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R Tersigni

Publications and source records attributed to R Tersigni.

At least 37 records · Page 2Linked to original sources
PubMed1984

Pancreatic carcinoma in childhood: case report of long survival and review of the literature.

A case of exocrine pancreatic carcinoma in a 14-year-old boy is reported. The primary site of the tumor was in the head of the pancreas, and pathologic features were consistent with an anaplastic lesion. Ten years after curative resection the patient is still living. Extensive review of the literature has revealed 27 other cases of pancreatic carcinoma in children under 15 years of age. Aggressive surgical treatment is emphasized by the long survival observed in four patients who underwent radical operations and by this case report.

Adolescent↗
PubMed1983

Transplantation of irradiated heterotopic segmental human pancreas.

The results of three irradiated segmental pancreatic autotransplantations in patients with cancer of the pancreatic head are presented. The grafts with ligated ducts were irradiated with 5000 or 2000 rad. Following irradiation, the pancreatic tails that were tumor-free at the section line were autotransplanted by anastomosing the splenic vessels to the common femoral vessels. The first graft (5000 rad) that was necrotic, was removed on the 15th postoperative day and the patient was placed on insulin therapy. The second and third patient (2000 rad) are both alive with functioning grafts without exocrine secretion and with normal carbohydrate metabolism, 7 months and 1 month after transplantation, respectively. Technically, irradiated pancreas transplantation is a feasible procedure, which could be applicable to patients with cancer of the pancreatic head to avoid secondary complications of diabetes after total pancreatectomy, and to patients with juvenile or chronic pancreatitis. It is possible that high-dose irradiation can completely destroy eventual multicenter tumor foci in the pancreatic tail.

Aged↗
PubMed1980

[Urinary excretion of arylsulfatases A and B in patients with renal transplants].

Arylsulfatase A and B activities have been determined in urine samples from four patients who received a Kidney allograft from living donors as a treatment for terminal uraemia. The values have been compared with those obtained in the urine of the respective donors. Two patients, with optimal renal functionality, the enzymatic activities were in the order of that observed in the urine of the donor in one case and lower than that of the donor in the other case. A patient showing kidney rejection episodes, reversed by the specific therapy, had the enzymatic activities higher than those shown by the donor. Another patient who suffered for two rejections, the last one irreversible, showed a constant higher value of the two enzymatic activities compared with those of the donor and a further increase during the rejection period. In the light of these preliminary results it seems that the determination of the arylsulfatase activities in the urine of transplanted subjects could contribute to establishing the functional activity of the transplanted kidney and also in establishing the tendency of the kidney to undergo rejection.

Adolescent↗
PubMed1980

[Esterification of cholesterol in patients with renal transplants. Determination of lecithin:cholesterol-acyl-transferase (LCAT) activity].

In man, cholesterol esterification is controlled by lecithin:cholesterol-acyl-transferase (LCAT), which is a key-role enzyme of lipid metabolism. Though LCAT is synthesized by the hepatocytes, its activity seems to be linked to the kidney: in fact, LCAT activity is lowered in uremic and anephric subjects, and probably also in long-term haemodialysis patients. On the contrary, in successfull renal allografts we found fully restored LCAT activity. But physiopathological mechanisms underlying relationships between LCAT and kidney are still unclarified.

Cholesterol↗
PubMed1976

Renal transplantation in high risk patients older than sixty years.

Nine patients between the ages of sixty and seventy-one years, with end-stage renal failure, received kidney grafts during a five year period. Five received related donor kidneys and four received cadaver donor kidneys. Six of these patients are still alive--four of the five (80%) with related kidneys and two fo the four (50%) with cadaver kidneys. All six patients have normal kidney function an average of twenty-seven months after transplantation. We believe the elderly uremic patient should not be categorically excluded as kidney graft recipients on the basis of age alone. The prognosis of these patients treated by transplantation far exceeds that for uremic patients of the same age who are restricted to hemodialysis therapy.

Age Factors↗
PubMed1976

Extra-abdominal transplantation of the pancreas.

Extra-abdominal pancreatic transplantation is a feasible surgical procedure. Transplantation of the pancreas without duodenum and with pancreatic duct-to-ureter anastomosis had better results than combined pancreaticoduodenal transplantation in the same position. The alternative extra-abdominal approach offers more definite advantages, such as ease of performance, location and identification of complications, than does the usual intra-abdominal technique.

Animals↗
PubMed1975

Pancreaticoduodenal preservation by hypothermic pulsatile perfusion for twenty-four hours.

Pancreaticoduodenal grafts remained viable after transplantation only if a modified plasma perfusate with high osmolarity was used during the 24 hours of preservation. When regular plasma perfusate was used during the pancreaticoduodenal preservation, irreversible damage resulted, and all dogs died of ischemie or vascular changes in the first few days after transplantation.

Animals↗
PubMed1975

Effects of methylprednisolone, glucagon, and allopurinol in the protection of pancreaticoduodenal allografts perfused for twenty-four hours.

To establish a model for 24 hours of hypothermic pulsatile perfusion-preservation, methylprednisolone, glucagon, and allopurinol were added to the perfusate of five groups of canine pancreaticoduodenal segments. Results after transplantation showed that neither allopurinol nor glucagon, when used alone, had any beneficial effect on the segments. The segments perfused with the additive combination of methylprednisolone and glucagon had the best results after transplant.

