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Biomedical subjects

A Ambrosi

Publications and source records attributed to A Ambrosi.

18 recordsLinked to original sources
PubMed2005

DNA sequences and proteic antigens of H. pylori in cholecystic bile and tissue of patients with gallstones.

BACKGROUND: Although Helicobacter pylori DNA sequences have been detected in cholecystic bile and tissue of patients with gallstones, controversial results are reported from different geographic areas. AIM: To detect H. pylori in cholecystic bile and tissue of patients with gallstones from a previously uninvestigated geographic area, southern Italy. Detection included both the bacterial DNA and the specific antigen (H. pylori stool antigen) identified in the stools of infected patients for diagnostic purposes. PATIENTS AND METHODS: The study enclosed 33 consecutive patients undergoing laparoscopic cholecystectomy for gallstones. DNA sequences of H. pylori were detected by polymerase chain reaction in both cholecystic bile and tissue homogenate. Moreover, we assayed H.pylori stool antigen on gall-bladder cytosolic and biliary proteins after their extraction. Bacterial presence in the stomach was assessed by urea breath test in all patients and Deltadelta13CPDB value assumed as marker of intragastric load. Fisher's exact probability and Student's t-tests were used for statistical analysis. RESULTS: DNA sequences of H. pylori in bile were found in 51.5% and significantly correlated with its presence in cholecystic tissue homogenate (P<0.005), H. pylori stool antigen in gall-bladder (P=0.0013) and bile (P=0.04) proteins, gastric infection (P<0.01) and intragastric bacterial load (P<0.001). No correlation was found, however, with sex and age of the patients. CONCLUSIONS: Our prevalence value of bacterial DNA in bile and gall-bladder of patients with gallstones agreed with that of the only other Italian study. The simultaneous presence of both bacterial DNA and proteic antigen suggests that the same prototype of bacterium could be located at both intestinal and cholecystic level and, therefore, the intestine represents the source of biliary contagion.

Aged↗
PubMed2005

Extended lymphadenectomy (D2) in patients with early gastric cancer.

AIMS: To investigate the survival benefit of extended lymphadenectomy (D2) in EGC patients in one European Institution. METHODS: A review was made of our prospective gastric database from January 1980 to December 2001. Of 527 patients with primary gastric adenocarcinoma, 119 with EGC underwent potentially curative resection (R0) with D2 lymphadenectomy. RESULTS: There were two post-operative deaths. Of the 117 evaluable cases, 96 were classified as N0 and 21 as N+, with metastases in the perigastric lymph nodes (level 1) in 13, and beyond this site (level 2) in eight. Five-year survival was 85.9 and 83.0% in N0 and N+ patients, respectively. During a median follow-up of 90 months, five of the eight patients with level 2 metastases died of recurrent disease and three were alive. The estimated survival benefit for 119 patients with EGC was 2.5% (3/119 cases). CONCLUSIONS: In patients with EGC, metastases to level 2 are rare. Our results indicate that D2 lymphadenectomy has a limited survival benefit and that in these cases a less extensive lymphadenectomy (D1) could be performed.

Adenocarcinoma↗
PubMed2003

Diagnostic utility of thyroglobulin detection in fine-needle aspiration of cervical cystic metastatic lymph nodes from papillary thyroid cancer with negative cytology.

Cystic changes in metastatic cervical lymph nodes (CLN) from papillary thyroid cancer (PTC) may be a diagnostic pitfall in fine-needle aspiration biopsy (FNAB) cytology. We investigated in a series of CLN metastases from thyroid cancers (TC), including cystic PTC, and from a wide spectrum of extrathyroidal malignancies, the diagnostic role for metastatic TC of the rapid detection of thyroglobulin in eluates from FNAB (FNAB-Tg) of CLN. The study was carried out in a group of 79 subjects (22/57 M/F; median age, 56 years; range, 20-86 years) with enlarged CLN and thyroid nodules (TN), examined for potential metastatic TC, and harboring a large spectrum of incidentally diagnosed extrathyroidal malignancies (n = 24, mostly represented by lymphomas, lung, and breast cancers), CLN metastases from thyroid cancers (n = 28, including 6 cystic metastatic PTC), 6 specific lymphadenitis and 21 reactive lymphadenitis mostly detected (n = 16) during follow-up of patients with previously ablated TC. Markedly high FNAB thyroglobulin (Tg) values were found in all metastatic CLN TC. Two of the six cases with cystic metastatic CLN PTC were diagnosed by FNAB-Tg but not by cytology. In conclusion, FNAB-Tg has been confirmed as an easy modality and fast procedure to diagnose CLN metastasis from TC and high FNAB-Tg values with nondiagnostic cystic cytology strongly suggest cystic metastatic PTC.

