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R Alloni

Publications and source records attributed to R Alloni.

11 recordsLinked to original sources
PubMed2005

Short-term ursodeoxycholic acid treatment improves gallbladder bile turnover in gallstone patients: a randomized trial.

UNLABELLED: Ursodeoxycholic acid (UDCA) prevents in vitro gallbladder (GB) muscle damage caused by acute cholecystitis and reduces risk of biliary pain and complications in gallstone (GS) patients. These effects could be partially explained by the improved GB bile turnover. OBJECTIVES: To assess the effect of short-term UDCA treatment on GB motility and bile turnover. METHODS: Ultrasonographic (US) assessment of GB volumes was performed in 16 GS patients, in the postprandial phase, for 90 min with a time sampling of 1 min, before and after 30 days of UDCA (10 mg kg(-1) die(-1)) or placebo, randomly assigned. US data were analysed with statistical tools and with computer fluido-dynamic (CFD) software Fluent(TM) to simulate GB bile flow. RESULTS: After therapy, fasting volume (FV) increased from 21.6 +/- 9 to 28.2 +/- 12 mL (p < 0.001) while the ejection fraction (EF) remained unchanged (44.5 +/- 17% vs 45.1 +/- 20%; p: ns). Volumes before and after treatment were poorly correlated (0.02 < r < 0.35), unlike those in placebo patients (r > 0.6). The average GB volume was increased in 7 out of 10 patients following UDCA (range 7-67%). CFD analysis supports the finding of improved bile flow after treatment. CONCLUSIONS: Unlike results of conventional US parameters of GB motility, CFD analysis shows that UDCA improves GB bile turnover in GS patients.

Adult↗
PubMed2001

Ultrasonographic assessment of gallbladder bile exchanges in healthy subjects and in gallstone patients.

Impaired gallbladder motility may contribute to gallstone pathogenesis by providing time for nucleation and aggregation of cholesterol crystals. Simultaneous scintigraphic-ultrasonographic techniques have been proposed to assess alternating phases of gallbladder emptying and filling. To evaluate patterns of gallbladder motility and of postprandial bile flow by means of a single ultrasonographic technique, 12 healthy volunteers and 20 gallstone patients underwent minute-by-minute gallbladder ultrasonography for 3 h postprandially. Mathematical analysis of volume measurements was used to estimate hepatic and cholecystic bile flux through the gallbladder. Compared to controls, gallstone patients showed greater amounts of unexchanged cholecystic-to-hepatic bile (11% vs. 1%, p <.001) and most of them showed impaired gallbladder washout efficacy. Utrasonographic values of bile exchanges were similar to those derived from scintigraphic-sonographic studies in comparable groups of subjects. This study provides new ultrasonographic variables, which better express gallbladder bile retention in gallstone patients and strongly discriminate gallstone patients from controls.

Adult↗
PubMed1999

Opsoclonus in a patient with cerebellar dysfunction.

After two days of malaise, headache, nausea, and vomiting, a 26-year-old man suddenly developed opsoclonus and stance and gait ataxia, without myoclonus. Having excluded a paraneoplastic etiology, we assumed that the disorder was probably related to a viral infection. Spontaneous resolution occurred in about two months. Opsoclonus became flutter dysmetria and then resolved. Saccadic eye movement recording disclosed the occurrence of hypermetria, increased velocity, and delayed latency, which also resolved. In this patient, the correspondence between clinical and ocular motor abnormality courses suggests a transient cerebellar dysfunction as the possible pathophysiologic mechanism for opsoclonus.

Adult↗
PubMed1989

[Cancer of the gallbladder].

The Authors report their experience about 20 patients operated on since 1975 for primary carcinoma of the gallbladder. They remark their disappointment because of the poor percentage of preoperative and early diagnosis, that only allows a radical surgical therapy. More attention, therefore, should be payed to this not so rare pathology in the hope the survival of the patients radically operated will increase.

Aged↗
PubMed1987

Gastric submucosal neoplasms: new diagnostic and therapeutic procedures.

Submucosal neoplasms can be found in the esophagus and stomach during radiologic or endoscopic examination; histological diagnosis, however, is not significant in many cases because sampling is difficult. Endoscopic biopsies usually do not allow to obtain tissue from the submucosal layer nor other techniques prove to be reliable enough. 23 patients, aged between 21 and 76 were studied over a period of 5 years; in 1 male large gastric folds were observed. Of the 22 patients affected by benign submucosal neoplasms, 2 underwent surgical operation; no significant samples were obtained in any of the 11 cases in which biopsy forceps had been used. In the remaining patients an electrosurgical snare for polypectomy was used; this technique proved to be successful in 77.8% of cases. It is often shown to be also a therapeutic method when polypoid neoplasms are found.

