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Biomedical subjects

S Contini

Publications and source records attributed to S Contini.

At least 55 records · Page 3Linked to original sources
PubMed1986

Foreign bodies of the biliary tract. Endoscopic management.

In the period 1978-1984, 23 patients underwent endoscopic intervention for foreign bodies of the biliary tract. The patients are subdivided into three groups: the first group consists of 11 cases in which the foreign bodies were suture threads, either simple or as a nidus for gallstones; the second group consists of six patients with a sump syndrome of the biliary tract; the third group includes six patients who retained drainage tubes or stents after a biliary tract operation. In our series, endoscopic extraction was performed as a first-choice procedure. The high success rate may favor endoscopy as a low-morbidity, low-mortality approach and as an alternative to a relaparotomy.

Biliary Tract↗
PubMed1986

Colonoscopic excision of large and giant colorectal polyps. Technical implications and results over eight years.

Large polyps are sessile or pedunculated lesions that are larger than or equal to 3 cm in size. Sixty-six colonoscopic piecemeal excisions of large pedunculated and sessile polyps (75 percent of 88 recognized large polyps) were performed over eight years. The macroscopic feature of the lesions and the result of an extensive snare biopsy were the deciding factors for endoscopic as opposed to surgical removal. Only three complications (4.5 percent) were recorded (two hemorrhages and one colonic wall burn syndrome), none of which required surgery. Fifty patients with 52 adenomatous lesions had colonoscopic follow-up (range, 3 to 85 months). Of 36 sessile adenomas, two cases of residual (5.5 percent) and four of recurrent disease (11 percent) were observed. Colonoscopic removal is an alternative to local surgical excision of large benign colorectal polyps, and often can be an alternative method to elective colectomy in elderly and high-risk patients.

Adenocarcinoma↗
PubMed1986

[Endoscopic sclerotherapy of esophageal varices. Personal cases].

The authors present their experience of endoscopic sclerosis of esophageal varices in 56 patients in a period of about two and half year (February '83-July '85). 46% of the patients were of the group C according to Child's criteria and 48.2% showed a fourth degree varices according to Paquet's criteria. Twenty-nine patients (51.7%) were submitted to the sclerosis as emergency treatment, 17 patients (30.3%) had an elective procedure and 10 (17.8%) were treated by a prophylactic sclerosis. The hemorrhage was stopped in 25 cases (86%) among emergency treated patients. However a new hemorrhage was observed before the end of the cycle of treatment in 48%. On the contrary 17% of patients complained recurrent hemorrhage after completing the treatment. Thirty-five per cent of patients electively treated showed recurrent hemorrhage while 40% bled after prophylactic treatment. Thirty-eight patients had a follow up of one year with results very similar to these reported in the literature. As a conclusion, on the bases of the reported results the authors suggest to submit to this treatment all the patients with recent hemorrhage or in emergency. The sclerosis should be reserved as elective procedure only to the patients of the class C; class A should be reserved to surgery while patients of the class B are matter of debate. Moreover prophylactic treatment, theoretically very attractive, needs further evaluation, at least in their hand.

Adult↗
PubMed1986

Glucose tolerance after portacaval shunt in liver cirrhosis.

The liver plays a key role in glucose homeostasis and insulin metabolism. Altered glucose and insulin levels in peripheral blood are common findings in chronic liver disease. The aim of the present study was to investigate the effect of surgical portosystemic shunt on plasma glucose and insulin responses to glucose administration in a group of cirrhotic patients. For this purpose 10 cirrhotic subjects (8 males and 2 females) aged 42 to 65 years underwent an oral glucose tolerance test (OGTT, 75 g), and an intravenous glucose tolerance test (IVGTT, 0.33 g/kg) before and after undergoing a side-to side portocaval anastomosis (PCS). 6 noncirrhotic, nondiabetic patients matched for sex, age and body weight who underwent abdominal vascular surgery served as controls. In cirrhotic subjects, the PCS resulted in: increased plasma glucose and insulin levels during OGTT; decreased C-peptide level during OGTT; unmodified plasma glucose and insulin concentrations during IVGTT. In control subjects the abdominal surgery did not affect plasma glucose and insulin responses to oral or intravenous glucose loads. These results suggest that in cirrhotic subjects surgical portocaval shunt results in: deterioration of oral but not intravenous glucose tolerance, due to an escape of ingested glucose from the liver; increased peripheral insulin response to oral glucose administration as a consequence of reduction in hepatic removal of the hormone; and decreased pancreatic response to oral glucose due possibly to a greater feed back inhibition of beta-cell. These events seem to be a consequence of the shunt per se and not of a deterioration of hepatocellular function.