Adult↗
PubMed2002

Three cases of papillary carcinoma and three of adenoma in thyroglossal duct cysts: clinical-diagnostic comparison with benign thyroglossal duct cysts.

The clinical and diagnostic findings of 3 cases of papillary thyroid carcinoma in thyroglossal duct cyst (TDC) were compared to those of 3 cases of adenoma in TDC and 2 cases of benign TDC. The neck masses of the subjects with benign TDC grew slowly, whereas those of 2 patients with papillary carcinoma and 1 of the patients with adenoma grew rapidly (especially those with carcinoma). On the other hand, one case of carcinoma, and two cases of adenoma in TDC were diagnosed incidentally. Benign TDC had an anechoic pattern at US, whereas the cysts containing carcinoma and adenoma showed the presence of a mural nodule at US. Microcalcifications in the mural mass were present in one patient with carcinoma. The 3 patients with carcinoma in TDC underwent total thyroidectomy. The histology was negative in all 3 patients for thyroid cancer and thyroid nodules. However, in 2 of them it revealed the carcinoma invading the cyst wall and adjacent tissues, 1 of which also exhibited 2 metastatic lymph nodes in the central neck area. The cases reported illustrate the utility of enhancing one's clinical suspicion of carcinoma in patients bearing TDC, even when incidentally discovered. In particular, rapid growth of the cystic mass, and the presence of a mural nodule on US, especially with calcifications, must raise the physician's suspicion for a cancer arising in TDC.

Adenoma↗
PubMed2002

[Papillary carcinoma of the thyroglossal duct cyst: a case report].

The thyroglossal duct cyst is the most common anomaly in thyroid development. To date, approximately 250 cases have been reported, the majority being papillary thyroid carcinomas. In most cases the diagnosis is established only after excision of a clinically benign thyroglossal duct cyst. Controversies exist in relation to a rational and effective therapeutic approach. A further case of thyroglossal duct papillary carcinoma affecting a 52 years-old man is presented to highlight the clinicopathological features of this condition. FNAC resulted false negative. Surgery consisted in a Sistrunk procedure, followed by total thyroidectomy and central lymphectomy after definitive histological diagnosis. In view of the prolonged course of papillary carcinoma, long-term follow-up is mandatory.

Carcinoma, Papillary↗
PubMed2001

High frequency of incidental diagnosis of extrathyroidal neoplastic diseases at the fine-needle aspiration biopsy of laterocervical lymph nodes in patients with thyroid nodules.

This study was undertaken to evaluate the frequency of the incidental diagnosis of extrathyroidal lymph node diseases at ultrasound-guided fine-needle aspiration biopsy/cytology (FNAB/C) being done to check the presence of metastatic thyroid cancer in 30 subjects with thyroid nodule (TN) and enlarged cervical lymph nodes (CLN). The patients in whom cytology suggested the presence of malignancy in the TN or in the CLN underwent surgical removal for histologic diagnosis. The spectrum of diseases revealed by this survey included: (1) 10 benign diseases including 1 case of Piringer-Kuchinka lymphadenitis with benign TN; (2) 10 metastatic thyroid cancers (2 anaplastic and 8 papillary cancers); (3) 3 benign TN associated with metastatic invasion of cervical lymph nodes from lung (2 cases) and breast (1 case) cancer; (4) 1 Hodgkin's lymphoma of the cervical lymph nodes with hyperplastic TN; (5) 3 nodal lymphomas with benign thyroid nodule and 2 cases of thyroid lymphoma with nodal invasion; and (6) 1 nodal sarcoidosis with benign TN. The results of this study demonstrate that important neoplastic and hematologic diseases affecting the cervical lymph nodes may frequently be incidentally detected using ultrasonography (US) and FNAB/C in the diagnostic procedure for thyroid nodule.

Adult↗
PubMed2000

Insulin-like growth factor 1 expression in thyroid tumors.

Insulin-like growth factor 1 (IGF-1) likely is involved in thyrocyte proliferation via autocrine mechanisms, but limited data are available on its in vivo expression in thyroid neoplasms. This prompted us to explore IGF-1 expression at the protein and mRNA levels and IGF-1 receptor (IGF-1rec) immunoreactivity in normal and neoplastic thyroids (50 adenomas and 53 carcinomas). We documented increased IGF-1 and IGF-1rec immunoreactivity in adenomas (31 of 50 and 40 of 50 cases, respectively) and carcinomas (38 of 53 and 42 of 53 cases) compared with normal thyroid, which only showed minimal immunoreactivity for the ligand and its receptor. A corresponding up-regulation of IGF-1 mRNA was documented in carcinomas, whereas adenomas exhibited down-regulated expression of IGF-1 mRNA. Immunoreactivity for IGF-1 and cognate receptor positively correlated with tumor diameter and wide intrathyroidal extension but not with patients' gender and age or with the stage of the tumors and the occurrence of lymph node metastases. These data emphasize a possible role of the IGF-1 system in thyroid tumorigenesis, as indicated by in vitro studies. In addition, the evaluation of IGF-1 and IGF-1rec immunoreactivity might have clinical implications, because it positively correlates with the aggressiveness of these tumors.

