Biomedical subjects
Publications and source records attributed to M Vergine.
Of unknown etiology, mainly located on the upper limbs, the nodular fasciitis nowadays is considered as a reactive inflammatory lesion more than a neoplastic one. With very few symptoms, it can be diagnosed through histology and the extent of the excision is related to the report of the pathological examination.
By clinical observation and surgical treatment of a patient with a primitive lymphoma of the breast, the authors describe the nosological approach, the correct diagnosis and the relative surgical treatment in that disease.
A 12-year-old, intact, male mixed-breed dog was presented with anorexia, vomiting and multiple cutaneous nodules on its neck, trunk and hindlimbs. Fine-needle aspiration cytology of the nodules was characterised by a pleomorphic population of cells arranged singly or in small cohesive clusters, embedded in an amorphous mucinous material stained positive by periodic acid-Schiff (PAS). Acinar structures were occasionally found. Cells appeared either small with scant basophilic cytoplasm or large with a histiocytic appearance. Large cells had cytoplasm filled with a PAS-positive granular material. A presumptive diagnosis of cutaneous metastases of a mucinous adenocarcinoma was made. A primary, gastric, signet-ring mucinous adenocarcinoma was confirmed at postmortem examination and by histopathology. To the authors' knowledge, this is the first report of a gastric mucinous adenocarcinoma with cutaneous disseminated metastases in a dog.
The aim of post-mastectomy breast reconstruction by tissue expanders is the mammary symmetry. The Authors report a personal experience in immediate (55 pts) and delayed (12 pts) breast reconstruction with implants. The technique is simple and safe with good aesthetical and functional results.
Adenoma of the nipple is a benign pathology which histologically interests the epithelium of the galactophorous ducts. This pathology looks like Paget's disease both macroscopically and microscopically, therefore an exact differential histologic diagnosis is needed with the breast's carcinoma to undertake the most timely surgical therapy.
The case of a upper extremity calcifying epithelioma of Malherbe in a 16-year-old boy is reported. Clinical and pathological features of this extremely rare tumour, arisen from hair cortex cells, are reviewed. Pilomatrixoma has been reported not only as a benign lesion, or as a low-grade malignant lesion with a tendency to recur locally, but also as a highly malignant tumour. Factors influencing clinical differential diagnosis and prognosis are discussed as well.
The employment of prosthesis in abdominal plastic surgery for incisional hernia has contributed to a remarkable improvement in the results of this surgery. The current use of PTFEe, according to the Authors experience, proves to be effective. Both satisfactory functional results and evident aesthetic advantages are obtained. The Authors report their experience in the treatment of the median incisional hernia also by means of a polypropylene mesh. The latter was shaped in a very original way thanks to a technique borrowed from plastic surgery. The complete mobilization of the ombilicus, by a circular incision, allowed the Authors to insert this prosthesis symmetrically under the rectus abdominis muscles for the entire extension of the incisional hernia.
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The Authors report a case of myofibroblastoma, a rare primitive mesenchymal tumor of the lymph node. Differential diagnosis with Kaposi sarcoma, neurilemmoma and metastatic neoplasm is discussed.
A correct approach to sexual disorders in vascular patients presupposes an accurate investigation before and after operation. The authors evaluate the reliability of the diagnostic methods used, pre- and postoperatively, to ascertain sexual disorders, and analyse the influence of surgery on sexual function.
The demolition-reconstruction sequence in patients suffering from breast cancer may, in selected cases, be reduced to two surgical steps alone without compromising the radical nature of the surgery or the aesthetic result. The technical details of a protocol realisable in a short time that proposes on the one hand classical radical mastectomy (according to Patey or Madden) and on the other reconstruction by tissue expansion are described.
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The authors report their personal experience in the treatment of the resurfacing by means of phenol chemical peeling using a new solution described by Dr. Yoram Fintsi and called Exoderm. They report dressing technique and possible contraindications as well.
A case of mesothelial cyst of the right hemidiaphragm in a 44 year old man is reported. Origin (most likely due to a recess of the primary coelomiatic cavity), topographical, histological and therapeutic features are discussed, stressing that it is now more frequently recognised thanks to progress in diagnostic imaging techniques. Complete surgical excision is mandatory to definitely differentiate such lesion from primary diaphragmatic neoplasm, not infrequently malignant.
The Authors, on the basis of their experience, underline the importance general surgeon has in carrying out a radical surgery for breast cancer without compromising a subsequent reconstruction. The latter, in fact, is nowadays considered a second step in the surgical management of breast cancer.
Experimental reports have proved that bile acids damage the gastric mucosa. Moreover it is now accepted that duodenogastric reflux occurs in 20-30% of cholecystectomized persons. The Authors, with the purpose of defining a correlation between gastric mucosa damage by duodeno-gastric reflux and postcholecystectomy syndrome have taken into consideration two groups of 14 patients each. To the first group belonged cholecystectomized patients, who had episodic, often postprandial pain, constant heart burn, with associated vomiting and Hypochromic anemia. To the second group belonged asymptomatic patients with previous cholecystectomy. All these patients were endoscoped (EGDS), and their endoscopic biopsy specimens were surveyed. 99Tc HIDA cholescintigraphy was performed in all the groups of patients, after endoscopy. In 85% of symptomatic patients we found, during endoscopy, reflux of bile into the stomach with associated reddish and inflammatory change of antral mucosa vs. 7.14% of the control group. Atrophic chronic gastritis was found in 71.43% of endoscopic biopsy specimens of Symptomatic vs. 14.28% of asymptomatic patients. Superficial chronic gastritis was found in 28.57% of symptomatic vs. 50% of asymptomatic patients. At last we found active atrophic or superficial antral gastritis (Whitehead) in 90% of symptomatic patients vs. 0% of asymptomatic people. The Authors conclude that there is a positive correlation between duodenogastric reflux and postcholecystectomy syndrome when biliary reflux is correlated with an histological finding of antral active chronic gastritis.
Surgical repair of ventral hernias may often be quite difficult; however, the use of prosthesis, now generally accepted by many surgeons, has improved the results of such type of surgery. The Authors experience confirm the safety of the expanded PTFE and its versatility of employment, obtaining good functional and aesthetic results.