Adult↗
PubMed1985

[Considerations on a case of the dislocation of Celestin's endoscopic esophageal prosthesis into the ileum].

Palliative endoscopic oesophageal intubation for obstructive tumor is an on-going procedure. Among the commonest complications is dislocation (proximal or distal) of the prosthesis; however it is a rare event to found the prosthesis distal to the stomach. We report a case of an 83 years old man whose prosthesis, endoscopically placed in the distal third of the oesophagus, was dislocated in the distal ileum causing abdominal pain and mechanical obstruction, thus requiring a surgical removal. The authors discuss the possible causes of this complication and its treatment together with a review of the literature.

Adenocarcinoma↗
PubMed1985

[Carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen in gastrointestinal neoplasms. Comparison of markers].

CA 19-9, a new antigenic tumor marker for gastrointestinal tumors, has been assayed with Carcinoembriogenic antigen, in 90 healthy patients and 47 patients with gastric cancer (20) and colorectal cancer (27). A good specificity has been found for this antigen (97.7%). Its sensibility seems to be slightly superior to that of CEA. However the sensibility for tumors at Mo stage (38%) is indeed scarcely, on the contrary it clearly elevated for tumors at advanced stage (M1)(76%).

Adult↗
PubMed1985

Endoscopic injection sclerotherapy of esophageal varices. Considerations on the first 85 patients.

Eighty-five consecutive cases of esophageal varices treated by endoscopic sclerotherapy are analyzed retrospectively. Most of these cases (84.7%) were done in emergency in patients (60) with poor liver function. Bleeding was stopped in 94.4% of cases but 22% of them had at least one rebleeding episode. Only a few and minor complications were observed. The safety and the immediate good results obtained by the procedure recommend it as a primary measure in bleeding esophageal varices. Moreover the actual role of endoscopic sclerotherapy as an elective or prophylactic procedure in the treatment of hemorrhage from esophageal varices, is discussed.

Adult↗
PubMed1984

Plasma levels and renal removal of gastrin after acute hepatic ischemia in dogs.

Plasma levels and renal uptake of gastrin were determined in ten dogs submitted to complete liver devascularization in order to induce an acute liver failure. Renal function was evaluated by renal plasma flow (RPF) and glomerular filtration rate (GFR) determinations. Liver devascularization was obtained by end-to-side porto-caval shunt (PCS) followed by temporary clamping of the hepatic artery. PCS alone did not affect renal function and renal ability to remove gastrin; after hepatic ischemia, both RPF, GFR and renal extraction of gastrin showed an abrupt decrease. At the end of the period of hepatic ischemia 5 dogs were submitted to glucose infusion, in consideration that: i) glucagon is able both to affect gastrin release and renal hemodynamics, and ii) hypoglycemia that develops after liver failure releases elevated amounts of glucagon. The renal handling of gastrin was not related to glucagon plasma levels, though the higher gastrin levels occurred at the lower glucagon concentrations. These data suggest that in acute liver failure there is a striking decrease of the renal clearance of gastrin associated with the impairment of kidney function. Furthermore, in this pathological condition plasma gastrin levels are affected by blood glucose concentrations through its effect on plasma glucagon levels.

Acid-Base Equilibrium↗
PubMed1983

Renal removal of glucagon and insulin after acute hepatic ischaemia in dogs.