Adenoma↗
PubMed2000

[Clinical considerations on malignant carcinoids: bronchial, gastric, ileocolic involvement].

Six cases of malignant neuroendocrine tumours (3 bronchial, 1 ileocolic) are presented; diagnostic and clinical features, functional behaviour and the results of the treatment are discussed. Early functional manifestation (diarrhoea) was observed only in the first case of ileocolic tumour: in this patient the diarrhoea disappeared after the operation but further relapse occurred at the recurrence of the pathology. In the second ileocolic tumour diarrhoea with increased levels of 5 HT appeared later on, after the operation, expressing repeated disease. In one malignant bronchial carcinoid with early spinal secondary, the typical flushes appeared only after the explosion of metastatic spread. No functional disorders were observed in one patient with metastasis localised only in the bones. On the basis of actual knowledge the authors discuss the pathogenetic hypothesis of these events. Even though these experience limited, it may remark the importance of the quantity and quality of produced hormones, of the localization of metastasis in the liver and portal district and the unconstant production of clinical symptoms. The importance of A-chromogranin and of NSE as specific markers is discussed; the studies on the chromogranin have furthermore demonstrated the possible effect of the inhibitors of protonic pump on structural, hyper-dysplastic modification of gastric mucosa and this requires further investigation.

Adult↗
PubMed1994

Insulin-like growth factor 1 (IGF-1) in multinodular goiters: a possible pathogenetic factor.

In order to support previous in vitro studies which had stressed a possible autocrine role for Insulin-like Growth Factor 1 (IGF-1) in thyroid growth regulation, we have investigated the presence of IGF-1, as detected by means of radioimmuno assay and of immunocytochemistry, in thyrocytes from normal thyroid and from multinodular goiter. Our study revealed that IGF-1 is detectable in thyroid cells from multinodular goiter and, to a lesser extent, from normal thyroid. Both techniques used in this study demonstrated that thyrocytes are the site of accumulation of IGF-1 and that stromal cells contain lower amounts of this growth factor. The findings of the present study seem to suggest that thyrocytes could produce IGF-1 in vivo. This feature gives further support to the hypothesis that IGF-1 may regulate thyroid growth and therefore it might be involved in the pathogenesis of multinodular goiter.

Goiter, Nodular↗
PubMed1990

Intestinal ischemia: morphological features--II.

Superoxide radicals produced during acute intestinal ischemia are biochemically related with the presence of hydrogen peroxyde. In this study we have investigated the distribution of peroxidase-catalase activity, histochemically determined, in the ischemic ileal wall. In the rat, complete arterial and venous occlusion produced a progressive increase in extra-vascular peroxidase-catalase activity with a maximum corresponding to the ileal wall. Probably the tissue peroxidase-catalase activity is related to massive degranulation of polymorphonucleates.

Animals↗
PubMed1984

Modifications of electrical potential in corrosive induced lesions of rat oesophagus.

The Authors reproduced, experimentally, lesions of oesophageal mucosa on "Wistar" rats, using 1% and 2% solutions of HCl and NaOH. They studied DP modifications and observed that acid solutions produced a complete and persistent DP modification, while alkaline solutions produce DP inversions that diminish few days after the treatment.

Animals↗
PubMedDate not supplied

[Congenital cystic dilatation of the bile ducts: case report and review of the literature].

Congenital cysts of the biliary tract are rare anomalies generally observed in pediatric age, exceptionally in adults. The different extension and the morphology of cystic lesions make possible a classification in subtype. This disease, of Len asymptomatic, is characterized by high incidence of complications such as pancreatitis, cholangitis, and cancer. For these reasons, congenital cystic dilatation of bile duct should be radically treated by complete resection of the dilated extraepatic biliary tract. A review of the International Literature and a rare case of congenite dilatation of the intra and extraepatic biliary ducts in a female 54 years old, treated by choledochal resection with hepatico-jejunostomy on Roux en Y segment, are presented.

Bile Ducts↗
PubMedDate not supplied

[Therapeutic problems in euthyroid multinodular goiter].

