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Biomedical subjects

U Costi

Publications and source records attributed to U Costi.

At least 19 recordsLinked to original sources
PubMed2006

Space occupying lesions of parotid gland. Comparative diagnostic imaging and pathological analysis of echo color/power Doppler and of magnetic resonance imaging.

Aim of the study was to evaluate the role of echo color/power Doppler and magnetic resonance imaging in the diagnosis of space occupying parotid lesions, in the attempt to establish criteria for differential diagnosis between benign and malignant types. The study population comprised 49 patients (23 male, 26 female), age range 30-85 years, with a space occupying lesion of the parotid gland. Each lesion was carefully studied with ultrasound integrated with colour/power doppler and magnetic resonance imaging; patients were then submitted to echo-guided needle-biopsy and surgical excision. A preliminary evaluation by means of ultrasound revealed the site, size of lesion, echostructure and borders. Echo colour/power Doppler and magnetic resonance imaging can play a very important role both in diagnosis and pre-operative surgical planning of parotid lesions, although cost and availability, the former to be recommended vs. magnetic resonance imaging, which is poorly accessible, expensive, and not always accepted by the patients.

Adult↗
PubMed2005

[Magnetic resonance and traditional radiology in the spine localizations of alkaptonuric ochronotic arthropathy].

AIM: To study the spine alterations in alcaptonuria with traditional radiology and magnetic resonance (MR), comparing the results of the two techniques. PATIENTS AND METHODS: Five patients (4 males, 1 female, mean age 51 years) underwent the examinations. For the study with X-rays we performed anteroposterior and lateral scan and the images have been studied making reference to a radiographic score; it examines the alterations of the joint space and the presence of calcifications. MR scan, oriented in the three spatial planes, were performed using spin echo T1-weighted and spin echo T2-weighted sequences. RESULTS: Both MR and X-rays pointed out, in the cases with known diagnosis, the typical alterations of the ochronosis: narrowing of the articular spaces, even osseous ankylosis, calcifications of the discs, osteophytosis, multiple disc protrusions and reactive sclerosis of the articular surfaces, evident above all to dorso-lumbar tract; nevertheless MR has been more accurate than X-rays for individualizing the lesions and recognizing alterations, such as the thickness of the anterior longitudinal ligament. In the case of new diagnosis, the MR is fundamental to recognize typical signs of the ochronotic arthropathy not well detected by X-rays. CONCLUSIONS: Imaging techniques, first of all the MR, are essential in the differential diagnosis of ochronosis vertebral lesions with other articular diseases.

Adult↗
PubMed2005

[Spontaneous rupture of duodenum: case report and review].

Although rare, injuries of the duodenum increased in frequency during the past ten years. Careful attention must be paid to them, especially in blunt trauma of the abdomen and lower thoracic regions. Often they occur along with lesions of other related structures in polytraumatized patients. X-rays are the most important mean used in diagnosis. Early diagnosis and surgical treatment are conditio sine qua non for successful results. Complete intraoperative inspection of the duodenum, careful suture of the perforation and a correct placement of drainage are essential for the prevention of postoperative complications. If the duodenal wall had lost its vitality, a gastrojejunal or duodenojejunal anastomosis or gastrostomy are performed; the duodenum is decompressed and drainage of the peritoneal cavity is established. In cases of associated injury of the pancreas or choledochus, the drainage of the extrahepatic bile duct is recommended. The Authors report a case of spontaneous rupture of duodenum in which all of the above mentioned procedures were used; they stress that only suspicion of a duodenum's rupture indicates an immediate laparotomy.

Diagnosis, Differential↗
PubMed2004

Parotid gland cancer: a case report of a primitive adenocarcinoma arising from a multirecurrent pleomorphic adenoma.

