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Biomedical subjects

V Puchetti

Publications and source records attributed to V Puchetti.

At least 37 records · Page 2Linked to original sources

Leiomyomata of the oesophagus: report of four surgically-treated cases.

Four patients with leiomyoma of the upper or middle third of the oesophagus treated by surgical excision are reported. All operations were performed through a right thoracotomy with simple enucleation of the lesion. Two patients were asymptomatic. In one the tumour had a spiral configuration almost completely surrounding the lumen. No complications occurred. Early surgical treatment is advised although the tumour grows slowly.

Adult↗

Penetration of ceftazidime in human pericardial fluid and lung tissue.

The penetration of ceftazidime in pericardial fluid and lung tissue was investigated in 14 thoracotomized patients, who had normal renal function and did not receive any antibiotic treatment before thoracotomy. The drug (28 mg/kg) was given by i.v. Blood, pericardial fluid and lung tissue samples were taken over the next 5 hours. Concentrations of ceftazidime in the lung tissue were very high in the first hour and over the 200 and 300 min time interval, the ratio between serum and lung tissue levels was 0.7. The correlation coefficient between pericardial fluid, serum ratio and time was calculated to be of 0.99 (P less than 0.001). From these data we can observe that ceftazidime rapidly diffuses into the pericardial space and lung tissue where good concentrations (5.4 mcg/g) persist for at least 5 hours.

Adult↗

[Parenteral and enteral nutrition in esophageal stenosis. Initial clinico-experimental results].

The Authors study the pre- and post-operative nutritional treatment of the patients suffering from oesophageal stenosis, principally neoplastic, waiting to undergo the radical operation. Although the compensation of the nutritional situation of these patients through the enteral and parenteral nutrition results difficult to be effected, the results encourage to apply this clinical practice everywhere a demolitive operation, always long, heavy, and burdened by a high morbidity and mortality, is foreseen.

Enteral Nutrition↗

[Traumatic rupture of the diaphragm. Diagnostic problems and surgical therapy].

The Authors show 10 cases of traumatic disruption of diaphragm, subsequent to close or open trauma, all subjected to urgency operation. They discuss the problems concerning diagnosis and surgical tactics, and point out the frequency of visceral and osseous associated lesions and their importance in conditioning prognosis.

Adolescent↗

[Delayed recognition of traumatic rupture of the diaphragm. Diagnostic and therapeutic problems].

The Authors face the diagnostic and therapeutical problems involved in the tardy recognition of diaphragmatic breakages. On the basis of two clinical cases observed, they emphasize the relative frequency of this lesion, the variability of the clinical pictures, the limits of the clinical and radiological diagnostics, the utmost seriousness of the complications. They face the problem of the choice of the surgical way of approach and the techniques for repairing the diaphragmatic lacerations.

Accidents, Traffic↗

[Multivariate statistical analysis in predicting bronchopulmonary complications after surgical interventions in cancer of the lung].

A multivaried statistic process, the linear discriminant analysis, applied to VEMS, CV, I.T., FEF 25-75, pH, PaO2, PaCO2, was used by the authors to foresee, in 42 patients suffering from bronchogenous carcinoma, the arising or absence of respiratory complications after operation. With such method, the falsely positive or negative previsions, resulted to be 13 with a total percentage of error as high as 30%. These results suggest that, even when elaborated through the multivaried analysis, the parameters studied do not allow to adequately discriminate the patients who would develop, after operation, bronchopulmonary complications from those who would be exent from them.

Adult↗

[Endobronchial lipomas].

The authors report three cases of endobronchial lipoma, and study the etiopathogenesis and the main clinical and therapeutical aspects of such neoplasiae. Both diagnosis and treatment should be timely, in order to prevent irreversible damages to lung parenchyma, compelling surgeons to mutilating operations making the function of the apparatus heavier.

Aged↗

[Long-term survival of patients operated on for carcinoma of the lung (author's transl)].

The long-term fate of patients treated surgically for carcinoma of the lung is not well known. In a careful review of the literature the authors found only nine papers with a postoperative followup of at least 10 years; the mean survival was 16,3% of patients so treated. Factors making for a good long-term prognosis include small initial tumor size, absence of mediastinal lymph node invasion, a favorable histologica type, and the type of surgery performed (partial exeresis). Translated into TNM code, this means that the best candidates for prolonged survival are patients with lung carcinoma of the squamous cell type, stage I, treated by limited lung exeresis.

Follow-Up Studies↗

[Palliative treatment of esophageal cancer].