Adenocarcinoma↗
PubMedDate not supplied

[Preoperative staging of gastric carcinoma using endosonography (EUS)].

Accurate staging of gastric malignancy can only be obtained at surgery and after detailed histological examination of the resection specimen. Endoscopic ultrasonography may provide accurate detection and staging of gastric cancer because of its ability to visualize both the intramural and extramural extent of the lesion and any adjacent lymph node involvement. From february 90 to april 91, 29 patients with a gastric carcinoma were studied endosonographically before surgery. All studies were performed with an Olympus EU-M3. Preoperative TNM classification and a prediction of the resectability of gastric cancer were done in every patient. The results were matched with those obtained with the histology of resected specimens according to the TNM classification 1987. Endoscopic ultrasonography was accurate in assessing the extent and depth of tumor infiltration. The overall accuracy rate was 90.5% (19 out of 21 patients). Overstaging occurred in 9.5% of the cases (2 patients); none understaging occurred. EUS was less accurate in assessment of lymph node metastasis; the overall accuracy rate was 57.1%. Distinction between reactive lymph node and small micrometastatic lymph node involvement could be hard. Local resectability was correctly diagnosed with EUS in each of 23 patients; in two patients an intramural mass with a deep infiltration into the surrounding tissue was correctly diagnosed. In our opinion EUS is an essential diagnostic procedure in the clinical staging of the gastric cancer.

Adult↗
PubMedDate not supplied

[Pancreatic tumor: unusual onset of Von-Hippel Lindau syndrome].

The Von-Hippel Lindau (VHL) disease is a rare genetically determined syndrome. Clinical course depends on the occurrence of multiple tumors as central nervous system tumors, phaeochromocytoma and renal cell carcinoma. We describe the second case in the literature reporting about a patient affected by a pancreatic neuroendocrine tumor as the first clinical sign of VHL disease. It has been showed that only a strict follow-up can effectively improve survival. Based on the present case, the follow-up of patients affected by VHL syndrome should routinely include functional tests and imaging exams of the pancreas.

Adolescent↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis and renal carcinoma. Report of a clinical case and review of the literature].

Xanthogranulomatous pyelonephritis is a rare disease of the kidney; renal parenchyma is replaced by lesions radiologically simulating clear cell carcinoma. We present a case of a 62-year-old diabetic woman observed at our institution for the appearance of back pain and dysuria. A CT scan revealed a large lesion of left kidney with psoas muscle infiltration and the patient undrwent a nephrectomy. Histology surprisingly showed a xanthogranulomatous pyelonephritis. Though recent reports demonstrated the feasibility of conservative management of XGP with antibiotics, the use of pre-operative biopsy is still limited by the risk of seeding and the high false-negative results. How to distinguish xanthogranulomatous pyelonephritis from renal cancer?

Carcinoma, Renal Cell↗
PubMedDate not supplied

[Clinical manifestations and diagnosis of hemorrhoids].

Haemorroidal disease has often typical presentation with rectal bleeding, anal prolapse and pain. Practitioners and patients usually underestimate the symptoms; in adults and older people the same symptoms may suggest neoplastic disease, which may be synchronous. Proctoscopy is the main diagnostic test for staging; endoscopic examination with biopsy is helpful to differentiate neoplastic, granulomatous and inflammatory anorectal lesions. In our mind, a complete study of anorectal function and morphology is necessary for a correct diagnosis.

Anus Diseases↗
PubMedDate not supplied

[Multifocal inflammatory pseudotumor of the liver].

Inflammatory pseudotumor of the liver is a rare entity of unknown etiology; fewer than 80 cases have been reported in the world literature. Its appearance on the computerized tomography, ultrasound and magnetic resonance have been previously described as nonspecific, and clinical presentation is not helpful in the diagnosis. This is why the diagnosis usually is made after laparotomy and often after the excision of the tumor. Several recent reports show that drug therapy is effective and lead to tumor regression, while other authors believe that an aggressive approach should be taken, due to the potential adverse impact of its vascular invasive and biliary obstructive nature. Herein we describe a case of this clinical entity, which occurred in a 52 years old patient, where the operative examination showed bilobar involvement, treated with right hepatectomy and contra-lateral tumor excision in the clinical suspect of hepatocellular carcinoma. The detailed clinical, radiological and pathological picture is described. At 6 months follow-up the patient conditions are excellent. On the basis of the available literature, we discuss the clinical features and the therapeutical problems of such rare clinical entity, and propose a selected use of liver biopsy when the clinical suspicion of pseudotumor can be considered, in order to achieve a preoperative diagnosis and therefore to avoid surgery.

Biopsy↗