Parotid tumours represent a wide group of tumours which are mostly localized in the major salivary glands. We report a case of a 69-year old female with a parotid tumour history who was referred to us with a prominent lump and swelling localized in the right parotid area. In the period between 1985-2002, she was operated 5 times elsewhere for a recurrent pleomorphic adenoma of the right parotid (mixed tumour until 1991), which was histologically confirmed. Sixteen years after the primitive tumour, she underwent mastectomy and axillary dissection for a ductal carcinoma. Routine follow-up has been conducted on both malignancies. Pleomorphic adenoma is the most frequent tumour of the parotid. The potential risk of a malignant transformation can increase over the years with an incidence of 1% to 7%. Management of these recurrences is complex and controversial because of the different treatment options advocated such as radical resection with possible facial nerve sacrifice, or postoperative radiotherapy in non radical cases.

Adenocarcinoma↗
PubMed2004

The role of Echo Colour/Power Doppler and magnetic resonance in expansive parotid lesions.

The purpose of this research was to evaluate the role of Echo Colour/Power Doppler and Magnetic Resonance Imaging (MRI) in the diagnosis of expansive parotid lesions, and to establish criteria for differential diagnosis between benign and malignant forms. Forty nine patients (23 males and 26 females), aging from 30 to 85 years, with an expansive pathology of parotid gland were enrolled in our study from February 1999 through August 2004. Each patient was carefully assessed employing both ultrasonography integrated with Color/Power Doppler and MRI. Eventually, all patients received echo-guided needle-biopsy and surgical excision of the parotid lesion. Preliminary ultrasound assessed site, size, echoic appearance and margins of the lesion. In order to assess blood supply by means of Colour/Power Doppler, we divided the patients in four groups. Our MRI diagnostic criteria included site, size, intensity of signal, behaviour of the lesion after i.v. contrast, relationship with facial nerve and retromandibular vein, detection of margins and proximity to adjacent structures. On the basis of our results, the Authors concluded that both Echo Colour/Power Doppler and MRI play a very important role in the diagnosis and surgical planning of parotid gland lesions.

Adenoma↗
PubMed2004

[Anaesthesiologic problems about hyperthermic intraoperative intraperitoneal chemotherapy].

The literature considers hyperthermic intraoperative intraperitoneal chemotherapy a safe and effective procedure for peritoneal carcinomatosis, but a technical improvement is necessary. Regional chemotherapy anticipates the "downfall" of tumoral cells in the peritoneum. The Authors considered 5 patients--female, age 27-45 years, ASA 2--operated of peritonectomy in ovaric neoplasia with peritoneal metastasis. The hyperthermic intraoperative intraperitoneal chemotherapy has been made at the end of the surgery with a hot solution (43 degrees C): 3000 ml of dextrose 1.5% with mytomicina C 25 mg e cysplatino 75 mg/m2. We considered variation of emodinamic parametres (blood pressure, central venous pressure, stroke volume, etc.) and biochemical parametres (Na, K, CI-, CO2, etc.). These parametres have been correlated with some complications: fistula, anastomotic leakage, pancreatitis and postoperative bleeding.

Adult↗
PubMed2001

Has desmoplastic response extent protective action against tumor aggressiveness in gastric carcinoma?

A clinical assessment of protective action of desmoplastic response by limiting tumor aggressiveness has been carried out in 171 patients with gastric carcinoma, surgically treated at the First Surgical Clinic of the University of Rome "La Sapienza" between 1988-1999. A univariate statistical analysis was performed using Kaplan-Meier method for: desmoplastic reaction, age, sex, histologic type, tumor size, stage, lymphonodal status and metastases. To determine the influence of these factors on prognosis, the Cox regression was applied. We found a significant association between desmoplastic reaction extent and presence or absence of metastases (p= 0.026), lymphonodal involvement (p = 0.05), stage (p = 0.036). In the univariate analysis, survival was significantly related to sex (p = 0.012), tumor size (p = 0.009), lymphonodal involvement (p = 0.000), metastases (p = 0.000), stage (p = 0.000), desmoplastic reaction extent (p = 0.05); age and histologic type showed no relationship (p = n.s.). The desmoplastic response extent is not a protective factor against tumor invasiveness in gastric carcinoma, on the contrary it may be considered a negative prognostic factor.