Now therapeutic different possibilities of goitre pathology seem well defined, in front of limit of suppressive therapeutic range in initial stages, prevalently diffuse, that interest young people and arise in jodic want lands; it's possible that medic theraphy ends can't be obtained because of not responders patient, or even for possibilities of controindications. Local presence of suspicious nodules and the need of goitre volumetric reduction for aesthetical and compressory ends, with the possibility in course of time of functional changes are sure reasons to surgery. Certainly main problems exist about surgery definition of multinodular disease with bilobar involvement where there is comparing between total and subtotal thyroid exeresis. Now by literature analysis and our School experience we think that surgery choice, considered before operation, must find absolute assurance after preoperative morphotopographic careful exploration of thyroid. We think that total thyroidectomy must be done when it's certain a total gland involvement, reserving subtotal thyroidectomy in the other cases; always employing a careful surgery technique, keeping operative field interely bloodless to identify important structures and dissection plan narrowly close by capsule.

Follow-Up Studies↗
PubMedDate not supplied

Right colectomy for cancer: validity of laparoscopic approach.

AIM: Laaroscopic assisted right colectomy for carcinoma is a procedure with demonstrated feasibility. We want to evaluate the advantages. MATERIAL: In the period 1999/2002 we have executed 7 laparoscopic right colectomy for carcinoma. We have compared the results with one group of 10 patients traditionally operated in the period 1998/2002. In both groups the oncologic staging was almost the same. RESULTS: Immediate results: operative time was 240' for laparoscopy vs. 150' for open operation; no anastomotic dehiscence for laparoscopy vs. 1/10 for open; no bronchopulmonary-thrombotic complications for laparoscopy vs. 2/10 for open, but there was 1/7 wound infection for laparoscopy vs. 1/10 for open; the return to the mobilization and normal diet was 3 days for laparoscopy vs. 7 days for open; the postoperative stay was 7 days for laparoscopy vs. 12 days for open. DISCUSSION: The two procedures did not condition differences neither in the extension of the resection and of the lymphectomy nor a different incidence of the anastomosis dehiscences. Differences were noted, in the operative time, in a more precocious mobilization with a minor use of analgesics, in a more rapid renewal of peristalsis and of feeding with a lower postoperative stay. These advantages are remarkable in our study, by reducing the postoperative morbidity. The very brief follow-up of almost 6 months, did not show a relapse of the disease in patients of both series. CONCLUSION: In our experience, laparoscopic-assisted right colectomy confirmed evident advantages in the immediate postoperative period for the treatment of the colonic cancer.

Aged↗
PubMedDate not supplied

[Clinical study of residual function and recurrences in patients after partial thyroidectomy for non-toxic nodular goiter].

The different surgical chances for the treatment of non toxic nodular goiter led the Authors to study the residual function after partial thyroidectomy. A variable rate of recurrences and hormone deficiency was shown in patients who underwent sub-total thyroidectomy, lobectomy and enucleation. It depended on the amount of residual gland and the different methods they used. Recurrences occurred more in patients studied by ultrasonography. After sub-total thyroidectomy the Authors noted a more reduced number of recurrences than after lobectomy and enucleation. There was a meaningless connection between high plasmatic levels of TSH and recurrences. Subclinical hypothyroidism was higher in patients who underwent subtotal thyroidectomy than in patients treated with lobectomy and enucleation. These clinical data show that recurrences could depend on growth factors (EGF, IGF) in thyroid tissues and not only on TSH action. Therefore the surgical attitude of the authors in the treatment of nodular goiter consists in total thyroidectomy.

Aged↗
PubMedDate not supplied

[Intestinal occlusion caused by cecal carcinoid].

It is possible that carcinoids present themselves by a surgical emergency, without a < >. For these reasons, whenever a rational treatment is requested, an intraoperative diagnosis should be performed. In fact these neoplasms--owing to a less intense aggressiveness--present more indications to undergo surgery. In fact the authors report a case of caecum carcinoid characterized by the lack of typical symptoms of the homonymous syndrome. Urgent surgery was performed because of intestinal occlusion; the ileocaecal valve involvement caused the necessity of a large ileocolic resection with a L-L ileo-transverse anastomosis. The diagnosis of carcinoid was revealed only by the definitive histopathological examination.

Carcinoid Tumor↗
PubMedDate not supplied

[Comparison of hernioplasty using the technic of Bassini and Trabucco. Comparative analysis and results].

We evaluated comparatively trough a randomized perspective study the hernioplasty by Bassini technique and the Trabucco repair, respectively using general and local anaesthesia, in a group of 80 patients. We studied incidence of complications and recurrences, surgery, in-patient hospitalization time, postoperative pain, costs and work resuming. Trabucco repair had better results in each considered parameter: hospitalization time, pain and costs respectively 80%, 50% and 66% lower vs Bassini technique; moreover we found no recurrence and work resuming two weeks shorter.

Adult↗