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Biomedical subjects

M R Pelizzo

Publications and source records attributed to M R Pelizzo.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Somatostatin in the treatment of lymphorrhea after lateral neck dissection].

A new pharmacological effect of somatostatin has been verified in the treatment of lymphorrea due to a thoracic duct injury, produced during left lateral neck dissection. The drug (stilamin 3 mcg/kg/h in continuous venous infusion) allowed in 3 case a strongly decrease of the lymphatic loss within 24 hours and the complete depletion within 6 days. Further studies are required to clarify the dynamic effects of the drug in this complication.

Adolescent↗
PubMed1992

[Surgical emergency in thyroid disease: acute respiratory failure caused by tracheal obstruction].

Diagnostic and therapeutic approach to emergency due to acute and severe respiratory compromise by thyroid goiters with tracheal obstruction is discussed. Such an alarming condition was observed in 5 (2.3%) out of 215 mediastinal goiters operated between 1967-91. Retrospective and critical analysis of these cases pointed out that preventive removal of a large goiter is the best prophylaxis; first management is not surgical, although urgent features. Admission to intensive care center and endotracheal intubation allow an adequate interpretation of the pathologic condition and operative troubles and risks. Diagnostic investigations, effective and kept to a minimum (chest x-ray, tracheo-laryngoscopy, TAC), must be carried out without delaying thyroidectomy and prolonging intubation for days. The extraction of goiter is nearly always performable by the cervicotomic way. Whenever necessary endotracheal intubation obviates the need of tracheostomy for solving transient postoperative complications such as laryngeal oedema, local hematoma and recurrent nerves stupor.

Acute Disease↗
PubMed1991

Expression of class I and II human leukocyte antigens by thyrocytes and lymphocytic infiltration on human thyroid tumors. An immunofluorescence study.

Surgical thyroid sections from 30 papillary carcinomas (PC), six medullary carcinomas (MC), three anaplastic carcinomas (AC), two follicular carcinomas (FC), and 16 adenomas (AD) were examined with an indirect immunofluorescence technique employing different monoclonal antibodies to evaluate the expression of human leukocyte antigen (HLA)-A, B, C (Class I) and DR, DP, DQ (Class II) by thyrocytes, together with the phenotype and distribution of inflammatory cells. Ten PC and four FC were also investigated for the presence of intercellular adhesion molecule-1 (ICAM-1). In situ deposits of immunocomplexes and circulating thyroid autoantibodies were also evaluated. An increased expression of Class I antigens was found in all PC and FC, in 33% of MC and AC, and in 31% of AD. An anomalous expression of Class II antigens was observed in 70% of PC, in 50% of FC, in 33% of AC, in 19% of AD, and in none of the MC. Expression of DP or DQ was revealed only in a portion of the DR-positive glands. A reduction of microsomal autoantigen expression was found. No ICAM-1-positive thyrocytes were detected. A moderate T-lymphocytic infiltrate was noticed only in PC, where it was correlated with DR and DP and/or DQ coexpression. B-cells and natural killer cells were virtually absent. The authors speculate that the weak Class II antigens expression, together with the partial or complete loss in microsomal autoantigen and the absence of ICAM-1 by thyrocytes, may account for the limited engagement of immunocompetent cells observed in thyroid tumors.

Adenoma↗
PubMed1990

High prevalence of occult papillary thyroid carcinoma in a surgical series for benign thyroid disease.

In a surgical series of 277 consecutive patients operated on the thyroid for benign diseases, a high prevalence rate (10.5%) of occult papillary carcinoma was found by means of an accurate histologic examination. Indications for surgery were euthyroid multinodular goiter in 25 patients, autonomously hyperfunctioning adenoma in 2 and Graves' disease in 2 patients. Neoplastic foci were unilaterally found in 25 cases but multifocally in 6 and bilaterally in 4 cases: the diameters ranged from 2-10 mm. After operation (14 subtotal and 15 total thyroidectomies), all patients received TSH-suppressive doses of T4. At a mean follow-up of 5.6 years, neither local recurrences nor lymph node or distant metastases had occurred; no patient died of the tumor. In keeping with other surgical and autopsy series, the prevalence of occult thyroid carcinoma in a normal population is calculated to be about 5-10%, whereas it is known that the prevalence of clinically evident thyroid cancer is only 0.05%. This means that only 1-2% of occult carcinomas may evolve in an overt tumor during life. In view of such an epidemiologic difference and the favorable course of our patients, although the mean follow-up is rather short, we suggest that lobectomy plus T4 treatment may be considered an adequate therapeutic approach in patients with occult papillary thyroid carcinoma.

Adolescent↗
PubMed1990

Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients.

Forty-one patients (17 men and 24 women) were treated with progressive pneumoperitoneum before repair of giant incisional hernias. The pneumoperitoneum was induced using nitrous oxide gas and a laparoscopic insufflator, and was topped up every other day for a mean of 5.5 days with a total injection of 23.2 litres of nitrous oxide. The pneumoperitoneum was well tolerated in 30 patients, caused a mild temporary pain in 10 patients and a sharp pain in one patient; no serious side-effects occurred. All the patients underwent surgery to repair their hernias, 40 patients were available for follow-up for a mean of 25.3 months, only two hernias recurred both within 4 months of the operation.