The AA. describe the indications, the technique and the complications of application of oesophageal endoprosthesis (Celestin or Haring) for palliative treatment of oesophageal cancer and they value the results of 34 applications of these prosthesis that were executed about Surgical Clinic in Verona with satisfactory results during the period 1974-77. They show the improvement of survival conditions in these patients, the rareness of complications, the absence of absolute contra-indications.

Adenocarcinoma↗

[Cavitary carcinomas of the lung with a pseudocystic aspect. Description of 2 clinical cases].

In this paper the Authors describe two cases of carcinoma of the lung with cavitary aspects that came under their observation. There are various hypotheses on the formation of such cavities: it is possible that the neoplastic cells may have a growth trend in a centrifugal direction, or that the cavity is due to a necroic-colliquaive process of the mass itself or to extensive phenomena of autophagism. In other cases the neoplastic cells carpet already existing air cysts, giving the appearance of thin wall cavitation. It is precisely this type of cavitation that poses problems of differential diagnosis. In fact, when other instrumental investigations such as bronchoscopy or needle biopsy, always combined with cytology of the sputum, are not decisive, a relatively certain diagnosis can be obtained only by observing the evolution of the picture for some time, as was the case in the patients referred to above.

Aged↗

[Oncocytoma of the lung: presentation of 1 case (author's transl)].

The Authors describe one case of pulmonary oncocytoma successfully treated by ablative surgery. The patient was a man aged 38 with an asymptomatic nodule, about the size of a walnut, in his right lower lobe. The whole right lower lobe was removes surgically, and histological examination resulted i na diagnosis of pulmonary oncocytoma. In the discussion, the authors point out that this type of malignancy is extremely rare, with only 7 cases reported in the more recent literature to the best of their knowledge.

Adenoma↗

[Lipoid pulmonary granuloma in Parkinson's disease. Presentation of clinical case].

The authors describe one case of lipoid granuloma of the lung in a patient with PARKINSON'S disease. The cause of this pulmonary sequel is probably to be found in the alteration of the mechanism of deglutition, typical of PARKINSON'S disease, with aspiration bronchopneumonia and subsequent evolution to granuloma formation. In the case presented (a man of 64) the X-ray picture resembled the irregular mass opacities and bronchial amputations characteristically associated with cancer of the lung. As the actual anatomical extent of the process exceeded the limits indicated by radiological examination, the whole left lung was removed at surgery; histological studies, however, revealed the essentially benign nature of the lesion. The patient was discharged in due course of time as surgically cured. There was no major deterioration of his neurological status either at discharge time or at later rechecks.

Granuloma↗

[Bronchogenic cyst of the lung and pulmonary tuberculosis. Presentation of a case].

The paper considers a clinical case of multiple bronchogenic cysts associated with a pneumonitic process of TB character, operated successfully by means of an upper right and middle bilobectomy. No similar case was found in literature. The malformations were of congenital origin, characterised histologically by a cavity, the walls of which contain elements proper to the bronchus: cartilage and ciliate columnar epithelium. The squamous metaplasia is rare, and the neoplastic transformation very rare. From the clinical point of view a distinction is made between asymptomatic cysts, in which the clinical picture is dominated by compressive phenomena affecting the surrounding structures, or sometimes by infection due to supervening bacterial, mycotic or--as in our case--tubercular contamination. The therapeutic indication is exclusively surgical, with methods of exeresis varying according to the extent and location of the morbid process.

Adult↗

[Paraganglioma of the posterior mediastinum (author's transl)].

The authors describe one case of paraganglioma of the posterior mediastinum successfully removed after being discovered accidentally in a young male patient who showed no symptoms attributable to the tumor. The latter was a round mass, about 6 cm in diameter, richly vascular, located in the right costomediastinal gutter. Histologically it was a functionally silent paraganglioma originating from the intrathoracic aortosympathetic paraganglia, these being part of the very numerous groups of the paragangliar system distributed segmentally into metamers, particularly in the adrenal medulla. According to the more recent views, chemodectoma or paraganglioma (chromaffine or non-chromaffine, functionally active or silent) and pheochromocytoma (functionally active or silent, adrenal or extra-adrenal) constitute a group of tumors sharing the same tissue matrix, namely paragangliar cells.

Adult↗

[Complications of lung surgery in the aged: relapsing postresection atelectasis (author's transl)].

The authors describe one case of relapsing postoperative atelectasis occurring with considerable severity after an upper left lobectomy for malignancy in a man of 68. Said complication recurred no fewer than six times during a hospital stay of 44 days and constituted a major threat to the good outcome of surgery. The patient was finally discharged in good conditions, and a later recheck revealed no important alterations in the surviving lower left lobe.

Age Factors↗