Adult↗
PubMed1999

[Surgery associated with intraoperative hyperthermia-chemotherapy in the treatment of malignant tumors of the digestive system with peritoneal carcinosis].

In the last two years the authors have treated 4 patients affected with malignant tumors of large bowel with very poor prognosis. In every cases they found large spreading to peritoneal cavity. These patients underwent to intraperitoneal hyperthermia-chemotherapy using a special device conceived by authors. This treatment produced promising results as related to life quality in these cases.

Adult↗
PubMed1997

Postoperative combined radiohyperthermia in Astler-Coller stages B2 and C distal rectal cancer.

Pelvic perineal recurrence rate is the major therapeutic problem after curative surgery of extraperithoneal rectal cancer, after lower anterior resection as well as abdomino-perineal resection: local failure rate is high, particularly for stages B2-C. Radiotherapy alone or in combination with chemotherapy proved to be an useful adjunct to surgery. Postoperative radiotherapy, with 40 to 50 Gy doses, has shown local improvement, but causing intestinal damaging. There is now evidence that hyperthermia enthances radiation effects, by killing radioresistant acid tumor cells. In order to give high postoperative radiation doses, without intestinal damage, and to kill acid tumor cells by hyperthermia, we developed a device, able both to displace intestinal loops and to produce combined hyperthermia. From 1993 to 1995, four patients with Astler-Coller stages B2 (2 patients), C1 (1 patient) and C2 (1 patient) distal cancer, were operated by Hartmann's procedure and treated with postoperative radio-hyperthermia with our device. Overall radiation dose delivered in the pelvic area was of 65 Gy, associated with three heating sessions at 43 degrees C for 30 minutes. Pelvic infection occurred in one patient; all pelvic byopsies were negative and no bowel damage was found. Three patients underwent recanalization, one had anasthomotic leackage. The C1 and C2 stage patients died from hepatic metastasis, 18 and 11 months after recanalization; one B2 stage patient is still under treatment and the other is alive and disease free 13 months after recanalization. Our technique allows to give high postoperative radiation doses, without small intestine damage, and to give a good hyperthermia for better control of local failure.

Adenocarcinoma↗
PubMed1991

[Use of the omental mesh graft in protecting intestinal anastomoses. Experimental research].

The faultless seal of the intestinal anastomosis makes up a very important event of abdominal surgery. This work proposes an original experimental method to reinforce the intestinal anastomosis and to prevent the complications due defective seal of the sutures. The results obtained show that this method reduces remarkably the possibility of peritonitis due to the filtration or dehiscence of reinforced anastomosis as regards a control group not treated with omental mesh graft.

Anastomosis, Surgical↗
PubMed1989

[Supplemental proposal in the surgical treatment of liver injury. Experimental studies].

Liver resections pose a great variety of problems, not least repair of the cut. The various reconstruction modalities are reviewed and personal experience in twenty rats submitted to surgical removal of the median lobe of the liver with cover of the sectioned surface by means of omental mesh autograft is reported. The results were flattering for the absence of significant complications and for the haematological and haematochemical data obtained which confirm low easily the graft takes, its regenerative potential and the modulator action of peritoneal repair processes.

Animals↗
PubMed1989

[Surgical proposals concerning omental mesh graft. Experimental studies].

In general surgery, the advantages deriving from the utilisation of omental graft are attributable to the ease with which it takes, its regenerating potential and the modulator action on tissue repair. Personal experience regarding the peritoneization and covering of surgical liver surfaces is reported and the use in various sectors of surgery of omental mesh graft is recommended.

Animals↗
PubMed1989

[Preliminary results of tumor marker monitoring in patients with colorectal carcinoma].

A study relating to the preliminary results of the measurement of tumoral markers (TPA, GICA) in patients suffering from colorectal carcinoma is reported. It is possible to state, on the basis of this experience, that the use of the two tumoral markers is justified in the preoperative period above all as a prognostic indicator, while greater clinical utility would seem to derive from their use through serial determinations, in the postoperative follow-up and in the monitoring of patients undergoing antiblastic and radiation treatment.

Antigens, Neoplasm↗