveness of mebendazole as adjuvant treatment in hydatidosis was evaluated in 19 patients; 12 were treated both before and after surgery, 6 were not treated, one had primary treatment only, owing to the refuse of surgery. Mebendazole was administrated at the dosage of 30-50 mg/kg/day po for 30 days followed by a washout of 15 days, for a mean of 4 cycles (range 1-7) and 12 cycles (range 1-24) before and after surgery, respectively. Patients were monitored by total IgE, specific anti-echinococcus IgE and IgG, at diagnosis, just before surgery and thereafter every six months. Antibody titer decrease was observed soon after the first cycles of medical treatment before surgery, as well as a clear-cut drop after surgery, followed by a continuing decrease after the following cycles of mebendazole. Relapse of disease was observed in two patients only at one and two years after surgery respectively. These preliminary results seem to point out that mebendazole might play a role in the treatment of hydatidosis as adjuvant of surgical therapy.

Adolescent↗
PubMed1991

[Aneurysms in various segments of the hepatic artery. Treatment by resection].

The authors report two cases of aneurysms of the hepatic artery, one of which, with a intrahepatic localisation, was complicated by rupture and infection. The etiology was atherosclerotic in the case involving the main trunk of the hepatic artery, and polyarteritis nodosa in the case with intrahepatic involvement. Both were resected; the extrahepatic aneurysm was excised and a venous graft inserted, whereas in the one with intrahepatic involvement, right lobectomy was performed. On the basis of these cases, the authors discuss the various etiologies and the problems related to the indications and surgical techniques for aneurysms of the main trunk of the hepatic artery and those of its intrahepatic branches.

Aged↗
PubMed1990

Clinical application of a new compression anastomotic device for colorectal surgery.

Fifty-six patients underwent large bowel anastomosis by the compression anastomotic device developed by the authors from May 1986 through December 1988. Operations performed were 40 left hemicolectomies or anterior resections of the sigmoid and rectum, 7 left colon resections, 7 right hemicolectomies, and 2 total colectomies. Twenty-one anastomoses were done on the extraperitoneal rectum, in 7 cases less than 4 cm from the anal verge and in 9 cases between 4.5 and 8 cm. Five intraoperative diverting colostomies were done (9%). The rings of the device were evacuated postoperatively after a mean of 11 days with little or no discomfort. Operative mortality was 1.8% (one patient died of myocardial infarction). Anastomotic complications were one (1.8%) clinical and one (1.8%) subclinical leak. Mean postoperative hospital stay was 14 days. This initial clinical experience shows that the anastomotic device is reliable.

Adult↗
PubMed1990

[The Fitz-Hugh-Curtis syndrome. Postgonococcal perihepatitis].

A case of Fitz-Hugh-Curtis syndrome (post gonococcal perihepatitis) is reported. The patient proved to be affected by a typical case of the syndrome and the approach used concentrated on an accurate diagnosis and immediate therapy carried out during laparoscopic examination. A control examination after approximately one month confirmed the resolution of both perihepatitis and symptoms. The patient is now in good health some three years following the operation.

Biopsy↗
PubMed1989

[Segmental splenectomy. Usefulness of linear surgical staplers].

As the high risk of sepsis after splenectomy is well recognized, reliable conservative surgical techniques in splenic surgery are widely advocated. Among these, segmental splenectomy carries specific and increasing indications. The use of linear staplers makes this operation quicker and safer. On the basis of a personal observation, Authors examine the anatomical features on which this operation is based, the surgical technique and the technical details to be followed using these devices. The advantages offered by staplers in this surgery allow to widen the indications to partial splenectomy, so as to yield a true primary prophylaxis of the post-splenectomy sepsis.

Adolescent↗
PubMed1989

Brain cholecystokinin depletion in rats with acute liver failure.

A decrease of both hypothalamic and cortical CCK occurred in the brain of rats killed 8 hours after hepatic artery ligation following portocaval anastomosis. Brain CCK depletion was not reproduced by exogenously provoked hyperammonemia nor by insulin-induced hypoglycemia, thus suggesting a central mechanism for the derangement of the CCKergic system in the course of acute liver failure.

Ammonia↗
PubMed1989

Pancreatic polypeptide response to food and cerulein in patients with total gastrectomy.

In order to investigate the intestinal phase of pancreatic polypeptide (PP) release, the hormonal response to food and cerulein was measured in 19 patients with truncal vagotomy and total gastrectomy (10 with simple esophagojejunal anastomosis and 9 with an additional duodenojejunal anastomosis) and in 7 healthy subjects. After gastrectomy, the early peak of the physiologic biphasic PP response to food was lost but the late predominant phase was unchanged so that the overall postprandial release of the hormone was not significantly lowered. Gastrectomized patients with duodenal bypass had postprandial serum levels only slightly lower than those of patients with preserved duodenal transit of food. Serum PP response to cerulein stimulation was significantly lower in vagotomized patients than in healthy subjects. However, in operated patients as well as in controls, cerulein infusion did induce a rapid increase of plasma PP, followed by persistently elevated levels. The PP response to cerulein was abolished by atropine pretreatment. Our findings indicate that the intestinal phase of meal-stimulated PP response is not dependent on the integrity of vagal pancreatic innervation and that the preservation of the duodenal transit of food after total gastrectomy is not crucial for the maintenance of the enteroinsular axis.

Adult↗