Biomedical subjects

A Cavallaro

Publications and source records attributed to A Cavallaro.

At least 217 records · Page 12Linked to original sources

PubMedDate not supplied

[Ileal invaginations caused by Peutz-Jeghers polyposis].

The Peutz-Jeghers syndrome is considered a familial polyposis syndrome. The polyps are of hamartomatous type. The symptomatology is due to the more voluminous polyps which can necrotize, ulcerate, bleed and cause intussusception and intestinal obstruction. A case of ileum-ileal intussusception due to Peutz-Jeghers syndrome is reported. The utility of a genealogic research is underlined and the recent results of the genetic research are evaluated. The surgical therapy of Peutz-Jeghers syndrome can have many aims: 1) to remove all big polyps, 2) to avoid the danger of canceration, 3) to prevent the hemorrhagic or occlusive risks and complications.

Adult↗

PubMedDate not supplied

[Assessment of conventional approaches in adrenalectomy].

The choice of operative approach represents one of the main problems of adrenal gland surgery, nowadays the minimally invasive techniques (laparoscopic adrenalectomy) in selected cases may be an important alternative to conventional approaches. Retrospective analysis was performed on 140 patients with adrenal gland tumors from 1980-1997; there were 95 women and 45 men: The tumors were resected through flank extraperitoneal approach (35 patients), transabdominal (91), thoraco-abdominal (14). Operating time, perioperative blood loss, postoperative course were evaluated. The authors conclude that in functioning and non-functioning adenomas, in pheochromocytoma, smaller than 6 cm., with precise pre-operative unilateral localization, flank extraperitoneal approach may be sufficient, in patients with Cushing disease resistant to pituitary surgery or irradiation, in patients with familiar history or bilateral pheochromocytoma, in patients with suspected malignant disease, a thorough surgical exploration of the abdominal cavity is recommended.

Adolescent↗

PubMedDate not supplied

[Therapeutic approach in Riedel thyroiditis].

Riedel's invasive fibrous thyroiditis is a rare disorder of unknown origin with progressive extension and invasion of adjacent structures. Clinically it is impossible to distinguish between Riedel's/thyroiditis and other diseases as undifferentiated carcinoma, Hashimoto's disease etc... The patients often have dyspnea, dysphagia, paralysis of the vocal cord; fine needle puncture-aspiration and biopsy themselves may be insufficient, Surgical treatment depends on the stage of the disease, when both lobes are involved generous wedge resection of the isthmus may be the treatment of choice to relieve tracheal compression; in earlier stages radical operation are considered. Corticosteroid treatment in Riedel's thyroiditis, as multifocal disease has been successfully used. Other drugs with antifibrosing actions have also utilised in small groups of patients with encouraging results.

Aged↗

PubMedDate not supplied

[Indications for the surgical treatment of cavernous angioma of the liver in adults. Report of a case].

The authors report a case of giant cavernous hemangioma of the liver, almost entirely extrahepatic, bulging from the inferior surface of the right lobe into the abdomen, treated surgically on account of worsening symptoms referable to continuing growth. A thorough search of the literature allows a critical review of the surgical indication in this benign pathology, rarely complicated by significant clinical events. Surgery is indicated, in lack of relevant complications, only when significant symptoms, continuing or worsening, are undoubtedly referable to the presence of the angioma.

Female↗

PubMedDate not supplied

Recurrent intussusception of the sigmoid colon caused by a transanal protruding sessile tubulo-villous malignant polyp.

We report a case of a 35 year-old woman with a large malignant sessile tubulo-villous polyp of the proximal end of a dolico-sigmoid colon causing intussusception and transanal prolapsing. The diagnosis presented some difficulties being the intussusception intermittent. The clinical feature had been initially misdiagnosed for a very large bleeding polyp (5 cm in size), protruding out of the anus with a long pedicle in the rectum. The histology of multiple bioptic samples of the lesion revealed malignancy. Conventional radiologic studies (plain x-rays, barium enema) after metal clips had been placed on the head of the polyp before it rose up the colon, led to the correct diagnosis without, nevertheless, documenting intussusception. An elective surgical resection of the dolico-sigmoid colon allowed the correct diagnosis and the curative treatment of the colonic intussusception and the malignancy.

Adult↗

PubMedDate not supplied

Clinical behavior of solitary fibrous tumors of the pleura. An immunohistochemical study.

Localized fibrous tumors of the pleura are uncommon, generally asymptomatic and usually have a benign behavior even if in a few cases a malignant variant can be observed. We report 11 cases of localized pleural neoplasms submitted to surgical resection during the period 1987-1996. The differentiation between the localized fibrous as well as the less frequent localized malignant mesothelioma has been researched employing cyto-histopathologic and immunohistochemical assays. For the purpose of identifying solitary fibrous tumors of pleura that will behave in malignant manner, we applied the more recent criteria of specific immunohistochemical stains, microvessel density and proliferation mdex. All solitary fibrous tumors resulted positive for Vimentin and negative for Cytokeratin. Among these forms, high cellularity and microvessel density, high expression of Ki 67 and CD31 and negativity of CD34 prognostic factors for a poor prognosis.

