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Biomedical subjects

Marco Santangelo

Publications and source records attributed to Marco Santangelo.

7 recordsLinked to original sources

Heme oxygenase 1 expression in postischemic reperfusion liver damage: effect of L-arginine.

Ischemia/reperfusion (I/R) injury is a multifactorial process that affects liver function after transplantation and resectional surgery. Alterations in hepatic microcirculation and decreased hepatic flow can cause local hypoxia and consequently liver damage, which is worsened by reperfusion. The aim of this study was to evaluate if treatment with L-arginine improved hepatic function in rats with I/R injury. Animals were treated with L-arginine, ischemized for 30 min, and reperfused for 3 h. Plasmatic levels of GOT, GPT, lipid hydroperoxides (LOOH), and total thiol groups (RSH) were evaluated. In addition, we analyzed hepatic LOOH and RSH levels, DNA fragmentation, heme oxygenase 1 (HO-1) expression, and histological modifications. Our results demonstrate a significant improvement in hepatic function of I/R rats compared to the control group. Treatment with L-arginine increased the expression of HO-1. These data suggest that L-arginine could be useful in preventing oxidative damage during hepatic surgery.

Alanine Transaminase↗

Can biliary carcinoembryonic antigen identify colorectal cancer patients with occult hepatic metastases?

BACKGROUND: Twenty-five percent of radically treated colorectal cancer patients already have occult hepatic metastases (OHM) that will later be observed during postoperative follow-up. Instrumental examinations, i.e., intraoperative ultrasound or Doppler perfusion index, have not improved diagnosis. As carcinoembyonic antigen (CEA) levels are useful to reveal hepatic metastases from colorectal cancer, determination of CEA in the bile rather than the blood may allow preclinical diagnosis of OHM thanks to the reduced volume of bile. METHODS: One hundred radically treated colorectal cancer patients were enrolled in the study. Bile was withdrawn from the gallbladder intraoperatively and biliary CEA levels determined using an immuno-enzymatic method (normal value 0-5 ng/ml). Eighty-nine fully evaluable patients were followed up for three years postoperatively to monitor hepatic metastases. Preoperative blood CEA, lymph node metastases and biliary CEA were compared in order to assess which procedure was more efficient in identifying patients who would develop hepatic metastases. RESULTS: Eleven of the 89 evaluable patients developed hepatic metastases: 9/11 presented elevated biliary CEA levels (mean: 12.73; range: 5.1-26.2); 8/11 had high preoperative blood CEA values; and 9/11 were at anatomopathological stage N+. In the 78 patients who did not develop hepatic metastases, biliary CEA was within normal limits in 73/78, preoperative blood CEA was normal in 60/78, and 58/78 patients were at anatomopathological stage N-. Hence, the sensitivity of biliary CEA was 81.8%, specificity was 93.6%, and diagnostic accuracy was 92.1%. CONCLUSIONS: Determination of biliary CEA seems to be more efficient in identifying patients presenting OHM who require frequent clinical examinations or adjuvant cancer treatment.

Adult↗

Bilateral Morgagni-Larrey hernia: a rare cause of intestinal occlusion.

Morgagni-Larrey hernia is a rare pathologic finding, representing approximately 3% to 5% of diaphragmatic hernias. Its bilateral presentation is an absolute rarity, and its description is based only on isolated case reports. Two different theories exist about its origin: congenital vs acquired. Morgagni-Larrey hernia is asymptomatic in most cases, but it can also manifest with abdominal or thoracic symptoms. Diagnosis is based on findings from conventional radiography and computed tomography. The only treatment is closure of the herniary pass, even if the patient is asymptomatic. We describe this case because of the absolute rarity of bilateral localization in Morgagni-Larrey hernia and because of its subocclusive symptoms.

Aged↗

A rare complication of the hepatic hydatid cyst: intraperitoneal perforation without anaphylaxis.

The hepatic hydatid cyst can lead to serious complications as a perforation into the biliary system or into the respiratory tract. The perforation into the peritoneal cavity can become dramatic, characterized by acute abdomen, usually with anaphylaxis. We recently treated a patient with a liver hydatid cyst perforated into the abdominal cavity. Computed tomography was a useful diagnostic tool, and the patient underwent emergency surgery. At laparotomy, 8 liters of hydatid liquid with floating daughter cysts and purulent material was found. The peritoneal cavity was washed with hypertonic solution, the hepatic cyst with daughter cysts. was removed, and a subtotal pericystectomy was performed. The critical clinical picture did not allow a cholecystectomy or a probe of the common hepatic duct to verify a biliary leakage. A biliary fistula appeared after 4 days and was successfully treated by endoscopic sphincterotomy. No anaphylactic phenomena were seen, probably because the great quantity of purulent material caused inactivity of the allergic component.

Biliary Fistula↗

Ancient schwannoma of the facial nerve: a case report.

Ancient schwannomas are rare benign tumours, deriving from neural crest cells. Schwannomas of the head and neck are frequently misdiagnosed and preoperative investigations are often fruitless. We report a very rare case of a patient with a schwannoma of the seventh nerve. T.A., a 43-year-old male, was referred to our department in September 2003 with a 6-month history of a gradually enlarging asymptomatic right neck mass. Ultrasonography of the parotid gland demonstrated the presence of a nodule, with irregular borders, measuring about 2.90 x 2.00 x 1.70 cm. During surgery we found a mass apparently spreading from the parotid gland and therefore we decided to resect the mass together with the gland. The histological examination yielded a diagnosis of ancient schwannoma. Schwannomas are very rare and approximately 25-30% of all reported cases occur in the head and neck, mostly in the eighth nerve, while involvement of the seventh nerve is extremely rare.

Adult↗

Totally implantable venous access ports: a clinical trial comparing percutaneous versus surgical technique.

Totally implantable venous access ports are valuable instruments for long-term intravenous treatment of patients with cancer, but implantation and use of these devices may be associated with complications. The aim of our study was to compare two implantation techniques in order to establish which one is better for the patient and the surgeon as regards morbidity, surgical time, tolerability, and costs. A prospective study was conducted on a series of 99 patients undergoing implantation of totally implantable venous access ports with surgical cut-down or percutaneous access from January 2000 to June 2004 at the Department of Surgical Sciences, Organ Transplantation and Advanced Technologies. Our experience shows that there are no statistically significant differences between these two techniques in terms of associated morbidity, technical failure, operative time and patient acceptance.

Aged↗