Abdomen↗
PubMed1990

Severe hyperthyroidism due to metastatic papillary thyroid carcinoma with favorable outcome.

A case of extremely severe hyperthyroidism due to bone metastasis of papillary thyroid cancer is described. Hyperthyroidism began in this patient soon after the discovery of pelvic metastasis and worsened after total thyroidectomy and after the first dose of radioiodine. The administration of methimazole, prednisone and multiple, fractioned and small doses of radioiodine cured the hyperthyroidism and stabilized the neoplastic growth. Hyperthyroidism lasted for at least six months and hypothyroidism appeared only after seven months. Thus, the fractionation of the doses of radioiodine together with antithyroid drugs appears to be an effective treatment in patients with hyperthyroidism due to metastatic thyroid cancer.

Aged↗
PubMed1989

[Benign Castleman's lymphoma. Remarks on 2 cases].

Two personally observed cases of Castleman's benign lymphoma of the hyaline vascular type located in the mediastinum are described. The stages in the development of our knowledge of this tumour are traced and the various aetiopathogenic theories discussed. The difficulty of preoperative diagnosis is emphasised while the potential predictive value of calcifications combined with hypervascularization in an asymptomatic mass usually in the mediastinum and revealed by CT is pointed out.

Adult↗
PubMed1989

Favorable long term results in patients with small differentiated thyroid cancer not treated with radioiodine.

Data on a group of 110 patients with differentiated thyroid cancer not treated by radioiodine are reported. Most of them had intrathyroid (stage I) papillary or capsuled follicular cancer of less than 3 cm diameters. They all received thyroxine at TSH suppressive doses. The follow-up ranged between 4 and 25 years, mean 8.7. No patient died of tumor. Two very old patients died free of disease. Four recurrences occurred, within 8 years, all in patients over 45 years, all local or nodal, all papillary, 3 out of 4 after total thyroidectomy. This study shows that radioiodine therapy may be avoided and that lobectomy may be sufficient in patients under 45 years with small papillary or capsuled follicular cancer.

Adolescent↗
PubMed1988

[High-resolution echography of the neck. Preoperative evaluation of lymph node metastases in patients with thyroid carcinoma].

Twenty-six patients with papillary and 4 with medullary thyroid carcinoma were examined by HRUS before surgery in order to evaluate its accuracy in detecting lymph node metastasis (N) of the neck from thyroid carcinoma. All patients underwent total thyroidectomy and nodal dissection. HRUS was accurate in 73% of cases in N staging, while clinical staging was accurate in 60% of cases only. In 50% of patients HRUS provided with interesting additional information, such as disclosing lymphadenopathy in 8 patients with no clinical evidence, proving nodal involvement in 5 cases, and showing extranodal extension in 5 cases. HRUS allowed the observation of anechoic necrotic areas and microcalcified nodes. On the other hand, according to our results, HRUS cannot either discriminate metastatic from benign nodal involvement, or identify mediastinal adenopathy. False negatives are possible due to micrometastatic areas in normal size nodes. Nevertheless, HRUS proved to be a valuable aid to complete clinical examination of the neck, and a good guide for the surgeon during nodal neck dissection.

Carcinoma↗
PubMed1985

Serum thyroglobulin levels in patients with well-differentiated thyroid cancer during suppression therapy: study on 429 patients.

UNLABELLED: Serum thyroglobulin (Tg) was measured in 429 patients with well-differentiated thyroid carcinoma, during thyroid hormone suppression therapy. 324 patients out of 429 were considered free of disease; 44 had only remnants in the thyroid bed; 61 had metastases, of them 40 were detected by TBS and 21 were nonfunctioning and were detected by other diagnostic procedures. Tg was measured by a RIA method in 257 patients and by an IRMA method in 277 patients. The correlation between the two methods was very good (r = 0.914) for values higher than 25 ng/ml with the RIA method. The cut-off limit to distinguish pathological from nonpathological values was considered the mean value found in the patients free of disease plus 2SD. The cut-off limit for the RIA method was 24.2 ng/ml and 3.0 ng/ml for the IRMA method. Of patients with high Tg levels 92% had metastases, either nodal or distant; only 8% had remnants in the thyroid bed. Tg levels were high in 80% of the patients with metastases, all but two of the patients with metastases and low Tg levels had nodal metastases. Moreover, Tg levels were high in 76% of the patients with metastases unable to take up radioiodine. IN CONCLUSION: patients with low levels of serum Tg during suppression therapy have a high probability of being free of disease, even though the presence of tumors cannot be excluded. On the other hand a value greater than the cut-off limit suggests the presence of metastases despite a negative scan.

Adenocarcinoma↗
PubMed1980

[Surgical treatment of post-traumatic mobile costal flaps].

Twelve cases of surgical management of post-traumatic mobile costal flap are reported. An account is given of the indications for surgery and the various types of costal immobilisation suitable for the anatomical features of the flap. The technique is described in detail and the results are discussed.

Adult↗