The renal extraction of insulin and glucagon was studied in dogs subjected to temporary interruption of vascular perfusion of the liver. This was performed using hepatic artery occlusion after functional end-to-side portacaval anastomosis. The renal extraction of immunoreactive insulin and glucagon was studied by means of renal arterial-venous concentration differences with concurrent estimates of renal plasma flow and glomerular filtration rate. The degree of liver damage was reflected by dramatic increases of liver enzymes in the plasma after ischaemia and by hypoglycemia which developed in all the animals. Ninety minute occlusion of hepatic blood flow resulted in a dramatic reduction of renal plasma flow and glomerular filtration rate. Portacaval shunt alone had little effect on these parameters. Because hypoglycemia developed after hepatic insult, some animals were made hyperglycemic by intravenous infusion of glucose. In both (hypo- and hyperglycemic) groups of animals the percentage extraction of hormones by the kidney fell dramatically 60 minutes after the end of the hepatic ischaemia and this reduction persisted 180 min later. These data suggest that the impaired renal function may contribute to the increased plasma levels of islet hormones observed during acute hepatic failure.

Acute Disease↗
PubMed1983

Hepatocellular transplantation in rats with toxic induced liver failure: results of iso-, allo- and xenografts.

Intrasplenic hepatocytes transplantation was carried out in Wistar-Lewis strain inbred rats, after inducing acute hepatic failure by intravenous injection of Dimethylnitrosamine (DMNA) (30 mg/kg). Iso-, allo-(CDF-Fisher strain) and xenogeneic (New Zealand White rabbit) grafts were performed. Liver cells suspension was obtained by mechanical separation. The results demonstrated the efficacy of iso- and allotransplants, but not of xenogeneic hepatocytes, in improving significantly the survival rate compared to the control group. It is concluded that immunogenicity of liver cells is a factor which must be taken into consideration in hepatocyte transplantation. Moreover the absence of liver cells into the spleen at one week after the transplant seems to suggest that an intact liver cell is not necessary to improve survival.

Animals↗
PubMed1982

[Case of retrosternal Morgagni-Larrey hernia].

Retrosternal hernia (Morgagni-Larrey) is the less frequent of diaphragmatic defects. Nevertheless its frequency is probably more elevated than commonly believed because very often there is a lack of symptoms. The clinical case which is referred has a typical presentation but it is outlined the difficult interpretation of routine chest x-rays, while a prompt diagnostic suspicion is not always present. Surgical repair is the discussed emphasizing the very good results within a virtual absence of recurrences.

Adult↗
PubMed1980

Abdominal aortic aneurysm--the forgotten diagnosis?

A review of all cases of abdominal aortic aneurysm presenting to Addenbrooke's Hospital, Cambridge, in a 4-year period revealed that there were 118 such patients and confirmed the relatively low operative mortality for elective aneurysmal surgery (6.6%) compared with the high mortality (66.6%) for ruptured or leaking abdominal aneurysm. In only 50% of the cases was the correct diagnosis made during the lifetime of the patient; nor was the correct diagnosis always made after admission to hospital. The need for an early and accurate diagnosis of abdominal aneurysms is stressed and an increased awareness of this condition, based on well established clinical features, would undoubtedly reduce the overall mortality.

Aged↗
PubMed1978

Incidence and pathophysiology of pulmonary edema in fulminant hepatic failure.

Thirty-seven of 100 consecutive patients with fulminant hepatic failure had clinical and radiological evidence of pulmonary edema. None of them had clinical evidence of left heart failure, and the pulmonary artery wedge pressure measured in 12 patients was normal. Similarly, there was no evidence to incriminate renal failure, endotoxemia, or hypoalbuminemia. However, there was a significantly higher incidence of pulmonary edema in patients with cerebral edema, suggesting either a central origin for the pulmonary edema or common factors predisposing to edema in both sites. An additional local factor may have been the presence of intrapulmonary vasodilatation. Detailed isotope studies in 11 patients showed a significantly increased pulmonary extravascular water volume in the patients with pulmonary edema which was in keeping with the severity of the radiological changes. Although the over-all mortality was higher in those patients with pulmonary edema than in those without, the difference was not significant, and early ventilation with positive and expiratory pressure achieved adequate oxygenation in all but 3 patients.

Blood Pressure↗