Aged↗

PubMedDate not supplied

Cysts of the adrenal gland: revision of a 15-year experience.

Ten specimens of adrenal cyst resected during the period 1984-1999 were re-examined. Thorough examination of multiple sections and the use of immunohistochemistry allowed to change the recorded diagnosis in 8 cases: three epithelial cysts and five pseudocysts were redefined as endothelial cysts. All 10 cysts were of the endothelial type. A synthetic review of the current knowledge about the pathogenesis, the classification and the clinical aspects of this rare disease is presented.

Adrenal Gland Diseases↗

PubMedDate not supplied

[Skin metastasis from renal carcinoma: epidemiologic and clinical features].

The Authors present an additional case of a 70-years old male patient with skin metastasis from renal cell carcinoma, 15 months after nephrectomy. The patient died ten months later for advanced neoplastic disease. Skin metastasis affect 3-6% of patients with renal cell carcinoma. The surgical treatment is mandatory for single nodule. Chemotherapy is often ineffectual. The prognosis is poor, with a 0-8% 5-years survival for patients with multiple nodules.

Aged↗

PubMedDate not supplied

[Breast carcinoma in pregnancy: a clinical case].

Breast cancer is a rare, but frequently hidden pathology. A woman, 36 years old, during the early months of pregnancy found a little tumor in her right breast. A fine needle biopsy was negative for cancer. Despite this, the tumor rose and two months after delivery (the patient breast-fed her daughter for a month), she had pain in the right axillary region and the tumors involved all superior dials of the right breast. A Madden mastectomy was performed. The histopathological report was: ductal invasive breast cancer 3 of 19 lymph nodes involved, stage IIIA, TNM pT3N2M0, ER -, PgR +--. Chemotherapeutic regimens were: at first ADM 75 mg/m2 for 5 cycles, and after CMF 1-8 for 6 cycles. After six months the woman had a cutaneous recurrence in the scar of mastectomy, treated with surgery and RT. Thirteen months after, she had lung MTS and then brain MTS. The patient died thirty months after the mastectomy. The surgeons have to discover the women high-risk for the breast cancer before and during the pregnancy. Excisional biopsy is the diagnostic procedure of choice for breast lump during pregnancy. When a breast cancer develops during a pregnancy, the surgeon has to operate immediately the tumors. Chemotherapeutic regimens should be delayed until the second o third trimester or after delivery.

Adult↗

PubMedDate not supplied

[A questionable surgical problem: the right treatment of occult thyroid carcinoma].

INTRODUCTION: The authors review their experience about treatment of occult thyroid carcinoma. PATIENTS AND METHODS: 24 patients with papillary occult carcinoma of the thyroid were observed in the period 1999-2001. All carcinoma was 10 mm in diameter. In seventeen patients (71%) was performed a total thyroidectomy, while in seven (29%) a lobectomy; in four of seven patients treated with lobectomy was subsequently performed a total thyroidectomy. Total thyroidectomy wasn't performed in three female patients aged < 35 years, with a 5 mm diameter carcinoma. In two patients (8.3%) with nodal metastasis a lymph node excision was performed. All patients were alive and free of disease at last control. CONCLUSIONS: The incidental finding of occult thyroid carcinoma in a patient treated with a lobectomy does not entail a subsequent total thyroidectomy, because of this surgical procedure may be oncologically correct; therefore the authors believe that total thyroidectomy may be the treatment of choice of occult carcinoma, because it allows a correct oncological follow-up.

Adult↗

PubMedDate not supplied

[Malignant pheochromocytoma. Personal experience, review of the literature].

Pheochromocytoma is a catecholamine-producing tumor of the sympathetic nervous system which in 4-14% of the cases may be malignant. The differentiation between benign and malignant phoechromocytomas is very difficult, the presence of metastatic lesions and gross invasion into surrounding tissues are the lonely accettable parameters to confirm malignancy. Since the patients with malignant pheochromocytomas have a very poor survival rate, care must be taken for an early detections and a careful follow up. Three cases of malignant pheochromocytoma are reported. In one of these cases the tumor was a functioning mass; the other two cases presented by a hemorrhagic complication. A careful review of the pertinent literature allows to outline the correct approach to this rare pathology as for the diagnosis and the treatment, also including the actual criteria to establish its malignancy.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

Concomitant subclavian and carotid artery disease: the need for a combined surgical correction.

