Biomedical subjects
Publications and source records attributed to M Rastelli.
The Authors relate about the current state of knowledge on Cyclosporin A metabolism, mechanism of action, toxic potential, necessity of therapeutic monitoring. The methods for measurement of Cyclosporin A and its metabolites and the study of their immunosuppressive activity are described. Their use for measurement of Cyclosporin G is discussed.
A case of hemangioma of the left twelfth rib is presented. clinical presentation, radiologic appearance and differential diagnosis with other vascular tumors of the bone are discussed, along with a review of the literature.
Bronchial carcinoid is the most frequent cause of Cushing's syndrome due to ectopic ACTH production. The authors report a case of bronchial carcinoid which diagnosis was difficult because of the presence of pulmonary mycosis, that determined a hypercorticosuprarenalism. Medical treatment with octreotide, ketoconazolo and mitotane was useless, and bilateral suprarenalectomy was performed. A scintigraphy with raced somatostatin revealed a left lung area capting radiation. A CT scan of the thorax revealed a lesion of the lingula and the patient underwent an atypical lung resection with complete solution of the symptom. The problems of diagnosis and treatment of neuroendocrine tumors of the lung are discussed and the importance of SSA in the diagnostic procedure is pointed out.
Castleman's disease(CD) is an uncommon lymph node syndrome, generally located in mediastinum side, rarely systemic. Two histhologic types are described: the more common, termed the hyaline-vascular type, generally asymptomatic, and the second termed plasma cell type, with systemic manifestations of the disease, like fever, anemia and weight loss. The authors present a case of a young man with Castleman's disease, treated by prednisone without reduction of the adenopathy, and thus successfully operated, and discuss about aetiopathogenic theories and treatment of this disease.
A case report of a patient with pleural empyema resulting from esophagopleural fistula following perforation of squamous cell carcinoma of the esophagus is presented. The patient had previously received a right pneumonectomy for bronchogenic carcinoma with the adjunct of postoperative radiotherapy. Description of the case, differential diagnosis and therapy of esophagopleural fistulas (EPF) as well as a review of the Literature is described and discussed.
In this review the authors after an introduction on the risk factors, the symptoms and diagnostic aspects of rectal carcinoma, show the different surgical techniques, used second the literature and personal experience on 37 cases for the upper, middle and lower neoplastic lesions of the rectum.
Successful closure of a iatrogenic tracheoesophageal fistula by means of bronchoscopic application of fibrin glue in a 77-year old patient is reported. The fistula was completely obliterated after a single application of the glue, with resolution of the clinical and radiological signs. The procedure may be suggested as an alternative to surgery or as first attempt before surgery in very selected patients with TEF.
Meckel's diverticulum is a frequent embryologic residual organ. The importance of considering this diagnosis in the young adult presenting chronic hypochromic [correction of hyperchromic] anemia, despite the difficulties of the same, is emphasized. The condition to be satisfied is the complete excision of Meckel's diverticulum, to avoid leaving ectopic mucosa residuals, so we think it useful to resect an ileal sleeve.
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Pneumomediastinum (spontaneous, iatrogenic and traumatic) is a relatively uncommon infrequently reported entity. The most common cause is the rupture of marginal pulmonary alveoli, allowing bubbles of air to dissect along the vascular sheaths and connective tissue planes to the mediastinum. Rupture of the trachea or thoracic traumas are other causes of pneumomediastinum. The most common presenting complaint was retrosternal pain, dyspnea, dysphagia, weakness and neck pain. Physical finding revealed: subcutaneous emphysema extended to face, chest or neck, and Hamman's sign. Chest X-ray was made in all cases and diagnosis was completed with chest CT scan and tracheoscopy. We present our series of 34 PM between January 1.1993 to July 31.1995 and discuss about etiology, diagnosis and treatment of this entity.