Allopurinol↗
PubMedDate not supplied

The success rate of identification of the sentinel lymph node in breast cancer: our training series.

A new phase of breast conserving surgery has started very recently, aimed at eliminating axillary dissection in node-negative patients by using the sentinel lymph node (SN) technique. Between November 1998 and January 2000 we performed 151 operations for breast cancer on 145 patients. We performed axillary lymphoscintigraphy using 99Tc-labeled human serum albumin microcolloidal particles injected subdermally in 50 patients who met our selection criteria. In this series we focused on the success rate of scintigraphic and surgical sentinel node identification. The number of scintigraphic identifications of the SN was 44 (88%). Only forty-three cases were evaluable, as in one case mapping showed an internal mammary hot node. All SNs were located at the first level. After removal of the SN complete axillary dissection was performed. Eighteen patients (41.8%) had metastatic disease in the axilla. There were five (11.6%) false negatives: two in T2 tumors, one in a T4 tumor and two in T1c tumors. We consider this series as our training series. Our results are similar to those reported in the literature. We believe that the most reasonable approach to SN biopsy is a two-step procedure: the ideal candidates are patients with T1 cancer who can undergo the operation in an outpatient setting under local anesthesia and sedation. Complete axillary dissection is performed only if paraffin sections and immunohistochemistry show metastatic disease.

Axilla↗
PubMedDate not supplied

[Treatment of perianal Crohn's disease].

Perianal Crohn's disease (PACD) is defined as the presence of persistent lesions in the anal canal and perianal region in patients with Crohn's disease. The relative incidence of PACD in Crohn's disease patients ranges from 15 to 80% in the literature, depending on the accuracy of the clinical investigations and the clinical importance attributed to the lesions in the various study populations. The incidence is significantly higher if the intestinal disease is located in the colon-rectum rather than in the small bowel. We reviewed our experience in 105 patients with PACD, 32 of whom presenting rectal localisation of the primary disease. We observed 2 stenoses, 3 perirectal abscesses, 3 rectal ulcerations, 5 skin tags, 10 fissures and 77 fistulas. Two dilatations under narcosis, 2 intrarectal drainages of abscesses, 19 fistulotomies, 7 partial fistulotomies and insertion of loose setons, 47 loose setons and 4 anoperineal diversions were performed. The remaining patients received medical and topical treatments. After a median follow-up of 30 months, 90 patients (86%) showed a good response with improvement in functional scores, while 15 (14%) showed no improvement or a worsening requiring proctectomy in 13 cases. All patients submitted to proctectomy had rectal localization of the disease.

Adolescent↗
PubMedDate not supplied

[Complex duodenopancreatic injuries].

Injuries of the duodenopancreatic region are rare and difficult to diagnose and treat. The related high mortality is mainly due to the presence of associated lesions. Complex traumas (AAST grade IV and V lesions) require difficult surgical treatment with high postoperative morbidity and mortality rates. In a review of 200 pancreaticoduodenectomies performed for pancreatic head traumas the postoperative mortality was 31%. The authors present 6 cases of complex duodenopancreatic traumas, treated from 1995 to 1999. The aetiology was blunt trauma in 5 cases (83%) and a shotgun wound in 1 case (17%). In 3 cases, with a grade V lesion of the pancreatic head, a pancreaticoduodenectomy was performed. A case of a grade IV lesion of the tail of the pancreas was treated with distal splenopancreatectomy. Two cases of grade IV lesions of the third part of the duodenum were submitted to duodenal resection with direct anastomosis. One postoperative death was observed in a patient treated with duodenal resection. The overall mortality was 16%. A pancreatic fistula, which healed spontaneously, was observed in a case of pancreaticoduodenectomy.

Adult↗
PubMedDate not supplied

[Anoplasty with House advancement flap for anal stenosis after hemorrhoidectomy. Report of a clinical case].

Anorectal strictures may occur after anorectal surgery and in particular after surgical haemorrhoidectomy. Anal examination under general anaesthesia was recommended to evaluate the stricture and to choose the appropriate technique. The house advancement flap has been recently proposed for postsurgical anal stenosis repair. The house flap receives its blood supply through unnamed vessels extending through a fatty pedicle from the underlying external sphincter muscle and not from a skin or mucosal bridge like the other common flaps (Y-V and mucosal advancement flap). The aims of this study were firstly to report a case of post-haemorrhoidectomy anal stenosis in a 68-year-old man treated in our institution by house advancement anoplasty and secondly to evaluate the efficacy and safety of this new technique. The technique was totally successful in alleviating anal stenosis and maintaining faecal continence. House advancement anoplasty should be part of the armamentarium of colon and rectal surgeons for treating severe anal stenosis.

Aged↗
PubMedDate not supplied

[Cystic pancreatic tumors. Review of literature and proposal of a diagnostic-therapeutic pathway].

In this paper the Authors consider the epidemiological, clinical, pathological, instrumental, chemical and physical findings of every type of pancreatic cystic lesions. They perform a critical examination of each of them. In this way, they can identify the most important features of every single class. A pathway consisting in four main groups of instrumental and chemical tests (abdominal ultrasonography / EUS, CT, MR, FNA / biopsy/ assay of tumoral markers and amylase of cystic fluid) was chosen to know all these informations according to careful principles of specificity, sensitivity and diagnostic accuracy taken from international scientific literature. In each subgroup of cystic pancreatic tumor, at last, the most reliable therapeutic project is suggested according to the common international scientific agreement.

Aged↗