To determine the importance of carotid artery disease in patients undergoing revascularization of the proximal subclavian artery for a subclavian steal syndrome, an 18-year experience of 55 patients was reviewed. Concomitant carotid artery disease (> 50% stenosis) was present in 35 patients (Group I: 63.6%). Twenty patients (Group II: 36.4%) had no evidence of hemodynamically significant carotid disease. Twenty-five patients in Group I (Group IA: 71.4%) were treated by endarterectomy (CEA) for all their carotid lesions while one or both carotid lesions were left untreated in 10 patients (Group IB: 28.6%). The actuarial 5-year freedom rate from neurological events was 87.2% in Group IA, 34.9% in Group IB (p < 0.001) and 100% in Group II (Group IB vs. II, p < 0.001; Group IA vs. Group II, p = ns). All untreated carotid lesions had a deleterious effect on the early and late functional results after surgical reconstruction of the subclavian artery. We conclude that the combined correction of subclavian and carotid lesions should be recommended in every case.

Actuarial Analysis↗

PubMedDate not supplied

Response of arterial smooth muscle cells to laminar flow.

This study was designed to determine whether laminar flow influences the proliferation rate and morphology of smooth muscle cells (SMC) in culture. Bovine aortic SMC were subjected to a shear stress of 6 dyne/cm2. The control group was subjected to similar incubation conditions without flow. Flow cytometry demonstrated decreased proliferation rate in SMC subjected to laminar flow. This phenomenon was still evident 24 hours after flow cessation. SMC were examined by light and electron microscopy. SMC subjected to laminar flow aligned along the direction of flow assuming a spheric morphology. These changes were reversible after a 48-hour resting period. The degree of organization of actin, tubulin and other microfilaments was evaluated by indirect immunofluorescence. SMC subjected to shear stress showed a clear reorganization of the cytoskeleton with expression of stress fibres. These changes were reversible after a 48-hour resting period. These findings may contribute to understanding the mechanisms by which SMC in vivo respond to forces generated by blood flowing under pressure.

Actin Cytoskeleton↗

PubMedDate not supplied

[Ileal diverticula: apropos of a case].

The authors report a case of abdominal aortic aneurysm surgically treated. At surgical exploration an ileal diverticulum was discovered. A 15 cm ileum tract was hyperemic and oedematous. The abdominal aortic aneurysm was resected and an aorto aortic graft implanted. The retroperitoneal space was carefully closed and then the diverticulum resected and an end-to end intestinal anastomosis performed. An etiological review of this pathology was done identifying two possible causes: true and false diverticula. The true diverticulum is a congenital lesion involving the 3 layers of the intestinal wall. On the contrary the false diverticulum is acquired and generally develops on the mesenteric site due to a pulsion mechanism. The wall involves the mucosa and serosa layers only. Diagnosis is often done during abdominal exploration for other cause (as in our case) or for complicated diverticula. Preoperative radiologic diagnosis is rare and doesn't always require surgical treatment.

Aged↗

PubMedDate not supplied

[Benign-thyroid nodule: what's therapy? Personal experience].

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy, (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobeisthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSION: Therefore our experience has carried us to consider the lobectomy which treatment choice for all those benign thyroid diseases, with, solitary nodule.

Adult↗

PubMedDate not supplied

[Benign thyroid nodule: what is the treatment? Personal experience].

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in the Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobe-isthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSIONS: Therefore our experience has carried us to consider the lobectomy which treatment of choice for all those benign thyroid diseases with solitary nodule.

Humans↗

PubMedDate not supplied

[The prognostic significance of the vascular invasion of colorectal tumors].

The authors report their experience about the clinical significance of the invasion of veins (BVI) in 68 patients with colorectal carcinoma, submitted to potentially curative surgery in the period 1980-1988. Every patient was screened for BVI. The tumoral spreading was differentiated into endovascular and perivascular permeation. The authors also considered the incidence and kind of BVI, the recurrence rate of the tumour and five-year survival rate. BVI was present in 33 patients (48.5%). Recurrence was observed in 22 patients (22.3%): 19 patients in the group with BVI (33 patients): 3 in the group of 35 patients without BVI. BVI was related to tumour stage, but it may be considered as an independent factor in its relationship with a poorer prognosis in patients affected by tumours in stages II or III; in fact, the patients in stage II had a poorer prognosis than those in stage III without BVI. These results suggest that BVI, as a prognostic factor, is independent from tumoral stage in determining the recurrence rate and the long term prognosis.

Colorectal Neoplasms↗

PubMedDate not supplied

[Colonic neoplasms: long-term survival after surgical treatment. Our experience].

The surgery is still the only treatment for large bowel tumours. The patients who underwent a radical operation and then were treated with chemo and/or radiotherapy have not shown a longer free-disease survival. Palliative resection should be preferred to by pass operation, since the latter has shown less postoperative morbility and mortality. The authors report their experience on 139 patients with large bowel tumours operated between 1979 and 1988, and they analyze the surgical results and the five-years survival according to the stage of disease.

Adult↗