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Biomedical subjects

R Greco

Publications and source records attributed to R Greco.

At least 127 records · Page 7Linked to original sources

Hemobilia following percutaneous transhepatic cholangiography.

Percutaneous transhepatic cholangiography is a safe, effective diagnostic procedure for use in evaluating the jaundiced patient. As is the case with most invasive diagnostic procedures there is a risk: an overall mortality rate of 0.5% and morbidity rate of 3-10%. Fortunately hemobilia is an uncommon complication, encountered only four times in our series of 102 percutaneous cholangiograms. In every case of hemobilia the clotting parameters were normal. The one factor common to each case was distal obstruction of the extra hepatic bile ducts. However, this one factor may play an important role in the etiology and therapy of post cholangiographic hemobilia. The hemorrhage subsided spontaneously in every case following surgical decompression of the bile ducts and there was no further active bleeding postoperatively. The possible explanation for the cause of bleeding and the fact that it subsided following demcompression of the bile ducts is discussed. All four patients survived this complication and in the 102 patients there were no deaths attributable to percutaneous transhepatic cholangiography.

Aged↗

Fetal bile salt metabolism. II. Hepatic excretion of endogenous bile salt and of a taurocholate load.

Bile salt metabolism was studied in fetal dogs 1 wk before term. The size and distribution of the fetal bile salt pool were measured, and individual bile salts were identified. The hepatic excretion of endogenous bile salts was studied in bile fistula fetuses, and the capacity of this excretory mechanism was investigated by the i.v. infusion of a load of sodium taurocholate-(14)C up to 20 times the endogenous pool size. The total fetal bile salt pool was 30.9+/-2.7 mumoles, of which two-thirds was in the fetal gallbladder. Expressed on a body weight basis, this was equal to approximately one-half the estimated pool size in the adult dog (119.2+/-11.3 vs. 247.5+/-33.1 mumoles/kg body wt). Measurable quantities of bile salt were found in small bowel (6.0+/-1.8 mumoles), large bowel (1.1+/-0.3 mumoles), liver (1.2+/-0.5 mumoles), and plasma (0.1+/-0.03 mumoles). Plasma bile salt levels were significantly greater in fetal than in maternal plasma (1.01+/-0.24 mug/ml vs. 0.36+/-0.06 mug/ml; P < 0.05). Fetal hepatic bile salt excretion showed a fall over the period of study from 2.04+/-0.34 to 0.30+/-0.07 mumoles/hr. The maximal endogenous bile salt concentration in fetal hepatic bile was 18.7+/-1.5 mumoles/ml. The concentration in fetal gallbladder bile was 73.9+/-8.6 mumoles/ml; and, in those studies in which hepatic and gallbladder bile could be compared directly, the gallbladder appeared to concentrate bile four- to fivefold.Taurocholate, taurochenodeoxycholate, and taurodeoxycholate were present in fetal bile, but no free bile salts were identified. The presence of deoxycholate was confirmed by thin-layer chromatography and gas liquid chromatography, and the absence of microorganisms in fetal gut suggests that it was probably transferred from the maternal circulation. After infusion of a taurocholate load, fetal hepatic bile salt excretion increased 30-fold, so that 85-95% of the dose was excreted by the fetal liver during the period of observation. Placental transfer accounted for less than 5% of the dose. Fetal bile volume increased 15-fold on average, while bile salt concentrations increased two- to threefold. It is concluded that bile salt is taken up, conjugated, and excreted by the fetal liver with remarkable efficiency. The excreted material is either stored and concentrated in the fetal gallbladder or released into the intestine and reabsorbed to be reexcreted in bile.

Animals↗

Bone metabolism in children with congenital hypothyroidism--a longitudinal study.

In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital hypothyroid children, we studied 23 (10 girls and 13 boys) consecutive patients. Their age ranged from 3 to 8 weeks. One of these patients had familiar dyshormonogenesis, 21 had ectopic glands and one hemiagenesis. As a control group, we studied 46 sex- and age-matched healthy newborns. Before the beginning of therapy, the hypothyroid patients showed higher values of calcium (2.78 +/- 0.04 vs 2.65 +/- 0.07 mmol/l; p < 0.05) and of 1,25-dihydroxy-vitamin D (159.7 +/- 31.6 vs 90.5 +/- 33.1 ng/l; p < 0.01), while they showed lower values of osteocalcin (1.9 +/- 0.8 vs 2.9 +/- 0.9 ng/ml; p < 0.01) than controls. After 3 months of therapy, we found a complete normalization of all these parameters and a progressive increase of osteocalcin. Our data show that in congenital hypothyroid children there are abnormalities in calcium metabolism which seem to be transient and reversible after L-thyroxine replacement therapy.

Bone and Bones↗

[Role of echography in the preoperative evaluation of palpebral basal cell epithelioma].

The palpebral region is one of the commonest locations for basal cell epitheliomas of the face. The tumor can spread to both orbital cavity and its structures. Ten patients with basal cell epitheliomas of the face were studied with US to investigate its diagnostic accuracy; US findings were compared with CT ones. In all cases US allowed a complete study of both morphology and structure of the tumor; it precisely defined the status of the superficial structures of the orbital cavity (cornea and anterior chamber of the eye), differentiating between tumor contiguity, compression and infiltration. US seems therefore essential to the preoperative assessment of tumor spread and during the follow-up of patients with palpebral basaliomas.

Basal Cell Carcinoma↗

Aneurysms of azygous anterior cerebral artery. Report of two cases treated by surgery.

The occurrence of a so called azygous anomaly of the distal ACA, consisting in a single branch, is rare. Authors report two cases of azygous aneurysm on which surgery was performed successfully, and describe their angiographic characteristics, the frequent association of an aneurysm with azygous and the morphological anomalies of azygous. A literature review is made.

Adult↗